Search PubMedSearch

Biomedical subjects

W H Knobloch

Publications and source records attributed to W H Knobloch.

7 recordsLinked to original sources

The visual status of diabetic patients after renal transplantation.

To determine the effect of renal transplantation on visual status, we studied 134 eyes of 67 diabetic patients prospectively for one to seven years, with a mean of three years, after surgery. The best-corrected visual acuity and retinopathy status were determined at the time of surgery and annually thereafter. Useful visual acuity (greater than or equal to 6/15 [20/5o]) was present in 49% (66) of the eyes at the time of the baseline examination and in 51% (69) at the final determination. Of the 134 eyes 40% (54) were legally blind (less than or equal to 6/60 [20/200]) before surgery. Sixty-eight percent (91) of the eyes showed no significant visual change during the period of follow-up, 15% (20) showed significant improvement, and 17% (23) deteriorated significantly after surgery. With regard to the retinovitreous findings, 13% (12) of the eyes had non-proliferative retinopathy, 20% (26 had active proliferative retinopathy, and 67% (90) had inactive or involutional retinopathy. The results of this study showed stable or improved visual function in 83% (111) of the eyes after renal transplantation. Transplantation before dialysis becomes necessary may ben an important consideration in an attempt to reduce the high incidence of visual impairment in diabetic patients with renal failure.

Adult

Retinal astrocytoma.

A 41-year-old man had a 6 x 6 x 5-disk diameter amelanotic tumor in the posterior fundus. The clinical and fluorescein angiographic appearance suggested a benign retinal vascular tumor, although amelanotic choroidal melanoma and retinoblastoma were diagnostic possibilities. An incisional 48-hour radioactive phosphorus (32P) uptake test was performed and the result showed an increased uptake over the tumor mass of 100% as compared to the control quadrants. The globe was enucleated and the pathologic diagnosis was isolated astrocytic glioma of the retina with minimal, if any, malignant potential. The highly developed vascular system of the tumor probably contributed to the false-positive test result.

Adult

Ocular perforation following retrobulbar anesthesia for retinal detachment surgery.

We encountered three examples of the perforation of the globe by the retrobulbar needle in a series of 4,000 patients who had undergone retinal reattachment surgery with local anesthesia. The presence of significant myopia was a contributing factor in all three cases. We managed the perforation site through the detached retina with cryopexy and external tamponade, and we treated perforations through the attached retinas either with cryopexy at surgery or photocoagulation postoperatively.

Adult

Involutional diabetic retinopathy.

The end-stage or involutional phase of proliferative diabetic retinopathy may result in stabilization of vision for long periods of time. However, the clinical resemblance to the progressive tapetoretinal degenerations suggests that marked functional impairment of the retina is present in such eyes. We studied 19 eyes with involutional retinopathy to document the status of the retinal function. Studies included fluorescein angiography, visual field examination, dark adaptation testing, color vision testing, electro-oculography and electroretinography (ERG). The results indicated marked functional abnormalities in all eyes. The ERG tracings showed uniformly subnormal responses and delayed implicit times, similar to those of dominantly inherited retinal pigment degeneration, and indicative of a progressive retinal disorder. In two patients, color vision testing showed defects similar to those seen in inherited tritanopia; and in the remaining patients, defects were indicative of an acquired blue-yellow dyschomatopsia.

Adaptation, Ocular

Retinal pigment epitheliitis.

Sixty-one patients with retinal pigment epitheliitis were studied. Fifty-two eyes in 40 patients were followed for 2 years. Good central visual acuity was maintained in more than 80% of these eyes. The differential diagnosis of retinal pigment epitheliitis and the characteristic findings are described.

Adult