Search PubMedSearch

Biomedical subjects

R L Radius

Publications and source records attributed to R L Radius.

At least 19 recordsLinked to original sources

Ab interno sclerostomy with a high-powered argon endolaser. Clinicopathologic correlation.

A high-powered argon blue-green laser coupled to a 300-microns quartz fiberoptic probe was used to create an ab interno sclerostomy in a patient undergoing enucleation for a blind painful eye. Despite the presence of diffuse rubeosis, 360 degrees peripheral anterior synechiae, and superior conjunctival scarring, it was possible to create a full-thickness defect from the anterior chamber angle to the subconjunctival space without operative complications. Six laser applications were required using 8 W of power per pulse and 0.1-second pulse duration. The eye was enucleated immediately after the laser procedure, prepared for light microscopy, and sectioned serially. Histologic analysis demonstrated a patent fistula approximately 300 microns in diameter with sharp wound margins. Tissue damage was localized to within 150 microns of the sclerostomy. The overlying conjunctiva was intact.

Adult

Ab interno sclerostomy with a high-powered argon endolaser.

We used a high-energy argon blue-green laser (15-W maximum power output) to create full-thickness sclerostomies from the region of the anterior chamber angle to the subconjunctival space in pigmented rabbits using an ab interno approach. One to four laser pulses delivered through a 300-micron noncontact fiberoptic probe produced patent sclerostomies in all 20 eyes treated using 0.1-second pulse duration and 5 to 14 W of power. No intraoperative complications were encountered. Intraocular pressure, measured in 12 animals, decreased an average of 12 mm Hg in the treated eye relative to the fellow eye on the first postoperative day. The drop in intraocular pressure was associated with formation of a functioning filtration bleb. Intraocular pressure returned to preoperative levels in ten of 12 (83%) of the animals by the fourth postoperative day, and there was an associated flattening of the filtration bleb. Histologic and radioautographic analysis indicated that the effect of the laser was focal. Tissue damage and cellular proliferative response were limited to within approximately 200 micron of the wound margin.

Animals

A comparison of betaxolol and timolol in open angle glaucoma and ocular hypertension.

In a randomized, double-masked study, 41 patients with primary open-angle glaucoma or ocular hypertension were treated with betaxolol 0.5% or timolol 0.5% drops for 26 weeks. The average decrease in intraocular pressure (IOP) over the total study period was significant with both betaxolol (-6.3 mmHg) and timolol (-7.2 mmHg) in patients receiving no adjunctive therapy. There was no difference between betaxolol and timolol with respect to changes from baseline IOP. Significantly decreased mean brachial arterial pressure (MAP) was seen only with timolol, although the difference between the two groups was not significant. Pulse, pupil size, and basal tear secretion were unchanged in both groups. Burning upon instillation of the drops was more frequent with betaxolol.

Adrenergic beta-Antagonists

Visual-field function in pseudophakia.

An automated perimeter (Octopus 2000) was used to examine visual-field function in 52 pseudophakic eyes. Threshold sensitivity was reduced throughout the visual field by from 0.4 to 20.0 decibels from that of threshold sensitivity in age-matched normal eyes. This reduction was comparable to that seen in contact-lens-corrected aphakic eyes.

Aged

Background illumination and automated perimetry.

Visual field function in the right and left eyes of 31 normal volunteers was evaluated with an automated projection perimeter (OCTOPUS). Serial visual field evaluations were repeated in these same eyes with neutral filters of increasing optical density. We compared the results of threshold determinations with the different neutral filters in place before the examined eye. Significant reduction in threshold sensitivity at several test spots throughout the central 30 degrees visual field was seen with neutral density filters of 0.5 log units or greater. The low level of background illumination of the OCTOPUS perimeter (4.0 apostilbs) may allow relatively minor reduction in light transmission by the ocular media to produce significant changes in the recorded level of threshold sensitivity during visual field evaluation.

