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1

Bilateral macular hole following myopic photorefractive keratectomy.  

PubMed

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole. PMID:24882962

Shoeibi, Nasser; Jabbarpoor Bonyadi, Mohammad Hossein; Abrishami, Majid; Ansari-Astaneh, Mohammad-Reza

2014-06-01

2

Bilateral and simultaneous cystoid macular edema associated with latanoprost use: report of two cases.  

PubMed

Cystoid macular edema is an uncommon, but well known, side effect of latanoprost. Two cases of bilateral and simultaneous cystoid macular edema associated with latanoprost use are described, which complete resolution of the edema is observed upon drug discontinuation. PMID:20549052

Brasil, Oswaldo Ferreira Moura; Brasil, Maria Vitoria Moura; Ventura, Marcelo Palis; Maia, Hugo Soares

2010-01-01

3

Optical coherence tomographic findings at the fixation point in a case of bilateral congenital macular coloboma  

PubMed Central

Background Congenital macular coloboma is a rare ocular disease that consists of atrophic lesions in the macula with well-circumscribed borders. We report the findings of spectral domain optical coherence tomography (SD-OCT) at the fixation point in a case of bilateral macular coloboma. Case report The subject is a 4-year-old boy. He visited our hospital at age 1 year and 4 months for the evaluation of strabismus. The fundus examination of both eyes showed round-shaped sharply-demarcated atrophic lesions involving the macula with large choroidal vessels and bared sclera at the base. Immunologic tests including toxoplasmosis, rubella, varicella, herpes virus, and human T-cell leukemia virus were all negative. At age 4 years and 1 month, cycloplegic refraction showed insignificant refractive errors and his best corrected visual acuity was 0.6 bilaterally. The SD-OCT showed a crater-like depression accompanying atrophic neurosensory retina, and the absence of retinal pigment epithelium and choroid. Examination of the fixation behavior by visuscope showed steady fixation with an area 0.5° nasal to the nasal edge of the atrophic lesion bilaterally. The SD-OCT findings at fixation area showed remaining normal retinal structures involving inner segment-outer segment (IS/OS) junction line. Conclusion The findings of SD-OCT have been shown to be useful in the diagnosis of macular coloboma. In the fixation point, the structure of retina and choroid were well preserved. PMID:24899799

Abe, Kosuke; Shirane, Jumi; Sakamoto, Masuo; Tanabe, Fumi; Kuniyoshi, Kazuki; Matsumoto, Chota; Shimomura, Yoshikazu

2014-01-01

4

Vitreoretinal surgery for bilateral macular holes after laser-assisted in situ keratomileusis for the correction of myopia: a case report  

PubMed Central

Introduction Laser-assisted in situ keratomileusis surgery may induce postoperative changes in the vitreomacular interface due to the mechanical stretch of the vitreous produced by the suction ring and the shock waves generated by the excimer laser and, subsequently, may provoke macular hole formation. Case presentation A 53-year-old Spanish woman who had undergone a laser-assisted in situ keratomileusis for the correction of myopia in her right and left eye (10 years ago) was referred to our department with a complaint of decreased visual acuity in both eyes. A fundoscopy and optical coherence tomography examination revealed a bilateral full-thickness macular hole. A 23-gauge sutureless pars plana vitrectomy was performed in both eyes, and 1 month after surgery her visual acuity improved and the hole closed. Conclusion The development of a bilateral full-thickness macular hole after laser-assisted in situ keratomileusis has been reported once. This case study enhances our understanding of the vitreoretinal pathology induced by laser-assisted in situ keratomileusis, showing the importance of a rigorous follow-up, because complications may occur even a decade later. In this case study we must also consider the contribution of the underlying myopia to the development of the bilateral macular holes. PMID:23140584

2012-01-01

5

Bilateral visual outcomes and service utilization of patients treated for 3 years with ranibizumab for neovascular age-related macular degeneration  

PubMed Central

Background The aim of this study was to describe bilateral visual outcomes and the effect of incomplete follow-up after 3 years of ranibizumab therapy for neovascular age-related macular degeneration. Secondarily, the demands on service provision over a 3-year period were described. Methods Data on visual acuity, hospital visits, and injections were collected over 36 months on consecutive patients commencing treatment over a 9-month period. Visual outcome was determined for 1) all patients, using last observation carried forward for missed visits due to early discontinuation and 2) only those patients completing full 36-month follow-up. Results Over 3 years, 120 patients cumulatively attended hospital for 1,823 noninjection visits and 1,365 injection visits. A visual acuity loss of <15 letters (L) was experienced by 78.2% of patients. For all patients (n=120), there was a mean loss of 1.68 L using last observation carried forward for missing values. Excluding five patients who died and 30 who discontinued follow-up, mean gain was 1.47 L. In bilateral cases, final acuity was on average 9 L better in second eyes compared to first eyes. Also, 91% of better-seeing eyes continued to be the better-seeing eye. Conclusion We have demonstrated our approach to describing the long-term service provision and visual outcomes of ranibizumab therapy for neovascular age-related macular degeneration in a consecutive cohort of patients. Although there was a heavy burden with very frequent injections and clinic visits, patients can expect a good level of visual stability and a very high chance of maintaining their better-seeing eye for up to 3 years. PMID:24748766

Chavan, Randhir; Panneerselvam, Swati; Adhana, Parul; Narendran, Nirodhini; Yang, Yit

2014-01-01

6

Macular telangiectasia type 2  

PubMed Central

Macular telangiectasia type 2 is a bilateral disease of unknown cause with characteristic alterations of the macular capillary network and neurosensory atrophy. Its prevalence may be underestimated and has recently been shown to be as high as 0.1% in persons 40 years and older. Biomicroscopy may show reduced retinal transparency, crystalline deposits, mildly ectatic capillaries, blunted venules, retinal pigment plaques, foveal atrophy, and neovascular complexes. Fluorescein angiography shows telangiectatic capillaries predominantly temporal to the foveola in the early phase and a diffuse hyperfluorescence in the late phase. High-resolution optical coherence tomography (OCT) may reveal disruption of the photoreceptor inner segment–outer segment border, hyporeflective cavities at the level of the inner or outer retina, and atrophy of the retina in later stages. Macular telangiectasia type 2 shows a unique depletion of the macular pigment in the central retina and recent therapeutic trials showed that such depleted areas cannot re-accumulate lutein and zeaxanthin after oral supplementation. There have been various therapeutic approaches with limited or no efficacy. Recent clinical trials with compounds that block vascular endothelial growth factor (VEGF) have established the role of VEGF in the pathophysiology of the disease, but have not shown significant efficacy, at least for the nonneovascular disease stages. Recent progress in structure–function correlation may help to develop surrogate outcome measures for future clinical trials. In this review article, we summarize the current knowledge on macular telangiectasia type 2, including the epidemiology, the genetics, the clinical findings, the staging and the differential diagnosis of the disease. Findings using retinal imaging are discussed, including fluorescein angiography, OCT, adaptive optics imaging, confocal scanning laser ophthalmoscopy, and fundus autofluorescence, as are the findings using visual function testing including visual acuity and fundus-controlled microperimetry. We provide an overview of the therapeutic approaches for both non-neovascular and neovascular disease stages and provide a perspective of future directions including animal models and potential therapeutic approaches. PMID:23219692

Issa, Peter Charbel; Gillies, Mark C.; Chew, Emily Y.; Bird, Alan C.; Heeren, Tjebo F.C.; Peto, Tunde; Holz, Frank G.; Scholl, Hendrik P.N.

2013-01-01

7

American Macular Degeneration Foundation  

MedlinePLUS

... A + A Search Search Welcome Welcome to the American Macular Degeneration Foundation web site where you can ... the United States, affecting more than ten million Americans. This time-lapse animation illustrates the central vision ...

8

Cystoid macular edema  

PubMed Central

We review the epidemiology, pathophysiology, and etiology of cystoid macular edema (CME). Inflammatory, diabetic, post-cataract, and macular edema due to age-related macular degeneration is described. The role of chronic inflammation and hypoxia and direct macular traction is evaluated in each case according to different views from the literature. The different diagnostic methods for evaluating the edema are described. Special attention is given to fluoroangiography and the most modern methods of macula examination, such as ocular coherence tomography and multifocal electroretinography. Finally, we discuss the treatment of cystoid macular edema in relation to its etiology. In this chapter we briefly refer to the therapeutic value of laser treatment especially in diabetic maculopathy or vitrectomy in some selected cases. Our paper is focused mainly on recent therapeutic treatment with intravitreal injection of triamcinolone acetonide and anti-VEGF factors like bevacizumab (Avastin), ranibizumab (Lucentis), pegaptamid (Macugen), and others. The goal of this paper is to review the current status of this treatment for macular edema due to diabetic maculopathy, central retinal vein occlusion and post-cataract surgery. For this reason the results of recent multicenter clinical trials are quoted, as also our experience on the use of intravitreal injections of anti-VEGF factors and we discuss its value in clinical practice. PMID:19668445

Rotsos, Tryfon G; Moschos, Marilita M

2008-01-01

9

Macular pigment and visual acuity in Stargardt macular dystrophy  

Microsoft Academic Search

Purpose. To test the hypothesis that macular pigment reflects foveal cone function and possibly the presence of foveal cones in recessive Stargardt macular dystrophy. Methods. Sixteen patients (32 eyes) diagnosed to have Stargardt macular dystrophy by clinical criteria were studied with a scanning laser ophthalmoscope (SLO) comparing argon laser blue (488 nm), green (514), helium-neon laser red (633 nm) and

Xinyuan Zhang; János Hargitai; Jaana Tammur; Amy Hutchinson; Rando Allikmets; Stanley Chang; Peter Gouras

2002-01-01

10

Molecular genetics of macular degeneration  

Microsoft Academic Search

Macular degeneration is a leading cause of blindness that affects the aged population. The complexity of the molecular basis of macular disease is now beginning to be elucidated with the identification of disease-causing genes. For example, mutations in the ABCR gene, (recently identified in cones as well) which codes for retinal rod-specific ABCR protein is responsible for Stargardt macular dystrophy\\/fundus

Maria A. Musarella

2001-01-01

11

Intravitreal triamcinolone acetonide as treatment of macular edema in central retinal vein occlusion  

Microsoft Academic Search

Purpose. To report the clinical outcome of a patient receiving an intravitreal injection of triamcinolone acetonide as treatment of bilateral, long-standing, cystoid macular edema due to central retinal vein occlusion. Methods. A 70-years-old patient suffering from bilateral central retinal vein occlusion for 2 years and 1.5 years, respectively, received transconjunctivally an intravitreal injection of 25 mg of crystalline triamcinolone acetonide

Jost B. Jonas; Ingrid Kreissig; Robert F. Degenring

2002-01-01

12

Macular hole after laser in situ keratomileusis in a 26-year-old patient.  

