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At least 703 records · Page 39Linked to original sources
PubMed2004

Sensitivity and specificity of digital retinal images in grading diabetic retinopathy.

PURPOSE: To assess three novel digital fundus cameras for diabetic retinopathy (DR) screening. METHODS: Digital colour and red-free retinal imaging (Topcon TRC 50 IA, Canon CR6-45NM, and MediTell) was used to capture 427 images of 70 diabetes patients and control subjects. The images were graded for DR by three readers in a randomized and masked manner using a modified Early Treatment Diabetic Retinopathy Study classification. The reference standard was based on mydriatic ophthalmoscopy and colour and red-free images. RESULTS: Digital 50 degrees red-free imaging had sensitivity of 97.7%, two-field 50 degrees colour imaging 94.0%, and two-field 45 degrees colour imaging sensitivity of 88.9%. The specificity of these imaging modalities was 98.9-100%, and ungradeable images represented 1.2-1.6%. The hand-held digital colour videocamera (MediTell) showed a sensitivity of 6.9% and ungradeable images represented 92.3%. CONCLUSION: Digital 50 degrees red-free and two-field 50 degrees or 45 degrees colour imaging were suitable for DR screening, whereas the hand-held digital videocamera did not fulfil the needs of DR screening.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging of a choroid plexus carcinoma and meningeal carcinomatosis in a dog.

A 6-year-old neutered female Boston Terrier had a slow onset of blindness and behavior changes. Neurologic abnormalities included bilateral visual loss with absent menace responses and visual tracking, mydriatic pupils, slow pupillary light responses and papilledema. On magnetic resonance imaging (MRI) there were multiple cyst-like structures found in the parenchyma of the cerebrum, cerebellum and brainstem. Histopathologically the diagnosis was a choroid plexus carcinoma with meningeal carcinomatosis. The findings differ from previous descriptions of the MRI characteristics of choroid plexus tumors.

Animals↗
PubMed1975

Treatment of traumatic hyphaema.

A series of 131 successive hospitalized cases of traumatic hyphaema after blunt injury of the eye were treated with complete bed-rest for 6 days and double eye-patching but without any topical medication. Seven patients (5.3%) had a secondary bleeding. The visual acuities of 115 patients were tested, and 105 regained their normal vision, i.e. 1.0 or over. These results are no better than those reported in series treated with moderate bed-rest for 3-4 days combined with topical administration of corticosteroids and mydriatics. The results indicate that our present treatment may be unnecessarily severe.

Adolescent↗
PubMed1983

Tranexamic acid and traumatic hyphaema. A prospective study.

112 patients with traumatic hyphaema were investigated prospectively over a period of 3 years. 53 had conservative treatment and 59 tranexamic acid treatment. They were hospitalized, but fully mobilized. Both groups were given supplementary local therapy with glucocorticoids and mydriatics as well as monocular patching. In neither group was any re-bleeding seen. The resorption of blood was delayed in the tranexamic treated patients, which may be taken as indirect proof of the efficacy of the treatment. The longer persistence of blood in the anterior chamber in the tranexamic acid treated group caused no complication. The treatment was well tolerated. In both departments treatment with tranexamic acid had replaced the bed rest treatment.

Adolescent↗
PubMed1988

Effects of adrenergic drugs on accommodation and distant refraction in daylight and darkness. A laseroptometric study.

Near point accommodation was measured using a RAF near point rule, and distant refraction in daylight and darkness were determined using a laseroptometer in a double-blind cross-over study on 10 healthy test subjects (19-31 years). Determinations were made before and 40 min after topical instillations of 3 X 10 microliters 10% phenylephrine, 0.5% thymoxamine, 1% adrenaline, 3% isoproterenol, 0.5% timolol and 0.5% betaxolol. Combinations of 3 X 10 microliters 0.5% thymoxamine + 10% phenylephrine, 0.5% timolol + 1% adrenaline and 0.5% betaxolol + 3% isoproterenol were also administered. The near point of accommodation decreased 0.8 +/- 0.3 diopter after instillations of the alpha 1 adrenoceptor agonist phenylephrine, while an increase of 0.6 +/- 0.2 diopter was determined after administration of the alpha adrenoceptor antagonist thymoxamine. Thymoxamine plus phenylephrine did not alter the pretreatment values. Beta adrenoceptor stimulation by isoproterenol or beta adrenoceptor inhibition by timolol or betaxolol had no effect on the near point accommodation. The difference between distant refraction in daylight and darkness, that is low-luminance myopia, amounted to -1.25 +/- 0.1 diopter. Phenylephrine caused a myopic shift in distant refraction in daylight and darkness of 0.32 +/- 0.1 and 0.9 +/- 0.2 diopter, respectively. This effect was due to the mydriatic action of phenylephrine.(ABSTRACT TRUNCATED AT 250 WORDS)

