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At least 253 records · Page 14Linked to original sources
PubMed1977

[Treatment of retinoblastoma by radioactive cobalt and xenon photocoagulation].

During the years 1961-1975, 50 cases of retinoblastoma in 31 boys and 19 girls from all parts of Poland were under treatment in the Ophthalmological Clinic in Cracow. The ages of the children at the time of diagnosis ranged from a few months to 10 years. The largest group included children between 1 and 3 years. In the majority of patients, neoplasm affected both eyes. The eye with the most advanced changes was enucleated, and the other subjected to treatment if the size of the tumor gave a prognosis of at least partial preservation of vision. In the case of unilateral tumors, treatment was undertaken if the changes were not too advanced. In the patients under treatment, 60Co according to themethod of Stallard and xenon light coagulation was applied. The observation period varied between 0.5 and 15 years. In our work, a correlation was found between the results and the size of the tumors, their localization, and postoperative complications. Our treatments proved successful in 70% (50.0-90.9%) of the cases.

Child↗
PubMed1993

Treatment of uncomplicated cases of rhegmatogenous retinal detachment with an expanding gas bubble.

We reviewed 55 consecutive cases of rhegmatogenous retinal detachment treated with pneumatic retinopexy as a primary procedure and followed up for a minimum of 1 year. 40 eyes were phakic, 11 aphakic and 4 pseudophakic. 0.6 ml of sulfur hexafluoride were injected into 42 eyes, while 0.3 ml of perfluoropropane were introduced into 13. Transconjunctival cryotherapy was performed in 51 eyes, while light coagulation was used as retinopexy after the retina was reattached in the remaining 4 cases. Of the 55 eyes undergoing treatment, 46 (83.6%) retinas were reattached with one operation. The benefits, complications and disadvantages of the procedure are reported.

Adolescent↗
PubMed1976

[Pathogenesis and treatment of diabetic retinopathy (author's transl)].

The initial disorder leading to any kind of diabetic retinopathy is hypoxia. After exhaustion of the compensatory autoregulation (vasodilatation and increase of the volume flow), the blood-retina barrier breaks down, and parts of the central retinal capillary network fall out (pre-retinopathy). In the non-proliferative and pre-proliferative stage, either disturbance of permeability or occlusion of capillaries is the prevailing process. The stage and predominance of one of the two pathogenic factors, which eventually may be jointed by vascular proliferation, are decisive for the application of light coagulation. The plan of the procedure must be based upon fluorescence angiography. If all progressive changes are treated, and fluorescence angiographic controls are made in intervals of several weeks or months, according to the stage and form (primary exsudative or primary occlusive) of the retinopathy, this procedure is preferable to the coagulation of big retinal areas (retinal ablation), and a maximum of retina with normal vascularisation can be saved. Medical treatment comprising calcium phosphate, the vasoprotecting Doxium, and clofibrate as a depressor of the lipid level in the blood, play a secondary role. Finally, hypophysectomy could not maintain its place in modern treatment of diabetic retinopathy.

Adult↗
PubMedDate not supplied

Changing trends in the management of retinoblastoma: 1951-1965 vs 1966-1980.

A retrospective analysis of the records of 1253 retinoblastoma patients (567 females, 665 males, and sex of one unknown) seen in the years 1951-1965 (575 patients, Interval I) and 1966-1980 (678 patients, Interval II) was conducted to determine changes in the manner of presentation of the disease, the treatment modalities employed, and their subsequent outcomes following treatment. There was no significant difference between the two 15-year time intervals in the age at presentation (mean, range), laterality, gender, family history, laterality vs gender distribution, family history vs laterality, employment of chemotherapy in unilateral cases or the use of external beam radiation (EBR) in bilateral cases. Changing trends in the management of retinoblastoma were observed as a result of the introduction of new treatment modalities, such as cryotherapy, light coagulation, and radioactive plaque therapy. Bilateral patients have received chemotherapy less frequently in interval II. The use of photocoagulation, cryotherapy, and brachytherapy for bilaterals, and cryotherapy for unilaterals increased significantly during Interval II. During both time intervals, a significantly higher percentage of unilaterally affected eyes were enucleated compared with bilaterally affected eyes; in addition, there was a decrease in the percentage of enucleations performed on both unilaterally and bilaterally affected eyes. In Interval II, 87% of unilateral patients and 91% of the bilateral patients had an enucleation performed.

