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Biomedical subjects

G Treister

Publications and source records attributed to G Treister.

At least 19 recordsLinked to original sources
PubMed2001

Management of persistent loculated subretinal fluid after pneumatic retinopexy.

AIM: To report on the incidence and management of a unique and troublesome complication of pneumatic retinopexy-localised, delayed subretinal fluid absorption (DSRFA). METHODS: A retrospective chart review was done for all patients who underwent pneumatic retinopexy for retinal detachment over a 5 year period to identify the patients with DSRFA. RESULTS: Seven phakic patients (five females, two males, age range 26-87 years) were identified with the phenomenon of delayed resolution of subretinal fluid after pneumatic retinopexy and cryotherapy. In four patients the subretinal fluid involved the macula. Time taken to complete absorption of the subretinal fluid ranged from 10 to 26 months. In one patient there was still residual fluid inferiorly at 18 months of follow up. During the follow up period additional procedures were performed--scleral buckling (five eyes), pars plana vitrectomy (one eye), and mild laser scatter to extramacular areas of shallow subretinal fluid (four eyes). None of these procedures appeared to influence the rate of fluid absorption. CONCLUSIONS: Loculated subretinal fluid following pneumatic retinopexy may persist for very long periods, extending up to more than 2 years. Additional surgical procedures or laser photocoagulation do not affect the rate of subretinal fluid absorption. Spontaneous reattachment eventually occurs in most eyes, and conservative management is indicated.

Adult↗
PubMed2000

Reduced rate of retinal detachment following silicone oil removal.

PURPOSE: To investigate the rate of retinal redetachment and other complications after silicone oil removal over a 4-year period. METHODS: Retrospective analysis of charts of patients who underwent vitrectomy and silicone oil injection between January 1994 and June 1998 followed by oil removal. RESULTS: Sixty-eight eyes of 67 patients were included. The average follow-up time after oil removal was 15 months. Significant retinal redetachment developed in 6 eyes (8.8%). The redetachment rate was slightly higher in the 32 eyes with proliferative vitreoretinopathy (9.3%) than in the 36 eyes with other pathologies (8.3%). The average time to redetachment was 4.2 months. These eyes were reoperated and reattached, and at the end of the follow-up, three retained silicone oil. Two other eyes without redetachment were hypotonus after oil removal. Cataract extraction and intraocular lens implantation were performed at the time of oil removal in 18 eyes; 2 (11%) developed redetachment. Visual acuity improved significantly after oil removal (P < 0.001). CONCLUSION: The rate of retinal redetachment after removal of silicone oil in recent years is low compared with previous series. The authors attribute this reduction to the improved surgical management of complicated retinal detachments; particularly, the introduction of perfluorocarbon liquids and wide-field viewing systems and the widespread use of endolaser.

Adolescent↗
PubMed2000

ICGA-guided laser photocoagulation of feeder vessels of choroidal neovascular membranes in age-related macular degeneration. Indocyanine green angiography.

PURPOSE: To report the ability of indocyanine green angiography (ICGA) with a confocal scanning laser ophthalmoscope (SLO) to identify feeder vessels of choroidal neovascular membranes (CNVM) secondary to age-related macular degeneration (ARMD) and to show the feasibility of inducing complete closure of the CNVM by photocoagulation targeted exclusively to the feeder vessels. METHODS: Five consecutive patients with exudative ARMD in whom ICGA with the confocal SLO showed extrafoveal feeder vessels supplying choroidal neovascular nets had laser photocoagulation done only to the feeder vessels. In two patients, two separate membranes were seen. RESULTS: Laser photocoagulation resulted in closure of the feeder vessels and the CNVM in four patients. Complete closure was achieved with one treatment in one patient and with two treatments in three patients. In one patient, two treatments failed to close the feeder vessel and the CNVM, but a third, more intense laser treatment resulted in temporary closure of the feeder vessel and CNVM, which recanalized 2 to 4 weeks later with development of a large rip in the retinal pigment epithelium. In one patient, two separate CNVMs grew from the edge of the laser scars, but they were not directly related to the original CNVM and its feeder vessel, and were treated successfully. The same eye later developed subfoveal occult CNVM with gradual deterioration of visual acuity. In the other four patients, visual acuity improved in two and was unchanged in two. CONCLUSIONS: Indocyanine green angiography with the confocal SLO can identify choroidal feeder vessels supplying CNVM secondary to ARMD. Laser treatment to such extrafoveal feeder vessels, particularly in membranes that are large or subfoveal, may be effective in closing the feeder vessel and CNVM with preservation of the fovea and central vision. More than one treatment may be required, however, and failures and complications may be expected with this treatment modality.

