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Biomedical subjects

M A Bloome

Publications and source records attributed to M A Bloome.

14 recordsLinked to original sources
PubMed2001

Surgical management of macular holes: a report by the American Academy of Ophthalmology.

OBJECTIVE: The document describes macular hole surgery and examines the available evidence to address questions about the efficacy of the procedure for different stages of macular hole, complications during and after surgery, and modifications to the technique. METHODS: A literature search conducted for the years 1968 to 2000 retrieved over 400 citations that matched the search criteria. This information was reviewed by panel members and a methodologist, and it was evaluated for the quality of the evidence presented. RESULTS: There are three multicenter, controlled, randomized trials that constitute Level I evidence and compare the value of surgery versus observation for macular hole. There are three multicenter, controlled, randomized trials studying the use of adjuvant therapy in macular hole repair. Postoperative vision of 20/40 or better has been reported in 22% to 49% of patients in randomized trials. The risks of surgical complications include retinal detachment (3%), endophthalmitis (<1%), cataract (>75%), and late reopening the hole (2% to 10%). CONCLUSIONS: The evidence does not support surgery for patients with stage 1 holes. Level I evidence supports surgery for stage 2 holes to prevent progression to later stages of the disease and further visual loss. Level I evidence shows that surgery improves the vision in a majority of patients with stage 3 and stage 4 holes. There is no strong evidence that adjuvant therapy used at the time of surgery results in improved surgical outcomes. Patient inconvenience, patient preference, and quality of life issues have not been studied.

Clinical Trials as Topic↗
PubMed1999

Current popularity of pneumatic retinopexy.

PURPOSE: To compare the popularity of pneumatic retinopexy (PR) in 1997 with its popularity in 1990 among retinal specialists. METHODS: In 1997, a survey was mailed to the 1994-1995 members of the Retina or Vitreous Societies who lived in the United States or Canada, asking how they would manage a hypothetical retinal detachment. The choices were limited to PR, segmental scleral buckling, scleral bucking with encircling, primary vitrectomy, and Lincoff balloon. The results of the survey were compared with those previously reported by a similar survey in 1990. RESULTS: The majority (55%) of respondents selected PR, which is a twofold increase over those who preferred it in 1990 (odds ratio 2.08; 95% confidence interval 1.53, 2.85). The popularity of PR was inversely proportional to the length of time the respondents had been in practice. If the eye with the hypothetical detachment had pseudophakia, only 30% of respondents selected PR. If the eye had additional tears, vitreous hemorrhage, or lattice degeneration, only about one-sixth preferred PR. CONCLUSION: Pneumatic retinopexy was much more popular in 1997 than it was in 1990. Its popularity continues to be influenced by the age of the surgeon and by the complexity of the detachment.

Data Collection↗
PubMed1992

Pneumatic retinopexy versus scleral buckle. Preferences of Vitreous Society members, 1990.

A survey was conducted among the 1990 members of the Vitreous Society in order to measure their acceptance of pneumatic retinopexy. They were asked which treatment they would prefer should they suffer a hypothetical detachment. The choices were limited to pneumatic retinopexy or scleral buckling (encircling or segmental). The majority of respondents selected a scleral buckling procedure for a phakic retinal detachment with two adjacent superior temporal quadrant tears. Surgeons who had been in practice for 10 years or less (median for entire group = 10 years) were significantly more likely to select a pneumatic retinopexy procedure. As the details of the hypothetical detachment became more complicated with myopia, additional tears, vitreous hemorrhage, or lattice degeneration with a positive family history, the respondents selected a scleral buckling procedure with greater frequency, and the differences between the choices of the surgeons became nonsignificant. This survey shows that many surgeons feel pneumatic retinopexy is an acceptable alternative to buckling surgery in select cases. There were no trends by geographic location.

Humans↗
PubMed1979

Acute retinal necrosis.

Three cases of acute retinal necrosis are presented. Acute retinal necrosis is an unusual syndrome which is the result of severe contusion to the globe. It is characterized by large irregular retinal holes with pieces of necrotic retina in the adjacent vitreous, retinal edema and hemorrhage surrounding the holes, underlying choroidal disruption, and vitreous hemorrhage. The incidence of acute retinal necrosis is difficult to determine but it does not appear to be common entity. Although acute retinal necrosis may be associated with a retinal detachment, other retinal breaks are usually responsible for the detachment. The necrosis results from the direct force of the injury striking the globe although a contrecoup mechanism may explain cases of nasal necrosis. Treatment is necessary for associated retinal detachments and acute lesions but may not be necessary if adequate fibrosis is present when the lesion is first seen.

Acute Disease↗
PubMed1978

Massive spontaneous subretinal hemorrhage.

We studied eight cases of massive, spontaneous subretinal hemorrhage which was characterized by the sudden appearance of one or more large, dark, elevated hematomas under the retina. The initial location of the hemorrhage may have been in the choroid or under the pigment epithelium, or both, but further extravasation of the blood anteriorly frequently resulted in hemorrhage under the neurosensory retina and in the vitreous. Although the lesion can initially be mistaken for a melanoma, the diagnosis is confirmed by the formation of a typical, elevated scar in the involved area. Frequent fundus examinations are essential, and ultrasound, radioactive phosphorus uptake testing, and bilateral patching are helpful in establishing the diagnosis. The hemorrhage is usually the result of a ruptured vessel from a subretinal neovascular network or arterioclerotic degeneration and may be precipitated by the use of anticoagulants.

Adult↗
PubMed1977

Transient angle-closure glaucoma in central retinal vein occlusion.

Two cases are presented in which unilateral transient angle-closure glaucoma accompanied occlusion of the central retinal vein. In both cases, the uninvolved eye had a wide-open angle and the involved eye demonstrated a marked anterior displacement of the lens-iris diaphragm. Short-term treatment with cycloplegics and carbonic anhydrase inhibitors resulted in a rapid and permanent deepening of both angles. The similarity of this picture to malignant glaucoma as well as possible causative factors is discussed.

Acetazolamide↗