Accommodation, Ocular↗
PubMed1990

Angle closure glaucoma precipitated by labour.

Acute angle closure glaucoma generally occurs in older hypermetropic individuals, precipitated by pupillary dilation. However it is often forgotten that it can occur in younger people and that it does not occur solely as a result of the use of mydriatics or normal pupillary dilation in response to darkness. It is recognised that it can occur during or shortly after a surgical procedure done under either spinal or general anaesthetic. We describe a case of acute angle closure occurring in a 37-year-old woman, precipitated by labour. To our knowledge no such case has been described in the literature.

Acute Disease↗
PubMed1994

Refraction and retinopathy in diabetic children below 16 years of age.

In a population-based cross-sectional study of insulin-dependent diabetes mellitus, 42 children--with a median age of 11 years (range 7-15 years) and a median duration of diabetes of 4 years (range 1-12 years)--underwent an ophthalmological and a biochemical examination (HbA1c). None of the children had visual loss due to diabetes, and only 4.8% had mild, non-proliferative retinopathy. Using cycloplegic refractioning, we found low degree myopia (less than -2D) in 12% of the patients, whereas non-mydriatic measurements increased the frequency of myopia to 29%. We therefore recommend the use of cycloplegia in refractive evaluations of diabetic children.

Adolescent↗
PubMedDate not supplied

Visual evoked potentials in the clinically normal dog.

Visual evoked potentials (VEP) in response to flashes of white light were recorded from 15 adult beagles of both sexes to provide a normative data base. Separate recordings were taken by stimulating each eye of every dog. Responses were recorded from a needle electrode placed over the nuchal crest referenced to an electrode just caudal to the eyes. Five positive and negative peaks were present in each VEP; P1, N1, P2, N2, and P3. Peak P2 was the most prominent. Mean (+/- standard deviation [SD]) latencies for peaks P1, N1, P2, N2, and P3 were 14.3 +/- 2.4, 29.2 +/- 2.2, 54.5 +/- 7.4, 78.0 +/- 13.1, and 98.1 +/- 12.6 msec, respectively. Peak-to-peak mean amplitudes ranged from 5.88 to 13.30 microV. Recordings were accomplished without sedation, anesthesia, or mydriatic drugs.

Animals↗
PubMed1976

Anticholinergic activity of antipsychotic drugs in relation to their extrapyramidal effects.

Antipsychotic drugs were evaluated with two indices of anticholinergic activity, mydriasis in mice in vivo and antagonism of carbamylcholine-induced contractions of guinea-pig tracheal strips in vitro. The drugs from most to least potent as oral mydriatic agents were mepazine, clozapine, thioridazine, promazine and chlorpromazine. Trifluoperazine, pimozide and haloperidol were inactive. These results were consistent with the hypothesis that anticholinergic activity of antipsychotic drugs is inversely related to their propensity to produce extrapyramidal effects in man. In vitro results appeared to predict the incidence of extraphyramidal effects less accurately than in vivo results.

Animals↗
PubMed1988

Ophthalmitis in meningococcal disease.

We report an infant with meningococcal septicaemia and meningitis who had panophthalmitis at presentation that was unresponsive to standard systemic antibiotic treatment but which responded to topical steroid and mydriatic treatment. The pathogenesis may have been immune mediated.

Administration, Topical↗
PubMed2006

The prevalence and severity of diabetic retinopathy, associated risk factors and vision loss in patients registered with type 2 diabetes in Luganville, Vanuatu.