Aged↗
PubMed1999

Spontaneous separation of an idiopathic macular pucker in a young girl.

PURPOSE: To report a young girl with spontaneous separation of an idiopathic epiretinal membrane and notable visual recovery. METHOD: Case report. RESULT: A 12-year-old girl had spontaneous improvement in visual acuity of the left eye from 20/100 to 20/40 attributable to spontaneous peeling of an idiopathic epiretinal membrane more than 2 years after it was diagnosed. CONCLUSION: Conservative treatment can be considered in young patients with epiretinal membrane because spontaneous separation may occur and result in good vision.

Child↗
PubMed1999

Total internal reflection of laser light in eyes filled with silicone oil.

BACKGROUND AND OBJECTIVES: This is the first report of clinical settings in which total internal reflection of laser light in eyes filled with silicone oil was observed. The authors analyze this phenomenon and outline the potential hazards it may present to patient, surgeon, and operating room personnel. MATERIALS AND METHODS: The authors observed significant reflection of laser light off the silicone-water interface both intraoperatively and in the clinic. The critical angle according to Snell's law (i.e., the angle at which total internal reflection occurs at the interface between silicone oil and vitreous) was calculated. The critical angle was found to be 71.9691 degrees(72 degrees). RESULTS: An analysis of each of the clinical conditions where this phenomenon was observed is presented. Clinical and surgical implications are discussed. CONCLUSIONS: The hazard of total internal reflection of laser light in eyes filled with silicone oil should be recognized by ophthalmologists to avoid possible complications. Techniques for overcoming and circumventing the difficulties resulting from this phenomenon are proposed.

Humans↗
PubMed1998

[Prevalence of pigmentary dispersion syndrome in Israel].

Pigmentary dispersion syndrome is a precursor of pigmentary glaucoma whose prevalence in the urban population of USA was found to be 2.45%. We evaluated its prevalence during ocular screening examinations among normal Israelis. We screened for excessive pigmentation on the corneal endothelium with the slit-lamp and determined in each patient best corrected visual acuity, intra-ocular pressure (after mydriasis), condition of the anterior segment, cup-disk ratio, posterior segment abnormalities and questioned about history of any ocular disease and family history of glaucoma. 374 patients (mean age 49 +/- 11) were examined on 10 consecutive days. In 5.9% excessive corneal endothelial pigmentation was found. Intra-ocular pressure (after mydriasis) averaged 15.52 +/- 1.93 mm Hg as compared to 14.73 +/- 2.04 among the rest of our study population, (p = 0.01). The prevalence of suspected pigmentary dispersion syndrome among young adults in Israelis is high.

Adolescent↗
PubMed1998

Confocal tomographic angiography of the optic nerve head in patients with glaucoma.

PURPOSE: To demonstrate the superficial and deep blood supply of the optic nerve using a new method, confocal tomographic angiography, which combines two new techniques, confocal laser scanning ophthalmoscopy and indocyanine green angiography, into one system. METHODS: In a prospective study using confocal tomographic angiography, we evaluated the correlation between the vascular supply of the optic nerve and that of the visual field in 90 eyes of 49 subjects (25 eyes of 20 subjects with normal visual field and 65 glaucomatous eyes of 39 subjects with visual field defects; 10 subjects each had one eye with normal visual field and one with visual field defects). RESULTS: In 22 of 25 eyes with a normal visual field, a diffuse microvascular filling pattern of the optic disk area was apparent with no filling defects. The confocal tomographic angiography of 49 of 65 glaucomatous eyes had good correlation with their visual field defect location. In 20 of 27 eyes with superior visual field loss, an inferior vascular filling defect was detected. In 10 of 13 eyes with inferior visual field loss, a superior vascular filling defect was detected. In 10 of 15 eyes with superior and inferior visual field loss, inferior and superior vascular filling defects were detected. Finally, in nine of 10 eyes with total visual field loss, no vascularity of the optic disk could be detected. CONCLUSION: Confocal tomographic angiography is a new imaging technology that may be applied for the evaluation of the vascular supply of the optic nerve head.

