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Biomedical subjects

S F Freedman

Publications and source records attributed to S F Freedman.

18 recordsLinked to original sources
PubMed1998

Use of latanoprost in the treatment of glaucoma associated with Sturge-Weber syndrome.

PURPOSE: To determine if latanoprost reduces intraocular pressure in eyes with glaucoma associated with Sturge-Weber syndrome. METHODS: We conducted a prospective study in which eyes with uncontrolled intraocular pressure associated with Sturge-Weber syndrome were treated with latanoprost 0.005% once daily. All eyes were already receiving at least two other antiglaucoma medications. Intraocular pressure was measured at baseline and after treatment for at least 1 month. All intraocular pressure measurements were taken within 24 hours of drug instillation. RESULTS: Six eyes of six patients received latanoprost. Two (28%) of the six eyes demonstrated an intraocular pressure decrease that averaged 8.8 mm Hg. These two responders had juvenile onset glaucoma, whereas the four nonresponders had congenital onset glaucoma. CONCLUSIONS: Latanoprost may significantly reduce intraocular pressure in selected patients with glaucoma associated with Sturge-Weber syndrome.

Adolescent↗
PubMed1998

Refractive changes after pediatric intraocular lens implantation.

PURPOSE: To report refractive changes after cataract surgery and intraocular lens implantation in infants and children. METHODS: In an ongoing prospective study, the refractive errors of all patients younger than 18 years undergoing intraocular lens implantation were determined at 6 weeks, 3 months, 6 months, and 1 year, and at least yearly thereafter. All patients with greater than 6 months of follow-up were included in the study. RESULTS: Eighty-three eyes of 81 patients were identified. Cataracts were traumatic in 32 eyes (38%) and developmental in 42 eyes (50%). At implantation, the mean (+/-SD) age was 6.3 +/- 4.6 years (range, 9 months to 17 years). The mean follow-up was 26.6 months (range, 6 months to 6.6 years). Patients 0 to 2 years old at the time of implantation demonstrated a mean myopic shift of -3.00 diopters during a mean follow-up period of 2.5 years. Patients 2 to 6 years old at the time of implantation demonstrated a mean myopic shift of -1.50 diopters in a similar follow-up period. Children aged 6 to 8 years experienced a mean myopic shift of -1.80 diopters during a mean follow-up period of 3.0 years, while children older than 8 years at the time of intraocular lens implantation experienced a mean myopic shift of -0.38 diopters during a mean follow-up period of 1.8 years. On average, the operated-on eye showed a greater mean myopic shift than the fellow eye. No statistically significant differences in refractive change were found in comparing amblyopic to nonamblyopic eyes, traumatic to nontraumatic cataracts, or primary to secondary intraocular lenses. CONCLUSIONS: Our data demonstrate a trend toward increasing postoperative myopia in pediatric patients undergoing intraocular lens implantation. This myopic shift is greatest in the younger age groups and persists until at least 8 years of age. There is much variability in the postoperative refractive changes, and predicting exactly when and where the refraction will stabilize for an individual patient is difficult.

Adolescent↗
PubMed1998

Long-term outcome of cyclocryotherapy for refractory pediatric glaucoma.