Adolescent↗
PubMed1986

Measurements of retinal microcirculation in retinal vessel occlusion before and after treatment.

Blood flow, arterial velocity, and vascular diameter were measured in patients with retinal vessel occlusion before and after treatment, especially after light coagulation. The mean values in the patient group showed significantly reduced blood flow and velocity compared to the normal group. The mean group difference before and after therapy revealed that while there is an increase in blood flow after treatment, the normal value is not reached. Individual patient values indicated both increased and decreased blood flow and velocity after treatment as compared with the values before therapy. There are various stages in microcirculatory disease and the microcirculation also behaves differently after treatment, which could be observed by measurement in vivo of the physiological flow parameters.

Adult↗
PubMed1989

The focal treatment of retinoblastoma with emphasis on xenon arc photocoagulation.

Two-hundred-seventy-eight retinoblastoma tumors in 169 patients were photocoagulated by one of two doctors with the xenon arc photocoagulator. More than 70% of tumors treated were cured by photocoagulation. The following features correlated with success: 1) size of the tumor, 2) location of the tumor and 3) elevation of the tumor. Seventy of 72 tumors (97%) up to 1 dd in size were cured while only 9 of 22 (41%) tumors larger than 5 dd were cured. The mean size of tumors cured was 2 dd, while the mean size of those that failed was 3.9 dd. Tumors located anterior to the equator were more often successfully treated (67/81 = 83%) than those posterior to the equator (44/74 = 60%). Tumors with the height equal to half the base were classified as 'low elevation', while those with heights larger than half the base diameter were classified as high elevation. Tumors with low elevation did significantly better (162/201 = 81%) than those with high elevation (33/76 = 43%). No correlation was found between success and the following features: age at diagnosis, sex, age at first photocoagulation, eye involved (right or left), time from radiation to first light coagulation, nasal versus temporal tumors or the clock hour of the tumor or category of tumor independent of size of location. Forty-four percent of tumors that failed photocoagulation went on to develop vitreous seeding and 55% required enucleation. Fifty percent of the eyes that were treated initially with photocoagulation went on to develop new tumor foci elsewhere in the eye. In all cases the new tumors appeared anterior to the equator. The children who developed additional tumors in the eye were younger (5.5 months) when photocoagulated than those who did not develop additional tumors (47.75 months). Photocoagulated retinoblastomas must be followed for at least three years before a cure is certain.

Eye Neoplasms↗
PubMed1989

Chemotherapy in retinoblastoma management.

Chemotherapy, in addition to surgery, irradiation, cryothermy and light coagulation has been used in three groups of patients with retinoblastoma. In the first group it was used to try to prevent the development of metastases in cases with large tumours (Reese-Ellsworth Grade 4-5), in the second group to treat local extra-ocular spread and in the third group to treat bony metastases. In the first group there were 14 children with unilateral and eight with bilateral disease (grade 4 or 5 in one or both eyes), who were given prophylactic chemotherapy; there were no significant complications. One child died from congenital heart disease five years after treatment with no signs of metastatic disease. The mean survival of the other 21 children is now 6.0 years (range 2.5-11 years). Six children with local extra-ocular spread, one with CNS involvement as well, had chemotherapy with only minor complications. One child who did not complete the chemotherapy or radiotherapy coursed died from CNS disease but the remaining five have survived for four to 13 years. Three children with bone metastases were treated with high dosage chemotherapy after marrow harvesting and then reinfusion of marrow; in two children this did not eliminate the tumour and they died but one child has now survived free from disease for six years. In our cases we have had encouraging results from the use of chemotherapy with few complications but other authors have suggested that there is a possibility of new primary tumours being caused by this treatment.