Blood Flow Velocity↗
PubMed1998

Experimental studies on viscofluids for intraocular surgery.

PURPOSE: To investigate the feasibility and efficacy of using diluted viscofluids during intraocular surgery. SETTING: Laboratory for Intraocular Microsurgery and Implants, Goldschleger Eye Research Institute, and the Sackler School of Medicine, Tel-Hashomer, Israel. METHODS: Diluted hyaluronic acid (0.06 to 0.12%) in balanced salt solutions were irrigated through the phacoemulsification machine or a separate irrigation line (i.e., anterior chamber maintainer). Irrigation was facilitated by increasing the atmospheric pressure in the bottle using compressed air. Experimental surgery was done in rabbit eyes. RESULTS: A viscous fluid could be irrigated at any practical rate by increasing the height of the bottle, increasing the atmospheric pressure within the bottle, or both. Experimental surgeries showed that viscofluids maintained intraocular pressure and anterior chamber volume, allowed safe intraocular manipulations, reduced turbulence in the anterior chamber, and probably provided tissue protection. CONCLUSION: Viscofluids irrigated using a high-pressure system combined the advantages of continuous irrigation of fluids and the protective qualities of viscoelastics in this rabbit eye study.

Animals↗
PubMed1998

Pneumatic retinopexy as supplemental therapy for persistent retinal detachment after scleral buckling operation.

PURPOSE: Persistent retinal detachment following scleral buckling may be caused by persistent open retinal tears with a large amount of subretinal fluid, despite proper positioning of the buckle. In this study we evaluated the effectiveness of supplemental pneumatic retinopexy in flattening of the detached retina. METHODS: During 1990-1994 twelve cases of persistent retinal detachment following scleral buckling operation with appropriate position of the buckle, underwent supplemental gas injection. RESULTS: Reattachment of the retina with complete absorption of the subretinal fluid was observed within 24-48 hours from the gas injection in all eyes. Three eyes redetached and required additional operations. At the end of the follow-up (mean 16 months) the retina was attached in all eyes, and the visual acuity was 20/120 or better in 11 eyes, and 20/30 or better in 7 eyes. No complications were observed. CONCLUSION: Pneumatic retinopexy for persistent retinal detachment, following scleral buckling, is effective in obtaining fast flattening of the retina and achieving good visual results.

Adult↗
PubMed1998

Analysis of genetic polymorphisms related to thrombosis and other risk factors in patients with retinal vein occlusion.

The purpose of this study was to investigate the role of genetic polymorphisms associated with venous and arterial thrombosis in patients with retinal vein occlusion (RVO). One-hundred and two consecutive patients with RVO were examined for factor V G1691A and factor II G20210A, methylenetetrahydrofolate reductase (MTHFR) C677T and apolipoprotein E4 by amplification of specific DNA fragments and restriction analysis. The risks exerted by these polymorphisms and by the conventional risk factors of RVO were evaluated by comparing their frequencies among patients and controls and by estimating the respective odds ratios. We found that the prevalences of the factor V G1691A, factor II G20210A, and apolipoprotein E4 polymorphisms were similar in the study and control groups. Logistic regression analysis involving the parameters for which significant differences were detected disclosed an odds ratio of 1.9 for MTHFR C677T homozygosity (95% confidence interval 0.95-3.81), an odds ratio of 2.12 for hypertension (95% confidence interval 1.16-3.73) and an odds ratio of 3.25 for a family history of stroke (95% confidence interval 1.07-9.51). Our data suggests that homozygosity for the MTHFR C677T polymorphism is a risk factor of RVO in addition to arterial hypertension and a family history of stroke.

Adult↗
PubMed1998

Vitrectomy and silicone oil injection in pediatric patients.

