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Biomedical subjects

R J Olk

Publications and source records attributed to R J Olk.

At least 55 records · Page 3Linked to original sources
PubMed1988

Grid laser photocoagulation for atypical central serous chorioretinopathy.

A 30-year-old man had symptoms and signs consistent with bilateral classic central serous chorioretinopathy. Conventional single-session laser treatments to both eyes stabilized the condition for 9 years. The patient then developed atypical central serous chorioretinopathy consisting of tracts of fluid emanating from the posterior pole and bilateral inferior exudative retinal detachments. Diffuse retinal pigment epithelial disease with recurrent leakage in both maculas was treated with grid laser photocoagulation, which was effective in stabilizing the patient's condition.

Adult↗
PubMed1988

Endophthalmitis after strabismus surgery with a good visual result.

A 78-year-old woman underwent recession-resection surgery for longstanding exotropia. A scleral perforation occurred at the time of surgery and was treated with transscleral retinocryopexy. Three days after surgery the patient experienced light perception vision, pain, and hypopyon. She underwent a trans pars plana vitrectomy with intravitreal and periocular antibiotics. Three months after vitrectomy, visual acuity returned to the preoperative level of 20/50. Six months after vitrectomy she underwent an uneventful cataract extraction with posterior chamber lens implant. Visual acuity 5 months after cataract surgery was 20/20.

Aged↗
PubMed1987

Supplemental photocoagulation on the buckle for prevention of surgical revision after scleral buckling procedures.

Supplemental photocoagulation on the buckle appears to be a useful therapeutic modality in selected cases of persistent retinal detachment. In a retrospective review, 71 (63%) of 113 eyes were successfully treated with photocoagulation, thus avoiding the need for surgical revision. Median response time between treatment and postoperative subretinal fluid absorption in the successfully treated eyes was two days, with the majority responding within one day. The one favorable prognostic factor was the use of a soft silicone segmental sponge. Unfavorable prognostic factors included the following: contour of subretinal fluid (combined, ie, both anterior and posterior to the buckle); excessive amount of subretinal fluid; inadequate support of break(s); multiple drainages at first operation; rolled edge in association with a giant break; and residual vitreous traction on the break. Postoperative photocoagulation alone on the buckle did not appear to influence the rate of development of premacular fibroplasia or proliferative vitreoretinopathy.

Adolescent↗
PubMed1987

Modified vitreoretinal forceps for membrane peeling.

We have designed a modified vitreoretinal forceps specifically for peeling delicate epiretinal membranes in cases of premacular fibroplasia. Improved features of the forceps include a positive-action closure, barrel design, and lightly serrated surfaces. Rotational movements are made easier by this modified forceps design. Over the past three years, 96 cases of premacular fibroplasia have been successfully managed with the modified forceps. Delicate membranes have been removed without tearing or shredding.

Humans↗
PubMed1987

Krypton red laser photocoagulation for branch retinal vein occlusion.

Krypton red (647 nm) laser photocoagulation may offer distinct advantages in the treatment of branch retinal vein occlusion (BRVO), particularly in eyes with extensive intraretinal hemorrhage or in the presence of media opacities such as vitreous hemorrhage or cataract. Twenty-three eyes were followed for a minimum of 6 months (range, 6-38). Of 19 eyes treated for macular edema, 17 (89%) had complete resolution of their edema, one (5%) had reduction of its edema, and one (5%) was unchanged. Of five eyes treated for retinal neovascularization of the disc or retina, all eyes had complete elimination of neovascularization. The authors were unable to demonstrate any statistical correlation between final visual acuity and the following factors: duration of symptoms, cystoid macular edema (CME), degree of paramacular nonperfusion, and contiguous intraretinal hemorrhage extending into the foveal avascular zone (FAZ).

Edema↗
PubMed1987

Transconjunctival anterior retinal cryotherapy for proliferative diabetic retinopathy.

