Collaborative ocular melanoma study group.
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Adult↗
Biomedical subjects
S L Fine
Publications and source records attributed to S L Fine.
Age-related macular degeneration.
Age-related macular degeneration (AMD) is the leading cause of irreversible severe visual loss in the United States in people over 50 years of age. The nonexudative stage includes hard drusen (associated with localized dysfunction of the retinal pigment epithelium [RPE]), soft drusen (associated with diffuse dysfunction of the RPE), and geographic (areolar) atrophy. These fundus changes may predispose the eye to develop the neovascular/exudative stages of AMD. Most patients who develop severe visual loss from AMD have this exudative stage. Treatment for AMD has been shown to be effective for only a small proportion of patients who have a well-defined choroidal neovascular membrane (CNVM) more than 200 microns from the foveal center. Even in successfully treated cases, severe visual loss is postponed only for about 18 months because of the high rate of recurrent CNVMs that extend into the fovea. Thus, despite recent breakthroughs in laser treatment for AMD, most patients who develop the exudative form of AMD will develop central visual impairment. At the present time, the only available treatments for the majority of patients who develop the exudative form of AMD are low vision aids. Investigators are currently evaluating whether treatment is effective for membranes within 200 microns of the foveal center. Future studies need to be directed toward further understanding of the pathogenesis, treatment and prevention of the blinding complications of AMD.
Aged↗
Macular hole.
A macular hole is a full-thickness defect of retinal tissue involving the anatomic fovea, thereby affecting central visual acuity. Macular holes have been associated with myriad ocular conditions and originally were described in the setting of trauma. The pathogenesis of idiopathic, age-related macular holes remains unclear despite a litany of theories. Recently, Gass has described an updated biomicroscopic classification of macular holes and postulated that tangential vitreous traction may play a role. Cellular components surrounding the rim of macular holes may also contribute tangential traction forces and elevate the rim. Pseudomacular holes may be mistaken for macular hole lesions, despite careful clinical examination. Careful biomicroscopic examination with a contact lens and use of the Watzke and laser aiming beam tests help to ensure accurate diagnosis. Newer imaging technology, such as optical coherence tomography, helps distinguish true macular holes from pseudoholes and may provide additional insight into the pathogenesis of this condition. Surgical management with or without pharmacosurgical adjuncts can improve vision in select cases. The most common surgical complication is progressive lens opacification in phakic patients.
Aged↗
The evaluation of patients with Eales' disease.
Thirty-two patients with documented Eales' disease who have been followed-up at Johns Hopkins Hospital for periods of as long as 37 years were investigated. The previously reported association of Eales' disease with tuberculoprotein hypersensitivity was confirmed in 10 of 21 patients tested. For the first time, associated vestibuloauditory dysfunction is described. The previously reported association with multiple sclerosis was not confirmed. Eales' disease is a specific vasculopathy that can affect both the retinal and vestibuloauditory circulations. Patients with suspected Eales' disease should also be examined to rule out other diseases such as diabetes, sarcoidosis, and connective tissue diseases including systemic lupus erythematosus. This can be done by obtaining such tests as fasting blood glucose, chest radiograph, erythrocyte sedimentation rate, antinuclear antibody, rheumatoid factor, and LE cell preparation. Tuberculoprotein sensitivity status should be ascertained and active tuberculosis should be ruled out. The patient should be questioned regarding hearing or balance problems, and if a history suggestive of abnormalities is elicited, referral for vestibuloauditory function testing should be made.
Adult↗
Transient delay in choroidal filling after krypton red laser photocoagulation for choroidal neovascular membranes.
The authors report four patients who were treated with krypton red laser photocoagulation for neovascular membrane in the papillomacular bundle. In each patient, from 1 to 7 days following photocoagulation, there was a transient delay in filling of the choroid in a localized area beyond the treatment site. No patient suffered permanent visual loss as a result of this complication. Each patient regained normal choroidal filling (except for the treatment site) within two to four weeks. This angiographic observation may be explained by the increased uptake of the krypton red wavelength in the deep choroid.
Adult↗
Clinicopathologic correlation of krypton red, argon blue-green, and argon green laser photocoagulation in the human fundus.
One day before the scheduled enucleation for a choroidal melanoma, a patient agreed to have experimental laser burns placed in her fundus for the purpose of comparing the histopathologic effects of krypton red, argon green, and argon blue-green laser photocoagulation. When photocoagulation burns were applied to simulate treatment for a juxtafoveal choroidal neovascular membrane ( NVM ) there was relative inner retinal sparing with krypton red and transretinal effects with argon green. When treatment was applied outside the macula to simulate scatter or panretinal photocoagulation (PRP), there were no differences in histopathologic effect. This suggests that krypton red laser photocoagulation may be advantageous in treating juxtafoveal neovascular membranes, but is of no particular advantage when treating outside the macula.
Argon↗
Clinicopathologic correlation of argon-laser photocoagulation of an idiopathic choroidal neovascular membrane in the macula.
The clinicopathologic features of an idiopathic choroidal neovascular membrane treated by argon laser photocoagulation are presented. The area of treatment is characterized microscopically by a proliferation of fibrocytes and retinal pigment epithelial cells. No choroidal vascular membrane was identified. Capillaries were present in the scar but not internal to the level of Bruch's membrane.
Choroid↗
Clinicopathologic correlation of krypton and argon laser photocoagulation in a patient with a subfoveal choroidal neovascular membrane.
Krypton-red laser photocoagulation for choroidal neovascular membranes has been shown to produce inner retinal sparing in contrast to argon blue-green or argon-green laser photocoagulation, which causes full-thickness retinal destruction. However, previous histopathologic reports have involved only primates or humans without known macular degeneration. Clinicopathologic features of a case in which a human eye with a choroidal neovascular membrane, associated with age-related macular degeneration, was photocoagulated on four occasions with the argon-green and krypton-red lasers are presented. The results of this study confirm previous reports of the inner retinal sparing noted with krypton-red laser photocoagulation in comparison with argon blue-green or argon-green laser photocoagulation.
Aged↗
Cystoid macular edema: histopathologic and angiographic correlations. A clinicopathologic case report.
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Edema↗
Branch retinal venous occlusion.
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Edema↗
Diseases of the macula: the diagnosis and management of choroidal neovascularization.
Choroidal neovascularization is the major complication of several macular diseases. Criteria for the selection of patients for consideration of photocoagulation treatment are presented. The distance of the foveal edge of the choroidal new vessel membrane to the center of the fovea is the most important criterion in considering the patient for photocoagulation. Photocoagulation is not considered unless the edge of the new vessel membrane is at least one fourth disc diameter (375micron) from the center of the fovea. Randomized controlled studies are required to document the role of photocoagulation therapy for choroidal neovascularization.
Adult↗