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Biomedical subjects

R Axer-Siegel

Publications and source records attributed to R Axer-Siegel.

At least 37 records · Page 2Linked to original sources
PubMed1998

Long-term follow-up of perfluorocarbon liquid in the anterior chamber.

BACKGROUND: Perfluorocarbon liquids are used as a vitreous substitute in the operative management of several ophthalmologic conditions. We examined the effects of residual perfluorocarbon droplets in the anterior chamber in patients after retinal detachment surgery. METHODS: The study group consisted of seven patients (seven eyes) aged 28-74 years in whom droplets of perfluorocarbon appeared in the anterior chamber subsequent to retinal detachment surgery involving scleral buckling, perfluorodecalin injection, and perfluorocarbon liquid-silicone oil exchange. Mean follow-up was 9.4 months. RESULTS: From 1 -15 droplets of perfluorocarbon liquid were found in the anterior chamber. There were no corneal complications or inflammatory reactions or blood vessel invasion into the corneal stroma. Some of the droplets appeared to be encapsulated in a membrane-like material. Perfluorocarbon liquid and silicone oil had to be removed in three patients at 20, 12, and 4 months postoperatively because of an increase in intraocular pressure due to blockage of the inferior iridectomy by a droplet of perfluorocarbon, emulsification of the silicone oil, or residual perfluorocarbon liquid on the retina (one patient each). Increased intraocular pressure in a fourth patient was successfully treated pharmacologically. CONCLUSION: Based on our experience, residual perfluorocarbon liquid droplets in the anterior chamber are well tolerated and do not induce corneal damage or ocular inflammation. These patients should be closely followed, however, and the liquid removed if complications develop.

Adult↗
PubMed1998

Retinal thickness variation in the diabetic patient measured by the retinal thickness analyser.

AIM: To evaluate the potential of the retinal thickness analyser (RTA) as an objective tool for assessment and follow up of diabetic macular oedema. METHODS: A prototype of the RTA that operates on the principle of laser slit biomicroscopy was used. Retinal thickness was obtained in 41 eyes of 41 diabetic patients. The clinical diagnosis was cystoid macular oedema (CMO) in 10 eyes, clinically significant macular oedema (CSMO) without retinal cysts in 21 eyes, and "dry" macula following grid pattern laser treatment in 10 eyes. The control group consisted of 46 eyes of age matched healthy volunteers. RESULTS: In normal eyes (46 eyes), the foveal thickness measured was 178 (SD 44) microns and the macular thickness around the fovea was 311 (51) microns. The eyes with CMO displayed the largest foveal thickening, 875 (287) microns (390% increase compared with normal values). The average thickness of the fovea in the non-cystoid CSMO group was 427 (175) microns (144% increase compared with normal fovea). The average thickness of the foveal centre in eyes judged as having "dry" macula after laser treatment was 315 (71) microns (77% increase compared with normal value and a 26% decrease in thickness compared with the CSMO eyes). Statistically significant differences were found in central thickness between these four groups (p = 0.0001). The average thickness at 500 microns surrounding the fovea was 566 (202) microns in the CSMO eyes compared with 311 (51) microns in normal eyes (80% increase). The "dry" macula group (after undergoing laser treatments) had an average thickness of 414 (94) microns (27% decrease compared with CSMO eyes and a 33% increase compared with eyes of healthy controls). CONCLUSIONS: RTA is a system for quantifying macular thickness and imaging of macular pathology. The system can be a useful tool for diagnosis of macular diseases and for evaluation of the effect of treatment modalities.

Adult↗
PubMed1998

Pneumatic retinopexy for late-onset recurrent retinal detachment.

