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Biomedical subjects

Y Yassur

Publications and source records attributed to Y Yassur.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Prevalence of pigmentary dispersion syndrome in Israel].

Pigmentary dispersion syndrome is a precursor of pigmentary glaucoma whose prevalence in the urban population of USA was found to be 2.45%. We evaluated its prevalence during ocular screening examinations among normal Israelis. We screened for excessive pigmentation on the corneal endothelium with the slit-lamp and determined in each patient best corrected visual acuity, intra-ocular pressure (after mydriasis), condition of the anterior segment, cup-disk ratio, posterior segment abnormalities and questioned about history of any ocular disease and family history of glaucoma. 374 patients (mean age 49 +/- 11) were examined on 10 consecutive days. In 5.9% excessive corneal endothelial pigmentation was found. Intra-ocular pressure (after mydriasis) averaged 15.52 +/- 1.93 mm Hg as compared to 14.73 +/- 2.04 among the rest of our study population, (p = 0.01). The prevalence of suspected pigmentary dispersion syndrome among young adults in Israelis is high.

Adolescent↗
PubMed1998

Ultrasound biomicroscopic detection of anterior ocular segment foreign body after trauma.

PURPOSE: To describe the role of ultrasound biomicroscopy in the detection and localization of foreign bodies in anterior ocular segment foreign body after trauma. METHODS: In a prospective study, ultrasound biomicroscopy was performed in five eyes of five consecutive patients with suspected anterior ocular segment foreign body. RESULTS: In all five eyes, ultrasound biomicroscopy detected and precisely localized small foreign bodies (metallic in two eyes, stone in one eye, plastic in one eye, and ceramic in one eye) in the cornea (one eye), superficial sclera (one eye), and anterior ocular segment (three eyes). Operative procedures to remove the intraocular foreign bodies (three cases) were guided by the ultrasound biomicroscopy information. CONCLUSIONS: Ultrasound biomicroscopy is a noninvasive method for detecting anterior segment intraocular foreign bodies after perforating trauma. It can be used to accurately diagnose foreign bodies and assist in surgical management, particularly when direct visualization is obscured because of the trauma. In eyes with partial-thickness corneoscleral lacerations or sealed full-thickness corneoscleral laceration and suspected anterior ocular segment foreign body, ultrasound biomicroscopy is a safe and effective method for detecting and localizing foreign bodies in the anterior ocular segment.

Adolescent↗
PubMed1998

Indocyanine green angiographic findings in nonproliferative diabetic retinopathy.

PURPOSE: To report angiographic findings of nonproliferative diabetic retinopathy patients by means of indocyanine green angiography. METHODS: Forty-two eyes (42 patients) with nonproliferative diabetic retinopathy were evaluated by indocyanine green angiography in addition to fluorescein angiography. Angiographic findings with the two imaging techniques were compared with the red-free fundus appearance. RESULTS: Among the 42 eyes, five (12%) had the appearance on indocyanine green angiography of lobular spotty hyperfluorescent and hypofluorescent areas ("salt and pepper" appearance) in the very late phase. Twenty eyes (48%) presented with diffuse late-phase hyperfluorescence on indocyanine green angiography, corresponding to areas of retinal capillary nonperfusion on fluorescein angiography, and retinal edema. A total of 3,564 microaneurysms were divided into three types: 58 (1.6%) appeared mainly on the fluorescein angiography and very faintly on the indocyanine green angiography, 3,029 (85%) appeared on the fluorescein angiography and the indocyanine green angiography, and 477 (13.4%) were uniquely hyperfluorescent on the indocyanine green angiography. CONCLUSIONS: Indocyanine green angiography in patients with nonproliferative diabetic retinopathy disclosed microvascular findings that were in addition to those shown on fluorescein angiography. These angiographic changes were not observed on fluorescein angiography because of imaging limitations. Indocyanine green angiography may be a useful adjunct to fluorescein angiography in the evaluation of chorioretinal vascular changes in nonproliferative diabetic retinopathy.

Adult↗
PubMed1998

Intravitreal gas injection for hypotony after cataract surgery.

PURPOSE: To evaluate the efficacy and safety of intravitreal perfluoropropane gas injection to treat hypotony after cataract surgery. SETTING: The ophthalmology department of a major tertiary medical center. METHODS: After uneventful cataract extraction, 5 patients with hypotony due to iridocyclitis, choroidal detachment, and serous retinal detachment were treated with an intravitreal injection of 1.0 cc of perfluoropropane gas. RESULTS: The hypotony, choroidal detachment, and exudative retinal detachment resolved in all 5 patients, and visual acuity improved. No complications were observed. CONCLUSION: Intravitreal gas injection can be used to treat hypotony after cataract surgery in selected patients.