PubMed

The purpose of this study is to describe the 26-year-old patient with developed macular hole after bilateral laser in situ keratomileusis (LASIK). A macular hole with sharp margins and irregular surface of surrounding retina appeared in the left eye of the female 26-year-old patient two months after LASIK for correction of myopia (followup of 6 months). Although the best corrected visual acuity (BCVA) after LASIK was 1.0, after the macular hole has developed BCVA became 0.5. After surgery, the final visual acuity recovered to 0.7. Macular hole may develop after LASIK for myopia correction due to unknown changes of vitreoretinal interface. Complete informed consent must be obtained from patients with high myopic eyes before LASIK. PMID:23840997

Bikbova, Guzel; Oshitari, Toshiyuki; Sakurai, Madoka; Baba, Takayuki; Yamamoto, Shuichi

2013-01-01

13

Macular Hole after Laser In Situ Keratomileusis in a 26-Year-Old Patient  

PubMed Central

The purpose of this study is to describe the 26-year-old patient with developed macular hole after bilateral laser in situ keratomileusis (LASIK). A macular hole with sharp margins and irregular surface of surrounding retina appeared in the left eye of the female 26-year-old patient two months after LASIK for correction of myopia (followup of 6 months). Although the best corrected visual acuity (BCVA) after LASIK was 1.0, after the macular hole has developed BCVA became 0.5. After surgery, the final visual acuity recovered to 0.7. Macular hole may develop after LASIK for myopia correction due to unknown changes of vitreoretinal interface. Complete informed consent must be obtained from patients with high myopic eyes before LASIK. PMID:23840997

Oshitari, Toshiyuki; Sakurai, Madoka; Baba, Takayuki; Yamamoto, Shuichi

2013-01-01

14

Vitreoretinal surgery for macular hole after laser assisted in situ keratomileusis for the correction of myopia  

PubMed Central

Ams: To describe the characteristics and surgical outcomes of full thickness macular hole surgery after laser assisted in situ keratomileusis (LASIK) for the correction of myopia. Methods: 13 patients (14 eyes) who developed a macular hole after bilateral LASIK for the correction of myopia participated in the study. Results: Macular hole formed 1–83 months after LASIK (mean 13 months). 11 out of 13 (84.6%) patients were female. Mean age was 45.5 years old (25–65). All eyes were myopic (range ?0.50 to ?19.75 dioptres (D); mean ?8.4 D). Posterior vitreous detachment (PVD) was not present before and was documented after LASIK on 42.8% of eyes. Most macular hole were unilateral, stage 4 macular hole, had no yellow deposits on the retinal pigment epithelium, had no associated epiretinal membrane, were centric, and had subretinal fluid. The mean diameter of the hole was 385.3 ?m (range 200–750 ?m). A vitrectomy closed the macular hole on all eyes with an improvement on final best corrected visual acuity (VA) on 13 out of 14 (92.8%) patients. Conclusions: This study shows that vitreoretinal surgery can be successful in restoring vision for most myopic eyes with a macular hole after LASIK. PMID:16234445

Arevalo, J F; Rodriguez, F J; Rosales-Meneses, J L; Dessouki, A; Chan, C K; Mittra, R A; Ruiz-Moreno, J M

2005-01-01

15

Unusual bilateral traumatic maculopathy following whiplash injury.  

PubMed

An unusual extensive bilateral macular oedema (MO) with spontaneous resolution occurred following a car crash accident. Qualitative and quantitative analysis of the macular region using spectral domain optical coherence tomography (SD-OCT) and multifocal electroretinogram (mfERG) was performed daily during the first 7?days, as well as at 3 and 6?months following the accident. SD-OCT examination demonstrated extensive MO accompanied by neurosensory detachment and subretinal fluid. During the 7?days following the accident there was gradual resolution of the oedema accompanied by visual recovery. One year later no anatomical changes were observed, the mfERG showed complete recovery and visual acuity returned to normal level. Although whiplash is a common injury in motor vehicle accidents, whiplash maculopathy (WMP) is rarely reported, most likely due to underdiagnosis. Here we describe the spontaneous resolution of a severe MO after whiplash injury in a car crash accident. PMID:25414232

Chronopoulos, Argyrios; Lipski, Andreas; Jonescu-Cuypers, Christian-Paul; Thumann, Gabriele

2014-01-01

16

Autosomal Dominant Stargardt-Like Macular Dystrophy  

Microsoft Academic Search

Autosomal dominant Stargardt-like macular dystrophy is one of the early onset macular dystrophies. It is characterized clinically in its early stages by visual loss and by the presence of atrophic macular changes with or without the presence of yellowish flecks. It is an important retinal dystrophy to study, not only because it has implications in the care and treatment of

Larry A Donoso; Albert O Edwards; Arcilee Frost; Tamara Vrabec; Edwin M Stone; Gregory S Hageman; Thomas Perski

2001-01-01

17

Macular oedema in idiopathic macular telangiectasia type 1 responsive to aflibercept but not bevacizumab.  

PubMed

We report a patient with macular oedema due to type 1 macular telangiectasia responding to intravitreal aflibercept injection. A 51-year-old man was diagnosed with type 1 idiopathic macular telangiectasia (IMT) in the right eye. The macular oedema was refractory to initial treatment with intravitreal bevacizumab and argon laser photocoagulation. The patient was then treated with intravitreal aflibercept injections, following which the macular oedema was completely resolved and his vision was significantly improved. Intravitreal aflibercept injection appears to improve vision and reduce persistent macular oedema secondary to type 1 IMT and demonstrated promising anatomical and visual outcomes. PMID:25349755

Shibeeb, O'Sam; Vaze, Anagha; Gillies, Mark; Gray, Timothy

2014-01-01

18

Macular Oedema in Idiopathic Macular Telangiectasia Type 1 Responsive to Aflibercept but Not Bevacizumab  

PubMed Central

We report a patient with macular oedema due to type 1 macular telangiectasia responding to intravitreal aflibercept injection. A 51-year-old man was diagnosed with type 1 idiopathic macular telangiectasia (IMT) in the right eye. The macular oedema was refractory to initial treatment with intravitreal bevacizumab and argon laser photocoagulation. The patient was then treated with intravitreal aflibercept injections, following which the macular oedema was completely resolved and his vision was significantly improved. Intravitreal aflibercept injection appears to improve vision and reduce persistent macular oedema secondary to type 1 IMT and demonstrated promising anatomical and visual outcomes.

Shibeeb, O'Sam; Gillies, Mark; Gray, Timothy

2014-01-01

19

Navigated macular laser decreases retreatment rate for diabetic macular edema: a comparison with conventional macular laser  

PubMed Central

Background The purpose of this study was to evaluate and compare clinical outcomes and retreatment rates using navigated macular laser versus conventional laser for the treatment of diabetic macular edema (DME). Methods In this prospective, interventional pilot study, 46 eyes from 46 consecutive patients with DME were allocated to receive macular laser photocoagulation using navigated laser. Best corrected visual acuity and retreatment rate were evaluated for up to 12 months after treatment. The control group was drawn based on chart review of 119 patients treated by conventional laser at the same institutions during the same time period. Propensity score matching was performed with Stata, based on the nearest-neighbor method. Results Propensity score matching for age, gender, baseline visual acuity, and number of laser spots yielded 28 matched patients for the control group. Visual acuity after navigated macular laser improved from a mean 0.48 ± 0.37 logMAR by a mean +2.9 letters after 3 months, while the control group showed a mean ?4.0 letters (P = 0.03). After 6 months, navigated laser maintained a mean visual gain of +3.3 letters, and the conventional laser group showed a slower mean increase to +1.9 letters versus baseline. Using Kaplan-Meier analysis, the laser retreatment rate showed separation of the survival curves after 2 months, with fewer retreatments in the navigated group than in the conventional laser group during the first 8 months (18% versus 31%, respectively, P = 0.02). Conclusion The short-term results of this pilot study suggest that navigated macular photocoagulation is an effective technique and could be considered as a valid alternative to conventional slit-lamp laser for DME when focal laser photocoagulation is indicated. The observed lower retreatment rates with navigated retinal laser therapy in the first 8 months suggest a more durable treatment effect. PMID:23345966

Neubauer, Aljoscha S; Langer, Julian; Liegl, Raffael; Haritoglou, Christos; Wolf, Armin; Kozak, Igor; Seidensticker, Florian; Ulbig, Michael; Freeman, William R; Kampik, Anselm; Kernt, Marcus

2013-01-01

20

Diabetic Macular Edema: Current and Emerging Therapies  

PubMed Central

Diabetic macular edema is a leading cause of vision impairment among people within the working- age population. This review discusses the pathogenesis of diabetic macular edema and the treatment options currently available for the treatment of diabetic macular edema, including for focal/grid photocoagulation, intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor agents. The biologic rationale for novel therapeutic agents, many of which are currently being evaluated in clinical trials, also is reviewed. PMID:22346109

Wenick, Adam S.; Bressler, Neil M.

2012-01-01

21

[Pathogenesis of age-related macular degeneration].  

