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Biomedical subjects

M T Trese

Publications and source records attributed to M T Trese.

At least 91 records · Page 5Linked to original sources
PubMed1991

Management of advanced retinopathy of prematurity in the older patient.

The authors studied 11 eyes of 10 patients who complained of a recent decrease in vision and whose eyes had the clinical appearance of stage 5 retinopathy of prematurity (ROP) as diagnosed by the presence of a dense, opaque retrolenticular membrane. Patients ranged in age from 4 to 33 years, and birth weights ranged from 680 to 1077 g. All eyes underwent vitrectomy, lensectomy, and membrane peeling and were found intraoperatively to have areas of retina that were attached (stage 4B). Preoperatively, a reproducible visual-evoked potential waveform appeared to better predict this retinal configuration and potential retinal function than did the contact B scan ultrasound of the globe. Postoperatively, seven (63.6%) eyes demonstrated an improvement in vision. Vitreous surgery may be beneficial in selected eyes of older patients with advanced ROP to clear media opacities and to uncover areas of functional, attached retina, which may allow these patients to more effectively use the vision they possess.

Adolescent↗
PubMed1991

Visual acuity in infants after vitrectomy for severe retinopathy of prematurity.

During the course of the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP), 98 infants (129 eyes) from the randomized segment of the trial developed total retinal detachment from retinopathy of prematurity (ROP) before the 1-year examination. The authors report as a case series the results of acuity card assessment of monocular grating acuity at 1 year in 53 infants (71 eyes) postvitrectomy and in 45 infants (58 eyes) who had retinal detachments but who did not undergo retinal reattachment surgery. The decision to undertake and the surgical technique used for a retinal reattachment procedure was not part of the randomized CRYO-ROP trial. Two eyes of one infant had pattern vision at the lowest measurable threshold after vitrectomy. None of the remaining eyes that had undergone vitrectomy and none of the eyes that did not undergo vitrectomy showed evidence of pattern vision. The relatively poor visual outcomes in this case series suggest that efforts are well-spent in attempting to prevent retinal detachment in ROP.

Cryosurgery↗
PubMed1991

Management of retinopathy of prematurity.

During the last year, ophthalmology has continued to benefit from an ordered approach to unraveling the pathophysiology and treatment of retinopathy of prematurity. Over the last year, new incidence and treatment information from the Cryotherapy for Retinopathy of Prematurity Study has been presented. The use of the indirect laser to treat retinopathy of prematurity has been introduced. Scleral buckling and vitrectomy continue to define themselves in the management of advanced retinopathy of prematurity. Oxygen continues to be deemphasized as a solitary causative agent in retinopathy of prematurity, and other biochemical agents are being explored as playing a role in the pathogenesis and treatment.

Cryosurgery↗
PubMed1989

Surgical management of vitreomacular traction syndromes.

A series of 106 consecutive symptomatic eyes considered to be at high risk for idiopathic macular holes developing underwent pars plana vitrectomy with membrane peeling. One of three types of vitreomacular traction was noted intraoperatively in all the eyes. The elimination of the vitreomacular traction resulted in improved vision in 89% of the eyes, no change in 7%, and decreased vision in 4%. A total of 62% of the patients were women (median age, 67 years). Follow-up ranged from 6 months to 118 months (average, 35 months). Complications included accelerated nuclear sclerosis in 16% and a 2% incidence of retinal detachment, macular pucker, and macular holes.

Adult↗
PubMed1989

Silicone oil for the treatment of severe proliferative diabetic retinopathy.

Although silicone oil is being used with increasing frequency for proliferative vitreoretinopathy (PVR), few studies have reported on its use for severe forms of proliferative diabetic retinopathy (PDR). Vitreous microsurgery with silicone oil tamponade was performed on 34 patients (37 eyes) with refractory severe neovascular glaucoma and/or recurrent retinal detachment (RD) from PDR that failed to respond to conventional techniques including vitrectomy, membrane peeling, gas tamponade and photocoagulation. With all patients followed a minimum of 6 months (mean, 13 months), anatomic attachment was maintained in 26 (70%) of the eyes. At the last follow-up examination, a final visual acuity of at least 5/200 was found in 9 (24%) of 37 eyes and 9 (35%) of 26 anatomically successful cases. Regression of iris neovascularization occurred in 8 (36%) of 22 eyes with rubeosis and the silicone oil was removed in 3 (8%) eyes. Significant complications included band keratopathy in nine (24%) eyes, corneal decompensation in three (8%) eyes, and recurrent retinal detachment in seven (19%) eyes.

Adolescent↗
PubMed1989

A cell line derived from non-neoplastic human neuroretinal cells.

We have derived a cell line from an epiretinal membrane excised surgically from a premature female infant born at a gestational age of 25 weeks, and who developed stage 5 retinopathy of prematurity. The cell line, which in early passages appeared immunocytochemically to contain cells with both neuronal and glial characteristics, has been maintained in culture for 14 months at the time this manuscript was submitted, and has survived 20 passages. The cells have a diploid, human karyotype, with most cells possessing 46 normal appearing chromosomes, including 44 autosomes and two X-chromosomes. Morphologically, the cell line at early passages consisted of polygonal cells and also of cells possessing long, spindly branching processes. These two cell types were cloned. Nearly 100% of the cells of both morphologic types in mixed cultures stained immunocytochemically for neuron-specific enolase (NSE), a neuronal marker, and approximately 5-10% of the cells in mixed cultures (including about 50% of the cells with the spindly morphology, that were less prevalent in mixed cultures) stained for glial fibrillary acid protein (GFAP), a glial marker. We have not performed "double-label" immunocytochemistry, but it was evident from the proportion of cells that stained with each marker that many cells must contain both GFAP and NSE. At least 50% of the cells in most of the early cultures were positive for keratin, while all were (and remain) negative for muscle actin. No cells are found that are immunocytochemically positive for factor VIII, a vascular endothelial cell marker. These cultured cells have also been studied immunocytochemically for their production of extracellular matrix substances. The cultures are immunocytochemically positive for type IV (but not type I) collagen, laminin and fibronectin. In later passages, cells of both clones lost their immunocytochemical positivity for GFAP and NSE, and all became positive for keratin. Cells of both clones also developed a similar, polygonal morphology, lacking long processes. By electron microscopy, many of the cells were seen to possess nonmotile cilia, with a 9 + 0 pattern of microtubule doublets. This cell line may be useful for studies of human retinal cell development and metabolism, and responses to pathological processes.

