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Biomedical subjects

M F Goldberg

Publications and source records attributed to M F Goldberg.

At least 91 records · Page 5Linked to original sources
PubMed1987

Persistent hyperplastic primary vitreous (PHPV): role of computed tomography and magnetic resonance.

The diagnosis of PHPV is often made difficult by its extremely broad array of clinical manifestations, its etiologic heterogeneity, and frequently opaque ocular media. The CT and MR findings are discussed in terms of how they can be of use in the differential diagnosis of PHPV. The strengths and weaknesses of each of these diagnostic methods is detailed in regard to patients who present with unilateral leucocoria, microphthalmos, lens opacity, and retinal detachment.

Child↗
PubMed1987

A clinicopathologic study of dye laser photocoagulation on primate retina.

Chorioretinal lesions produced by dye laser photocoagulation were examined on normal monkey retinas, using angiographic and histopathologic techniques. Retinal burns produced by green (514 nm), yellow (577 nm), orange (600 nm), and red (630 nm) laser lights were placed in the posterior pole between the fovea and the major vascular arcades. When examined histopathologically 24 hours after treatment, greater damage to the inner retina and deep choroid was noted with the red laser light than with the green, yellow and orange laser lights. These differences were not detectable 31 days after treatment. There were no appreciable acute differences among the lesions caused by green, yellow and orange irradiation. Laser light at four wavelengths of the orange spectrum (590, 595, 600, and 605 nm) produced comparable chorioretinal destruction in the juxtafoveal zone when examined 24 hours and 31 days after treatment. Retinal arterioles and venules treated with yellow (577 nm) and orange (600 nm) laser light demonstrated endothelial and pericytic cell damage. Changes in the outer retina, pigment epithelium, and choriocapillaris were also present beneath the photocoagulated vessels.

Animals↗
PubMed1986

A clinicopathologic study of hematic cysts of the orbit.

Hematic cyst of the orbit has been described in association with various diseases, but its pathogenetic mechanism remains unclear. We treated two patients (two men, 38 and 35 years old) who had growing cysts suspected of being malignant tumors. Surgical exploration of the orbits disclosed birefringent crystals (hematodin) either in the cyst wall or in the cyst's contents. The crystals imitated foreign bodies in their appearance and in the reactions they induced.

Adult↗
PubMed1986

Alteration of the blood-retinal barrier and vitreous in sickle cell retinopathy.

Nineteen eyes with background sickle cell retinopathy, eleven from patients with SC disease, eight from patients with SS disease, and twelve eyes with proliferative sickle cell retinopathy were examined by direct and indirect ophthalmoscopy, slit-lamp, fluorescein angiography and vitreous fluorophotometry. Calculation of the alteration of the blood-retinal barrier (BRB) and estimation of the diffusion coefficients of fluorescein in the vitreous were performed by fluorophotometry. In background sickle cell retinopathy, the results show a normally functioning BRB in the posterior pole. Abnormally increased fluorescence values to the mid-vitreous (peripheral leakage) were found only in 3 of these 19 eyes, at the two-hour examination (all SC patients). Similarly, mid-vitreous fluorescence values at the two-hour examination were 4.19 +/- 1.52 ng/ml in eyes of patients with SC disease, compared with 2.65 +/- 0.56 ng/ml in eyes of patients with SS disease. All eyes with background sickle cell retinopathy, except one, showed values for the coefficient of diffusion of fluorescein within normal limits, indicating normal vitreous gel structure. In proliferative retinopathy, the mid-vitreous fluorophotometry readings were abnormally increased, correlating well with the extent of the peripheral angiographic changes (neovascularization). The coefficient of diffusion of fluorescein in the vitreous was generally increased in the eyes with proliferative retinopathy (15.0 +/- 8.4 X 10(-4) cm2/min) in comparison with a mean value of 5.4 +/- 1.4 X 10(-4) cm2/min in the eyes with background sickle cell retinopathy, suggesting an alteration of the vitreous structure eyes with proliferative retinopathy. Fluorophotometry is considered a useful tool to follow patients with sickle cell retinopathy by quantitating peripheral retinal vascular leakage.

Adult↗
PubMed1986

Iatrogenic choroidal neovascularization in sickle cell retinopathy.

Fifteen patients (16 eyes) with proliferative sickle retinopathy treated with argon or xenon arc feeder vessel photocoagulation had chorioretinal (CRN) or choriovitreal (CVN) neovascularization develop. These patients were followed from 2 1/2 to 11 1/2 years with a mean follow-up of 6 years and 8 months. Clinically important late complications of the choroidal neovascularization included vitreous hemorrhage (in three of eight patients with CVN). However, in only two of these three eyes was there any drop in vision related to residual vitreous hemorrhage, and this was limited to loss of only one line of Snellen visual acuity. Therefore, treatment is not usually recommended if CRN or CVN develops after intense photocoagulation. Vitreous fluorophotometry was performed on these patients to examine the breakdown of the blood-retinal barrier. This gave a quantitative measure of fluorescein leakage not obtained with fluorescein angiography. Midvitreous measurements, which are more representative of these peripherally located proliferative lesions than are pre-retinal measurements, suggest that vitreous fluorophotometry may be helpful in differentiating the higher leakage of CVN from the CRN.