Aged↗
PubMed1998

Long-term follow-up of perfluorocarbon liquid in the anterior chamber.

BACKGROUND: Perfluorocarbon liquids are used as a vitreous substitute in the operative management of several ophthalmologic conditions. We examined the effects of residual perfluorocarbon droplets in the anterior chamber in patients after retinal detachment surgery. METHODS: The study group consisted of seven patients (seven eyes) aged 28-74 years in whom droplets of perfluorocarbon appeared in the anterior chamber subsequent to retinal detachment surgery involving scleral buckling, perfluorodecalin injection, and perfluorocarbon liquid-silicone oil exchange. Mean follow-up was 9.4 months. RESULTS: From 1 -15 droplets of perfluorocarbon liquid were found in the anterior chamber. There were no corneal complications or inflammatory reactions or blood vessel invasion into the corneal stroma. Some of the droplets appeared to be encapsulated in a membrane-like material. Perfluorocarbon liquid and silicone oil had to be removed in three patients at 20, 12, and 4 months postoperatively because of an increase in intraocular pressure due to blockage of the inferior iridectomy by a droplet of perfluorocarbon, emulsification of the silicone oil, or residual perfluorocarbon liquid on the retina (one patient each). Increased intraocular pressure in a fourth patient was successfully treated pharmacologically. CONCLUSION: Based on our experience, residual perfluorocarbon liquid droplets in the anterior chamber are well tolerated and do not induce corneal damage or ocular inflammation. These patients should be closely followed, however, and the liquid removed if complications develop.

Adult↗
PubMed1998

Retinal thickness variation in the diabetic patient measured by the retinal thickness analyser.

AIM: To evaluate the potential of the retinal thickness analyser (RTA) as an objective tool for assessment and follow up of diabetic macular oedema. METHODS: A prototype of the RTA that operates on the principle of laser slit biomicroscopy was used. Retinal thickness was obtained in 41 eyes of 41 diabetic patients. The clinical diagnosis was cystoid macular oedema (CMO) in 10 eyes, clinically significant macular oedema (CSMO) without retinal cysts in 21 eyes, and "dry" macula following grid pattern laser treatment in 10 eyes. The control group consisted of 46 eyes of age matched healthy volunteers. RESULTS: In normal eyes (46 eyes), the foveal thickness measured was 178 (SD 44) microns and the macular thickness around the fovea was 311 (51) microns. The eyes with CMO displayed the largest foveal thickening, 875 (287) microns (390% increase compared with normal values). The average thickness of the fovea in the non-cystoid CSMO group was 427 (175) microns (144% increase compared with normal fovea). The average thickness of the foveal centre in eyes judged as having "dry" macula after laser treatment was 315 (71) microns (77% increase compared with normal value and a 26% decrease in thickness compared with the CSMO eyes). Statistically significant differences were found in central thickness between these four groups (p = 0.0001). The average thickness at 500 microns surrounding the fovea was 566 (202) microns in the CSMO eyes compared with 311 (51) microns in normal eyes (80% increase). The "dry" macula group (after undergoing laser treatments) had an average thickness of 414 (94) microns (27% decrease compared with CSMO eyes and a 33% increase compared with eyes of healthy controls). CONCLUSIONS: RTA is a system for quantifying macular thickness and imaging of macular pathology. The system can be a useful tool for diagnosis of macular diseases and for evaluation of the effect of treatment modalities.

Adult↗
PubMed1998

Pneumatic retinopexy for late-onset recurrent retinal detachment.

BACKGROUND AND OBJECTIVE: Pneumatic retinopexy is used as a primary procedure for the repair of retinal detachments caused by visible retinal tears. Its application for late-onset recurrent retinal detachments following previous pneumatic retinopexy or scleral buckling procedure has not been reported to date. PATIENTS AND METHODS: Pneumatic retinopexy was performed in 12 patients with recurrent retinal detachments due to new retinal tears who presented 6 months to 10 years after pneumatic retinopexy (8 patients) or scleral buckling surgery (4 patients). Follow-up ranged from 6 to 24 months. RESULTS: All the retinas reattached within the first few postoperative days and remained attached throughout follow-up. No intraoperative or postoperative complications were observed. Visual acuity either remained unchanged (if good before) or improved. CONCLUSION: Pneumatic retinopexy may be a feasible option for recurrent late-onset retinal detachment under the proper clinical conditions.

Cryotherapy↗
PubMed1997

Ultrasonography of the optic nerves: clinical application in children with pseudotumor cerebri.