Antineoplastic Agents↗
PubMed1996

Laparoscopy in the Treatment of Tubal Infertility

Since 1992 we have performed 371 bilateral salpingostomies in infertile women (age 20-32 yrs, infertility duration 2-9 yrs) with blockage in the ampullas. Salpingostomy was performed after retrieving the tube from the commisure and filling it with methylene blue. The ampullary part of the tube was grasped at 1 to 2 cm to place the stoma, the wall was coagulated, and the site of greatest thinness of the star scar was dissected by microscissors. The fimbriae were identified and washed with physiologic heparinized solution. The distal tubal serosa was lightly coagulated with point endocoagulation along the perimeter. The abdomen was irrigated with physiologic heparinized solution, and a small amount of solution was left for hydroflotation. Second-look laparoscopy with chromopertubation in 1.5 months revealed 234 patent tubes (63.1%), 66 commissures (17.8%), 23 cases of one patent tube and the other with a hydrosalpinx (6.2%), and 48 recurrent hydrosalpinges (12.9%). One hundred three women conceived within 6 months, with 86 (23.2%) uterine and 17 (4.6%) tubal pregnancies. Laparoscopic treatment of hydrosalpinges restored tubal patency with minimal risk of complications.

Journal Article↗
PubMed1981

Simultaneous bilateral radiation for advanced bilateral retinoblastoma.

A retrospective review of 1,424 cases of retinoblastoma disclosed 34 patients with advanced bilateral retinoblastoma whose sole initial treatment was simultaneous bilateral radiation. All patients had a combination of bilateral group IV or V retinoblastoma. Mean age at diagnosis was 13.1 months. Five-year survival of patients was 88% (28/32). In two (7%) of 28 surviving patients, a second nonocular tumor developed: one inside and one outside the field of radiation. Of the 64 eyes treated, 44 ultimately were enucleated. Of ten eyes requiring a second course of radiation, nine were enucleated. In only one eye was enucleation due to radiation complications. Eleven patients required additional treatment with light coagulation, cryopexy, or cobalt plaques.

Adolescent↗
PubMed1983

Radiation regression patterns after cobalt plaque insertion for retinoblastoma.

An analysis of 31 eyes of 30 patients who had been treated with cobalt plaques for retinoblastoma disclosed that a type I radiation regression pattern developed in 15 patients; type II, in one patient, and type III, in five patients. Nine patients had a regression pattern characterized by complete destruction of the tumor, the surrounding choroid, and all of the vessels in the area into which the plaque was inserted. This resulting white scar, corresponding to the sclerae only, was classified as a type IV radiation regression pattern. There was no evidence of tumor recurrence in patients with type IV regression patterns, with an average follow-up of 6.5 years, after receiving cobalt plaque therapy. Twenty-nine of these 30 patients had been unsuccessfully treated with at least one other modality (ie, light coagulation, cryotherapy, external beam radiation, or chemotherapy).

Adolescent↗
PubMed1998

Virtual reality versus conventional training in retinal photocoagulation: a first clinical assessment.

Virtual reality can provide a new method for apprenticeship in surgery. We have developed a training simulator for retinal photocoagulation. This paper describes a comparison between this new training tool and the conventional teaching method. Residents were divided into two groups, each group being trained exclusively with one of the methods. A final evaluation was made by a single expert, who did not know which training mode the residents had undergone. The results show that this new training mode is at least as efficient as the current one and may reduce training duration. While experts remain in control of the contents of training and assessment of skill, this study outlines new prospects for apprenticeship and evaluation in the field of medicosurgical techniques. In addition, this preliminary study emphasizes the difficulties in introducing a new modality in a traditional teaching environment.

Humans↗
PubMed2000

Selective photothermolysis in skin by using subcutaneous optical fibers.