Adult

Axon morphology at the lamina cribrosa in monkey eyes.

The eyes of 8 monkeys (Aotus trivirgatus) were studied. The mean cross-section area and the least diameter of axon cylinders were calculated from measurements made by computer assisted planimetry of electron photomicrographs of sections through the optic nerve head at the level of the lamina cribrosa. The density of intrabundle connective tissue and glial cell elements in nerve fiber bundles was also calculated. The mean cross-section area and minimum diameter of axons in the temporal part were less than in the nasal part of the nerve. The values for axons in the superior and inferior parts of the nerve were intermediate. A similar pattern of increasing dimensions was seen in axons from the more axial nerve compared to neurons in the more circumferential nerve sectors. The density of the intrabundle, nonaxonal tissue elements did not differ significantly across the nerve. Although axon dimensions may play some role in defining the vulnerability of neuronal tissue to a pressure insult, the results of this anatomic investigation do not support the hypothesis that differences in axonal distribution by size across the nerve section define the regional vulnerability of the nerve head to elevated intraocular pressure.

Animals

The mechanism of disc pallor in experimental optic atrophy. A fluorescein angiographic study.

Ascending optic atrophy was produced in 13 eyes of owl monkeys (Aotestrivirgatus) by retinal photocoagulation. Color fundus photography and fluorescein angiography were used to study and document the evolution of nerve head abnormalities. The optic nerve heads were also studied histopathologically. Except in certain instances of early transient (relative) filling defects, normal disc fluorescent patterns were preserved, despite clinically apparent optic nerve head pallor. Sectorial defects did not persist into the later phases of the angiogram. These findings may suggest a reduced blood flow, but neither angiographic nor histopathologic studies detected a reduced vascularity in the atrophic optic nerve. Pallor of the optic nerve head seems to result from alterations in the tissue reflectance and translucency following axonal loss and glial reorganization rather than from a decreased microvascular bed.

Animals

The histology of retinal nerve fiber layer bundles and bundle defects.

The fiber bundle striations recognized clinically in normal monkey eyes appear to be bundles of axons compartmentalized within glial tunnels formed by Müller's-cell processes, when viewed histologically. The dark boundaries that separate individual bundles are the broadened foot endings of these cells near the inner surface of the retina. Within one week after focal retinal photocoagulation, characteristic fundus changes could be seen in experimental eyes. In histologic sections of the involved retina, there was marked cystic degeneration of the retinal nerve fiber layer. Within one month, atrophy of distal axon segments was complete. With the drop-out of damaged axons and thinning of individual fiber bundles, retinal striations became less prominent. The resulting fundus picture in these experimental eyes is similar to fiber bundle defects that can be seen clinically in various neuro-ophthalmic disorders.

Animals

The course of axons through the retina and optic nerve head.

By identifying degenerating axons in tissue specimens from 22 primate eyes, it was possible to demonstrate the normal course of axon fibers. Nerve fiber bundles from a group of retinal ganglion cells travel together with little tendency to disperse laterally. In addition, axons are stratified such that processes from more central ganglion cells are successfully added to the inner strata of the retinal nerve fiber layer. Within and behind the lamina cribrosa, areas of degeneration following retinal photocoagulation were well circumscribed and confined to a group of adjacent axon bundles. This degree of retinotopic organization of axons within the nerve head and retinal fiber layer is believed to be consistent with the premise that isolated lesions within the lamina cribrosa could cause well-organized paracentral scotomas such as those characteristic of early glaucoma.

Animals

Timolol. A new drug for management of chronic simple glaucoma.

