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Biomedical subjects

M J Elman

Publications and source records attributed to M J Elman.

27 records · Page 2Linked to original sources
PubMed1988

Neovascularization in central retinal vein occlusion: electroretinographic findings.

Electroretinograms (ERGs) were measured in 15 patients with central retinal vein occlusion (CRVO). Seven of the patients had neovascularization of the iris (NVI) at the time of testing, and two developed NVI within one month of testing; six did not have NVI or any other form of neovascularization (NV) and were no longer considered to be at risk for NV from their present occlusion. The ERGs were recorded as a function of the stimulus intensity and to a 30-Hz flickering stimulus. A Naka-Rushton-type function was fit to b-wave amplitudes, measured as a function of stimulus intensity, to evaluate changes in ERG amplitude and sensitivity. Compared with eyes in the no-NV group, eyes developing NVI had significantly reduced ERG sensitivity and amplitudes. The distributions of sensitivity values in these two groups did not overlap. All of the eyes with NV showed large a- and b-wave and 30-Hz implicit time delays, but only one eye had a b/a-wave amplitude ratio close to or less than 1. A comparison of ERG sensitivity, amplitude data, and flicker timing data with retinal fluorescein angiography in a two-alternative forced-choice analysis showed that ERG sensitivity and amplitude loss were better than retinal fluorescein angiography at discriminating eyes with CRVO and NVI from eyes with CRVO without NVI.

Electroretinography↗
PubMed1988

Assessment of visual function in patients with age-related macular degeneration and low visual acuity.

The visual function of 100 eyes with low visual acuity of 100 patients with age-related macular degeneration was examined using measurements of visual acuity, peak contrast sensitivity, and the ability to read, to tell time, and to distinguish colors, products, and facial expressions. Visual acuity and peak contrast sensitivity were correlated (r = .62); however, a range of peak contrast sensitivities was observed at each level of acuity. When considered individually, visual acuity and peak contrast sensitivity were related to the ability to perform each of the tasks. When multivariate methods were applied, both visual acuity and peak contrast sensitivity contributed independently to the ability to read and tell time. Among patients with the same contrast sensitivity, visual acuity had little or no relationship to the ability to identify colors, products, and faces.

Aged↗
PubMed1987

Vitreous fluorophotometry in patients with cataract surgery.

Cystoid macular edema frequently complicates recovery from cataract surgery. Our understanding of this disease would be enhanced by more sensitive and quantitative methods to evaluate it. We performed vitreous fluorophotometry in 66 nondiabetic patients who had recently undergone cataract surgery. Eyes with definite macular edema on fluorescein angiography were ranked according to the severity of the leakage. The rank of the leakage correlated significantly with the vitreous fluorophotometry values (P less than 0.01). The mean fluorophotometry result in the eyes with cystoid macular edema was greater than that in the phakic, control group (P less than 0.01). However, eyes with minimal or no leakage visible on fluorescein angiography had fluorophotometry values indistinguishable from normal. The quantitative vitreous fluorophotometry results provided an indicator of cystoid macular edema that may prove useful in following this problem and evaluating therapy for it.

Aged↗
PubMed1987

Skin necrosis following fluorescein extravasation. A survey of the Macula Society.

Three patients developed cellulitis and skin necrosis following fluorescein dye extravasation. This experience prompted a survey of the Macula Society membership to determine whether this complication of fluorescein angiography is as rare as the paucity of cases in the literature suggests. In addition, the manufacturer was asked to reexamine the dye lot to determine whether an impurity had been introduced unintentionally during the manufacturing process. No impurity was found in the dye lots tested. The survey disclosed only nine additional cases of skin necrosis, leading to the conclusion that skin necrosis probably represents a rare, idiosyncratic reaction. Although fluorescein angiography remains a safe procedure, efforts should be directed toward prevention of dye extravasation. When extravasation does occur, prompt and proper medical attention with close follow-up study may minimize the likelihood of skin necrosis.

Aged↗
PubMed1986

Earliest symptoms caused by neovascular membranes in the macula.

One hundred three patients with neovascular maculopathy and relatively recent vision loss were surveyed to determine the most frequent symptoms and to assess the reliability of the Amsler grid in helping patients to detect early symptoms. Blurred vision and distortion, most often with near vision, were the most frequent first symptoms reported by patients. Of 49 patients who said that they were observing the Amsler grid on a regular basis, only five indicated that the Amsler grid abnormality was the first visual symptom. However, all but five of 49 patients did notice an Amsler grid abnormality during the office examination, suggesting noncompliance as the probable explanation for failure to detect an Amsler grid abnormality earlier. Patients at risk for neovascular maculopathy should be encouraged to assess a variety of visual functions--including reading vision, color saturation, and image clarity--in addition to observing the Amsler grid, in order to help them detect the earliest symptoms of submacular fluid from a potentially treatable neovascular membrane.

Choroid↗
PubMed1986

Galactokinase activity in patients with idiopathic cataracts.

Ninety-four consecutive patients admitted for elective cataract surgery were prospectively examined for erythrocyte galactokinase activity. The presumed etiology for the cataract was established by history and physical examination in 51 patients (21 were diabetic). The cataract was classified as idiopathic in 43 patients. Galactokinase activity was significantly lower in idiopathic vs. presumed (nondiabetic) etiology patients 50 years of age or younger (P less than 0.05) and in idiopathic cataract patients 50 years of age or younger vs. those older than 51 years of age (P = 0.0033). Three of the idiopathic cataract patients (6.9%) had galactokinase levels less than two standard deviations below the mean galactokinase level for age-matched patients with suspected (nondiabetic) etiology. Compared with the expected distribution for the heterozygote in the general population (0.2%), this was highly significant (P = 0.0001). Diminished galactokinase activity may increase the risk of developing presenile cataracts requiring surgery by the fourth decade.

Adult↗
PubMed1986

The natural history of serous retinal pigment epithelium detachment in patients with age-related macular degeneration.

One hundred ten patients with serous detachment of the retinal pigment epithelium (RPE) were reexamined to enhance our knowledge of the natural course of this condition. All patients were greater than 50 years of age, had age-related macular degeneration, and had neither blood, lipid, nor angiographic evidence of a definite choroidal neovascular membrane (NVM) at the time of the initial examination. All patients were followed up for at least six months except for two patients who had developed a choroidal NVM within the first six months of the initial exam. Forty-five of 140 eyes (32%) developed a choroidal NVM within an average of 19.6 months (median, 12 months). This was associated with a final visual acuity of 20/200 or worse (P less than 0.0001). Ophthalmoscopic and angiographic features present at the initial visit which were associated with the development of NVM and poor final visual acuity were: sensory retinal detachment; increased size of PED; hot spot; late filling; notching; and irregular filling. At the most recent examination, 39% of the eyes had a final visual acuity of 20/20 to 20/40, while 24% of the eyes had a final visual acuity of less than or equal to 20/200.

Aged↗