BACKGROUND AND OBJECTIVE: Vascular selective photothermolysis has been shown to be effective in treating hypertrophic scars. Performing selective photothermolysis on the vasculature deep within thick scars requires new methods for delivering laser energy. It is the objective of this study to model the use of subcutaneous fiber optics to perform selective photothermolysis in skin as a possible aid in the treatment of thick scars. STUDY DESIGN/MATERIALS AND METHODS: A Monte Carlo simulation was performed to study the expected region of vascular necrosis in a two layer skin model when 585-nm radiation is delivered into the dermis by means of subcutaneous optical fibers. RESULTS: The extent of vascular necrosis is independent of fiber diameter for a fixed total energy. A fiber penetrating barely below the epidermis decreases the maximum epidermal fluence by more than an order of magnitude relative to a superficial beam. Using four fibers simultaneously can significantly increase the depth of vascular necrosis. CONCLUSIONS: Small diameter fibers are optimum if the maximum fluence tolerable in the dermis is not a limiting factor. Shallowly inserted fibers can significantly decrease epidermal damage to dark-skinned patients undergoing laser therapy.

Algorithms↗
PubMed2000

Inadvertent corneal burn by using indirect wide-field contact lenses and different laser beam delivery systems during experimental fundus photocoagulation.

BACKGROUND AND OBJECTIVE: At fundus photocoagulation by using a wide-field indirect contact lens, the laser radiant exposure may be increased at the anterior segment of the eye. We examined the likelihood of producing inadvertent corneal burn by using parfocal and sharped edge defocus laser delivery systems with various indirect contact lenses. STUDY DESIGN/MATERIALS AND METHODS: The two laser delivery systems were used with four lenses of different viewing angles during fundus photocoagulation in a total 44 eyes of rabbits. RESULTS: By using the lenses, the parfocal system increased corneal radiant exposure more than did the sharped edge defocus system. By using the Widefield PRP 165 lens of the widest viewing angle, there was no difference between the two systems in the corneal burns produced. CONCLUSION: Some indirect contact lenses used in combination with the parfocal system caused inadvertent corneal burns more readily than did the same lenses in combination with the sharped edge defocus system.

Animals↗
PubMed1988

Treatment of retinoblastoma. Results obtained from a prospective study of 51 patients.

During 4 years, 51 patients with retinoblastoma were studied (unilateral 32, and bilateral 19). Treatment consisted of enucleation of those eyes which showed massive involvement followed by radiotherapy when there was optic nerve and/or orbit involvement. Systemic chemotherapy was administered to all patients who underwent nonsurgical treatment and when the histologic examination showed choroidal optic nerve head and/or optic nerve involvement or residual tumor after enucleation. When there was compromise of the central nervous system intrathecal chemotherapy was administered. Nonsurgical treatment consisted of radiotherapy and/or light coagulation. Survival was 90.6% for unilateral cases and 84.2% for the bilateral. The median follow-up was 31 months and 29 months, respectively. Of 19 conservated eyeballs, 16 preserve useful vision (63%).

Antineoplastic Agents↗
PubMed1991

A prospective study on the treatment of retinoblastoma in 72 patients.

Seventy-two patients with retinoblastoma (RTB) (unilateral [47 patients] and bilateral [25 patients]) were studied for a period of 6 years. Treatment consisted of enucleation of those eyes that had severe involvement and was followed by radiation therapy and/or chemotherapy (systemic or intrathecal) according to clinical pathologic staging. All patients who underwent nonsurgical treatment received systemic chemotherapy. Intrathecal chemotherapy was administered when there was involvement of the central nervous system. Nonsurgical treatment consisted of radiation therapy and/or light coagulation, followed by enucleation if there was no response. The overall survival rates were 79% for unilateral disease (median follow-up time, 63 months) and 72% for bilateral disease (median follow-up time, 81 months). Vision was regained in 14 of 21 conserved eyes.

Antineoplastic Combined Chemotherapy Protocols↗