Biomedical subjects
Y Yassur
Publications and source records attributed to Y Yassur.
Extracapsular cataract extraction and intraocular lens implantation in eyes filled with silicone oil.
Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed in five phakic eyes filled with silicone oil following vitreoretinal surgery. Silicone oil migration was prevented during surgery using an anterior chamber maintaining system and a self-sealed corneoscleral tunnel incision. The posterior capsule opacified within 3 months in all patients, and neodymium:YAG capsulotomy or surgical discission was performed in a diamond-shaped pattern. No silicone-related complications were found, including silicone oil migration into the anterior chamber. There were no difficulties visualizing the peripheral retina during funduscopy.
Retinal detachment after noncontact pneumatic tonometry.
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Bell's phenomenon in newborns and premature babies.
AIMS: To evaluate the development and course of Bell's phenomenon (BP) in premature and normal neonates. METHODS: Twenty seven preterm infants and 42 healthy full term infants were studied. Mean birth weight, gestational age, and head circumference were recorded. BP was graded from no response to full response. The premature group was examined in the first week of life, and then at 4 and 8 weeks after birth. The full term group was initially examined at the age of 3 days until a full response was observed. RESULTS: No preterm infants exhibited BP during the first week of life, while 8/28 (29.6%) exhibited a weak to full reflex at 8 weeks of age. In the full term group 15/42 neonates (35.7%) demonstrated a mature reflex at age of 3 days and 36/37 (97.3%) at age 16 weeks. A significant correlation was observed between BP, sex, and birth weight, as well as gestational age in the premature group. No such correlation was found in the full term infants. CONCLUSION: BP has a longitudinal course. It is an important clinical marker for evaluation and follow up of neuro-ophthalmic maturation in neonates.
Fundus pigmentation in retinopathy of prematurity.
OBJECTIVE: A prospective study design was used to investigate the association between different degrees of fundus pigmentation and the indicence of retinopathy of prematurity (ROP) among very low birth weight infants in a large neonatal intensive care unit. METHODS: The study group consisted of 161 infants weighing 1500 g or less at birth and included all infants born from 1988 to 1990 who survived at least 10 weeks. Presence or lack of any acute stage ROP was determined by weekly ophthalmological examination from the age of 4 weeks. The degree of fundus pigmentation was recorded for each infant during the first examination. RESULTS: Infants with dark fundus pigmentation were found to be at half the risk of developing ROP as compared with infants having light/medium fundus pigmentation (relative risk = 0.5; 95% confidence interval = 0.2-1.1). When controlled for birth weight, gestational age, length of oxygen therapy, and ethnic group in multivariate analysis, dark pigmentation was an independent and statistically significant protective factor (odds ration = 0.09, 95% confidence interval = 0.02-0.06). None of the infants with Stage III ROP or higher had dark pigmentation. CONCLUSION: We speculate that large amounts of melanin in the retinal pigment epithelium or choroid may protect the dark-pigmented very low birth weight infant from developing ROP.
Ultrasonographic findings of the optic disc in congenital glaucoma.
A 2-month-old female infant with intractable congenital glaucoma and diffuse corneal opacification underwent trabeculectomy with 5-fluorouracil (5-FU) injection in both eyes followed by penetrating keratoplasty (PKP) combined with partial cyclocryotherapy in the right eye. The latter procedure was undertaken despite the B-scan ultrasonographic finding of extensive optic disc cupping in order to provide the infant with some degree of improved visual function. The anatomic and functional results are discussed.
Effect of green argon (514 nm) laser exposure on rose bengal-stained guinea pig cornea.
Our purpose was to study the effect of continuous wave (CW) green argon laser (514 nm) exposure on rose bengal-stained cornea. Following staining with rose bengal (1%), the corneas of 48 albino guinea pigs were exposed to different power levels of argon laser, ranging between 0.04 and 0.8 W. The beam diameter ranged between 50 and 200 microns, and exposure time was 0.1 sec. Histology revealed minimal tissue coagulation at 0.05 W and 50 microns. Moderate coagulation of the anterior stromal lamellae was found at power levels of 0.07-0.6 W and a beam diameter of 100-200 microns. At power levels of 0.7 and 0.8 W, lamellar disruption was also noted. Our data indicate that 1% rose bengal is a good photosensitizer for superficial corneal stromal photocoagulation.