OBJECTIVE: Pseudotumor cerebri (PTC) in children has a wide spectrum of clinical presentations, from headache, which may be posterior and associated with nausea, vomiting or diplopia, to nonspecific headache, which may not be posterior and related or unrelated to other symptoms. In children with nonspecific headache, supportive evidence for diagnosis may be required before invasive procedures such as lumbar punctures are performed. Ultrasonography of the optic nerves (USON) is a noninvasive examination that can provide information about optic nerve changes, including those resulting from increased intracranial pressure. The applicability of USON in the diagnosis and follow-up of PTC was examined. STUDY DESIGN: Seventeen children were referred to our service because of a clinical suspicion of PTC, suggested by the presence of swollen optic nerve discs and/or headache, without clinical evidence of another cause. All had normal brain computed tomography and/or magnetic resonance imaging results before referral. Each child was examined with USON while in the supine position and with a 30-degree head tilt and underwent a lumbar puncture. USON was repeated on follow-up evaluation. RESULTS: The diagnosis of PTC was confirmed by lumbar puncture in 10 children and ruled out in 6 children. Overall, the USON results correlated with an increased opening pressure on lumbar puncture in 11 children. CONCLUSION: We noted an excellent correlation between the clinical results and the USON findings in PTC, and in many cases repeated lumbar punctures could be avoided. USON is more easily applied than a lumbar puncture, without the accompanying risks. It may be used as an indicator of increased intracranial pressure, as well as a follow-up tool. However, further studies are required before the accuracy of USON can be fully established.

Adolescent↗
PubMed1997

A comparative study of two dose regimens of latanoprost in patients with elevated intraocular pressure.

OBJECTIVE: The purpose of the study was to determine whether latanoprost (13,14-dihydro-17-phenyl-18,19,20-trinor PGF2a-isopropyl ester), a new prostaglandin analogue that has been found effective in reducing intraocular pressure (IOP) in humans, is equally effective at lower concentrations than those currently employed. DESIGN AND PARTICIPANTS: Fifty patients with glaucoma or ocular hypertension were treated in a randomized, crossover, double-masked fashion with 1 drop of latanoprost (50 microg/ml once daily and 15 microg/ml twice daily) in the affected eye(s) for 3 weeks on each concentration. Tonometry was obtained at 8:00, 13:00, and 17:00 hours at baseline (untreated) and after 3 weeks on each concentration. Placebo (a buffer solution of latanoprost eye drop) was administered for complete masking of the study. RESULTS: Mean baseline (untreated) diurnal IOP for the entire sample was 24.7 mmHg. Intraocular pressure was reduced by 6.1 mmHg with latanoprost 15 microg/ml twice daily, and by 7.5 mmHg with 50 microg/ml once daily. Results with both regimens were significant (P < 0.001 each, Student's t-test). However, the 50 microg/ml dose was significantly more effective than the 15 microg/ml dose, with a difference of 1.4 mmHg (P < 0.001, ANOVA). Both dose regimens were well tolerated, with little, predominantly mild, ocular discomfort. The higher dose did not cause more hyperemia at 3 weeks than the lower one, i.e., the lower dose yielded a slightly higher score (1.8 mm) on the visual analogue scale (P < 0.29, ANOVA). CONCLUSIONS: Latanoprost administered at a concentration of 50 microg/ml once daily effectively reduces IOP in patients with elevated IOP. Administration of a lower concentration (15 microg/ml) twice daily is less effective, but still significant.

Adult↗
PubMed1997

Sulfur hexafluoride injection for Descemet's membrane detachment in cataract surgery.

Extensive Descemet's membrane detachment persisted after small incision cataract surgery in three patients. Unfolding and repositioning of Descemet's membrane by sodium hyaluronate (Healon) were followed by injection of sulfur hexafluoride 20% gas mixed with air to fill the anterior chamber. Initially, the gas bubble filled most of the anterior chamber; it disappeared over 7 to 9 days. Descemet's membrane remained attached, and the corneal edema cleared.

Aged↗
PubMed1997

Thirty years of penetrating keratoplasty in Israel.

We studied the indications for keratoplasty and their changes during 30 years in Israel by retrospective evaluation of pathologic records of 1,018 corneal buttons (from 1961 to 1990). The population included 634 (62.3%) male patients and 384 (37.7%) female patients. Keratoconus (n = 222, 21.8%) was the most common indication, followed by corneal graft failure (n = 113, 11.1%), herpetic infections (n = 95, 9.3%), ocular trauma (n = 87, 8.5%), scarring (n = 74, 7.3%), pseudophakic bullous keratopathy (n = 72, 7.1%), nonherpetic infections (n = 71, 7.0%), and other indications. Whereas ocular infections were the most common indications for keratoplasty before 1970, keratoconus has been the most common indication since 1970. Pseudophakic bullous keratopathy became the second most common indication (13.8%) between the years 1981 and 1990. The number of keratoplasties increased in Israel during the past three decades, and the low percentage of pseudophakic bullous keratopathy is related to the types of intraocular lenses that we implanted in the late 1970s and the early 1980s.

