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Biomedical subjects

R K Blach

Publications and source records attributed to R K Blach.

At least 19 recordsLinked to original sources

The technique and indications for photocoagulation in diabetic retinopathy. II. The treatment of diabetic retinopathy.

The beneficial effect of photocoagulation in diabetic retinopathy is now established (3-7, 10). Whereas the capability of providing photocoagulation is widespread, the indications and actual technqiues are poorly defined. In an earlier paper (1) we discussed the principles of photocoagulation. In this paper the detailed techniques required for the treatment of individual lesions and of different types of retinopathy will be discussed.

Diabetic Retinopathy

Closed vitrectomy after trauma.

The results of vitrectomy in fifty traumatized eyes were assessed, and six types of pathological change resulting from trauma identified. The anatomical and visual results were good except where surface vitreo-retinal traction was present either at the vitreous base or posteriorly.

Adolescent

Bull's eye maculopathy with early cone degeneration.

Seven patients with acquired cone degeneration were investigated. The initial visual acuities in 6 of the series were normal or near normal but later deteriorated, although they did not fall below 6/60 in any patient. All the patients tested had colour vision defects and abnormalities on electrodiagnostic testing referable to the cone system. The typical picture was of a bull's eye maculopathy accompanied by an annular scotoma around the fovea, but the clinical and electrophysiological investigations showed that there were considerable variations especially in the early stages.

Adult

Panretinal photocoagulation in central retinal vein occlusion: A randomised controlled clinical study.

A randomised controlled study of photocoagulation compared with no treatment in central retinal vein occlusion is reported. Forty-eight patients were allocated into treated and control groups by a random procedure 3 months after their first visual symptoms. For the analysis they were subdivided into (1) ischaemic type, and (2) hyperpermeability-response macular-oedema type of central retinal vein occlusion. In neither group did treatment confer benefit as far as visual acuity was concerned. However, iris, disc, and retinal neovascularisation improved after treatment in the ischaemic group. In addition none of the treated patients progressed to neovascular glaucoma. Macular-oedema improved in treated patients with the hyperpermeability response, but the visual field was affected and atrophic changes at the macular precluded visual improvement. It is concluded that photocoagulation should be used only to prevent complications in the ischaemic type of central retinal vein occlusion. It does not appear to be of value in the hyperpermeability group.

Adult

Behaviour of the iris vasculature in central retinal vein occlusion: a fluorescein angiographic study of the vascular response of the retina and the iris.

The findings in iris fluorescein angiograms of 48 eyes with central retinal vein occlusion (CRVO) were correlated with the predominant retinal vascular response. In 24 eyes with the non-ischaemic type of CRVO there were no or only minimal iris vessel changes, whereas in all 24 eyes with ischaemic type of CRVO there was iris vessel dilatation and leakage with or without neovascularisation. These findings support the hypothesis that hypoxic retina may be a cause of rubeosis iridis in CRVO.

Fluorescein Angiography

Results of closed vitrectomy.

The results of 101 closed vitrectomy operations are reported. The cases were classified on morphological grounds, and analysis showed that eyes with anterior segment or pure gel pathology responded favourably to surgery, while those with associated retinal disease had a poorer prognosis.

Eye Diseases