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Biomedical subjects

M Ruttum

Publications and source records attributed to M Ruttum.

11 recordsLinked to original sources
PubMed1999

The IOLAB, Inc pediatric intraocular lens study. AAPOS Reasearch Committee. American Association for Pediatric Ophthalmology and Strabismus.

PURPOSE: This report is a summary of the data of the IOLAB, Inc pediatric intraocular lens (IOL) implantation investigation. The goal of this study was to evaluate the safety and efficacy of IOL implantation for the treatment of pediatric aphakia, pending approval by the Food and Drug Administration. METHODS: From May 1981 to July 1994, a total of 1260 pediatric eyes received 171 styles of IOLs implanted by 361 US investigators. Preoperative, operative, and postoperative status reports over the first year were required for each eye entered into the study. Annual visit reports were requested thereafter to determine the long-term effects. The study was terminated in November 1995. All IOLs were obtained from IOLAB, Inc (now Chiron Vision Corp). RESULTS: Reporting compliance was 98.3% for the preoperative and operative reports, 45.1% at 1 year, and 13.8% at 3 years. The subjects' ages ranged from younger than 1 yearto 17 years. Nine subjects (0.7%) were younger than 1 year, with the largest group of 533 subjects (42.3%) aged between 6 and 12 years atthe time of surgery. Cataract types were congenital (45.6%), traumatic (37.1%), secondary (11%), senile (0.95%), and unrecorded (5.4%). The IOL was implanted primarily in 74.8% of cases and secondarily in 21.4% of cases. There was no record in 3.8% of the cases. IOL types included anterior chamber (4.1%), iridocapsular (0.71%), posterior chamber (93.6%), and unrecorded (1.59%). There were 130 adverse reactions that required secondary surgical intervention. The most frequently performed surgical procedures included lens removal without replacement, vitrectomy, lens repositioning, and lens replacement. More than half (52%) of all eyes had a visual acuity of 20/200 or worse before surgery; amblyopia was reported in 21.1% of all participants at baseline. Postoperative visual acuity data were available on 563 eyes at 1 year after surgery. Overall, 52.8% of all eyes attained a visual acuity of 20/40 or better by the 1-year visit, and only 15.5% had visual acuity worse than 20/200. In general, the older patient, traumatic cataract, and secondary cataract categories were overrepresented in the better visual acuity outcome group. CONCLUSION: The IOLAB, Inc pediatric IOL study is the first multiple-practitioner, national study designed to evaluate the safety and efficacy of IOL implantation in children. The study results are compromised by the almost 50% loss of follow-up at the 1-year evaluation. Other variables that most likely influenced outcome results were the methods of cataract extraction, medical management, and IOL design, all of which evolved dramatically over the time course of the study. Despite these issues, pediatric IOL implantation seems to be a reasonable treatment modality for aphakia, on the basis of the available 1-year follow-up data of the remaining 45.1% of eyes in the study.

Adolescent↗
PubMed1984

The Bagolini striated lens test for cyclotropia.

Measurements of cyclotropia obtained by two different techniques were compared in ten patients with superior oblique palsies. These techniques were the Maddox double rod test and a new test for cyclotropia using the Bagolini striated lenses. In contrast to the Maddox rods, the Bagolini lenses permit a nearly normal view of the visual environment; in addition with the Bagolini striated lens test, the patient's eyes were not prismatically dissociated as in the Maddox double rod test, but instead prisms were used when necessary to eliminate horizontal and vertical image disparities prior to measuring cyclotropia. The Bagolini striated lens test thereby permitted cyclotropia adaptive mechanisms to function under nearly normal viewing conditions. The two tests yielded similar measurements of cyclotropia under dissociated binocular conditions, but in several patients different results were found with the Bagolini striated lenses when associated vertical and horizontal heterotropias were eliminated spontaneously or prismatically. Three cases are reported in whom the Bagolini striated lens test provided important clinical information not revealed by the Maddox double rod test.

Adult↗
PubMed1984

Pseudo-internuclear ophthalmoplegia after surgical paresis of the medial rectus muscle.

Unilateral or bilateral limitation of adduction with jerk nystagmus of the abducting eye occurred after a weakening operation of the medial rectus muscle in five patients aged 9 to 39 years. The nystagmus waveform was indistinguishable and the clinical findings were similar to those in internuclear ophthalmoplegia. Persistence of the abducting nystagmus after occluding the adducting fellow eye in four of the five patients reflected a continued attempt of the central nervous system to increase neural activity to the paretic eye. This hypermetric response disappeared after several days of patching of one eye, only to reappear after removal of the patch. These observations suggested that the generation of abducting nystagmus in conjunction with medial rectus muscle palsy of the fellow eye does not necessarily depend on lesions in the median longitudinal fasciculus, but may also be caused by a gain-step mismatch of the saccadic generation system.

Adolescent↗
PubMed1983

Adaptation to tilting of the visual environment in cyclotropia.

We evaluated adaptations to tilting of the visual environment in 18 patients with cyclotropia by comparison of subjective tests for torsion with the actual rotation of the globes determined by fundus photography. Patients with congenital cyclotropia had a sensory reorientation of the spatial values of retinal meridians in the cyclotropic eye that prevented awareness of tilting of the environment under uniocular and binocular conditions. Patients with cyclotropia acquired as adults in many instances also had retinal sensory reorientations of the cyclotropic eye or eyes. Additionally, they used spatial clues from the visual environment to correct for image tilting under uniocular conditions. Under dissociated binocular conditions, however, these patients became aware of tilting of the visual environment, and therefore these adaptations were less deeply rooted than those in patients with congenital cyclotropia. Because certain patients with acquired cyclotropia showed evidence of using these adaptations under uniocular conditions but had constant or intermittent torsional diplopia under casual binocular viewing conditions, binocular mechanisms such as cyclofusion, suppression, and anomalous retinal correspondence may also be necessary to eliminate subjective tilting of the visual environment.

Adaptation, Physiological↗