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Biomedical subjects

T C Burton

Publications and source records attributed to T C Burton.

At least 37 records · Page 2Linked to original sources
PubMed1983

Predicting age of onset for individuals at risk for phakic retinal detachment.

Three hundred sixty-five cases of nontraumatic phakic retinal detachment were examined by analysis of covariance to determine the degree of association among type of detachment, refractive error, and age of onset. The combination of type of detachment and refractive error explained 57% of the variation in age of onset. Discrimination among types of detachment by variation in mean age was limited. Discrimination among types of detachment by variation in mean refractive error could not be established. Detachments due to vitreoretinal adhesion, lattice degeneration, and retinal dialysis differed significantly in mean age of onset and regression of age on refractive error. A regression model was created to predict from refractive error the age of onset with 95% confidence limits for individuals who appear to be at risk for these types of detachment.

Adolescent↗
PubMed1982

Epidemiology of retinal detachment.

A survey of rhegmatogenous retinal detachment during 1976 was conducted on the population of Iowa. The annual incidences (per 100,000 populations) of four types of detachment were determined: nontraumatic phakic (6.1), traumatic phakic (1.0), nontraumatic aphakic (4.9), and traumatic aphakic (0.4). The incidences of nontraumatic phakic detachment for men and women were similar, although there was a preponderance of women that reflected their greater representation in the general population. The proportions of men were significantly higher in traumatic detachments compared with nontraumatic detachments. Men tended to be younger than women for all types of detachment; however, only in nontraumatic aphakic detachment was there a significant difference between mean ages. There was an insignificant preponderance of right eye involvement in all four detachment groups.

Adolescent↗
PubMed1982

Sarcoid granuloma of the choroid.

Two patients were found to have macular choroidal granulomas associated with systemic sarcoidosis. This unusual fundus picture was documented by serial fundus photography and fluorescein angiography. Both patients had a similar clinical picture of decreased vision, chorioretinal granulomas, and overlying neurosensory detachments. Staining of the inflammatory mass with fluorescein and leakage of dye into the neurosensory space was typical. Lymph node biopsies were performed to substantiate the diagnosis. Both patients responded promptly to systemic corticosteroid therapy with dramatic improvement in visual acuity and resolution of the choroidal lesions.

Adrenal Cortex Hormones↗
PubMed1982

Bilateral phakic retinal detachment.

Ninety-nine (11.6%) of 850 phakic retinal detachment patients had bilateral detachments. The incidence of bilaterality was greater in nontraumatic detachments (13.4%) than traumatic detachments (3.8%). Patients were divided into two refractive classes: (1) myopic, containing refractive errors of -2.50 diopters or more, and (2) nonmyopic, containing all other refractive errors. The rate of bilaterality in nontraumatic detachments varied with refractive class and lattice degeneration: nonmyopic without lattice (8.1%), nonmyopic with lattice (14.2%), myopic without lattice (16.3%), and myopic with lattice (24.6%). Mean age in years at onset of the initial detachment varied with refractive class and lattice degeneration: nonmyopic without lattice (59.1), nonmyopic with lattice (55.8), myopic without lattice (49.2), and myopic with lattice (28.2). Lattice degeneration reduced the interval between detachments. Annual risks of fellow eye detachments were calculated for four groups: nonmyopic without lattice (0.12%), nonmyopic with lattice (0.95%), myopic without lattice (1.3%), and myopic with lattice (0.98%).

Eye Injuries↗
PubMed1982

Differentiating traumatic from nontraumatic retinal detachment.

Five hundred and eighty-six phakic retinal detachments were studied to characterize the features of 111 cases with a history of trauma and to establish improved guidelines for medico-legal determinations. Twenty-eight percent of contusion detachments were myopic, nine times higher than expected. Myopes typically developed giant tears and nasal dialyses (p less than 0.001); emmetropes developed inferotemporal dialyses (p less than 0.005). Lattice degeneration did not increase post-traumatic detachments risk. Dialyses and giant tears caused 69% of traumatic detachments and 6% of nontraumatic detachments (p less than 0.001). Forty-seven percent of contusion detachments had no late objective evidence of trauma. Five percent of detachments with a history of trauma were not caused by trauma (false positives).

Accidents↗
PubMed1980

Retinal dialysis.

Analysis of 196 patients with retinal dialysis indicated that unilateral nasal and superior dialyses almost invariably were produced by trauma (87.5%). A traumatic cause is proposed for unilateral inferotemporal dialyses, which also had an inordinately high rate of trauma (56%). Bilateral retinal dialyses, making up 14% of all cases, had a much lower incidence of trauma. A nongenetic, developmental anomaly at the ora serrata may account for some bilateral cases. In all types of dialyses, women acknowledged trauma less frequently than men, which probably reflects a sociologic tendency for women to deny physical abuse. Twelve percent of dialysis patients had ocular hypertension exceeding 22 mm Hg and 16% had angle recessions. Successful detachment surgery normalized the intraocular pressure in most cases without additional filtering surgery or medications.

Adolescent↗
PubMed1980

Measurement of the relative afferent pupillary defect in retinal detachment.

A swinging flashlight test and calibrated neutral density filters were used to quantitate the depth of relative afferent pupillary defects in ten patients with retinal detachment. Postoperatively, the pupillary responses returned to normal in seven of nine patients with anatomically successful surgery.

Adolescent↗
PubMed1980

Unilateral Purtscher's retinopathy.

Four patients with unilateral Purtscher's retinopathy are described. Fluorescein angiography demonstrated impaired arteriolar flow, capillary non-perfusion, venous staining, retinal edema, and optic disc edema. Resolution exceeded three months with variable degrees of permanent visual loss, optic atrophy, and pigment epithelial alteration. The pathogenesis of Purtscher's retinopathy is unknown. Arterial embolization, possibly air from the lungs, seems to be the most plausible explanation.

