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Biomedical subjects

S L Fine

Publications and source records attributed to S L Fine.

At least 91 records · Page 5Linked to original sources
PubMed1985

Simulated treatment of recurrent choroidal neovascularization in primate retina. Comparative histopathologic findings.

We simulated the treatment of recurrent choroidal neovascular membranes (CNVM) by applying two courses of laser treatment to monkey retinas. Argon green, argon blue-green, and krypton red lasers (KRLs) were used in juxtafoveal, papillomacular bundle, and nonmacular areas. The effects were examined clinically and histopathologically. Results of once-treated control eyes were consistent with those of previous studies. Repeat treatment, however, resulted in full-thickness retinal destruction or necrosis with all laser modalities and in all fundus locations. These results are consistent with the absorptive characteristics of xanthophyll and melanin and suggest only limited advantages to the KRL when treatment of recurrent CNVM is performed in a previously treated area of the fundus. However, treatment of recurrent CNVM is still probably most successful with a KRL, because recurrent CNVM is usually at a border of a photocoagulation scar, where the retina is still untreated, and because histologic studies have demonstrated inner retinal sparing with a KRL in juxtafoveal areas.

Animals↗
PubMed1985

Peripheral retinal function in age-related macular degeneration.

Aging changes are seen histopathologically outside the central retina, but have not been correlated with the presence of age-related macular degeneration (AMD). We studied 21 patients with drusen and AMD to see if peripheral retinal function changes are correlated with changes in the central retina. Electrooculogram Arden ratios were normal. Intensity-response analysis of dark-adapted electroretinogram b-waves and analysis of flicker electroretinograms were normal except for a small sensitivity loss presumed to reflect aging and lens yellowing. There was no difference between patients' severely involved AMD eye and their fellow eye with only drusen. Static perimetry showed sensitivity loss in the central 20 degrees, but normal thresholds peripheral to this. These results suggest that retinal function abnormalities in AMD are confined to the central retina, and the small age-related peripheral changes found do not correlate with the degree of AMD.

Age Factors↗
PubMed1985

The risk of cerebrovascular and cardiovascular disease in patients with anterior ischemic optic neuropathy.

Of 217 patients in whom anterior ischemic optic neuropathy (AION) was diagnosed during the period from 1975 to 1985, verifiable medical information was obtained for 212 (98%). Over a median follow-up period of three years, no group of patients had an increased mortality rate over that of age-, sex-, and race-matched controls; however, patients with "idiopathic" AION and patients with systemic hypertension who developed nonarteritic AION had a statistically significant increased risk of experiencing cerebrovascular events and myocardial infarctions compared with appropriately matched control groups. In view of the findings of our study, we suggest that patients with idiopathic AION and hypertensive patients who develop nonarteritic AION undergo a complete physical examination, cardiac evaluation, tests of carotid artery patency, and careful medical follow-up to attempt to prevent subsequent cerebrovascular or cardiovascular events.

Adult↗
PubMed1985

Eccentric visual acuity in patients with macular disease.

A series of cards each containing a two dimensional array of identical Snellen "E's" was used to determine best eccentric visual acuity in patients with macular disease having Snellen visual acuity of 20/70 or worse. Each "full field E" card simultaneously presents the same letter to foveal and parafoveal areas. This test can therefore determine quickly if potentially useful vision is present in any area of the central visual field. In our study of 37 eyes, 70% demonstrated potential visual acuity at least two times better than visual acuity measured by conventional methods, and 20% demonstrated at least a fourfold improvement. This suggests that most patients with macular disease do not spontaneously employ their best remaining area of retina for fixation.

Aging↗
PubMed1985

Early detection of extrafoveal neovascular membranes by daily central field evaluation.

Argon laser photocoagulation can reduce the risk of severe vision loss in patients with age-related macular degeneration, ocular histoplasmosis, and idiopathic neovascularization. Early detection of neovascularization soon after the onset increases the likelihood of identifying patients with a new vessel membrane in a potentially treatable position. Patients with one or both eyes at risk for the development of a new vessel membrane should assess their central visual fields on a daily basis by occluding first one eye and then the other. Any disturbance in distance vision or reading vision or the appearance of distortion in the patient's field or on the Amsler grid should prompt an eye examination at the earliest feasible time, in an effort to detect neovascularization in a treatable position.

Aged↗
PubMed1984

Comparison of krypton and argon laser photocoagulation. Results of stimulated clinical treatment of primate retina.

We compared the clinical and histological effects of argon blue-green laser (ABGL), argon green laser (AGL), and krypton red laser (KRL) photocoagulation on the primate retina. Burns were produced in juxtafoveal and papillomacular bundle and in nonmacular areas in a manner simulating treatment of a choroidal neovascular membrane (NVM). In the juxtafoveal and papillomacular bundle areas, ABGL photocoagulation caused extensive inner retinal damage while KRL photocoagulation spared inner retinal structures. The effects of AGL photocoagulation in the fovea were intermediate in extent between KRL and ABGL photocoagulation. Axonal transport studies also showed differential effects of these wavelengths on retinal ganglion cell function. Nonmacular effects were similar for all three modalities. These results suggest that the krypton red wavelength may be more suitable than the argon green or argon blue-green wavelengths in treating choroidal NVMs near the fovea.

Animals↗
PubMed1984

Age-related macular degeneration and blindness due to neovascular maculopathy.