AIM: To determine the prevalence and severity of diabetic retinopathy in patients with type 2 diabetes in Luganville, the second largest town in Vanuatu. Additionally, to investigate risk factors for retinopathy and the effect of retinopathy on visual acuity (VA) within this group. METHOD: All 83 registered patients with type 2 diabetes in Luganville, a town of 13 121 people, were invited for an interview and anthropometric measurements. A questionnaire including assessment of hypertension and glycaemic control, which are known risk factors for diabetic retinopathy, was administered. This sample accounted for approximately 1.07% of Luganville's adult population. Presenting VA was measured. The retina was photographed with a non-mydriatic fundus camera and images later independently graded for the extent of retinopathy. RESULTS: 68 (82%) of the 83 patients attended. The mean (SD) age was 54 (11) years and 31 (46%) were male. Diabetic retinopathy was present in 36 (52.9%) of the sample. Sight-threatening retinopathy requiring urgent referral was present in 15 (22.1%) patients. Presenting VA was worse than 6/12 in the better eye in n = 32 (47%) and in up to half of these cases the principal cause was retinopathy. In addition, four people had uniocular blindness resulting from diabetes. The mean body mass index was lower in those patients with diabetes with retinopathy than in those without (p = 0.010), but there were no other significant differences between the two groups and, specifically, no difference in the frequency of retinopathy risk factors. 42 (61.8%) patients had hypertension (>or=135/85 mm Hg) or were taking antihypertensive therapy. CONCLUSIONS: The prevalence of registered patients with diabetes in Luganville's adult population was 1.07%. Diabetic retinopathy was highly prevalent in the sample (in 36, 52.9%), and in 15 (22.1%) there was a significant threat to sight, with up to 25% of the sample possibly already affected by decreased VA or blindness resulting from diabetes-related eye disease. Retinopathy risk factors were also prevalent. A diabetes screening programme with baseline ophthalmic assessment and follow-up are urgently needed to enable timely intervention and treatment.

Adult↗
PubMed1980

Ocular reticulum cell sarcoma.

Although rare, ocular reticulum cell sarcoma presents a recognisable clinical pattern, as confirmed by 3 new cases. Typical patients, in their sixth and seventh decades, initially complain of gradual visual loss. Examination reveals 'uveitis' with prominent vitreous debris and/or chorioretinal infiltrative lesions. Topical steroid and mydriatic therapy is ineffective. Reticulum cell sarcoma in the central nervous or other systems may precede or accompany the ophthalmic presentation. In an increasing number of cases tissue diagnosis and effective therapy have followed vitreous aspiration.

Aged↗
PubMed1983

Evidence for a neuropathic aetiology in the small pupil of diabetes mellitus.

Infrared television pupillometry was performed on 34 insulin-treated diabetic patients and 55 healthy subjects. Sixteen of the diabetic patients had pupils that failed to dilate normally in darkness. The occurrence of a small pupil was associated with cardiac vagal dysfunction and somatic sensory loss. The small pupil was found to be supersensitive to the mydriatic effect of topical 2% phenylephrine but normally sensitive to 0.5% hydroxyamphetamine eyedrops. It is concluded that the failure of the pupil to dilate in darkness in some diabetic patients is due to neuropathy of the sympathetic innervation.

Adolescent↗
PubMed1985

Extracapsular lens extraction and posterior chamber intraocular lens insertion combined with trabeculectomy.

Trabeculectomy for primary glaucoma was successfully combined with extracapsular lens extraction and insertion of a Pearce tripod posterior chamber lens in seven eyes of five patients. The results were similar to those expected from each component of the operation when performed alone, and all eyes achieved visual acuity of 6/9 or better with control of intraocular pressure below 22 mmHg without supplementary medical treatment. The incidence of mild anterior uveitis (three out of seven eyes) and hyphaema (two out of seven eyes) was greater than usual with this type of cataract extraction but no more than expected after trabeculectomy. Mydriatic drops may be used to treat postoperative iritis without danger to the stability of this pattern of implant. In addition the anterior chamber cannot become shallow, as the rigid legs of this lens extend behind the iris beyond the periphery of the cornea and prevent forward movement of the implant even if there is excessively free drainage of aqueous after the operation.

Aged↗
PubMed1986

Subretinal neovascularisation and snow banking in a case of sarcoidosis: case report.