Adolescent↗
PubMed1979

Changing concepts of failures after retinal detachment surgery.

One thousand eighty-eight consecutive operations for retinal detachment were analyzed to determine the influence of current methods of examination and treatment on failures following surgery. The majority of failures were produced by preretinal membranes formation (33%) and massive preretinal retraction (27%). Other causes of failure included undetected retinal breaks (13%), inadequate scleral buckel (10%), new retinal breaks (8%), inadequate chorioretinal reaction (7%), and iatrogenic retinal breaks (2%). Primary operations yielded an initial cure rate of 76%. Successful reoperations raised the final cure rate to 89%. Reoperations were associated more frequently with preretinal membrane formation and chance of recognition and management of preretinal membrane formation. Except for new retinal tears and massive preretinal retraction, surgical failures can be avoided by improved utilization of current examination and operative techniques.

Humans↗
PubMed1979

Intraocular pressure in retinal detachment.

Relative hypotony in the affected eye was present in 40% of patients with uncomplicated unilateral retinal detachments. The average pressure asymmetry was only 1.3 mm Hg, but in one out of every four patients the difference was 3 mm Hg or more. In a control group, such a difference occured in only one out of every twenty patients. Relative hypotony persisted for longer than six months after scleral buckling operation, occuring even in patients that did not exhibit hypotony preoperatively.

Humans↗
PubMed1979

Direct and indirect laser photocoagulation of central serous choroidopathy.

A 3 1/2-year prospective randomized clinical trial showed a definite superiority of direct argon laser photocoagulation to the fluorescein leaking site compared to indirect treatment away from the leak in patients with central serous choroidopathy. One patient in each treatment group developed a subretinal neovascular membrane after photocoagulation to the fluorescein leak. Moderate prolongation of the neurosensory detachment did not adversely influence the final visual acuity in the indirect treatment group. Although direct laser photocoagulation reduces the duration of central serous choroidopathy, there is a risk of producing subretinal neovascularization. The principles of risk vs benefit should be explained to all patients and treatment should be advised only for compelling reasons.

Adolescent↗
PubMed1978

The incidence of macular pucker after retinal detachment surgery.

In a study of 63 cases of macular pucker among 857 patients who underwent retinal detachment repair, we isolated several statistically significant risk factors: preoperative vision of less than 6/15 (20/50); preoperative presence of rolled edges, starfolds, or equatorial ridges; re-operations; choroidal hemorrhage; and age past 30 years. We were unable to confirm the risk associated with vitreous loss, vitreous hemorrhage, and degeneration. Results suggested that macular pucker after detachment surgery is produced by a membrane similar in origin to those causing other forms of periretinal proliferation.

Adult↗
PubMed1978

A predictive model for visual recovery following retinal detachment surgery.

By multiple regression analysis we have identified 26 out of 200 observations which significantly affect the visual acuity following retinal detachment surgery. In addition, we have developed a highly significant mathematical model, which is able to predict in rather broad ranges of visual acuity to approximately 67% accuracy. There is still a large percentage of patients for whom we cannot account for the variability in final vision, a problem requiring future investigation. Potentially important factors which were not analyzed in this study include duration of macular detachment, afferent pupil defect, drainage of subretinal fluid, extent of the scleral-buckling procedure, and postoperative follow-up longer than six months. While most of the variables are fixed and cannot be alterd, such as age, senile cataract, and refractive error, improved knowledge of influential factors may allow us to manipulate some of them and provide mechanisms for improving results in recovery or maintenance of macular function after retinal detachment surgery.

Adult↗
PubMed1977

Glaucoma and retinal detachment.

In a survey of 817 patients undergoing primary operations for retinal detachment, glaucoma was present in 9.5%. Ocular hypertension (intraocular pressure [IOP] greater than 21 mm Hg) was present in an additional 6.5%. Primary open-angle glaucoma; the type of glaucoma most frequently encountered, occurred in 4% of the patients. Aphakic eyes and eyes with peripheral anterior synechiae had high prevalences of glaucoma. A high percentage of eyes with posttraumatic angle recessions had either glaucoma or elevated IOPs. Miotics used in the treatment of glaucoma could not be definitely implicated as a cause of retinal detachment. The rate of successful retinal reattachment was the same, whether or not glaucoma was present. However, a good visual result occurred less frequently in patients with glaucoma.

Eye Injuries↗
PubMed1977

False-positive results with the radioactive phosphorus test.

A chorioretinal granuloma that contained acid-fast bacilli and a choriodal nevus that consisted of benign nevus cells yielded false-positive radioactive phosphorus tests. The beta emission exceeded that of the control areas by more than 100% in each case. The granuloma had infiltrated the sclera, permitting inflammatory tissue to be in closer proximity to the counting probe than was the normal choroid. The reason for the increased metabolic activity of the nevus cells remains unexplained.

Adult↗
PubMed1977

Axial length changes after retinal detachment surgery.

A-scan echography was an accurate method for detecting changes in the depth of the anterior chamber, lens thickness, and length of the vitreous cavity after retinal detachment surgery in 30 eyes. Approximately 60% of the eyes had significant alterations in axial lengths exceeding+/-0.36 mm in aphakic eyes and +/-0.54 mm in phakic eyes. However, the operation of scleral bucklingg with large segments of hard silicone rubber implants or explants supported by an encircling band failed to result in a significant predictable shift of axial change in phakic or aphakic eyes. A-scan echography showed significant shallowing of the anterior chamber, and scleral buckling significantly increases lens thickness for at least six weeks. This induced a minor myopic refractive change that may explain some of the difference in postoperative refracitons between phakic and aphakic eyes.

Astigmatism↗