BACKGROUND AND OBJECTIVE: Pneumatic retinopexy is used as a primary procedure for the repair of retinal detachments caused by visible retinal tears. Its application for late-onset recurrent retinal detachments following previous pneumatic retinopexy or scleral buckling procedure has not been reported to date. PATIENTS AND METHODS: Pneumatic retinopexy was performed in 12 patients with recurrent retinal detachments due to new retinal tears who presented 6 months to 10 years after pneumatic retinopexy (8 patients) or scleral buckling surgery (4 patients). Follow-up ranged from 6 to 24 months. RESULTS: All the retinas reattached within the first few postoperative days and remained attached throughout follow-up. No intraoperative or postoperative complications were observed. Visual acuity either remained unchanged (if good before) or improved. CONCLUSION: Pneumatic retinopexy may be a feasible option for recurrent late-onset retinal detachment under the proper clinical conditions.

Cryotherapy↗
PubMed1997

The development and progression of diabetic retinopathy in type I diabetic patients: a cohort study.

To describe the course and risk factors for development and progression of retinopathy, we studied a cohort of 333 Israeli Jewish patients with Type 1 (insulin-dependent) diabetes mellitus. The median age at diagnosis was 9.5 (range 0.04-26.2) years and the median duration of follow-up was 14 (range 1.6-30) years. Evaluation of both retinae was performed yearly since referral and HbA1 values were tested every 3 months since 1978. During a follow-up of 4070 patient-years, 162 patients developed non-proliferative retinopathy. The median retinopathy-free interval was 14.9 years and after 30 years all patients were affected. Pre-pubertal duration of diabetes was relevant. Independent and significant risk factors for early onset of non-proliferative retinopathy were: poor cumulative glycaemic control (median retinopathy-free interval in the 1st vs 4th quartiles of mean HbA1 values over all years: 18.0 vs 12.5 years, p = 0.0001); onset of diabetes during or after puberty (median retinopathy-free interval in patients with onset of diabetes before, during or after pubescence: 16.3, 13.2 and 14.0 years, respectively, p = 0.0001); and non-Ashkenazi Jewish origin (median retinopathy-free interval 15.8 years in Ashkenazi vs 14.0 in non-Ashkenazi patients, p = 0.0004). Of 162 patients with non-proliferative retinopathy, progression to proliferative retinopathy occurred in 37, during 707 patient-years. The first event of proliferative retinopathy was diagnosed within the 1st year after non-proliferative retinopathy evolved, and at 6.3 years since onset of non-proliferative retinopathy 75% of the patients were still free of proliferative changes. Risk factors significantly and independently associated with an early progression to the proliferative stage were: poor glycaemic control in the last 3 years prior to the development of proliferative retinopathy and non-Ashkenazi Jewish origin. All patients in the 4th quartile of HbA1 values were affected by proliferative retinopathy within 11.6 years after onset of non-proliferative retinopathy.

Adolescent↗
PubMed1997

Rhegmatogenous retinal detachment operation after radial keratotomy.

Radial keratotomy has recently been introduced for the correction of myopia. This procedure does not hinder progression of the pathophysiological changes in the myopic eye. We hereby describe a case of rhegmatogenous retinal detachment operation after radial keratotomy and present the operative considerations and refractive results.

Cornea↗
PubMed1996

Diabetic retinopathy during pregnancy.

PURPOSE: The purpose of the study is to evaluate the incidence, prevalence, progression, and risk factors of diabetic retinopathy during pregnancy. METHODS: Sixty-five patients who were pregnant and had insulin-dependent diabetes mellitus were evaluated before pregnancy, in every trimester during the pregnancy, and 12 months postpartum. The medical data included age, diabetes duration, glycohemoglobin, fructosamine, hemoglobin, creatinine, uric acid, and systolic and diastolic blood pressure. RESULTS: Progression of the retinopathy occurred in 77.5% of the patients who presented with diabetic retinopathy at conception; proliferative diabetic retinopathy occurred in 22.5%. Only 26% of the patients who started the pregnancy without diabetic retinopathy had some progression of the retinopathy. Duration of the diabetes was longer in the progressive group compared with the nonprogressive group (P = 0.007). The glycohemoglobin was higher in the progressive group than in the nonprogressive group at each time point, but only in the third trimester was the difference statistically significant (P = 0.04). The hemoglobin level was lower in the progressive group than in the nonprogressive group (P < 0.01). The systolic blood pressure was higher in the progressive group (P < 0.005). CONCLUSION: Understanding the risk factors contributing to the aggravation of diabetic retinopathy during pregnancy is helpful in designing criteria for the team management of pregnant patients with diabetes.