A 49-year-old Japanese man presented with chronic granulomatous uveitis in his left eye. Later he developed macular subretinal neovascularisation. The chest x-ray showed bilateral hilar lymphadenopathy. Bronchoscopy and gallium-67 scanning were positive, PPD skin test negative, and serum angiotensin converting enzyme (ACE) levels increased. Ophthalmoscopy and fluorescein angiography of the left eye showed perivasculitis, retinochoroidal exudates, snow banking, and vitreous opacity. On these findings, the diagnosis of sarcoidosis was made. Treatment was based on topical corticosteroids, mydriatics, beta blockers, and oral carbonic anhydrase inhibitors. After 15 months the visual acuity decreased in the left eye, and a neovascular membrane was observed in the macula. Fluorescein angiography confirmed subretinal neovascularisation. Almost two years later the patient still has the neovascular membrane in his left eye.

Eye Diseases↗
PubMed1989

Occurrence of malignant glaucoma after laser iridotomy.

A case is described of malignant glaucoma with extreme shallowing of the anterior chamber (AC) and an abnormally high intraocular pressure (IOP) following laser iridotomy for acute angle closure glaucoma. The episode followed the use of strong miotic (pilocarpine hydrochloride 4%) and was reversed by mydriatics including phenylephrine hydrochloride. Serial estimation of anterior chamber depth is important in the management of angle closure glaucoma.

Aged↗
PubMed1994

Intraocular adrenaline maintains mydriasis during cataract surgery.

Cataract surgery is performed more easily if mydriasis can be maintained until the intraocular lens has been inserted. Intraocular irrigation with adrenaline is thought to be of benefit in this respect, and is used by some surgeons but not others. This prospective double blind controlled trial assessed the efficacy and safety of using perioperative adrenaline during extracapsular cataract surgery, as an adjunct to preoperative topical mydriatics. Seventy patients were randomised to receive intraocular irrigation fluid with or without 1:1,000,000 adrenaline. The adrenaline entering the eye through the anterior capsulotomy needle helped to resist the miosis induced by expression of the nucleus (7.1 versus 6.5 mm). The mydriasis maintained during irrigation aspiration was significantly greater in the group receiving adrenaline (6.6 versus 6.0 mm, p < 0.02). Their pupil diameters were also significantly larger at 20 minutes (p < 0.001) and 30 minutes (p < 0.01) into surgery. Pupillary constriction to a diameter of less than 5 mm occurred more frequently in the group not receiving adrenaline. Pulse rate and blood pressure in the 27 patients who had local anaesthesia showed no significant difference between the treatment groups (p > 0.05), and there was no significant variation from baseline (p > 0.05). Intraocular irrigation with adrenaline 1:1,000,000 is a safe and effective means of maintaining mydriasis during cataract surgery.

Administration, Topical↗
PubMed2003

Screening for primary angle closure in Mongolia: a randomised controlled trial to determine whether screening and prophylactic treatment will reduce the incidence of primary angle closure glaucoma in an east Asian population.

AIM: To describe the methods used and initial results of a prospective study designed to determine whether screening and prophylactic treatment will reduce the incidence of primary angle closure glaucoma (PACG) in Mongolia. METHODS: A total of 4725 individuals aged 50 years and above were recruited to the study and randomised to intervention or control groups. All subjects had non-mydriatic optic disc examination. The intervention arm had measurement of anterior chamber depth (ACD) by A-scan ultrasound and intraocular pressure (IOP) with Tonopen. Gonioscopy was performed on test positive cases (ACD <2.53 mm or IOP >or=24 mm Hg either eye). Those with occludable angles were offered laser iridotomy. Primary outcome will be incidence of PACG at 5 year follow up. RESULTS: Glaucoma was diagnosed in 128 (2.7%) subjects. Of the remaining 4597, 2293 were randomised to intervention. Intervention as allocated was received by 2280 (99.4%) individuals. 160 (23.4%) of 685 test positive cases had occludable angles, of which 156 were treated with iridotomy. CONCLUSIONS: This trial is a further step in determining whether screening and prophylactic treatment for primary angle closure in east Asian populations will reduce the incidence of glaucoma.

Aged↗