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Biomedical subjects

M Wand

Publications and source records attributed to M Wand.

At least 37 records · Page 2Linked to original sources
PubMed1991

The influence of iris pigmentation on the miotic effect of thymoxamine.

We performed a randomly assigned, double-masked, placebo-controlled study in 78 patients with varied iris pigmentation to evaluate the influence of iris pigmentation on the ability of 0.1% thymoxamine to reverse mydriasis produced by 2.5% phenylephrine. Patients were chosen so that a 1.6:1 ratio of dark to light irides was obtained. Within one-half hour after medication, thymoxamine-treated nonbrown irides constricted significantly compared to their fellow placebo-treated irides (P less than .001). Thymoxamine-treated pupils of nonbrown irides were 1.0 to 3.1 mm smaller than placebo-treated fellow eyes. Thymoxamine-treated light brown irides constricted less (0.6 to 2.0 mm) and more slowly compared to fellow placebo-treated irides. Thymoxamine did not reverse the mydriasis in eyes of patients with dark brown irides. Thymoxamine appears similar to other adrenergic agents that bind to melanin, delaying onset and strength of action. Its efficacy as presently formulated may be limited, in part, by iris color.

Adolescent↗
PubMed1990

Neovascular glaucoma following pars plana vitrectomy for complications of diabetic retinopathy.

The patient charts of 81 consecutive vitrectomies performed for complications of proliferative diabetic retinopathy were reviewed. Sixty-five preoperative, intraoperative, and postoperative variables were analyzed. In eyes with completed panretinal photocoagulation, only postoperative retinal detachment had a statistically significant correlation with postvitrectomy development of neovascular glaucoma. Eighty-three percent of eyes with detached retinas, as compared with 4% of eyes with attached retinas, developed neovascular glaucoma (P less than .00001). Aphakia alone did not have a statistically significant effect on the development of neovascular glaucoma; however in the presence of retinal detachment the incidence was very high (92%). Our study shows that a completely attached retina and aggressive panretinal photocoagulation are of paramount importance in decreasing the risk of neovascular glaucoma following vitrectomy for complications of proliferative diabetic retinopathy.

Adult↗
PubMed1988

Nd: YAG laser iridectomies: 100 consecutive cases.

We reviewed the patient charts of our first 100 consecutive Nd:YAG laser iridectomies. Our success rate (99%) is the same as that reported by others. Iris bleeding was not problematic. We did find that relative pupillary block may still be present with a patent but very small Nd:YAG iridectomy; that transillumination is not an adequate criterion for assessing patency; and that a Nd:YAG laser iridectomy, probably in part because of its small size, frequently closes with chronic inflammation.

Aged↗
PubMed1985

Neovascular glaucoma and carotid artery obstructive disease.

Carotid artery obstructive disease, although infrequently diagnosed as a primary or contributing cause of neovascular glaucoma, can produce distinctive characteristics. Decreased perfusion of the ciliary body may decrease aqueous humor production. As a result, such eyes with neovascular glaucoma may occasionally be normotensive or even hypotensive. Fluorescein angiography may show an increased arm-to-retina time and leakage from the major retinal arterioles. Panretinal photocoagulation may not eliminate the anterior segment neovascularization because of anterior segment ischemia. Endarterectomy can significantly increase intraocular pressure as perfusion to the ciliary body returns to normal. These characteristics were found in two patients, a 67-year-old woman and a 49-year-old man, with diabetes and hypertension. In both cases cyclocryotherapy significantly reduced the intraocular pressure and the rubeosis iridis regressed.

Aged↗
PubMed1983

Neovascular glaucoma and vitreous hemorrhage following cataract surgery in patients with diabetes mellitus.

The potential complications of cataract surgery in the general population are well known. In addition, cataract extraction in the patient with diabetes mellitus is associated with other potential complications common to this disease: neovascular glaucoma and acceleration of proliferative diabetic retinopathy with or without vitreous hemorrhage. We analyzed the records of 154 patients with diabetes mellitus who had undergone standard intracapsular cataract extraction in one eye only with the other eye serving as the unoperated control eye. We were able to determine the status of the diabetic retinopathy before the operation and to note the development of vitreous hemorrhage and rubeosis iridis/neovascular glaucoma after the operation. If either event occurred within six weeks of the surgery, it was considered to be a complication of the cataract extraction. Intracapsular cataract extraction in this diabetic population, without regard of the preoperative status of the retinopathy, was associated with a statistically significant incidence of postoperative rubeosis iridis/neovascular glaucoma (7.8% vs 0%). In patients with preoperative active proliferative diabetic retinopathy, the risk of developing postoperative rubeosis iridis/neovascular glaucoma was even higher (40% vs 0%). There was also a statistically significant incidence of vitreous hemorrhage after surgery in eyes with no diabetic retinopathy or background diabetic retinopathy (6.5% vs 0%). In patients with active proliferative diabetic retinopathy, there was an increased incidence of vitreous hemorrhage after surgery (20% vs 6.5%), but this was not statistically significant due to the small number of patients studied. Possible explanations for these findings are explored and therapeutic and prophylactic measures recommended.