PubMed

Age-related macular degeneration is a multiform disease of the macula, the region responsible for detailed central vision. In recent years, plenty of new knowledge of the pathogenesis of this disease has been obtained, and the treatment of exudative macular degeneration has greatly progressed. The number of patients with age-related macular degeneration will multiply in the following decades, because knowledge of mechanisms of development of macular degeneration that could be subject to therapeutic measures is insufficient. Central underlying factors are genetic inheritance, exposure of the retina to chronic oxidative stress and accumulation of inflammation-inducing harmful proteins into or outside of retinal cells. PMID:19341030

Kaarniranta, Kai; Seitsonen, Sanna; Paimela, Tuomas; Meri, Seppo; Immonen, Ilkka

2009-01-01

22

Bilateral adrenal lesions.  

PubMed

Bilateral adrenal lesions include a spectrum of disorders: neoplastic disorders (metastases, lymphoma, bilateral phaeochromocytoma, adrenocortical carcinoma and myelolipoma); longstanding congenital adrenal hyperplasia and macronodular adrenal hyperplasia; infections such as tuberculosis, histoplasmosis and blastomycosis; adrenal haemorrhage; adrenals in hypoperfusion complex and paediatric masses. Bilateral distribution in addition to other imaging characteristics can help narrow differential diagnoses in case of adrenal masses. We present a pictorial review highlighting the adrenal lesions that can present bilaterally. PMID:23210583

Gupta, Pankaj; Bhalla, Ashu; Sharma, Raju

2012-12-01

23

Surgery for full-thickness macular hole in patients with idiopathic macular telangiectasia type 2.  

PubMed

The authors report surgical outcomes of full-thickness macular hole repair in two patients with idiopathic macular telangiectasia in a non-comparative case series. Both patients underwent pars plana vitrectomy with indocyanine green-assisted internal limiting membrane peeling and injection of 16% C(3)F(8) gas. Patients were imaged with optical coherence tomography (OCT) before and after surgery. The first patient demonstrated macular hole closure on examination and OCT with visual improvement from 20/50 preoperatively to 20/30 after macular hole surgery and subsequent cataract surgery. The second patient's hole closed per OCT immediately after surgery but reopened 4 months later, and visual acuity remained 20/70. Macular hole surgery may be an effective treatment in patients with idiopathic macular telangiectasia and full-thickness macular holes and should be further investigated. PMID:21158375

Gregori, Ninel; Flynn, Harry W

2010-01-01

24

Idiopathic macular telangiectasia type 2 (idiopathic juxtafoveolar retinal telangiectasis type 2A, Mac Tel 2).  

PubMed

Macular telangiectasia type 2-also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A or Mac Tel 2-is an acquired bilateral neurodegenerative macular disease that usually manifests itself during the fourth to sixth decades of life and is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right-angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV). Optical coherence tomography images typically demonstrate intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic finding is a deep intraretinal hyperfluorescent leakage in the temporal parafoveal area. With time the leakage may involve the whole parafovea, but does not extend to the center of the fovea. Long-term prognosis for central vision is variable and depends on the development of SRNV or macular atrophy. Pathogenesis remains unclear, but Müller cells and macular pigment appear to play a central role. Currently there is no known treatment for the underlying cause of this condition, but treatment of the SRNV may be beneficial. PMID:24160729

Wu, Lihteh; Evans, Teodoro; Arevalo, J Fernando

2013-01-01

25

Macular degeneration: recent advances and therapeutic opportunities  

Microsoft Academic Search

The central retina mediates high acuity vision, and its progressive dysfunction due to macular degeneration is the leading cause of visual disability among adults in industrialized societies. Here, we summarize recent progress in understanding the pathophysiology of macular degeneration and the implications of this new knowledge for treatment and prevention. The past decade has witnessed remarkable advances in this field,

Amir Rattner; Jeremy Nathans

2006-01-01

26

Ranibizumab in diabetic macular edema  

PubMed Central

By 2050 the prevalence of diabetes will more than triple globally, dramatically increasing the societal and financial burden of this disease worldwide. As a consequence of this growth, it is anticipated that there will be a concurrent rise in the numbers of patients with diabetic macular edema (DME), already among the most common causes of severe vision loss worldwide. Recent available therapies for DME target the secreted cytokine, vascular endothelial growth factor (VEGF). This review focuses on the treatment of DME using the first humanized monoclonal antibody targeting VEGF that has been Food and Drug Administration-approved for the use in the eye, ranibizumab (Lucentis®). PMID:24379922

Krispel, Claudia; Rodrigues, Murilo; Xin, Xiaoban; Sodhi, Akrit

2013-01-01

27

Bilateral Subclavian Steal Syndrome  

PubMed Central

Bilateral subclavian steal syndrome is a rare condition. It is usually due to reversal of vertebral blood flow in the setting of bilateral proximal subclavian or left subclavian plus innominate artery severe stenosis or occlusion. This finding may cause cerebral ischemia related to upper extremities exercise. We report a case of bilateral subclavian steal secondary to total occlusion of the innominate and left subclavian arteries in a patient who presented with cardiomyopathy and flow reversal in the right carotid and bilateral vertebral arteries. PMID:24804108

Amini, Reza; Gornik, Heather L.; Gilbert, Leslie; Whitelaw, Sue; Shishehbor, Mehdi

2011-01-01

28

Macular telangiectasia type 2 (MacTel) in a 34-year-old patient.  

PubMed

We report macular telangiectasia type 2 (MacTel) in a 34-year-old man, the youngest patient so far published with MacTel type 2. The patient presented with metamorphopsia and impaired reading ability. Diagnosis was based on bilateral abnormal macular autofluorescence, perifoveal telangiectasia with fluorescein angiographic hyperfluorescence without cystoid oedema, a small foveal avascular zone, asymmetric configuration of the foveal pit, disruptions in the inner segment/outer segment layer and hyper-reflective haze and spots in the outer nuclear layer. Although MacTel usually manifests with a slowly progressive decrease in visual acuity in the fifth to seventh decades of life, younger patients may occasionally be diagnosed with the disease. Awareness of subtle signs of the condition is essential for early diagnosis. PMID:25249218

Nicolai, Heleen; Wirix, Mieke; Spielberg, Leigh; Leys, Anita

2014-01-01

29

Serous Macular Detachment Associated with Dome-Shaped Macula and Tilted Disc  

PubMed Central

Introduction: An entirely new type of staphyloma has been recently described as dome-shaped macula (DSM). It is characterized by an abnormal convex macular contour within the concavity of a posterior staphyloma. We found DSM associated with serous macular detachment (SMD) and tilted disc in two consecutive cases. Case Reports: Case 1: A 37-year-old female presented to our department because of sudden onset blurred vision in her right eye (OD). The best-corrected visual acuity (BCVA) was 0.5 in both eyes. Funduscopy evidenced bilateral tilted disc associated with posterior staphyloma. Optical coherence tomography (OCT) demonstrated a DSM with SMD in her OD. After 15 months of follow-up, BCVA of her OD remained stable with chronic SMD. Case 2: A 32-year-old female presented to our department because of blurred vision in her OD. The BCVA was 0.4 in the OD and 1.0 in the left eye (OS). Bilateral tilted disc and posterior staphyloma were evidenced in the funduscopy. OCT demonstrated a bilateral DSM with SMD in her OD. After 45 months of follow-up, two further episodes of transient SMD were observed in her OD and seven in her OS. The final BCVA was 0.63 in the OD and 0.8 in the OS. Discussion: SMD associated with tilted disc constitutes a potential cause of subretinal fluid accumulation in myopic patients. OCT is essential for the detection of both SMD and DSM. PMID:22087101

Pardo-Lopez, Diamar; Gallego-Pinazo, Roberto; Mateo, Carlos; Rohrweck, Stephanie; Suelves, Ana M.; Dolz-Marco, Rosa; Mullor, Jose Luis; Diaz-Llopis, Manuel

2011-01-01

30

Diode laser photocoagulation for diabetic macular oedema.  

PubMed Central

AIMS--This study aimed to investigate whether diode laser irradiation, which is poorly absorbed by haemoglobin, can induce closure of leaking retinal microvascular lesions in the treatment of diabetic macular oedema. METHODS--Thirty three eyes with clinically significant diabetic macular oedema were treated with a diode laser. Fundus evaluation before and after treatment included visual acuity, stereoscopic biomicroscopy, colour photographs, and fluorescein angiography. RESULTS--At a mean period of review of 6 months macular oedema had completely or partially resolved in 27 eyes. Visual acuity improved in three, deteriorated in one, and was unchanged in 29 eyes. CONCLUSION--Preliminary data suggest that diode laser therapy induces closure of leaking retinal microaneurysms and is effective in the treatment of diabetic macular oedema. Images PMID:7742274

Ulbig, M W; McHugh, D A; Hamilton, A M

1995-01-01

31

Unilateral Idiopathic Macular Telangiectasia with Choroidal Neovascularization.  

PubMed

A 40-year-old man with decreasing visual acuity in his left eye over 1 year, diagnosed elsewhere as vein occlusion and treated unsuccessfully by systemic steroids was reported. Retrospective analysis of available previous imaging studies was undertaken, and a retrospective diagnosis of idiopathic macular telangiectasia (IMT) was made. Examination revealed subfoveal neovascularization and retinochoroidal anastomosis (RCA) in his left eye with macular edema and exudates surrounding it. The right eye was normal. Current fluorescein angiography (FA) confirmed the presence of choroidal neovascularization and RCA, and optical coherence tomography (OCT) demonstrated cystoid macular edema and subfoveal neovascularization.The patient was diagnosed with unilateral idiopathic macular telangiectasia complicated by subretinal neovascularization. The presences of a choroidal neovascularization process and an RCA have not, to our knowledge, been reported in this type of IMT. PMID:20337307

Mezad-Koursh, Daphna; Zayit-Soudry, Shiri; Barak, Adiel; Loewenstein, Anat

2010-03-01

32

Combination Therapy for Diabetic Macular Edema  

PubMed Central

Diabetic macular edema is a main reason for visual loss in diabetic patients. Until recent years, macular laser photocoagulation was the only available therapy. The awareness that inflammation is an important factor in the pathogenetic process of DME gave reason for intravitreal treatment with corticosteroids. The introduction of anti-VEGF drugs brought a revolutionary change in the treatment of DME. This paper will review the important clinical trials with an emphasis on combination therapies. PMID:22523648

Zur, Dinah; Loewenstein, Anat

2012-01-01

33

[Pregnancy following bilateral salpingectomy].  