OBJECTIVE: To evaluate the success rate and long-term outcome of cyclocryotherapy for refractory pediatric glaucoma. DESIGN: Retrospective interventional case series. PARTICIPANTS: A total of 64 eyes of 49 patients from 2 institutions with pediatric glaucomas resistant to conventional medical and surgical therapies treated with cyclocryotherapy from 1975 to 1996 were included in this review. INTERVENTION: Cyclocryotherapy was performed on eyes with pediatric glaucoma resistant to maximal medical and surgical interventions. Each cyclocryotherapy session was evaluated in terms of area treated, temperature, and number of applications placed. MAIN OUTCOME MEASURES: Criteria for success included intraocular pressure (IOP) of 21 mmHg or less without devastating complications or need for further glaucoma surgery. RESULTS: The mean baseline pretreatment IOP of all eyes was 30.0 +/- 8.1 mmHg. Six months after their last treatment, 42 eyes (66%) were successes. Longer term follow-up (mean, 4.8 +/- 3.3 years) yielded a lower final success rate in 28 eyes (44%). For these 28 eyes, mean IOP was reduced from 30.3 +/- 7.8 mmHg pretreatment to 16.8 +/- 4.0 mmHg after their last cyclocryotherapy treatment session (P < 0.001). The average number of cyclocryotherapy sessions for successful eyes was 4.1 +/- 4.0 (range, 1-17). The mean follow-up time for these successful eyes was 4.9 +/- 3.4 years. Devastating complications attributable to cyclocryotherapy included phthisis (5 eyes) and retinal detachment (5 eyes). Devastating complications occurred more frequently among eyes with aniridia than among all other eyes (nonaniridics) (50% vs. 11%, respectively; P < 0.05). CONCLUSION: Cyclocryotherapy is an effective means of lowering IOP and is a reasonable treatment option in selected pediatric patients with refractory glaucoma. Eyes with aniridia experienced a very high rate of phthisis after cyclocryotherapy and may be poor candidates for this treatment.

Adolescent↗
PubMed1995

Clinical course and systemic correlates of retinopathy of prematurity in quintuplets.

PURPOSE/METHODS: We studied clinical correlates of retinopathy of prematurity in four surviving quintuplets with similar low birth weights and gestational age of 27 weeks. Prospective serial ophthalmoscopic examinations and retrospective chart analysis were used. RESULTS/CONCLUSIONS: Retinopathy of prematurity varied among the neonates from stage 2 with total regression to threshold progressing to retinal detachment. Severity of eye disease correlated with duration of mechanical ventilation and of parenteral nutrition, as well as frequency of hypoglycemia and of hypercapnia. Poor outcome correlated inversely with weight gain.

Adult↗
PubMed1995

A numeric index based on spatial frequency for the tortuosity of retinal vessels and its application to plus disease in retinopathy of prematurity.

BACKGROUND: In retinopathy of prematurity (ROP), tortuosity of vessels near the posterior pole of the fundus is an important clinical sign, yet clinicians have difficulty estimating how tortuous the vessels are. METHODS: The authors have devised an objective, numeric index of retinal blood vessel tortuosity that is especially sensitive to the structural changes in vessels that occur in ROP, but it is not particularly sensitive to non-ROP changes. Computer software is used to calculate the index from fundus images; the quality of these images is typical of photographs or video-cassette frames that the authors record in the premature nursery. RESULTS: The index reliably segregates tortuous vessels from nontortuous ones and separates eyes that reach ROP treatment threshold from eyes that do not. CONCLUSIONS: The index forms an objective measure of the ROP disease state. Its calculation requires only segments of vessels and thus, is potentially adaptable to imaging systems that automatically extract vessel portions from fundus images.

Fundus Oculi↗
PubMed1994

Growth inhibition of human Tenon's capsule fibroblasts and rabbit dermal fibroblasts with non-carcinogenic N-alkylated anthracyclines.

Bleb fibrosis after glaucoma filtering surgery and proliferative vitreoretinopathy after retinal detachment surgery are complications caused by proliferation of fibroblasts or fibroblastlike cells. The anthracycline daunomycin (DNM) has been used for treatment of those proliferative processes in humans. However, complications such as conjunctival necrosis and corneal or scleral ulcerations have been reported after administration of DNM to glaucoma patients. Intravitreal administration of DNM in rabbit eyes resulted in morphological and functional retinal damage. DNM also has the undesired general effect of carcinogenicity. N-Alkylation of the aminosugar moiety of DNM results in reduction or loss of carcinogenicity. We evaluated the inhibitory effect of the new non-carcinogenic N-alkylated analogues aclacinomycin A (ACA), N,N-dimethyladriamycin (AD280), and N-trifluoroacetyladriamycin-14-O-hemiadipate (AD143) on the growth of cultured human Tenon's capsule fibroblasts and rabbit dermal fibroblasts. Using DNM as a positive control, we conducted proliferation assays that demonstrated that ACA and AD280 inhibited fibroblast growth as effectively as DNM. AD143 was less efficacious. The magnitude of cellular growth inhibition was concentration dependent for all drugs tested. Extension of exposure times resulted in increased rates of cell death. Our in vitro studies suggest that further evaluation of ACA and AD280 should be carried out in animal models of ocular proliferative disorders.