Transconjunctival anterior retinal cryotherapy (ARC) for proliferative diabetic retinopathy (PDR) in 408 eyes was reviewed retrospectively. Of 266 eyes available for analysis for treatment effect on neovascularization, 138 (52%) had reduced neovascularization at 6 months. Eighty (30%) had no change in neovascularization, and 48 (18%) had increased neovascularization at 6 months. Factors having a significant effect on reduction of neovascularization were duration of diabetes and severity of retinopathy. Of 238 eyes available for analysis for treatment effect on vitreous hemorrhage at 6 months, 118 (50%) had reduced vitreous hemorrhage, 80 (33%) had no change, and 40 (17%) had increased vitreous hemorrhage. Severity of vitreous hemorrhage significantly affected the outcome in the subgroup of eyes with both neovascularization and vitreous hemorrhage. Of the total 408 eyes in this series, at 6 months, 172 (44%) had improved visual acuity, 89 (23%) had no change, and 126 (33%) had decreased visual acuity. Retinal detachments developed in 17 eyes (4%) post-treatment, 68 eyes (17%) had significant recurrent vitreous hemorrhage, and 61 eyes (15%) eventually underwent vitrectomy.

Conjunctiva↗
PubMed1987

Macular disease resembling adult foveomacular vitelliform dystrophy in older adults.

Fifty-three eyes of 31 patients over age 50 with macular disease were reviewed. Clinical appearance of the macula was of two types: a yellow slightly elevated lesion (29 eyes) and a pigmented flat lesion with surrounding atrophy (24 eyes). Drusen were found in 60% of affected eyes. No familial tendencies were documented. A reduced electro-oculogram (EOG) was present in approximately 50% of all eyes tested. Fluorescein angiographic findings and differential diagnosis are described. Visual prognosis was markedly different for the two groups: 69% of eyes with yellow elevated lesions lost two or more lines of visual acuity and 48% went on to visual acuity equal to or less than 20/200, whereas 33% of eyes with pigmented flat lesions lost two or more lines of visual acuity and 8% went on to visual acuity equal to or less than 20/200.

Aged↗
PubMed1987

New retinal detachment after pneumatic retinopexy.

Thirteen cases of rhegmatogenous retinal detachment repaired by pneumatic retinopexy were reviewed retrospectively. All patients were followed for a minimum of 6 months after surgery. At the end of follow-up, retinal detachment repair by pneumatic retinopexy succeeded in nine cases (70%) and failed in four (30%). Within 2 days of pneumatic retinopexy, vitreous condensation and traction with new retinal tears and associated detachments in previously uninvolved quadrants developed in two patients. The occurrence of new retinal detachments in the early postoperative period after pneumatic retinopexy has not been previously observed.

Aged↗
PubMed1987

Neovascular glaucoma: a retrospective analysis of treatment with peripheral panretinal cryotherapy.

A retrospective analysis of thirty-one eyes in thirty patients with neovascular glaucoma (NVG) associated with proliferative diabetic retinopathy or venous occlusive disease was performed. Eyes treated with transconjunctival peripheral panretinal cryotherapy alone, or in combination with limited cyclocryotherapy had improvement or stabilization of visual acuity in 55%, reduction of intraocular pressure in 55%, and stabilization or regression of iris neovascularization in 70% of eyes at 12-14 months post-treatment. Transconjunctival peripheral panretinal cryotherapy alone, or in combination with limited cyclocryotherapy is recommended in the treatment of eyes with NVG and media opacities precluding photocoagulation therapy, or in eyes unresponsive to previous photocoagulation therapy.

Aged↗
PubMed1987

The management of endophthalmitis: diagnostic and therapeutic guidelines including the use of vitrectomy.

The use of vitrectomy in the management of endophthalmitis is controversial. All cases of suspected clinical endophthalmitis should have immediate anterior chamber and vitreous aspiration combined with an intravitreal antibiotic/steroid injection. Vigorous systemic, topical and periocular therapy should accompany frequent examinations of the patient. Vitrectomy is recommended in selected clinical situations. An intraocular lens usually can be left in place and should be removed only in certain rare instances.