OBJECTIVE: To determine the functional and anatomic results of vitrectomy with silicone oil injection in complicated retinal detachments in children. DESIGN: A retrospective review of all records of children aged 15 years or younger who underwent vitrectomy with silicone oil injection between 1985 and 1994 in the Goldschleger eye institute. RESULTS: Twenty-eight eyes of 27 patients were included in the series, with a mean follow-up time of 24 months. The underlying pathologies included penetrating injury (11 eyes), high myopia (8 eyes), choroidal coloboma (2 eyes), retinopathy of prematurity (2 eyes), and various other pathologies (5 eyes). At the end of the follow-up, complete or partial anatomic success was obtained in 9 eyes (32%) and 3 eyes (10%), respectively. The final visual acuity was 20/400 or better in 5 eyes (18%) and hand motions or less in 19 eyes (68%). The visual acuity could not be determined in 3 eyes due to the age of the patients, and in 1 eye due to mental retardation. The worst results occurred in the perforating injury group. The usual complications associated with silicone oil occurred frequently. CONCLUSIONS: Satisfactory anatomic and functional results were obtained in a minority of the eyes included in our series. The grave prognosis was determined by the devastating nature of the external injury in the trauma cases and the severe vitreoretinal pathology in the other eyes.

Adolescent↗
PubMed1996

Pressure sore in a patient who underwent repair of a retinal tear with gas injection.

PURPOSE: To demonstrate a pressure sore following strict head positioning in a patient who underwent encircling band, vitrectomy and gas injection. METHODS: A male patient was admitted to the hospital with a large posterior horseshoe tear in the inferior temporal retina with severe vitreous traction and retinal detachment. Encircling band, vitrectomy cryotherapy and gas injection was performed. After surgery the patient was instructed to sit in a face-down position. RESULTS: A pressure sore resulted from prolonged immobility of the right elbow due to face-down positioning following encircling band, vitrectomy and gas injection. CONCLUSION: A patient may rarely have compulsive personality traits that result in extreme compliance to the physician's recommendations; therefore, general instructions given for head positioning should include permission for a change in position when required, at least for brief periods of time.

Gases↗
PubMed1996

A standardized classification of ocular trauma.

BACKGROUND: No internationally standardized classification of ocular trauma terminology has existed heretofore. Despite a growing interest in eye injuries, the absence of a common language continues to impede both clinical care and research. METHODS: A classification was initially developed based on the authors' extensive personal experience. It then under-went repeated reviews over a 3-year period by international ophthalmic specialists. Written and oral suggestions from respondents in 19 countries and from selected ocular trauma experts were considered and incorporated. RESULTS: By always using the entire globe as the tissue of reference, the new classification is unambiguous, consistent, simple, and comprehensive. It provides definitions for the terms commonly used in eye trauma and creates a logical system of injury types. CONCLUSION: In addition to widespread international acceptance by professionals, the new classification has been endorsed by the International Society of Ocular Trauma, the United States Eye Injury Registry, the American Academy of Ophthalmology, the Hungarian Eye injury Registry, the Vetreous Society, and the Retina Society. It can be reasonably expected that the system will ultimately become the standardized international language of ocular trauma.

Eye Injuries↗
PubMed1996

A standardized classification of ocular trauma.

BACKGROUND: No internationally standardized classification of ocular trauma terminology has existed previously. Despite a growing interest in eye injuries, the absence of a common language continues to impede both clinical care and research. METHODS: A classification has been developed initially based on the authors' extensive personal experience. It then has undergone repeated reviews over a 3-year period by international ophthalmic audiences, incorporating suggestions from respondents in 13 countries and selected ocular trauma experts. RESULTS: By always using the entire globe as the tissue of reference, the new classification is unambiguous, consistent, and simple. It provides definitions for the commonly used eye trauma terms within the framework of a comprehensive system. CONCLUSION: The new classification has been endorse by the Board of Directors of the International Society of Ocular Trauma, the United States Eye Injury Registry, the Hungarian Eye Injury Registry, the Vitreous Society, the Retina Society, and the American Academy of Ophthalmology. It can be reasonable expected that the system eventually will become the standardized international language of ocular trauma. The authors urge ophthalmologists to begin using this terminology in both clinical practice and research.

Eye Injuries↗