Animals↗
PubMed1993

Effects of ocular carteolol and timolol on plasma high-density lipoprotein cholesterol level.

Fifty-eight healthy, normolipidemic adult men participated in a prospective, masked, randomized crossover study designed to compare the effects of two topical nonselective beta-adrenergic antagonists, carteolol and timolol, on plasma high-density lipoprotein cholesterol levels. Two eight-week treatment periods were separated by an eight-week drug-free period. Carteolol 1.0% or timolol 0.5% was used, one drop twice daily, in both eyes without nasolacrimal occlusion. Fresh plasma was assayed for levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and apolipoproteins A-I and B-100. With indistinguishable effects on intraocular pressure, carteolol and timolol induced different (P = .013) decrements in high-density lipoprotein cholesterol levels. Carteolol treatment decreased high-density lipoprotein cholesterol levels by 3.3% (-0.04 mmol/l) and raised the ratio of total to high-density lipoprotein cholesterol levels by 4.0% (0.15 unit); timolol treatment decreased high-density lipoprotein cholesterol levels by 8.0% (-0.10 mmol/l) and raised the ratio of total to high-density lipoprotein cholesterol levels by 10.0% (0.37 unit). There was no differential drug effect on the other lipid variables measured. Ocular nonselective beta-adrenergic antagonist therapy can produce clinically relevant decrements in high-density lipoprotein cholesterol levels in healthy men.

Administration, Topical↗
PubMed1992

Pentoxifylline modulates deformability, F-actin content, and superoxide anion production of polymorphonuclear leukocytes from diabetic cats.

Capillary occlusion is an early event in the development of diabetic retinopathy, and white blood cells have recently been shown to be involved. We have shown previously that pentoxifylline improves deformability and decreases F-actin content of unstimulated polymorphonuclear leukocytes from normal human subjects. The purpose of this study was to determine if pentoxifylline would improve three properties of unstimulated polymorphonuclear leukocytes from diabetic cats. The measured parameters were mechanical (whole cell deformability), structural (F-actin content) and biochemical (rate of superoxide anion production). Chronic hyperglycemia was induced in three cats by partial pancreatectomy, and they were kept in poor glycemic control for at least 6 months prior to the study. Polymorphonuclear leukocytes were isolated and the entry time of individual passive cells was measured during aspiration into a 4-micron micropipette under constant suction pressure (-15 cmH2O). Deformability was defined as the inverse of the entry time. F-actin content of passive cells was measured by NBD-phallacidin labeling followed by flow cytometry. The rate of superoxide anion production was measured spectrophotometrically by superoxide dismutase-inhibitable cytochrome c reduction. Following incubation for 15 min with 0.1, 1.0 and 10.0 mM pentoxifylline, the average entry time of passive polymorphonuclear leukocytes was reduced from control by 11 +/- 5% (P = 0.045), 17 +/- 6% (P = 0.007), and 36 +/- 5% (P < 0.001), respectively. The F-actin content decreased by 0%, 4 +/- 0.6% (P < 0.001), and 10 +/- 3% (P < 0.001), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Actins↗
PubMed1992

Enhanced superoxide radical production by stimulated polymorphonuclear leukocytes in a cat model of diabetes.