Endophthalmitis↗
PubMed1987

Factors related to spontaneous visual recovery in the ocular histoplasmosis syndrome.

In an effort to better describe the phenomenon of spontaneous visual recovery in the ocular histoplasmosis syndrome (OHS), 700 patient records were reviewed. Spontaneous visual recovery was defined as a two or more line improvement in Snellen acuity after a minimum of 12 months of stable visual reduction to 20/70 or less, secondary to central disciform scarring. Ten cases of spontaneous visual recovery were found. Eight patients had recovery of vision only when visual acuity was reduced to 20/80 or less in the fellow eye. One patient experienced spontaneous recovery without visual loss in the fellow eye. Another patient experienced spontaneous visual recovery 57 months after xenon photocoagulation in the study eye. This group of patients was compared to 14 similar patients who did not experience spontaneous recovery when visual acuity was reduced to less than 20/80 in the fellow eye. Compared to the nonrecovery group, patients experiencing spontaneous visual recovery in OHS were younger at the time of visual loss in the fellow eye (30 years vs. 48 years, p less than 0.01); had a shorter interval of visual loss prior to visual loss in the fellow eye (44 months vs. 150 months, p less than 0.10); had smaller diameter scars (1,711 microns vs. 3,078 microns, p less than 0.05); and had shorter distances from the foveal center to adjacent normal retina (267 microns vs. 846 microns, p less than 0.01).

Cicatrix↗
PubMed1986

The Lincoff temporary balloon buckle.

The Lincoff temporary balloon buckle is an equally effective alternative to more conventional techniques in the management of selected retinal detachments. We used this technique in the management of 45 selected primary retinal detachments operated on since Nov. 22, 1980. Initial complete retinal flattening was achieved in 42 eyes (93%). Two of the three eyes that initially did not show complete flattening ultimately went on to do well without further surgery. Redetachment occurred in three of the five aphakic eyes (60%) and in four of the 36 phakic eyes (11%). None of the retinas in the four eyes with intraocular lenses redetached. Conventional scleral buckling techniques were used in the one case of initial failure and in the seven cases of redetachment for a final success rate of 98% after an average follow-up of 13 months.

Adult↗
PubMed1986

Factors associated with a poor visual result in endophthalmitis.

In a retrospective study of 82 cases of endophthalmitis treated between 1976 and 1982 at Barnes Hospital-Washington University, St. Louis, Missouri, 51 (62%) cases were culture-proven. Forty-nine (60%) were associated with cataract extraction, 16 cases (20%) were associated with trauma, and 17 cases (20%) were associated with other events. Sixty-four patients (78%) had undergone neither anterior chamber nor vitreous paracentesis before referral. Seventeen of the 51 culture-proven cases were initially thought to be sterile inflammatory responses and not infectious by the referring ophthalmologist. A poor visual result (visual acuity of less than 20/400) was associated with positive cultures, accidental trauma, virulent organisms, poor initial visual acuity, or a combination of these.

Anterior Chamber↗
PubMed1986

Pseudophakic retinal detachments in the presence of various IOL types.

A series of 600 pseudophakic retinal detachments in 578 patients undergoing surgical repair between 1974 and 1984 was reviewed. Patients with previous retinal surgery of less than six months follow-up were excluded. The series included 395 iris-fixated (IF) lenses, 130 anterior chamber (AC) lenses, and 75 posterior chamber (PC) lenses. The overall success rate for retinal detachment was 88% but was significantly better in the PC lens group and significantly worse in the AC lens group. Forty-one percent of all cases achieved 20/40 visual acuity or better, although the AC lens group did worse (28%), while the PC lens group did significantly better (48%). Risk factors that were predictive of failure also were identified. Many of these factors occurred more frequently in the AC lens group and probably are related to the overall worse outcome in eyes with AC lens implants. The implications of these results for retinal and cataract surgeons are discussed.

Humans↗