PubMed

This report presents a rare case of spontaneous pregnancy following bilateral salpingectomy. A woman with a history of bilateral salpingectomy was admitted to hospital because of abdominal pain and positive urine HCG. Surprisingly, ultrasound confirmed a live intrauterine fetus. The pregnancy was unwanted, and the woman decided to terminate the pregnancy. She was offered diagnostic examination to localise a potential fistula, but she declined. In a MEDLINE search of English literature this is only the second case of spontaneous pregnancy following bilateral salpingectomy. PMID:18462619

Bang, Anne

2008-04-21

34

Ranibizumab: in diabetic macular oedema.  

PubMed

Ranibizumab, an intravitreally administered inhibitor of vascular endothelial growth factor (VEGF), is approved for the treatment of visual impairment associated with diabetic macular oedema (DME) in the EU. In four well designed, phase II or III trials (RESOLVE, RESTORE, RIDE and RISE), 1-2 years' treatment with ranibizumab was more effective than sham or focal/grid laser therapy in improving best corrected visual acuity (BCVA) and reducing central retinal thickness (CRT) in patients with visual impairment associated with DME. Additionally, in two well designed phase III trials (RESTORE and DRCR.net-1), 1 year of treatment with ranibizumab as an adjunct to laser therapy was more effective than laser monotherapy in improving BCVA and CRT in patients with visual impairment associated with DME. Improvements in BCVA with ranibizumab alone or as an adjunct to laser therapy were observed at the first follow-up visits in these studies (i.e. 1-4 weeks after the start of treatment), and were associated with gains in vision-related quality of life, as assessed using the National Eye Institute Visual Functioning Questionnaire-25. The ocular and non-ocular adverse event profile of ranibizumab in patients with DME is similar to that observed in patients with neovascular (wet) age-related macular degeneration or retinal vein occlusion. Based on tolerability data from clinical trials, there is no indication that ranibizumab alone or combined with laser is associated with an increased risk of cardiovascular or cerebrovascular events potentially related to systemic VEGF inhibition. PMID:22356289

Frampton, James E

2012-03-01

35

Resonance Raman Measurement of Macular Carotenoids in Retinal, Choroidal, and Macular Dystrophies  

Microsoft Academic Search

Background: It has been hypothesized that the macu- lar carotenoid pigments lutein and zeaxanthin may pro- tect against macular and retinal degenerations and dys- trophies. Objective: To test this hypothesis by objectively mea- suring lutein and zeaxanthin levels in a noninvasive man- ner in patients who have retinitis pigmentosa (RP), cho- roideremia (CHM), and Stargardt macular dystrophy and comparing them

Da-You Zhao; Steven W. Wintch; Igor V. Ermakov; Werner Gellermann; Paul S. Bernstein

2003-01-01

36

Bilateral lunate intraosseous ganglia.  

PubMed

An intraosseous ganglion is a relatively uncommon, benign cystic lesion that occurs in young and middle-aged adults. Bilateral and symmetrical lesions of the wrist are rare. Intraosseous ganglia of the carpal bones are uncommon causes of chronic wrist pain. Isolated cases of intraosseous ganglion have been reported most commonly in the lunate and scaphoid. The lunate was most frequently affected, followed by the capitate, scaphoid, and triquetrum bones. Radiolucent lesions in the carpal bones are not uncommon and are often seen incidentally in asymptomatic patients. The differential diagnosis of a lytic lesion in a carpal bone includes unicameral bone cyst, degenerative cyst, fibrous developmental defect, osteomyelitis, and intraosseous ganglion cyst. This article describes a case of bilateral lunate intraosseous ganglia. A review of the literature revealed that bilateral and symmetrical intraosseous ganglia of the wrist are rare, with only 3 other reported cases of bilateral lunate lesions. PMID:20608626

Kural, Cemal; Sungur, Ibrahim; Cetinus, Ercan

2010-07-01

37

Echinoderms Have Bilateral Tendencies  

PubMed Central

Echinoderms take many forms of symmetry. Pentameral symmetry is the major form and the other forms are derived from it. However, the ancestors of echinoderms, which originated from Cambrian period, were believed to be bilaterians. Echinoderm larvae are bilateral during their early development. During embryonic development of starfish and sea urchins, the position and the developmental sequence of each arm are fixed, implying an auxological anterior/posterior axis. Starfish also possess the Hox gene cluster, which controls symmetrical development. Overall, echinoderms are thought to have a bilateral developmental mechanism and process. In this article, we focused on adult starfish behaviors to corroborate its bilateral tendency. We weighed their central disk and each arm to measure the position of the center of gravity. We then studied their turning-over behavior, crawling behavior and fleeing behavior statistically to obtain the center of frequency of each behavior. By joining the center of gravity and each center of frequency, we obtained three behavioral symmetric planes. These behavioral bilateral tendencies might be related to the A/P axis during the embryonic development of the starfish. It is very likely that the adult starfish is, to some extent, bilaterian because it displays some bilateral propensity and has a definite behavioral symmetric plane. The remainder of bilateral symmetry may have benefited echinoderms during their evolution from the Cambrian period to the present. PMID:22247765

Zhao, Wenchan; Wang, Sishuo; Lv, Jianhao

2012-01-01

38

The historical discovery of macular edema.  

PubMed

The occurrence of macular edema, or of intraretinal fluid in general, was largely unknown prior to the invention of the ophthalmoscope. One of the first reports on 'Retinitis in Glycosuria', a disease complex, which today would partly be described as diabetic maculopathy, was published in 1856 by Jaeger. His observations were confirmed less than twenty years later by Nettleship in London, and in 1875 Appolinaire Bouchardat from Paris described fluid and lipid accumulation in the macula which led--in his words--to a glucose induced amblyopia. The first pathophysiological hypotheses of fluid accumulation in the posterior pole were then put forward in 1882 by Tartuferi, who thought the edema represented swelling of photoreceptor sheaths. In 1896, the Frenchman Nuel coined the term 'oedème maculaire' which he had observed in a retinitis pigmentosa patient. However, it was not until the end of the first World War, that the Swiss ophthalmologist Alfred Vogt observed macular edema in a variety of other ocular conditions such as iridocyclitiOFF macular edema to a macular hole. A quarter of a century later Bangerter coined the German term 'Zystoides Makulaödem', and in 1950, Hruby was the first to draw attention to the development of macular edema after cataract extraction. Three years later this was followed by Irvine's classical paper on cystoid macular edema after intra- and extracapsular cataract extraction which had been complicated by incarceration of the vitreous in the anterior segment with consecutive tugging on the macula. A decade later, the phenomenon of cystic fluid accumulation in the macula after cataract extraction was further characterised by Gass and Norton using fluorescein angiography. The ensuing years saw the emergence of new concepts regarding the blood-retinal barrier and the paramount role of its dysfunction in the development of macular edema. PMID:10896334

Wolfensberger, T J

1999-01-01

39

Macular microcirculation in cystoid maculopathy of diabetic patients  

Microsoft Academic Search

BACKGROUND--In patients with diabetic macular oedema and central cysts ischaemia of the retina appears to be an important contributing factor in the pathogenesis of cysts. This study was performed to further elucidate the role of the inner retinal microcirculation in diabetic cystoid macular oedema (CMO). METHODS--Video fluorescein angiography allows visualisation of the macular microvasculature and measurements of the capillary blood

O Arend; A Remky; A Harris; B Bertram; M Reim; S Wolf

1995-01-01

40

Kinetics of central macular thickness reduction in patients with macular edema after intravitreal drug therapy  

PubMed Central

Background The purpose of this study was to characterize central macular thickness and retinal volume following intravitreal injections using time domain and spectral domain optical coherence tomography (TD-OCT and SD-OCT, respectively). Methods Nine patients with macular edema secondary to diabetes or retinal vein occlusion treated with intravitreal triamcinolone 4.0 mg and/or bevacizumab 1.25 mg were enrolled. Central macular thickness and volume was measured by SD-OCT and TD-OCT scan at baseline, and 1, 3, 6, 24, 48 hours, and 1 week postinjection. Results Equations were derived to describe central macular thickness and volume reduction in the hours following intravitreal injection. Measurements of central macular thickness by SD-OCT were significantly reduced by 3 hours (P = 0.03) and retinal volume by 6 hours (P = 0.03). Central macular thickness measured 40.9 (28.6–53.2) ?m thicker on the SD-OCT instrument while volume measured 3.47 (3.27–3.66) mm3 higher. Conclusion Significant central macular thickness and volume reductions occur in the first hours after injection with triamcinolone and/or bevacizumab. PMID:22205836

He, Lingmin; Chan, Annie; Leng, Theodore; Blumenkranz, Mark S

2011-01-01

41

Role of long-chain and very-long-chain polyunsaturated fatty acids in macular degenerations and dystrophies  

PubMed Central

Macular degeneration is a progressive, bilateral eye disorder that damages the macula of the human eye. The most common form of macular degeneration is age-related macular degeneration (AMD), which is the leading cause of irreversible blindness in people older than 50 years in developed countries. Autosomal dominant Stargardt disease-3 (STGD3) is an inherited macular dystrophy that has clinical features similar to dry AMD, but occurs at a much earlier age. It is caused by a mutation in the elongation of very-long-chain fatty acids-like 4 (ELOVL4) gene, which is responsible for encoding the elongase enzyme that converts shorter chain fatty acids into C28–C38 very long-chain polyunsaturated fatty acids (VLCPUFAs, total number of carbons ?24). Diets rich in long-chain polyunsaturated fatty acids (LCPUFAs) have inverse associations with the progression of AMD and STGD3, and a deficiency in retinal LCPUFAs and VLCPUFAs has been detected in AMD retinas and STGD3 animal models. This article systematically summarizes the roles of LCPUFAs and VLCPUFAs in AMD and STGD3, and discusses future research directions.