Cataract↗
PubMed1978

Thymoxamine test. Differentiating angle-closure glaucoma form open-angle glaucoma with narrow angles.

To help differentiate mild angle-closure glaucoma from open-angle glaucoma in patients with elevated intraocular pressure (IOP) and angles so narrow that the structures cannot be seen adequately, we used a thymoxamine hydrochloride eyedrop that induces miosis and tends to widen the angle. Thymoxamine does not contract the ciliary muscle and does not alter the IOP or facility of outflow in open-angle glaucoma, but it can relieve angle-closure glaucoma. A test with thymoxamine was performed in 26 patients because of this differential diagnostic dilemma. When gonioscopic, tonometric, and tonographic findings appeared to indicate a diagnosis of angle-closure glaucoma, a peripheral iridectomy was done. Subsequent (one to 27 months) observations have substantiated that testing with thymoxamine is a helpful aid in this differential diagnosis, and merits more widespread evaluation.

Adult↗
PubMed1978

Effects of panretinal photocoagulation on rubeosis iridis, angle neovascularization, and neovascular glaucoma.

Ninety-three patients received ruby laser panretinal photocoagulation in one eye for diabetic retinopathy and we examined them at an average time of 7.1 years later. In 14 patients, the untreated eye developed rubeosis iridis and the contralateral treated eye did not. In seven patients, the untreated eye developed angle neovascularization and the contralateral eye did not. The untreated eye developed neovascular glaucoma and the contralateral treated eye did not in four patients. Our findings suggest that eyes with proliferative retinopathy that received panretinal photocoagulation are less likely to develop rubeosis iridis, angle neovascularization, and probably neovascular glaucoma, than those eyes not receiving panretinal photocoagulation.

Adult↗
PubMed1976

Thymoxamine hydrochloride: effects on the facility of outflow and intraocular pressure.

Eleven subjects with normal eyes and sixteen subjects with open-angle glaucoma had a selective alpha-adrenergic blocking agent, thymoxamine hydrochloride 0.5 per cent eyedrop, applied to one of their eyes. This consistently produced miosis, but did not significantly alter the intraocular pressure or the tonographically determined facility of aqueous outflow. Because we find that thymoxamine can selectively induce miosis without significant accompanying effect on the ciliary muscle or facility of outflow, we expect that this drug may prove to be a useful diagnostic adjunct to gonioscopy in distinguishing between angle-closure glaucoma and open-angle glaucoma with narrow angle. It seems worthwhile proceeding with clinical evaluation of this possibility.

Adult↗
PubMed1975

Corneal perforation and iris prolapse due to Mima polymorpha.

An 11-year-old girl had hyperacute conjunctivitis but was lost to follow-up until nine days later when she returned with a corneal perforation and iris prolapse. A smear at that time showed Gram-negative intracellular diplococci, but subsequent bacteriological study revealed the causative organism to be Mima polymorpha. This apparently is the first documented case of corneal perforation due to Mimeae, and emphasizes that Mimeae can be completely indistinguishable, clinically and on smear, from infection caused by Neisseria. Only a high index of suspicion and the proper bacterial cultures can prevent a possible tragic misdiagnosis.

Acinetobacter Infections↗
PubMed1975

Cholesterosis bulbi: the ocular abnormality known as synchysis scintillans.

Review of inpatient records at the Massachusetts Eye and Ear Infirmary for ten years and the inpatient and outpatient records at the Children's Hospital Medical Center for eight years revealed no diagnosed cases of synchysis scintillans. The pathology reports from the Ophthalmic Pathology Laboratory at the Massachusetts Eye and Ear Infirmary for the last ten years revealed 12 eyes with cholesterol crystals in the vitreous cavities or subretinal spaces, or both. All were blind, long-term damaged eyes; there were no vitreous cholesterol crystals observable clinically. This study corroborates previous reports and suggests that synchysis scintillans occurs only in severely damaged, blind eyes not visible to observation. Both the current concept and terminology of synchysis scintillans are inaccurate. Cholesterosis bulbi is a more appropriate term. Cholesterol crystals are clinically different from asteroid bodies since the former occurs only in a damaged, functionless eye.

Adolescent↗