[Ocular onchocerciasis in Israel].
Onchocerciasis is a systemic disease caused by the filarial parasite Onchocerca volvulus. It is endemic in Central Africa and South America and causes blindness which is directly related to the severity of the infection. World-wide, there are about 18 million suffering from onchocerciasis, of whom 2 million are blind. The most common symptom is pruritus, which appears early in the disease. Ocular manifestations appear later, and when present, life expectancy is less than 10 years. We present a 31-year-old male Ethiopian immigrant with this disease, which was brought to Israel with the Ethiopian immigration of the past decade. In this population can be found the various manifestations of the disease in all its stages. Patients are treated with oral Ivermectin, once a year, the safest of known medications for this disease. The need for early detection and treatment is emphasized because of the potential for ocular destruction.
Three-dimensional measurements of idiopathic macular holes using a scanning laser tomograph.
PURPOSE: The diagnosis of macular holes is difficult. Confocal laser tomographic analysis of the retina permits the precise measurements of the macular surface. The authors used this technique to study the macular area of patients with full-thickness macular holes. The purposes of these studies is to perform three-dimensional measurements of the macular holes and their rims and to search for a correlation between these parameters. METHODS: Thirty-one eyes with idiopathic full-thickness macular holes underwent scanning of their affected macular area using the Heidelberg retinal tomograph (HRT). The authors evaluated the following parameters: area of the hole and its elevated rim, the maximal depth of the hole, and the maximal elevation of the rim at 12, 3, 6, and 9 o'clock. RESULTS: The average hole area was 0.33 mm2, and the rim area average was 2.99 mm2. The average area of the rim was found to be 9.06 times larger than that of the hole (P < 0.001). The depth of the hole averaged 144 microns. CONCLUSIONS: The area of the rim is usually bigger than that of the hole and in direct correlation to it. Also, the bigger the hole area, the greater its depth. The average height in each of the four quadrants (12, 3, 6, and 9 o'clock) correlates to the other quadrant heights (P < 0.001).
Intraocular intrusion of sutures after retinal detachment buckling surgery.
BACKGROUND: Intraocular intrusion of tight encircling silicone band is a major complication of retinal detachment surgery leading to subretinal and vitreous hemorrhage, retinal detachment, and phthisis bulbi. Intrusion of the sutures into the eye has only been reported as an adjunct to buckle intrusion. METHODS: Seven patients (9 eyes) are presented in whom intrusion of sutures occurred as a late complication of retinal detachment surgery using the extrascleral buckling technique. Their complications and treatments are discussed. RESULTS: Eleven anchoring sutures were observed under the retina and two sutures penetrated into vitreous cavity. In five eyes (55.5%), small subretinal or vitreous hemorrhages were noted and in one of them perforation with total detachment occurred. In four eyes, no complications were detected. In four eyes, the silicone band was cut and left in place and the hemorrhages were spontaneously absorbed. The perforated eye underwent replacement of the silicone band with a wide silicone sponge, followed by vitrectomy and silicone oil injection. CONCLUSIONS: Intrusion of sutures into the eye can rarely be seen years after retinal detachment surgery and usually do not require surgical intervention. When hemorrhage occurs, cutting of the silicone band only, with no attempt to remove the band or the sutures, is recommended.
Late visual field changes following cryotherapy for retinopathy of prematurity stage 3.
AIMS: The correlation between cryoscars and visual field defects following cryoablation was studied. METHODS: A Humphrey 120 full field screening test was performed in 10 children (15 eyes) who were treated by cryotherapy between 10 and 14 years previously for retinopathy of prematurity (ROP) stage 3. RESULTS: In eight eyes treated by cryoablation through 360 degrees in zone I or II, a moderate circumferential peripheral visual field constriction was found. In seven other eyes, cryotreated up to 180 degrees only in the temporal retina (zone III), a nasal field constriction was noted. There was no evidence of late development of retinal tears or retinal detachment. The correlation between the primary cryoapplications, late chorioretinal cryoscars, and the visual field changes was evaluated. CONCLUSION: Late chorioretinal scars following cryotherapy for ROP stage 3 are associated with visual field defects, but as these defects are at the periphery of the visual field they do not cause any subjective derangements 10-14 years after treatment.