Liu, Aihua; Lin, Yanhua; Terry, Ryan; Nelson, Kelly; Bernstein, Paul S

2014-01-01

42

Diabetic macular edema: New promising therapies  

PubMed Central

The treatment of diabetic macular edema is rapidly evolving. The era of laser therapy is being quickly replaced by an era of pharmacotherapy. Several pharmacotherapies have been recently developed for the treatment of retinal vascular diseases such as diabetic macular edema. Several intravitreal injections or sustained delivery devices have undergone phase 3 testing while others are currently being evaluated. The results of clinical trials have shown the superiority of some of these agents to laser therapy. However, with the availability of several of these newer agents, it may be difficult to individualize treatment options especially those patients respond differently to various therapies. As such, more effort is still needed in order to determine the best treatment regimen for a given patient. In this article, we briefly summarize the major new therapeutic additions for the treatment of diabetic macular edema and allude to some future promising therapies. PMID:24379924

Shamsi, Hanan N Al; Masaud, Jluwi S; Ghazi, Nicola G

2013-01-01

43

Embarazo ectópico bilateral espontáneo  

Microsoft Academic Search

Spontaneous bilateral ectopic pregnancy is a rare event and is difficult to diagnose preoperatively. We report a case diagnosed by transvaginal ultrasonography in a patient without risk factors. Laparoscopic left salpingectomy and right linear salpingostomy were performed. This case illustrates the importance of carefully examining both adnexa when ultrasound examination or surgery are performed.

Lorenzo Mier Lobato; M. del Carmen Bango Álvarez

2006-01-01

44

Bilateral thoracic extraadrenal myelolipoma  

Microsoft Academic Search

Myelolipoma commonly occurs in the adrenal gland and is composed of both adipose tissue and normal hematopoietic elements. Extraadrenal myelolipoma may occur in the retroperitoneum, stomach, liver, lung, and in 3% of cases even in the mediastinum. We present a 65-year-old female patient with unspecific clinical symptoms. Routine chest roentgenograms revealed bilateral widening of the posterior mediastinum. Computed tomography showed

T. Franiel; B. Fleischer; B. W. Raab; L. Füzesi

2004-01-01

45

Bilateral Retrovascular Femoral Hernia  

PubMed Central

A 34-year-old woman with cystic fibrosis presented with bilateral femoral hernias, which were found to be retrovascular at operation. The hernias were not amenable to conventional open or laparoscopic repair, and were repaired using pre-peritoneal mesh inserted deep to transversalis fascia. The anatomical basis and management of uncommon variants of femoral hernia are discussed. PMID:18634743

Papanikitas, Joseph; Sutcliffe, Robert P; Rohatgi, Ashish; Atkinson, Simon

2008-01-01

46

Surgical outcomes of macular buckling techniques for macular retinoschisis in highly myopic eyes  

PubMed Central

Purpose To report the anatomic and visual results following macular buckling for patients with macular retinoschisis related to high myopia. Methods Thirty-nine highly myopic eyes (mean refractive error ?16.7 D; range, ?9 to ?24 D) of 36 patients (mean age 59 years; range, 35–79 years) presenting with macular retinoschisis associated with a posterior staphyloma, who underwent combined vitrectomy and macular buckling were evaluated. Main outcome measures included best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) findings. Three cases were excluded due to short follow-up (less than 3 months). The mean follow-up was 16 months. Results The mean BCVA increased from 0.76 to 0.43 LogMAR (p = 0.001). Visual acuity improved in 30 eyes (83.3%), remained stable in three eyes (8.3%) and decreased in three eyes (8.3%). OCT showed resolution of foveoschisis with foveal reattachment in all eyes. None of the evaluated patients developed a macular hole during follow-up. Conclusion Macular buckling associated with vitrectomy results in good anatomic and visual outcomes in patients with myopic foveoschisis. PMID:24409086

Mateo, Carlos; Gomez-Resa, Maria V.; Bures-Jelstrup, Anniken; Alkabes, Micol

2013-01-01

47

Evaluation of posturing in macular hole surgery  

Microsoft Academic Search

Aim To objectively evaluate the postoperative face down posturing in macular hole surgery.Materials and Methods An electronic device called ‘Maculog’ was developed consisting of three basic components, a mercury switch triggered by the angle of tilt placed inside an earpiece, a data-recording device connected to the earpiece with cables and a windows based software program, specially written to analyse the

D Verma; M W Jalabi; W G Watts; G Naylor

2002-01-01

48

Current status in diabetic macular edema treatments  

PubMed Central

Diabetes is a serious chronic condition, which increase the risk of cardiovascular diseases, kidney failure and nerve damage leading to amputation. Furthermore the ocular complications include diabetic macular edema, is the leading cause of blindness among adults in the industrialized countries. Today, blindness from diabetic macular edema is largely preventable with timely detection and appropriate interventional therapy. The treatment should include an optimized control of glycemia, arterial tension, lipids and renal status. The photocoagulation laser is currently restricted to focal macular edema in some countries, but due the high cost of intravitreal drugs, the use of laser treatment for focal and diffuse diabetic macular edema (DME), can be valid as gold standard in many countries. The intravitreal anti vascular endothelial growth factor drugs (ranibizumab and bevacizumab), are indicated in the treatment of all types of DME, but the correct protocol for administration should be defined for the different Retina Scientific Societies. The corticosteroids for diffuse DME, has a place in pseudophakic patients, but its complications restricted the use of these drugs for some patients. Finally the intravitreal interface plays an important role and its exploration is mandatory in all DME patients. PMID:24147200

Romero-Aroca, Pedro

2013-01-01

49

Depression in Age-Related Macular Degeneration  

ERIC Educational Resources Information Center

Age-related macular degeneration (AMD) is a major cause of disability in the elderly, substantially degrades the quality of their lives, and is a risk factor for depression. Rates of depression in AMD are substantially greater than those found in the general population of older people, and are on par with those of other chronic and disabling…

Casten, Robin; Rovner, Barry

2008-01-01

50

Driving and Age-Related Macular Degeneration  

PubMed Central

This article reviews the research literature on driving and age-related macular degeneration, which is motivated by the link between driving and the quality of life of older adults and their increased collision rate. It addresses the risk of crashes, driving performance, driving difficulty, self-regulation, and interventions to enhance, safety, and considers directions for future research. PMID:20046818

Owsley, Cynthia; McGwin, Gerald

2009-01-01

51

The Psychosocial Impact of Macular Degeneration  

Microsoft Academic Search

Background: Age-related macular degeneration (AMD), the leading cause of irreversible blindness and low vi- sion among the elderly, has not been well studied with regard to its impact on daily life. This study was de- signed to demonstrate the impact of AMD on quality of life, emotional distress, and functional level. Participants: The study sample consisted of 86 elderly adults

Rebecca A. Williams; Barbara L. Brody; Ronald G. Thomas; Robert M. Kaplan; Stuart I. Brown

1998-01-01

52

Macular pigments: their characteristics and putative role  

Microsoft Academic Search

The macular pigments (MP) absorb light in the blue-green region of the visible spectrum and comprise two carotenoids, lutein and zeaxanthin. In humans the concentration of MP varies widely across the normal population. There are two (not mutually exclusive) proposed roles for MP: to improve visual function and to act as an antioxidant and protect the macula from damage by

Nigel P. Davies; Antony B. Morland

53

Genetic susceptibility to age related macular degeneration  

Microsoft Academic Search

Age related macular degeneration (AMD) is the leading cause of visual impairment in the elderly and a major cause of blindness in the developed world. The disease can take two forms, geographic atrophy and choroidal neovascularisation. The pathogenesis of AMD is poorly understood. There are undoubtedly environmental and other risk factors involved and the adverse effect of smoking is well

John R W Yates; Anthony T Moore

2000-01-01

54

Genetics of Age-Related Macular Degeneration  

Microsoft Academic Search

\\u000a Age-related Macular Degeneration (AMD) is a multifactorial disease involving genetic and environmental influences. Complement\\u000a Factor H (CFH) and HTRA1\\/LOC387715 are the two main loci associated with AMD. A genetic understanding of AMD may allow for\\u000a early diagnosis and treatment.

Daniel T. Kasuga; Yuhong Chen; Kang Zhang

55

Management of traumatic macular holes: case report.  