Adult↗
PubMed1996

Extracapsular cataract extraction and intraocular lens implantation in eyes filled with silicone oil.

Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed in five phakic eyes filled with silicone oil following vitreoretinal surgery. Silicone oil migration was prevented during surgery using an anterior chamber maintaining system and a self-sealed corneoscleral tunnel incision. The posterior capsule opacified within 3 months in all patients, and neodymium:YAG capsulotomy or surgical discission was performed in a diamond-shaped pattern. No silicone-related complications were found, including silicone oil migration into the anterior chamber. There were no difficulties visualizing the peripheral retina during funduscopy.

Cataract↗
PubMed1995

Intraocular intrusion of sutures after retinal detachment buckling surgery.

BACKGROUND: Intraocular intrusion of tight encircling silicone band is a major complication of retinal detachment surgery leading to subretinal and vitreous hemorrhage, retinal detachment, and phthisis bulbi. Intrusion of the sutures into the eye has only been reported as an adjunct to buckle intrusion. METHODS: Seven patients (9 eyes) are presented in whom intrusion of sutures occurred as a late complication of retinal detachment surgery using the extrascleral buckling technique. Their complications and treatments are discussed. RESULTS: Eleven anchoring sutures were observed under the retina and two sutures penetrated into vitreous cavity. In five eyes (55.5%), small subretinal or vitreous hemorrhages were noted and in one of them perforation with total detachment occurred. In four eyes, no complications were detected. In four eyes, the silicone band was cut and left in place and the hemorrhages were spontaneously absorbed. The perforated eye underwent replacement of the silicone band with a wide silicone sponge, followed by vitrectomy and silicone oil injection. CONCLUSIONS: Intrusion of sutures into the eye can rarely be seen years after retinal detachment surgery and usually do not require surgical intervention. When hemorrhage occurs, cutting of the silicone band only, with no attempt to remove the band or the sutures, is recommended.

Foreign-Body Migration↗
PubMed1993

Choroidal metastasis of cutaneous malignant melanoma treated by ruthenium-106 plaque irradiation.

Symptomatic dissemination of cutaneous malignant melanoma to the choroid occurs rarely and is a grave prognostic factor. Therefore, choroidal tumors are treated only as a palliative measure. We present a case of cutaneous malignant melanoma with symptomatic metastasis in the choroid OD of a 38-year-old woman. We treated it using brachytherapy with a ruthenium-106 plaque. The tumor totally regressed with restoration of good vision. Twelve months of follow-up showed no systemic spread.

Adult↗
PubMed1991

Effect of partial cryoablation on retinopathy of prematurity.

Cryotherapy has been shown to be an effective treatment for retinopathy of prematurity stage 3. It is said to reduce the unfavourable outcome of the disease by 50%. The accepted method of therapy includes ablation of the whole avascular retina from the ridge to the ora serrata. This is achieved by two to three rows of cryoapplications. When 360 degrees cryo treatment is performed, it requires 52 cryo applications. We present our method of cryotherapy which involves only one row of cryoapplications in the avascular retina anterior to the fibrovascular ridge. An average of 25-30 cryoapplications was required for a 360 degrees treatment. The anatomical results in 23 babies are presented. Complete regression of active retinopathy was found in all.

Cryosurgery↗
PubMed1991

Evaluation of bilirubin as possible protective factor in the prevention of retinopathy of prematurity.

