Laser treatment of the retinal periphery with the +90-diopter lens.
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Biomedical subjects
Publications and source records attributed to G Treister.
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Two cases of association between the Morquio Syndrome and glaucoma in one family are described. Possible role of Mucopolysaccharides acting in the anterior chamber angle is discussed.
We measured prostaglandin E2 (PGE2) and prostacyclin levels in the vitreous bodies of 5 eyes of patients with diabetic retinopathy complicated by rhegmatogenous retinal detachment (RRD) and compared them with the corresponding levels in 9 nondiabetic eyes with the same condition as well as with 10 control eyes of deceased patients with no known ocular pathology. We also studied the effect of surgical retinal reattachment on vitreal PGE2 and prostacyclin levels in 4 eyes. Vitreal samples from both nondiabetic and diabetic eyes with RRD were obtained during vitrectomy, while samples from deceased subjects (controls) were obtained 2-6 h after death. Vitreal PGE2 and prostacyclin levels in the control eyes approximated plasma levels (79.9 +/- 20.5 and 124.5 +/- 38.5 pg/ml, means +/- SD, respectively), while RRD in the nondiabetic eyes was associated with increased levels of both PGE2 and prostacyclin (3,170 +/- 3,024 and 467 +/- 283 pg/ml, respectively). In the diabetic eyes with diabetic retinopathy complicated by RRD, all of which underwent retinal photocoagulation, PGE2 and prostacyclin levels were 2-4 times lower than those of the nondiabetic eyes with detached retina. Following surgical retinal reattachment, vitreal levels of both components in diabetics and nondiabetics showed a reduction suggesting that the surgical procedure for obtaining vitreal samples was not the cause for elevated prostaglandin levels in the eyes with detached retina. We showed that RRD is associated with an excessive accumulation of PGE2 and prostacyclin in the vitreous, which is higher in nondiabetic than in diabetic eyes, indicating that diabetic retinopathy in laser-treated eyes might lead to reduced vitreal levels of these metabolites.
A patient with refractory glaucoma 1 year after cataract extraction and trabeculectomy had Molteno implant surgery. Three days after surgery a kissing choroidal effusion and retinal detachment adherent to the posterior chamber IOL were detected. Repeated choroidal taps were unsuccessful. Removal of the Molteno implant, vitrectomy, and silicone oil injection were required to reattach the retina.
The management of posterior penetrating ocular trauma includes thorough preoperative evaluation and exploration and careful debridement with excision or repositioning of the uvea. Vitreous incarceration should be avoided and the sclera and cornea should be reapproximated. Preventive antibiotic and steroid therapy are indicated. Vitreoretinal evaluation includes CT scan, ultrasonography and electroretinography. Vitrectomy should be performed within 5-10 days after injury when there is retinal detachment, an opaque vitreous, extensive vitreous hemorrhage, double perforating injuries, or a reactive foreign body. When there is endophthalmitis or chalcosis, vitrectomy should be performed earlier. A 22-year-old man with severe penetrating trauma of the eye is presented.
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We studied a group of 157 patients who had retinal detachment surgery in one eye with successful anatomical reattachment and a fellow eye without a retinal detachment. In a group of 7 out of 8 patients who had a retinal detachment that included the macula and who underwent surgery, we found that the development of macular degenerative changes was much less pronounced in the operated eye than in the fellow, control eye. In a group of 3 patients who had retinal detachment without macular involvement, the appearance of macular degenerative changes appeared to be rather symmetric in the operated and in the fellow eye. The presence of a circling buckle did not appear to have an influence on the ARMD changes. It appears that the presence of a macular detachment is a factor in modifying the natural history of age-related macular degeneration. The diminution of signs of ARMD could be related to a degree of atrophy in the retinal pigment epithelium occurring after a retinal detachment with the macula off.
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A 32-year-old man with central retinal vein occlusion followed by severe and rapidly progressing neo-vascular glaucoma is presented. This case was characterized by a severe ischemic process, in which the rubeosis iridis was followed by almost total atrophy of the iris within a short period of time. The onset of the central retinal vein occlusion was associated with mild dehydration and stress polycythemia following strenuous physical activity.
Two young sisters of Yemenite Jewish family with progressive cone-rod dystrophy accompanied with progressive alopecia of the scalp in one patient and with alopecia of the scalp and eyelashes in the other patient are presented. This rare disease seems to be autosomal recessively inherited since the patient's parents are first cousins and the family history is positive for a paternal grandmother and great-aunt having the same condition.
Twenty patients suffering from perforating injury involving the posterior segment of the eye without retinal tear or detachment underwent posterior vitrectomy. In 12 of these where traction of the retina was suspected, prophylactic scleral buckling was performed as well. Only two of these patients developed delayed retinal detachment. Six of the eight patients who did not undergo scleral buckling at the time of the vitrectomy developed this complication. This finding was statistically significant (P = .015) and supports the use of prophylactic scleral buckling in the treatment of eyes with perforating injuries involving the posterior segment to prevent delayed retinal detachment.
Three cases are described of acute glaucoma following vitrectomy and silicone oil injection in proliferative vitreous retinopathy. The first case developed silicone-induced pupillary block in a phakic eye. Cases 2 and 3 developed elevated pressure in aphakic eyes with deep anterior chambers. Cases 1 and 3 were treated by laser iridectomy. Case 2 was treated by removal of silicone. The pathogenesis and treatment of these problems are discussed.
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Subconjunctival administration of cefsulodin sodium (100 mg), but not systemic administration (500 mg), provided therapeutic concentrations in the primary aqueous humor of 22 patients who underwent cataract surgery. Therapeutic concentrations of cefsulodin persisted in the aqueous humor for at least five hours after subconjunctival administration of the agent.
The routine in our department for years used to be: prevention of bearing down during the end of the 2nd stage of labor in high myopic parturients, by forceps delivery, with the assumption that this will prevent increased intraocular pressure--thus preventing deterioration or increased damage to the eyes. The goal of this study was to challenge our theory and thus we decided to re-evaluate this approach. Various obstetrical data were recorded in 50 women with myopia from 4.5 to 15.0 diopters who were admitted in labor to our department. Fundus examination was performed in all of them before and after delivery. Various types of retinal degeneration and retinal breaks were observed in most of them at their arrival but no deterioration of these retinal defects was observed in any of the cases at the later examination. In view of our results, it is recommended to let high myopic patients deliver spontaneously.
Computed Tomography (CT) is the only imaging modality whereby bone and anatomical soft tissue structures are clearly defined. Detection of intraocular foreign bodies (FBs) can be easily obtained by scanning in the axial plane. For the precise localization of FBs, information in two planes is necessary; this is usually achieved by adding a CT study in the coronal plane to the axial plane study. When using a superimposed grid with millimeter calibration on a zoom orbital scan, the accurate location can be calculated. This contribution is of the utmost importance in deciding upon the appropriate approach when surgical removal is indicated.