Timolol maleate, a potent beta-adrenergic antagonist, reduces intraocular pressure in rabbits. With topical application in one eye, a significant reduction in pressure is seen in the contralateral, untreated eye also. When used in conjunction with timolol, other adrenergic amines, such as norepinephrine and epinephrine, produce an additional hypotensive response. On the other hand, pretreatment with timolol does inhibit the ocular hypotensive response to topically applied albuterol. No further reduction in pressure is seen after application of this beta-adrenergic agonist to eyes pretreated with timolol. In a double-blind study with patients who had previously been receiving various medications for control of elevated intraocular pressures, timolol was as effective as pilocarpine in reducing intraocular tension. Many common complaints associated with pilocarpine therapy, including miosis, ocular irritation, and blurred vision, were not encountered with timolol therapy.

Adult

Dilated episcleral vessels and open-angle glaucoma.

We studied four patients with idiopathic dilated episcleral vessels. Three of these patients had asymmetric or unilateral open-angle glaucoma in the eye with the greater degree of episcleral vascular anomaly. The fourth patient showed dilated episcleral vessels, but the intraocular pressure (IOP) was not increased. In the three patients with increased IOP, the facility of outflow was decreased. The episcleral venous pressure was not measured, but in one eye Schlemm's canal was engorged with blood despite an IOP of 35 mm Hg. We explored the possibility of a congenital vascular anomaly in the four cases.

Adolescent

Retinal ganglion cell degeneration in experimental optic atrophy.

By ophthalmoscopic and histopathologic examinations at various intervals after retinal injury, we studied progressive ganglion cell atrophy following retinal photocoagulation in 25 owl monkey eyes. A reduced ganglion cell population was apparent within three to four weeks after the photocoagulation and was maximal by six weeks.

Animals

Optic atrophy and glaucomatous cupping.

We reviewed 170 eyes of 112 patients with optic atrophy from various causes. Special attention was directed towards measured cup:disk ratios as well as presence of glaucomatous-like cupping of the optic nerve head. We observed a small but significant increase in nerve head cupping in eyes with optic atrophy when compared to contralateral eyes, as well as to eyes of 50 diabetic patients. No characteristic glaucomatous disk changes were documented. We evaluated these findings with respect to possible causes of glaucomatous disk and field changes.

Adolescent

Pit-like changes of the optic nerve head in open-angle glaucoma.

Six patients with open-angle glaucoma and acquired pit-like changes in the optic nerve head are presented. In 1 patient evolution of the pit-like defect is documented. In all 6 patients progression of associated visual field deficits is described. It is suggested that such pit-like changes in selected patients with glaucoma may not represent congenital lesions but rather local, progressive nerve head disease, occurring particularly in response to raised intraocular pressure. The management of patients with optic nerve head pitting and the pathogenesis of glaucomatous optic neuropathy are discussed with respect to this observation.

Adult

Central retinal artery occlusion (reversible in sickle trait with glaucoma.

We report a case of central retinal artery occlusion in an 18-year-old black woman with sickle-trait haemoglobinopathy and acute glaucoma after hyphaema. The central retinal artery occlusion occurred immediately after treatment of the glaucoma with osmotic agents, raising the possibility that they played a precipitating role. We suggest that osmotic agents be used with extreme caution in sickle patients with glaucoma. The occlusion was treated by anterior chamber paracentesis with eventual return of good vision. The reversibility of retinal and optic nerve function after total ischaemia is discussed.

Adolescent

Anatomy of the optic nerve head and glaucomatous optic neuropathy.

The mechanism of axon damage in eyes with glaucomatous optic neuropathy remains undefined. Interestingly, it has been observed that, although the entire nerve cross-section may be involved by the nerve damage, in many instances, the superior and inferior axon bundles are preferentially affected by the pressure insult. Thus, recent studies by many investigators have stressed a re-examination of the optic nerve head anatomy, including the nerve head microcirculation, the glial and connective tissue elements within the nerve head, and the morphology of the axons themselves. Any correlation between regional differences in this anatomy and the preferential involvement by specific axon bundles within the nerve head by the pressure insult may suggest some further insight into the mechanisms underlying the pressure-induced axon loss in glaucomatous eyes.

Axons