Non-retinovascular leakage in diabetic maculopathy.
BACKGROUND: Diabetic macular oedema is the leading cause of vision deterioration in diabetic retinopathy. Extracellular fluid within the retina, which distorts the retinal architecture, was assumed to be strictly of retinal vasculature origin. However, there is some experimental evidence supporting clinical observations suggesting a possible role of the retinal pigment epithelium (RPE). An unusual form of diabetic maculopathy is presented in which the RPE and the subretinal space play the main role. METHODS: Fluorescein angiograms of 1850 non-proliferative diabetic retinopathy (NPDR) patients were examined. Nineteen eyes (14 patients, 1% of NPDR patients) met the criteria-mainly having minimal diabetic retinopathy with only a few microaneurysms and no clinically significant macular oedema (CSMO). Early phase angiograms were compared with late phase angiograms. RESULTS: It was found that in all 19 eyes the area of diffuse RPE late phase leakage was spread around the macular area. No cystic changes or cystoid macular oedema were present in any of the eyes and the visual acuity was 6/10 or better in all the eyes. CONCLUSIONS: Possible changes occur in the RPE that may be responsible for the late leakage in NPDR patients-namely, diabetic retinal pigment epitheliopathy. These changes are associated with a breakdown of the outer blood-retinal barrier, consisting of leakage through RPE cells. No focal or diffuse leakage across the RPE has been reported in the literature related to the fluorescein angiograms in diffuse diabetic maculopathy.
A complex chromosome translocation resulting in deletion 11p and associated with uveal colobomata.
A boy with a complex chromosome rearrangement of chromosomes 3, 10, and 11 resulting in a deletion of the short arm of chromosome II is presented. The occurrence of uveal coloboma as an isolated congenital malformation might suggest a chromosomal site for this ocular anomaly in proximity to the aniridia locus.
Primary B-cell lymphoma of the eyes and brain in a 3-year-old boy.
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Intraocular pressure after neodymium:YAG laser treatments in the anterior segment.
Intraocular pressure (IOP) increase soon after neodymium:YAG (Nd:YAG) treatments in the anterior segment has been reported. To evaluate this complication in a large sample of patients, we conducted a retrospective study of all Nd:YAG treatments during three years. Three hundred forty capsulotomies and 212 iridotomies were performed with the Q-switched Nd:YAG laser. An IOP elevation of 10 mm Hg or more within two hours of laser surgery was seen in 15 eyes (4.4%) that had a capsulotomy but in 45 eyes (21.2%) that had an iridotomy. In 13 of the 15 eyes in which the IOP increased after capsulotomy, additional risk factors (glaucoma, high myopia, aphakia) were found. Our results indicate that posterior capsulotomy with the Nd:YAG laser in otherwise healthy, pseudophakic eyes is usually not accompanied by immediate IOP elevation. Elevation can be predicted by risk factors and therefore anticipated in a small group of vulnerable patients.
Argon green laser photoepilation in the treatment of trachomatous trichiasis.
We describe the treatment of focal trachomatous trichiasis with argon green laser. We treated 70 eyelashes in 17 patients with 80% success and found this treatment modality convenient both for the patient and the practitioner.
Rhabdomyosarcoma: invading the orbit in an adult.
Sites in the head and neck region are among the most frequent locations of rhabdomyosarcoma (RMS) in patients younger than 15 years. However, comparable neoplasms in adults are very uncommon. We present a case report of a 27-year-old man who was diagnosed as having RMS. RMS rarely presents in the head and neck of adults, but should be considered in the differential diagnosis of a small cell neoplasm in patients during the third and fourth decades of life.
Bilateral panuveitis in a boy with hypogammaglobulinemia and high IgM.
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