PubMed

Traumatic macular hole is a disease whose pathogenesis is not fully understood and the best treatment guideline is controversial. We report 2 cases of traumatic macular hole with different treatment approaches. In the first case, a 9-year-old boy presented with a traumatic macular hole secondary to blunt ocular trauma with a stone, and initial vision of 20/300. He underwent surgical repair and his final vision was 20/70 with hole closure after a 1 year follow-up. In the second case, a 20-year-old woman suffered a penetrating bullet wound on the left side of her forehead. The injury caused optic nerve head avulsion in the left eye with loss of light perception. The right eye had a traumatic macular hole and signs suggestive of sclopetaria chorioretinitis, with 20/60 vision. This case was initially observed and vision improved to 20/30 with reduction of the hole diameter. Vision and hole diameter remained stable after 8 months. PMID:18797673

Brasil, Oswaldo Ferreira Moura; Brasil, Oswaldo Moura

2008-01-01

56

The Intravitreal Autologous Platelet Concentrate Injection as an Adjunct of Vitrectomy for the Treatment of Refractory Macular Holes  

ClinicalTrials.gov

Macular Hole With High Myopia (Spherical Equivalent ? -6.0 Diopters) or,; Large Size Macular Hole (Diameter > 600 Microns) or; Recurred or Failed Macular Hole From Previous Surgery; or Chronic Macular Hole (Symptom Duration > 6 Months)

2014-03-06

57

Novel Rodent Models for Macular Research  

PubMed Central

Background Many disabling human retinal disorders involve the central retina, particularly the macula. However, the commonly used rodent models in research, mouse and rat, do not possess a macula. The purpose of this study was to identify small laboratory rodents with a significant central region as potential new models for macular research. Methodology/Principal Findings Gerbillus perpallidus, Meriones unguiculatus and Phodopus campbelli, laboratory rodents less commonly used in retinal research, were subjected to confocal scanning laser ophthalmoscopy (cSLO), fluorescein and indocyanine green angiography, and spectral-domain optical coherence tomography (SD-OCT) using standard equipment (Heidelberg Engineering HRA1 and Spectralis™) adapted to small rodent eyes. The existence of a visual streak-like pattern was assessed on the basis of vascular topography, retinal thickness, and the topography of retinal ganglion cells and cone photoreceptors. All three species examined showed evidence of a significant horizontal streak-like specialization. cSLO angiography and retinal wholemounts revealed that superficial retinal blood vessels typically ramify and narrow into a sparse capillary net at the border of the respective area located dorsal to the optic nerve. Similar to the macular region, there was an absence of larger blood vessels in the streak region. Furthermore, the thickness of the photoreceptor layer and the population density of neurons in the ganglion cell layer were markedly increased in the visual streak region. Conclusions/Significance The retinal specializations of Gerbillus perpallidus, Meriones unguiculatus and Phodopus campbelli resemble features of the primate macula. Hence, the rodents reported here may serve to study aspects of macular development and diseases like age-related macular degeneration and diabetic macular edema, and the preclinical assessment of therapeutic strategies. PMID:20976212

Huber, Gesine; Heynen, Severin; Imsand, Coni; vom Hagen, Franziska; Muehlfriedel, Regine; Tanimoto, Naoyuki; Feng, Yuxi; Hammes, Hans-Peter; Grimm, Christian; Peichl, Leo; Seeliger, Mathias W.; Beck, Susanne C.

2010-01-01

58

Bilateral renal calculi  

PubMed Central

Bilateral renal calculi were present in 114 (10.7%) of 1,070 cases of proved urinary calculus admitted to the Urological Department of the General Hospital, Kuala Lumpur, during the period November 1968—May 1973. The management of bilateral renal calculi is discussed with reference to the first 100 cases in this series. The introduction of renography has greatly facilitated the decision as to which kidney should be operated on first. The management of patients with and without uraemia is discussed and the use of the modified V and V—Y incisions for the removal of staghorn calculi is described. Complications and results are briefly reviewed. ImagesFig. 1Fig. 4Fig. 6Fig. 7 PMID:4845653

Sreenevasan, G

1974-01-01

59

Bilateral multifocal Warthin tumours.  

PubMed

Warthin tumour, also known as papillary cystadenoma lymphomatosum, is the second most frequent benign tumour of the parotid gland after pleomorphic adenoma. A 57-year-old man was referred to our hospital with bilateral buccal masses without pain. He presented with a 1-year history of the condition and stated that growth of the mass has accelerated during the last 6 months. Ultrasonography examination showed two heterogeneous solid masses. Axial contrast-enhanced CT image revealed bilateral heterogeneous solid masses. The masses showed enhancement after contrast administration (95 HU). Fine needle aspiration cytology was recommended for further analysis and typical benign features of Warthin tumour was obtained. Right parotid gland including the masses was resected completely. 5 weeks later superficial parotidectomy was performed to the left parotid gland. Histological examination revealed cystic tumour in the parenchyma of parotid gland, composed of prominent lymphoid stroma and large epithelial cells with oncocytic features covering it consistent with Warthin tumour. PMID:23704438

Deveer, Mehmet; Sahan, Murat; Sivrioglu, Ali Kemal; Celik, Ozgür Ilhan

2013-01-01

60

Bilateral superior oblique palsies.  

PubMed Central

Eighteen consecutive cases of bilateral superior oblique palsy have been studied retrospectively. The patients were typically adults with a history of severe head trauma. All patients complained of diplopia, either vertical, torsional, or both. Other neurological sequelae were common. Central disruption of fusion was seen in three patients. Eight patients underwent surgery for torsional or vertical diplopia, and the results are briefly discussed. PMID:4016044

Lee, J; Flynn, J T

1985-01-01

61

Bilateral pulmonary artery aneurysms  

Microsoft Academic Search

Pulmonary artery aneurysms are rare. The estimated incidence is 1 in 14,000 in autopsies. Bilateral main pulmonary artery aneurysms have not been previously reported in the literature.A 36-year-old woman who has been diagnosed as having an ostium secundum defect with severe pulmonary hypertension was found dead. Autopsy revealed an emaciated body. The heart was enlarged. Right atrium and ventricle were

Sarathchandra Kodikara; Murugapillei Sivasubramanium

2009-01-01

62

Bilateral silent sinus syndrome.  

PubMed

Silent sinus syndrome is a rare clinical entity associated with progressive enophthalmos, collapse of the maxillary sinus, and hypoglobus. We report a case of bilateral silent sinus syndrome in a 29-year-old man. Representative radiographic and intraoperative images are presented. The purpose of this article is to illustrate a new presentation of the disease and to review the current diagnostic and treatment modalities. PMID:23288826

Suh, Jeffrey D; Ramakrishnan, Vijay; Lee, Jennifer Y; Chiu, Alexander G

2012-12-01

63

Bilateral intraocular dirofilariasis  

PubMed Central

Ocular dirofilariasis mostly presents as a subconjunctival or eyelid lesion.[1] Intraocular dirofilarial infestation is rare.[23] We report a case of a young woman who was accidentally detected to have a live motile worm in the anterior segment in one eye and a cystic lesion on the optic disc in the other eye. To our knowledge, bilateral intraocular dirofilariasis has never been reported. PMID:24008780

Gupta, Viney; Sankaran, Preeti; Mohanraj; Samantaray, Jyotish Chandra; Menon, Vimla

2014-01-01

64

Retinal Crystals in Type 2 Idiopathic Macular Telangiectasia  

PubMed Central

Purpose To characterize the phenotype and investigate the associations of intraretinal crystalline deposits in a large cohort of Type 2 Idiopathic Macular Telangiectasia (MacTel) Design Case-control study Participants Patients with and without retinal crystals from the Macular Telangiectasia Project, an international multi-centre prospective study of Type 2 MacTel. Methods Grading of stereoscopic 30° colour fundus (CF), confocal blue light reflectance (CBR), red-free (RF) and infrared (IR) images was performed according to the MacTel Natural History Study protocol and staged using the classification system devised by Gass & Blodi. SD-OCT and adaptive optics imaging were used for a finer analysis of the phenotype. Associations between crystals and other characteristics of the disease as well as potential risk factors were investigated. Main outcome measures Presence of crystals, fundus signs of MacTel, clinical characteristics, presence of potential risk factors of MacTel. Results Out of 443 probands enrolled in the MacTel study, 203 (46%) had crystalline deposits present; 60% of the cases were bilateral at baseline. Eyes with crystals had a mean letter score of 70.7 (SD=15.9) while those without crystals had a mean of 66.5 letters (SD=15.5, p<0.001). Crystals were present at all stages of the disease and showed high reflectivity within a wide wavelength range. They were located at the anterior surface of the nerve fibre layer, arranged along the nerve fibres, within an annular area centred on the fovea. Significant associations of crystalline deposits were found with a loss of retinal transparency, MPOD loss, fluorescein leakage, retinal thickness and a break in the IS/OS junction line. Associations with environmental risk factors were not found. Conclusions Intraretinal crystals are a frequent phenomenon associated with type 2 MacTel, they may appear at all stages and may aid in the early diagnosis of the disease. Their morphology further implicates Müller cells in the pathogenesis of the disease. Insight into their physical and chemical properties may provide clues to the metabolic pathways involved in the pathogenesis of the disease. PMID:21839520

Sallo, Ferenc B; Leung, Irene; Chung, Mina; Wolf-Schnurrbusch, Ute EK; Dubra, Alfredo; Williams, David R; Clemons, Traci; Pauleikhoff, Daniel; Bird, Alan C; Peto, Tunde

2012-01-01

65

Genetics and molecular pathology of Stargardt-like macular degeneration  

Microsoft Academic Search

Stargardt-like macular degeneration (STGD3) is an early onset, autosomal dominant macular degeneration. STGD3 is characterized by a progressive pathology, the loss of central vision, atrophy of the retinal pigment epithelium, and accumulation of lipofuscin, clinical features that are also characteristic of age-related macular degeneration. The onset of clinical symptoms in STGD3, however, is typically observed within the second or third

Vidyullatha Vasireddy; Paul Wong; Radha Ayyagari

2010-01-01

66

Clinical characterization and genetic mapping of North Carolina macular dystrophy  

Microsoft Academic Search

North Carolina macular dystrophy (NCMD) is an autosomal dominant macular disease, was mapped to 6q14-q16.2, the disease-causing gene has yet not been identified. It shares phenotypic similarity with age-related macular degeneration including drusen and choroidal neovascularization. We collected six families with NCMD including 75 members, and conducted clinical characterization and genetic mapping for these families. Forty-five patients were diagnosed as

Zhenglin Yang; Zongzhong Tong; Louis J. Chorich; Erik Pearson; Xian Yang; Anthony Moore; David M. Hunt; Kang Zhang

2008-01-01

67

Intravitreal bevacizumab for macular edema from idiopathic juxtafoveal retinal telangiectasis.  