Age-related macular degeneration (AMD) is one of the four most common causes of blindness in the United States. Retinal manifestations of AMD can be categorized as either atrophic or neovascular/exudative. To the best of our knowledge, the proportion of patients legally blind due to the neovascular/exudative manifestations of this disease has not been previously reported. Data from two studies, the Framingham Eye Study and a large case-control study, demonstrate that the vast majority of patients with legal blindness due to AMD have the neovascular/exudative form of the disease. Seventy-nine percent of eyes legally blind due to AMD in the Framingham population and 90% of eyes legally blind due to AMD in the case-control study had neovascular/exudative retinopathy. This is in spite of the fact that neovascular/exudative retinopathy is a relatively infrequent complication of AMD.

Aged↗
PubMed1984

Pseudoxanthoma elasticum: high calcium intake in early life correlates with severity.

The characteristic histopathologic lesion of pseudoxanthoma elasticum (PXE) is calcification of the central core of elastic fibers in affected organs; it is correlated with clinical severity. One hypothesis holds that lowering dietary calcium might reduce or prevent tissue injury and minimize clinical effects. This hypothesis would be supported by demonstrating that clinical expression is positively associated with previous calcium intake. We studied 32 unrelated PXE patients (20 men and 12 women, mean age 43 years, SE = 14.2, range = 13-71) by grading their clinical severity and their presumed calcium intake during childhood, adolescence, and adulthood. Overall severity in the study group varied greatly and correlated positively with age (P less than 0.001). Overall severity correlated positively with calcium ingestion as an adolescent (P less than 0.001, with the other predictor variables held constant). Overall cardiovascular and eye severity were a function of age (P less than 0.000001 for both), whereas skin severity was not. These results confirm that PXE is a highly variable condition that generally worsens with age and support the rationale for a clinical trial to determine the effects of different levels of dietary calcium ingestion in young PXE patients on their subsequent clinical course.

Adolescent↗
PubMed1984

Retinal neovascularization and ocular toxoplasmosis.

Retinal neovascularization, a rare complication of ocular toxoplasmosis, is a source of vitreous hemorrhage. We examined three patients (all women, 70, 36, and 19 years old) with inactive toxoplasmosis scars associated with occlusion of a retinal arteriole or venule passing through the scar, capillary nonperfusion, and adjacent retinal neovascularization. In two patients photocoagulation of the ischemic areas produced a cessation of hemorrhage and the disappearance of neovascularization. In the third case, the neovascular frond was avulsed from its supplying retinal arteriole without treatment.

Adult↗
PubMed1984

Combined hamartomas of the retina and retinal pigment epithelium.

Combined hamartomas of the retina and retinal pigment epithelium are rare fundus lesions. By combining cases seen by members of The Macula Society, clinical data was collected on 60 patients with combined hamartomas. We reviewed the clinical presentations, ophthalmoscopic, and fluorescein angiographic features and differential diagnosis of this tumor. Of 41 patients with adequate follow-up information, 10 (24%) lost at least two lines of visual acuity, usually due to tractional distortion of the fovea, and four (10%) had improved visual acuity following either amblyopia therapy or vitreous surgery for macular traction.

Adolescent↗
PubMed1984

Prognosis of patients with bilateral macular drusen.

Of 71 patients with only bilateral macular drusen, 8 eyes in 7 patients (9.9%) developed exudative maculopathy over an average follow-up of 4.3 years (14.5% cumulative risk). Severe visual loss due to exudative maculopathy occurred in 7 eyes of 6 patients (8.5%) for a 5-year cumulative risk of 12.7%. Features of the drusen were analyzed, but only the association with focal hyperpigmentation (P less than 0.001) and more than minimal drusen confluence (P less than 0.05) were statistically significant. Older patients had more severe drusen. Photostress test delay did not correlate with visual acuity, age, or severity of drusen.

Adolescent↗
PubMed1984

Long-term follow-up of central serous chorioretinopathy.

The Wilmer Retinal Vascular Center's experience with central serous chorioretinopathy from 1970 to the end of 1979 was reviewed and compared with previous studies. Retrospective analysis of 73 patients seen at follow-up suggests no clinically significant effect of focal argon laser photocoagulation on final visual acuity or recurrence rate. Patients with initial visual acuity of 20/20 remained at that level, and patients with initial visual acuity of less than 20/30 gained, on average, two to three Snellen lines at follow-up. Approximately one-third of both untreated and treated patients had recurrence or presumed persistence during the follow-up period. With the inclusion of episodes that occurred before the first Wilmer Institute visit about half of each group had recurrence or presumed persistence. Recurrences were most often due to leakage from a site within one disc diameter of the original site of leakage.

Adult↗
PubMed1983

The second eye of patients with senile macular degeneration.

Patients with senile macular degeneration and exudative maculopathy in one eye and drusen in the second eye have a 3% to 7% risk per year of exudative maculopathy developing in the second eye during the first three years following their initial presentation. The risk is the same for patients with new vessel membranes or other types of exudative maculopathy in the first eye. Second eyes in which exudative changes develop are more likely to have larger numbers of drusen or greater confluence of drusen (or both) initially. The data from this study were analyzed using the Kaplan-Meier technique of estimation, a method (to our knowledge) not previously employed by other investigators. The demographic features of the overall study population, as well as the photographic features associated with increased risk of development of exudative maculopathy, were in agreement with those previously reported.

Aged↗
PubMed1983

Photocoagulation for choroidal neovascularization.

Nearly 90% of severe visual loss among patients with senile macular degeneration can be ascribed to the neovascular form of the disease. The Senile Macular Degeneration Study demonstrated that argon laser photocoagulation can reduce the risk of severe visual loss by more than 60% among patients with choroidal new vessel membranes 200 microns or greater from the center of the foveal avascular zone (FAZ). The Krypton Photocoagulation Study, also supported by the National Eye Institute, is evaluating whether krypton red laser photocoagulation can reduce the risk of visual loss in SMD patients with new vessels within 200 microns of the center of the FAZ.

Blindness↗