Corneal Diseases↗
PubMed1997

A portable slit lamp attachment for examination of donor cornea.

A new portable device is available for direct examination of donor cornea at the slit lamp. This attachment provides a clear view of the donor cornea and can be helpful to any corneal transplant surgeon, especially at medical centers that do not have an established eye bank.

Cornea↗
PubMed1996

Three-dimensional measurements of central serous chorioretinopathy using a scanning laser tomograph.

PURPOSE: To evaluate the topographic three-dimensional mapping of retinal elevation in central serous chorioretinopathy using the Heidelberg Retina Tomograph and to correlate the measured parameters with the fluorescein angiographic findings. METHODS: Seventy-six consecutive patients with central serous chorioretinopathy (63 men, 13 women), between 26 and 54 years of age, were examined to identify areas of neurosensory retinal detachment and fluorescein leakage. In areas of retinal detachment, the parameters measured were the area, volume, maximal height, and diameters of the retinal elevation, which were statistically analyzed, and the correlations between these parameters were evaluated. RESULTS: Mean +/- SD area of elevation was 9.6 +/- 5.22 mm2 (range, 2.7 to 21.5 mm2); mean volume was 1.16 +/- 1.3 mm3 (range, 0.11 to 4.73 mm3); mean maximal height was 238 +/- 108 microns (range, 97 to 450 microns); mean x-axis was 3.4 +/- 1.1 mm (range, 1.6 to 5.6 mm); and mean y-axis was 3.03 +/- 0.98 mm (range, 1.6 to 4.7 mm). Most of the retinal elevations were oval (the x-axis longer than the y-axis); the maximal height was in the geometric center in the smaller blebs and below the geometric center in the larger blebs. There were statistically significant correlations between area, volume, and height of the sensory elevation. No correlation was found between the location and the shape of leakage on fluorescein angiography and the Heidelberg Retina Tomograph measurements. CONCLUSIONS: Confocal laser tomography is potentially useful as a noninvasive diagnostic technique for quantitative measurements of the neurosensory retinal detachment in central serous chorioretinopathy.

Adult↗
PubMed1996

Reading-evoked visual dimming.

PURPOSE: To carry out a neuroradiologic investigation in a monocular 49-year-old patient who during the past five years described symptoms of dimming of central vision in his left eye, which was provoked only by reading. METHODS: Computed tomography and magnetic resonance imaging were performed. RESULTS: An orbital apex intraconal tumor situated laterally to and above the optic nerve was found. CONCLUSIONS: Reading-evoked visual dimming can be a variant of gaze-evoked amaurosis. The optic nerve displaced laterally and superiorly, and stretched by the act of reading, may be compressed between the tumor above and the contracted inferior rectus muscle inferiorly.

Blindness↗
PubMed1996

Diabetic retinopathy during pregnancy.

PURPOSE: The purpose of the study is to evaluate the incidence, prevalence, progression, and risk factors of diabetic retinopathy during pregnancy. METHODS: Sixty-five patients who were pregnant and had insulin-dependent diabetes mellitus were evaluated before pregnancy, in every trimester during the pregnancy, and 12 months postpartum. The medical data included age, diabetes duration, glycohemoglobin, fructosamine, hemoglobin, creatinine, uric acid, and systolic and diastolic blood pressure. RESULTS: Progression of the retinopathy occurred in 77.5% of the patients who presented with diabetic retinopathy at conception; proliferative diabetic retinopathy occurred in 22.5%. Only 26% of the patients who started the pregnancy without diabetic retinopathy had some progression of the retinopathy. Duration of the diabetes was longer in the progressive group compared with the nonprogressive group (P = 0.007). The glycohemoglobin was higher in the progressive group than in the nonprogressive group at each time point, but only in the third trimester was the difference statistically significant (P = 0.04). The hemoglobin level was lower in the progressive group than in the nonprogressive group (P < 0.01). The systolic blood pressure was higher in the progressive group (P < 0.005). CONCLUSION: Understanding the risk factors contributing to the aggravation of diabetic retinopathy during pregnancy is helpful in designing criteria for the team management of pregnant patients with diabetes.

Adult↗