PubMed

To assess the potential visual benefit of intravitreal bevacizumab in a patient with idiopathic juxtafoveal retinal telangiectasis refractory to focal laser treatment, an intravitreal injection of bevacizumab (1.25 mg) was given. Within 1 week, visual acuity improved from 20/50 to 20/25 and optical coherence tomography demonstrated complete resolution of macular edema. There was no adverse effect. The macular edema recurred after 3 months, requiring a repeat injection of bevacizumab with subsequent resolution of macular edema. An intravitreal injection of bevacizumab may provide potential short-term visual benefit in patients with macular edema from idiopathic juxtafoveal retinal telangiectasis. PMID:17396701

Moon, Suk J; Berger, Adam S; Tolentino, Michael J; Misch, David M

2007-01-01

68

[New aspects in age related macular degeneration].  

PubMed

Being the leading cause of blindness in modern world Age Related Macular Degeneration has beneficiated in the last decade of important progress in diagnosis, classification and the discovery of diverse factors who contribute to the etiology of this disease. Treatments have arised who can postpone the irreversible evolution of the disease and thus preserve vision. Recent findings have identified predisposing genetic factors and also inflamatory and imunological parameters that can be modified trough a good and adequate prevention and therapy This articole reviews new aspects of patology of Age Related Macular Degeneration like the role of complement in maintaining inflamation and the role of oxidative stress on different structures of the retina. PMID:22888685

Turlea, C

2012-01-01

69

Macular Pigment and Its Contribution to Vision  

PubMed Central

Three dietary carotenoids, lutein (L), zeaxanthin (Z) and meso-zeaxanthin (MZ) accumulate at the central retina (macula), where they are collectively referred to as macular pigment (MP). MP’s pre-receptoral absorption of blue light and consequential attenuation of the effects of chromatic aberration and light scatter are important for optimal visual function. Furthermore, antioxidant activity of MP’s constituent carotenoids and the same blue light-filtering properties underlie the rationale for its putative protective role for age-related macular degeneration (AMD). Supplementation with L, Z and MZ augments MP and enhances visual performance in diseased and non-diseased eyes, and may reduce risk of AMD development and/or progression. PMID:23760061

Loskutova, Ekaterina; Nolan, John; Howard, Alan; Beatty, Stephen

2013-01-01

70

Bilateral Testicular Epidermoid Cysts  

PubMed Central

Testicular epidermoid cysts are the most common benign tumors of the testes, but account for only 1-2% of all testicular tumors. In a young man presenting with a testicular mass, a high index of suspicion must be maintained for the malignant testicular germ cell tumor, which is 50-times more common than testicular epidermoid cyst. Bilateral testicular epidermoid cysts are a very rare condition, with only a few reports in the literature. It is extremely important in this condition to make a correct pre-operative diagnosis on imaging to enable a testis-sparing surgery. PMID:21915385

Loberant, Norman; Bhatt, Shweta; Messing, Edward; Dogra, Vikram S.

2011-01-01

71

Prevention of age-related macular degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. Although effective\\u000a treatment modalities such as anti-VEGF treatment have been developed for neovascular AMD, there is still no effective treatment\\u000a for geographical atrophy, and therefore the most cost-effective management of AMD is to start with prevention. This review\\u000a looks at current evidence on preventive

Ian Yat Hin Wong; Simon Chi Yan Koo; Clement Wai Nang Chan

2011-01-01

72

[Hemorrhagic macular choroidopathy in young subjects].  

PubMed

The haemorrhagic macular choroidopathy is a characteristic and rather frequent disease, which is seen in young subjects. We observed it in 23 patients, aged between 12 and 51 years. The disease resembles the presumed histoplasmin choroiditis, described in the American literature. In our cases, histoplasmosis can nevertheless be excluded and in the American cases it is not proven. In fact, the etiology is still unknown, but in 13 of our cases the origin may have been a disseminated choroiditis. PMID:1128878

Francois, J; DeLaey, J J; Dakir, M

1975-01-01

73

[Vitrectomy with autoserum for idiopathic macular hole].  

PubMed

Using autoserum, we operated on eyes with full thickness macular hole and achieved greater anatomic and visual success than with eyes that underwent vitrectomy alone. A total of 34 eyes were treated with vitrectomy and fluid-gas exchange: 14 eyes with autoserum instillation and 15 eyes without autoserum. Five eyes with macular holes persisting after initial vitrectomy underwent reoperation with autoserum. After vitrectomy and fluid-air exchange, 0.1 to 0.3 ml of autoserum was placed for about 7 minutes over the hole, and then 30% SF6 was instilled. After treatment, successful anatomic closure occurred in 53% of the eyes without autoserum, in 86% of those with autoserum, and in 80% of those which underwent reoperation with autoserum. Visual acuity improved 2 lines or more in 53% of the eyes without autoserum, in 79% of those with autoserum, and in 60% of those that underwent reoperation with autoserum. The results of the current preliminary study shows that treatment of full-thickness macular holes with autoserum seems to be more beneficial than vitrectomy alone. PMID:8712078

Mori, K; Yoneya, S; Abe, T

1996-06-01

74

Macular Bioaccelerometers on Earth and in Space  

NASA Technical Reports Server (NTRS)

Space flight offers the opportunity to study linear bioaccelerometers (vestibular maculas) in the virtual absence of a primary stimulus, gravitational acceleration. Macular research in space is particularly important to NASA because the bioaccelerometers are proving to be weighted neural networks in which information is distributed for parallel processing. Neural networks are plastic and highly adaptive to new environments. Combined morphological-physiological studies of maculas fixed in space and following flight should reveal macular adaptive responses to microgravity, and their time-course. Ground-based research, already begun, using computer-assisted, 3-dimensional reconstruction of macular terminal fields will lead to development of computer models of functioning maculas. This research should continue in conjunction with physiological studies, including work with multichannel electrodes. The results of such a combined effort could usher in a new era in understanding vestibular function on Earth and in space. They can also provide a rational basis for counter-measures to space motion sickness, which may prove troublesome as space voyager encounter new gravitational fields on planets, or must re-adapt to 1 g upon return to earth.

Ross, M. D.; Cutler, L.; Meyer, G.; Vazin, P.; Lam, T.

1991-01-01

75

Bilateral optic nerve hypoplasia.  

PubMed

In the past 10 years, 15 children with bilateral optic nerve hypoplasia have been studied at the Royal Alexandra Hospital for Children. There were 5 boys and 10 girls. Nine were first-born and they presented at a mean age of 5 months (range: 4 days to 25 months). Five presented with suspected blindness and 7 with abnormal eye movements (nystagmus or less commonly squint). The other 3 presented because of fits or developmental delay. Eight showed evidence of neural damage--microcephaly, seizures and/or abnormalities of tone. Four appeared to be of normal or near normal intelligence, 6 were mildly retarded and 5 severely so. Two patients had already died, one suddenly. Six of the 7 cases investigated in detail had evidence of hypothalamic pituitary dysfunction. Another one had a minimal hypothalamic abnormality. Four were severely growth retarded and 2 were receiving growth hormone replacement. Two males had micropenis and a girl had precocious puberty with partial diabetes insipidus. Neuroradiological investigations showed an absent septum pellucidum in only 5 cases. Five patients had other major CNS malformations. Five patients had normal CT scans; 3 of these 5 appeared of normal intelligence and all 5 had normal neurological examinations. Bilateral optic nerve hypoplasia is frequently associated with serious brain and endocrine abnormalities. PMID:6926392

Ouvrier, R A; Lewis, D; Procopis, P G; Billson, F A; Silink, M; de Silva, M

1981-01-01

76

Defective Lipid Transport and Biosynthesis in Recessive and Dominant Stargardt Macular Degeneration  

PubMed Central

Stargardt disease is a common inherited macular degeneration characterized by a significant loss in central vision in the first or second decade of life, bilateral atrophic changes in the central retina associated with degeneration of photoreceptors and underlying retinal pigment epithelial cells, and the presence of yellow flecks extending from the macula. Autosomal recessive Stargardt disease, the most common macular dystrophy, is caused by mutations in the gene encoding ABCA4, a photoreceptor ATP binding cassette (ABC) transporter. Biochemical studies together with analysis of abca4 knockout mice and Stargardt patients have implicated ABCA4 as a lipid transporter that facilitates the removal of potentially toxic retinal compounds from photoreceptors following photoexcitation. An autosomal dominant form of Stargardt disease also known as Stargardt-like dystrophy is caused by mutations in a gene encoding ELOVL4, an enzyme that catalyzes the elongation of very long chain fatty acids in photoreceptors and other tissues. This review focuses on the molecular characterization of ABCA4 and ELOVL4 and their role in photoreceptor cell biology and the pathogenesis of Stargardt disease. PMID:20633576

Molday, Robert S.; Zhang, Kang

2010-01-01

77

Automatic classification of diabetic macular edema in digital fundus images  

Microsoft Academic Search

Diabetic macular edema is a common complication of diabetic retinopathy due to the presence of exudates in proximity with the fovea. In this paper, an automated method to classify diabetic macular edema is presented. The fovea is localized and the regions of macula are marked based on the Early Treatment Diabetic Retinopathy Studies (ETDRS) grading scale. Extraction method using marker-controlled

S. T. Lim; W. M. D. W. Zaki; A. Hussain; S. L. Lim; S. Kusalavan

2011-01-01

78

The triple flash electroretinogram and its significance in macular diseases  

Microsoft Academic Search

• Purpose: The purpose of this study was to evaluate recovery data for the b-wave of the electroretinogram (ERG) elicited using multiple flash stimulation with increasing stimulus intervals in normal controls and in patients with macular diseases. The results will describe effects of age and macular disease and define indexes characterizing the recovery process. • Methods: Scotopic Ganzfeld flash ERGS

Karl Ulrich Bartz-Schmidt; Richard Brunner; Peter Esser; Christoph Liike; Peter Walter; Werner Sickel

1996-01-01

79

Genetic and molecular studies of macular dystrophies: recent developments  

Microsoft Academic Search

Macular degeneration is a heterogeneous group of disorders characterized by progressive central visual loss and degeneration of the macula and underlying retinal pigment epithelium (RPE) of the eye. Age-related macular degeneration (ARMD), the most common form of the disease, is the leading cause of legal blindness in the elderly population in the United States and in the many developed countries

Kang Zhang; Alan Crandall; Larry A. Donoso

1995-01-01

80

Age-Related Macular Degeneration: Etiology, Pathogenesis, and Therapeutic Strategies  

Microsoft Academic Search

Age-related macular degeneration is the principal cause of registered legal blindness among those aged over 65 in the United States, western Europe, Australia, and Japan. Despite intensive research, the precise etiology of molecular events that underlie age-related macular degeneration is poorly understood. However, investigations on parallel fronts are addressing this prevalent public health problem. Sophisticated biochemical and biophysical techniques have

Jayakrishna Ambati; Balamurali K Ambati; Sonia H Yoo; Sean Ianchulev; Anthony P Adamis

2003-01-01

81

[Bilateral hand transplantation].  