This study examines the possibility that polymorphonuclear leukocyte activation, which can cause endothelial injury, may contribute to the capillary closure of diabetic retinopathy. To examine diabetes-related alterations in polymorphonuclear leukocyte activation, we compared the production of superoxide radical by these cells from normal and from diabetic cats that were maintained hyperglycemic. Polymorphonuclear leukocytes isolated from five diabetic and five normal cats were stimulated with 10 ng ml-1 phorbol myristate acetate, and the maximum rate of their superoxide radical production was measured spectrophotometrically. Stimulated polymorphonuclear leukocytes from diabetic cats generated more superoxide radical, at significantly higher rates, than did those from normals (3.32 +/- 0.33 and 2.50 +/- 0.41 nmol O2- min-1 10(-6) cells, respectively; P < 0.02). While addition of insulin or glucagon did not alter stimulated polymorphonuclear leukocyte radical production, glucose in high concentration did mildly impair its production in both groups. The exaggerated respiratory burst of polymorphonuclear leukocytes in diabetes could contribute to microvascular injury in the retina as well as in other tissues.

Animals↗
PubMed1992

Neurotologic manifestations of von Hippel Lindau disease.

Von Hippel Lindau disease is a hereditary phakomatosis characterized by congenital angiomatosis of the retina and cerebellum. This autosomal dominant syndrome exhibits variable penetrance and expressivity. Because of the marked clinical variability and sporadic age of onset, members of affected families must be counseled and screening protocols established. It has been recommended that initial screening include appropriate laboratory work, ophthalmologic and neurologic examination, radiologic evaluation of the CNS, and when appropriate, abdominal ultrasound. Follow-up examination should be annually with acute evaluations as focal signs and symptoms develop. With the help of technological advances and screening of family members, patients with vHL disease can live long, productive lives with reduced morbidity.

Adult↗
PubMed1992

Relapsing polychondritis.

Relapsing polychondritis is a rare disease of unknown etiology. It is characterized by progressive episodic recurring inflammation and degeneration of cartilaginous structures. The inflammation typically involves the cartilage of the ear, nose, trachea, and various peripheral joints. Treatment options most commonly involve the use of anti-inflammatory drugs and corticosteroids.

Biopsy↗
PubMed1990

Reinke's edema.

Reinke's edema is a benign disorder of the larynx. This pathological condition involving a potential laryngeal space is most often seen in middle-aged smokers, and has a slight female predilection. The diagnosis, histopathology, and conservative as well as surgical treatment modalities are discussed.

Adult↗
PubMed1989

Caustic ingestion.

Caustic ingestion is a serious medical problem affecting anywhere from 5,000 to 15,000 persons per year. The factors influencing the type and seriousness of the burn are numerous. Correct diagnosis using endoscopic technique is imperative in choosing the proper treatment whether it be medical or surgical. Stricture is the most common complication with rates from 2% to 4%.

Burns, Chemical↗
PubMed1988

Intraocular neurilemmoma arising from the posterior ciliary nerve in neurofibromatosis. Pathologic findings.

A classic neurilemmoma was found in the eye of a 31-year-old man with known neurofibromatosis. The pathologic features of this rare intraocular tumor were examined histologically, immunohistochemically, and ultrastructurally. Contiguity of the neurilemmoma with its nerve of origin, the long posterior ciliary nerve, was clearly demonstrated. Expansion of the nerve by proliferating Schwann's cells was present.

Adult↗
PubMed1985

Superoxide dismutase and catalase of calf trabecular meshwork.

Superoxide dismutase and catalase activities have been measured in cell-free extracts of calf trabecular meshwork, and for comparison, in calf iris, retina, lens, liver, and erythrocytes. Gel electrophoresis has been used to identify isozymes of each enzyme. The superoxide dismutase and catalase activities per milligram wet weight of calf trabecular meshwork, 0.184 and 0.884 U/mg wet wt, respectively, were comparable to those found in iris and retina, and much higher than those found in lens. Three isozymes of superoxide dismutase were identified in trabecular meshwork. Two of these presumably correspond to cytoplasmic superoxide dismutase, while the third corresponds to a mitochondrial isozyme. A presumably mitochondrial superoxide dismutase activity was also observed in iris and retina, but not in lens. A single catalase isozyme was found in all tissues examined. At physiologic H2O2 concentrations, catalase may have similar levels of activity to glutathione peroxidase. Superoxide dismutase, catalase, and glutathione peroxidase may constitute an important defense mechanism of trabecular meshwork against the toxic O2-. and H2O2 to which it must be continuously exposed from endogenous production as well as from the aqueous humor.