Retinopathy of prematurity (ROP) appears to be a multifactorial disease, the prevention of which is probably impossible even with the most accurate methods of blood-gas monitoring and oxygen restrictions. The oxidative processes and consequent formation of free radicals are probably influenced by the availability of various antioxidants in the immature retina. Bilirubin, the end product of haem catabolism, has recently been regarded as a potential physiological antioxidant. In order to test the suggestion as to the possible effect of bilirubin in reducing the incidence of ROP a retrospective study was undertaken of the medical records of 151 neonates born between 1984 to 1988 who weighed less than 1500 g. Of these, 78 had various degrees of ROP, whereas 73 had no ROP and served as a control group. The daily mean bilirubin values were analysed in accordance with gestational age and birth weight as well as the severity of ROP, and the results were compared with those obtained for the control group. The results showed no correlation between bilirubin levels and severity of ROP in all subgroups of gestational age and birth weight. These findings indicate that there is no apparent protective effect of bilirubin on the development of ROP.

Bilirubin↗
PubMed1990

Central venous stasis retinopathy following the use of tranexamic acid.

Central venous stasis retinopathy (CVSR) was observed in two young women following the administration of oral tranexamic acid (TA) for the treatment of menorrhagia. Clinical and laboratory parameters were normal. Withdrawal of the drug and treatment with systemic steroids and fibrinolytic drugs resulted in improvement of visual acuity to 6/6. The pathogenesis of the CVSR in these cases is suggested, and the rationale of systemic treatment is discussed.

Adult↗
PubMed1989

Radiation retinopathy treated with the krypton red laser.

We present two cases of radiation retinopathy treated with the krypton red laser (647 nm). The macular edema and exudates resolved completely after treatment, but visual acuity improved only partially due to the development of a lamellar macular hole. The rationale for laser therapy and the selection of the red wavelength are discussed.

Adult↗
PubMed1983

Argon laser treatment of senile retinoschisis.

Fifty-seven eyes of 49 patients with senile retinoschisis were treated by argon laser photocoagulation and followed up for 3 to 6 years. In most of the treated eyes the retinoschisis either completely or partially collapsed and in none did the retinoschisis or loss of visual field progress further. No long-term complications due to the treatment were noted. In none of the treated eyes did retinal detachment develop. In view of this the indications at present for argon laser treatment in retinoschisis may be extended to include any case in which the retinoschisis progresses beyond the equator and visual field loss continues. This may prevent further visual field damage and other rare complications of slowly progressive retinoschisis and facilitate the many years' follow-up of elderly patients with retinoschisis who develop cataracts.

Aged↗
PubMed1982

Treatment of neovascular senile maculopathy at the foveal capillary free zone with red krypton laser.

Sixty-eight eyes with neovascular senile maculopathy involving the capillary free zone that were assigned randomly for red krypton laser photocoagulation were followed for two years and compared to 55 eyes with the same disease that were not treated. In the majority of the studied eyes there was a decline of visual acuity during the follow-up period. However, an increase in visual acuity was encountered in one third of treated eyes, but no increase in the untreated eyes. The extent of visual acuity deterioration was greater in the nontreated than in the treated eyes. Eyes that were treated when visual acuity was between 6/9-6/60 generally belonged to a better final visual acuity group than those eyes that were treated when visual acuity was less than 6/60. The technique of red krypton laser photocoagulation is described, the rationale for this treatment is discussed, and the results of the treatment are evaluated.

Aged↗
PubMed1981

Surgical management of retinal detachment without cryopexy.

A clinical study of eyes with rhegmatogenous retinal detachment compared the reattachment rate in two groups of eyes: in the control group, cryopexy was applied over the retinal breaks during surgery; in the test group, cryopexy was not applied. There was a similar rate of retinal reattachment in the two groups in the immediate postoperative period. However, during the long follow-up period (36 months) there was a considerable difference in the two groups. Eyes that had undergone cryopexy had a lower rate of redetachment than eyes that had not. The rate of operative and postoperative complications was low in both groups, except for periretinal proliferation, which was more frequent in the test group. These results suggest that cryopexy may lower the incidence of redetachment after retinal detachment surgery.

Cryosurgery↗