Cell Division↗
PubMed1987

Surgical therapy for stage V retinopathy of prematurity. A two-step approach.

Between February 1985 and February 1986, ten eyes from a larger series of infants operated on for stage V retinopathy of prematurity were seen with the open funnel type of retinal detachment and vascularly active eyes. We have developed a technique for these eyes involving two-step treatment. The first step is cryotherapy to the avascular peripheral retina which rarely detaches, even in stage V retinopathy of prematurity, followed by lensectomy, vitrectomy and membrane peeling. This technique has allowed us to operate on these ten eyes much earlier than would generally have been possible if the eyes were allowed to become vascularly inactive on their own. We were able to achieve anatomic reattachment of zone 1 as described in the International Classification of Retinopathy of Prematurity in 80% of these eyes. Light perception or better visual function was achieved in 70%, with 30% of the eyes capable of grasping brightly colored unlit objects of 1 in. (2.5 cm) in diameter. This represents a marked improvement in both anatomic and visual results. We feel that this improvement is due to the earlier treatment by lensectomy, vitrectomy and membrane peeling seemingly allowed by pretreating with cryotherapy. In addition, close attention was paid to the refractive status in visual stimulation during the postoperative period.

Cryosurgery↗
PubMed1986

Visual results and prognostic factors for vision following surgery for stage V retinopathy of prematurity.

As our surgical techniques improve we are able to achieve anatomic retinal reattachment in 48% of eyes with advanced retinopathy of prematurity. Only 31% of these eyes, however, have achieved visual function by the six-month follow-up visit. In an attempt to determine the factors that lead to better visual outcome, we analyzed 85 eyes of 45 children who underwent surgical therapy for Stage V retinopathy of prematurity by one surgeon. These eyes were followed from 6 to 36 months. We analyzed the timing of surgery, retinal configuration, subretinal fluid composition, and appearance of retinal pigment epithelium following resolution of detachment as these related to visual results. We also used visual evoked response testing in an attempt to predict which eyes might achieve visual function. Children with best visual results tended to have rapidly regressing vascular activity, were operated earlier, and had little subretinal exudate sparing the macula and little alteration of RPE following retinal reattachment, and if measured, low iron concentration in subretinal fluid.

Child, Preschool↗
PubMed1986

Silicone oil for advanced proliferative vitreoretinopathy.

Repeated vitreous microsurgery followed by silicone oil injection was performed on a consecutive series of 51 patients with retinal detachment and advanced proliferative vitreoretinopathy who were not cured by previous conventional management, including vitrectomy, membrane peeling, gas tamponade, and scleral buckling. Anatomic reattachment was achieved in 65% of these cases. Ambulatory or better vision was restored in 74% of the anatomically successful cases. The silicone oil was removed from 30% of the eyes with complete attachment of the retina posterior to the buckle.

Adolescent↗
PubMed1985

Subretinal strands: ultrastructural features.

This report describes the histologic and ultrastructural features of 13 subretinal strands removed during vitreous surgery for retinal detachment with proliferative vitreoretinopathy. On the surface of the subretinal strands, retinal pigment epithelial cells were found that maintained their cellular characteristics. Inside the strand were modified pigment epithelial cells, fibroblasts, fibrocytes, myofibroblasts, macrophages, basal lamina material, fibrin, and often large amounts of collagen. In some strands, the basal lamina material was similar to the types found in Drusen and in the inner layer of bruch's membrane. Glial cells were rarely found in these strands.

Basement Membrane↗
PubMed1985

Removal of epimacular membranes.

Vitreous surgery was used to remove epiretinal macular membranes in 328 cases, 184 (56%) of which had membranes that were considered idiopathic and 144 (44%) which were due to other causes. The 12- to 92-month follow-up showed that visual acuity improved two lines or more in 243 (74%) of the eyes, 79 (24%) were unchanged and 6 (2%) became worse. Recurrence of membranes was seen in 24 (7.3%) eyes and 27 (8%) eyes developed complications. In the idiopathic cases visual results were significantly better and complications fewer. Rapidly progressive nuclear sclerosis was noted in 23 (12.5%) eyes. The degree of cystoid edema had no relationship to the final visual result. Pseudoholes which were present in 14 (8%) of the idiopathic cases either became smaller or disappeared following successful surgery with an average increase in acuity of five lines.

Adolescent↗
PubMed1984

Surgical results of stage V retrolental fibroplasia and timing of surgical repair.

Analysis of forty Stage V RLF eyes which underwent lensectomy, pars plicata vitrectomy, membrane peeling and scleral buckling surgery with a minimum 6-month follow-up is presented. Anatomic reattachment was achieved in 45% of eyes. Functional success was achieved in 30% of eyes. Prognostic indicators such as the configuration of the tractional detachment, vascularization of the iris and retrolenticular membrane were analyzed. This analysis showed that timing of surgery may alter surgical success. This information, coupled with the variable rates of progression of the RLF process, suggests more frequent examination of the children at risk than is currently suggested is necessary to allow maximum benefit.

Female↗