Animals↗
PubMedDate not supplied

Observer sensitivity to retinal vessel diameter and tortuosity in retinopathy of prematurity: a model system.

BACKGROUND: Abnormally increased diameter and tortuosity of retinal blood vessels in the posterior pole, or "plus disease," is recognized as a powerful predictor of poor outcome in eyes with retinopathy of prematurity (ROP). Although the diagnosis of plus disease depends upon the examiner's ability to examine retinal blood vessels, the ability of the human observer to identify changes in retinal blood vessel diameter and tortuosity accurately has not been studied. METHODS: Using computer-aided analysis of fundus photographs from eyes with a wide range of ROP severity, we generated tracings of posterior pole blood vessels which varied by quintiles of mean vessel diameter and tortuosity. Subjects (23 naive and 12 expert observers) ranked groups of tracings in order of increasing mean vessel diameter and tortuosity. These ranking tests were performed on tracings derived from the same fundus and tracings derived from distinct fundi. In a similar fashion, subjects also compared one designated standard fundus tracing with 25 distinct fundus tracings. RESULTS: Vessel diameter was assessed correctly more often than vessel tortuosity, both among similar (> 99% vs 92% of the time, respectively, P < 0.001), or among distinct (88% vs 78% of the time, respectively, P < 0.001) fundus images. The mean vessel diameter and tortuosity of 25 distinct fundus images were correctly ranked versus a standard image in 89% of attempts. Assessments of increments in vessel diameter and tortuosity were independent. Naive and expert subjects performed indistinguishably on all tests. CONCLUSIONS: Intelligent human observers have considerable ability to discern clinically relevant increments in blood vessel diameter and tortuosity. This ability may facilitate standardization in the diagnosis of plus disease in ROP.

Computer Simulation↗
PubMedDate not supplied

Transscleral diode laser cyclophotocoagulation for refractory pediatric glaucomas.

PURPOSE: To evaluate the success of contact transscleral cyclophotocoagulation (TDC) in patients with refractory pediatric glaucomas. METHODS: Twenty-six eyes of 20 patients with therapy-resistant pediatric glaucomas were included in this retrospective study. Subgroup analysis was performed for patients 10 or younger and patients older than 10 at time of first TDC procedure. Diode laser cyclophotocoagulation was applied using a fiber optic G-probe. Follow up until time of failure or for a minimum of 6 months was obtained for all procedures in all eyes. Failure was defined as intraocular pressure (IOP) greater than 21 mm Hg, repeat of TDC due to clinically inadequate IOP control, progression to another procedure, or serious complication. RESULTS: Baseline mean pretreatment IOP was 34.2 +/- 10.4 mm Hg (range, 15 to 62 mm Hg). Ten of 26 eyes (38%) were successful 6 months after initial TDC. A mean decrease in IOP of 10.3 +/- 14.7 mm Hg was noted after the first procedure (P < 0.05). Eighteen eyes (70%) were retreated at least once. The mean decrease in IOP for all patients after all procedures was 12.9 +/- 13.4 mm Hg (P < 0.001). This represents a mean percent decrease in IOP of 33.2 +/- 6.9%. The overall success rate was 50%, including retreated patients. The younger and older subgroups did not differ with regard to overall success, time to failure, or retreatment rats. One patient suffered a retinal detachment. Visual loss was noted in 4 of 22 eyes with reliable visual acuity measurements. CONCLUSION: TDC is an effective means of decreasing IOP in some patients with refractory pediatric glaucomas. Although the retreatment rate is high, the procedure generally is well tolerated with few complications.

Adolescent↗