Anemia, Sickle Cell↗
PubMed1986

Nanophthalmic sclera. Morphologic and tissue culture studies.

We performed morphologic and tissue culture studies on scleral tissues obtained from a nanophthalmic patient. Seen by light and electron microscopy, collagens in these unusually thick scleral tissues were arranged in irregularly interlacing bundles. The size of the collagen fibers was more variable than that observed in the controls. These abnormal fibers appeared twisted and, in some areas, were more closely packed. In tissue culture, scleral cells derived from the nanophthalmic patient synthesized proteins and collagen at a rate similar to that of normal control cells. The level of glycosaminoglycan produced, however, was markedly reduced. The modified glycosaminoglycan metabolism in scleral cells may be related to the abnormal packing of collagen bundles, which may in turn contribute to the thickening of sclera and the formation of nanophthalmos.

Adult↗
PubMed1986

A comparison of two dose regimens of epsilon aminocaproic acid in the prevention and management of secondary traumatic hyphemas.

Fifty-nine patients who sustained hyphema following blunt trauma were randomly assigned prospectively to either of two dose regimens of epsilon aminocaproic acid (Amicar). Twenty-six took an oral dosage of 50 mg/kg ("half dose") every four hours for five days, up to a maximum of 30 g/day, and 33 patients received 100 mg/kg ("full-dose") every four hours up to a maximum of 30 g/day. Five patients in the full-dose group experienced dizziness, hypotension, and syncope. Half-dose Amicar substantially reduced such serious side effects (P = 0.063), had no adverse effect on the reduced rate of recurrent hemorrhages (P = 0.22), and was more cost effective than the full-dose regimen. When the two patients in the half-dose group receiving 30 g/day of Amicar were deleted, however, the comparison of dizziness and hypotension in the two groups became more significant (P = 0.050). The incidence of nausea and vomiting was approximately the same in both groups (P = 0.52). Serum Amicar levels were within the range of plasminogen inhibition at both dose levels. Prior aspirin ingestion appeared to have no influence on the rate of rebleeding (P = 0.58).

Administration, Topical↗
PubMed1986

Diagnosis and management of ocular complications of sickle hemoglobinopathies: Part V.

Sickle cell retinopathy in its advanced form is complicated by preretinal neovascularization, vitreous hemorrhage, and retinal detachment. Treatment of neovascularization can be performed with photocoagulation. Complications such as retinal breaks, retinal detachments, and choroidally fed neovascularization may result from such treatment. The risks vs. the benefits of various types of photocoagulation are currently being evaluated. Cryotherapy also may be used to treat neovascularization. It is currently being used in eyes with media that are too hazy to permit photocoagulation. It is used commonly during scleral buckling and vitrectomy procedures. In eyes with decreased visual acuity secondary to prolonged vitreous hemorrhage, pars plana vitrectomy can be utilized to produce optically clear media. Complications (including erythrocyte-induced glaucoma), however, may be severe. Retinal detachment can be treated by scleral buckling, but the markedly increased risk of anterior segment ischemia in patients with sickle cell hemoglobin necessitates preoperative, intraoperative, and postoperative prophylactic measures to minimize the risk of this potentially devastating complication. In eyes with retinal detachment with cloudy media and severe vitreous traction, combined scleral buckling and vitrectomy may be necessary. These eyes are extremely fragile, and a successful result is currently obtained in only about 50% of such cases. Hyphemas in patients with sickle cell hemoglobinopathies, whether traumatically or surgically induced, may have devastating effects on the eye. If elevated IOP results decreased vascular perfusion of the eye may cause irreversible damage to the retina and optic nerve. Most antiglaucoma medications, when used in the sickle cell patient, have a narrow margin of safety. Therefore, early surgical intervention for the treatment of sickle cell hyphemas is currently being evaluated.

Anemia, Sickle Cell↗
PubMed1985

Nodular adenomatosis of iris pigment epithelium.

A 62-year-old man manifested multiple nodular growths in his left iris and unilateral glaucoma. Detailed clinical and pathologic studies showed that these lesions were adenomas derived from the spurs of Fuchs, Michel, and Grunert in the iris pigment epithelium. We suggest terming this newly described entity nodular adenomatosis of the iris pigment epithelium and propose a classification of primary neoplastic lesions of the iris.

Adenoma↗
PubMed1985

Effects of topical epinephrine on experimental sickle cell hyphema.

Experimental sickle cell hyphemas were produced by injecting human sickle cell-beta(0)-thalassemia blood into rabbit anterior chambers. Eyes treated with topical 2% epinephrine hydrochloride showed no significant difference in the duration of the hyphema or in the percentage of sickled cells in the anterior chamber compared with untreated eyes. Topical 2% epinephrine had no apparent sustained effect on intraocular pressure.

Anemia, Sickle Cell↗