PubMed

In March 2000 we performed a bilateral hand transplantation on a 47-year-old policeman who had lost both hands in a bomb accident. Although he was fitted with myoelectric prostheses, he kept investigating the possibility of hand transplantation. The ethical, surgical, medical, legal and human aspects of this special kind of reconstruction was discussed in a symposium in Vienna, and it was decided to go ahead with it if a suitable candidate presented. The operation was successful, the immunosuppressive regimen well-planned and carried out, the post-operative course without any remarkable events. Under intensive physical therapy, the patient gradually but steadily regained sensory and motor functions in his hands. Now, two years after the operation, the patient is practically independent in the activities of daily living and is able to work at his job. PMID:12073182

Piza-Katzer, H; Hussl, H; Ninkovi?, M; Pechlaner, S; Gabl, M; Ninkovi?, M; Schneeberger, S; Margreiter, R

2002-03-01

82

Bilateral lambdoid dermoid cyst.  

PubMed

Generally, dermoid and epidermoid cysts arise as a result of incomplete separation of the neuroectoderm from the superficial ectoderm with displacement of ectodermal elements along their lines of fusion during development. Dermoid cysts of the posterior head are rare lesions composed of epidermal and mesodermal elements. Furthermore, dermoid cysts in the occipital area are extremely rare. The presence of synchronous, bilateral occipital dermoids is quite rare and has not been reported previously. A unique case of lambdoidal dermoids in a 75-year-old woman is presented. Large right lesion was excised concurrently through direct skin incision, and a very small left mass was observed. And the etiology, natural history, management, and prognosis of dermoids are reviewed. PMID:24978680

Choi, Hwan Jun

2014-07-01

83

Case-control study of the risk factors for age related macular degeneration  

PubMed Central

AIM—A case-control study was initiated to determine the risk factors for the development of age related macular degeneration (AMD).?METHODS—Study participants, who were all white, aged 50-85 years, and were recruited from private ophthalmology practices. Each practitioner enrolled patients with bilateral AMD, who were then matched with controls for sex and age. Environmental factors and systemic and ocular histories were screened. All patients had bilateral red-free fundus photographs and fluorescein angiography. Photographs were classified into pigment epithelium alterations, drusen, geographic atrophy, and exudative AMD. Statistical analysis included the identification of risk factors for AMD. A multivariate analysis was performed at the end of the study. Analysis included the entire study population and was carried out for each stage of AMD.?RESULTS—1844 controls were compared with 1844 patients with AMD. Mean age was 71 years for controls and 72 for cases. Logistic regression identified six major risk factors for AMD (whole population): arterial hypertension (odds ratio (OR) =1.28), coronary disease (OR=1.31), hyperopia (OR=1.33), light coloured irises (OR=1.22), and lens opacities or previous cataract surgery (OR=1.55). The significance of vascular risk factors was increased for late stages of AMD, especially the atrophic forms (coronary disease, OR=3.19).?CONCLUSIONS—This large case-control study confirms some of the risk factors previously identified and may contribute to the determination of methods for prevention of AMD.?? Keywords: age related macular degeneration; risk factors; case-control study PMID:9893587

Chaine, G.; Hullo, A.; Sahel, J.; Soubrane, G.; Espinasse-Berrod, M.; Schutz, D.; Bourguignon, C.; Harpey, C.; Brault, Y.; Coste, M.; Moccatti, D.; Bourgeois, H.

1998-01-01

84

Examination of macular vitreoretinal interface disorders with monochromatic photography.  

PubMed

Monochromatic light accentuates details of different retinal layers because of its variable absorption and reflectance by structures both within and above these layers. Monochromatic photography was used to examine macular vitreoretinal interface abnormalities in 19 patients. Short wavelength photographs (490 nm) provided the best detail of inner retinal abnormalities, including epiretinal membranes, vitreoretinal traction, and the internal surface of confluent macular edema (pseudocyst). Although 540-nm red-free photography provided acceptable photographs, it did not provide optimal detail of inner or deep retinal abnormalities. Longer wavelengths, 585 and 610 nm, best disclosed the extent of deep retinal abnormalities, including the extent of confluent macular edema (pseudocysts) and retinal detachment that surrounded macular holes. The addition of short- and long-wave-length photography to traditional red-free photography may provide better localization, understanding, and documentation of the three-dimensional relationships in macular vitreoretinal interface disorders. PMID:1543217

Ortiz, R G; Lopez, P F; Lambert, H M; Sternberg, P; Aaberg, T M

1992-03-15

85

Vitrectomy Combined with Intravitreal Triamcinolone Acetonide Injection and Macular Laser Photocoagulation for Nontractional Diabetic Macular Edema  

PubMed Central

Purpose To evaluate the efficacy of vitrectomy combined with intravitreal injection of triamcinolone acetonide (IVTA) and macular laser photocoagulation for the treatment of nontractional diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) therapy. Methods Twenty-eight eyes from 28 subjects who were diagnosed with nontractional DME refractory to three or more sequential anti-VEGF injections underwent sequential vitrectomy, IVTA, and macular laser photocoagulation. Changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST) during the six months following vitrectomy were evaluated. Additionally, the CST and BCVA outcomes were compared with those of 26 eyes treated with the same triple therapy for nontractional DME refractory to conventional treatment, such as IVTA or macular laser photocoagulation, or both. Results The mean logarithm of the minimum angle of resolution BCVAs before and one, three, and six months after vitrectomy were 0.44 ± 0.15, 0.36 ± 0.18, 0.31 ± 0.14, and 0.34 ± 0.22, respectively. The mean CSTs were 433.3 ± 77.9, 329.9 ± 59.4, 307.2 ± 60.2, and 310.1 ± 80.1 microns, respectively. The values of both BCVA and CST at one, three, and six months were significantly improved from baseline (p < 0.05). The extent of CST reduction during the first month after triple therapy was greater in eyes refractory to conventional treatment than in eyes refractory to anti-VEGF (p = 0.012). Conclusions Vitrectomy combined with IVTA and macular laser photocoagulation had a beneficial effect on both anatomical and functional outcomes in eyes with nontractional DME refractory to anti-VEGF therapy. PMID:23730111

Kim, Jae Hui; Ha, Hyo Shin; Kim, Jae Ryung

2013-01-01

86

Macular hole in Beh?et's disease  

PubMed Central

Objective: To investigate the clinical features, prevalence, role of surgical intervention and the visual prognosis of macular holes (MH) in patients with Behcet's disease (BD). Materials and Methods: Retrospective study of patients with BD and MH from January 1998 to November 2008. Results: Out of 159 patients, 21 eyes of 17 patients were identified with MH. The mean age was 38.59 (range 23-61) years and the mean follow-up period was 5.1 years (range 13-164 months). The prevalence of MH was 7%. Visual acuity (VA) at the time of presentation ranged from 20/70 to hand-motion. Optical coherence tomography (OCT) findings revealed intraretinal cysts at the edge of the MH. The mean size of MH was 983.6 um; 52% had elevated edges, 43% had flat edges and only one eye (5%) was closed postoperatively. Fluorescein angiography (FA) was consistent with macular ischemia in 76% of the cases. Human leukocyte antigen (HLA) B51 association was found in 14 of the 15 patients investigated. Six patients (out of 17) underwent pars plana vitrectomy. The final VA on their last follow-up ranged from 20/70 to 2/200. Surgical intervention for MH did not result in any visual improvement as compared to non-operated eyes. One patient lost vision completely due to elevated intraocular pressure post vitrectomy and silicon oil tamponade. Conclusions: MH in patients with BD may lead to significant visual disability. Surgical intervention does not seem to have any potential beneficial effect on the VA, probably due to significant macular ischemia and sequelae from the ocular inflammation. PMID:21836340

Al-Dhibi, Hassan; Abouammoh, Marwan; Al-Harthi, Essam; Al-Gaeed, Abdulrahman; Larsson, Jorgen; Abboud, Emad; Chaudhry, Imtiaz

2011-01-01

87

Utilization of scanning laser ophthalmoscopy in laser-induced bilateral human retinal nerve fiber layer damage  

NASA Astrophysics Data System (ADS)

In this paper, we describe a military laser accident case where bilateral Q-switched laser exposure resulted in bilateral macular damage with immediate visual acuity loss in one eye (OS) and delayed visual acuity loss in the other exposed eye (OD), where retinal damage appeared more parafoveal. At 6 weeks post exposure, OS had recovered to 20/17 and OD had dropped to 20/100 Snellen activity. Retinal nerve fiber damage was observed in both eyes at this time. Contrast sensitivity measurements made in OS were suppressed across all spatial frequencies, even though Snellen acuity measured in the normal range. More severe high spatial frequency loss in contrast was measured in the right eye as well as low spatial frequency loss. Both OS and OD revealed a parafoveal preferred retinal locus with scanning laser ophthalmoscopy contrast sensitivity measurements, suggesting parafoveal retinal compensatory processes.

Zwick, Harry; Gagliano, Donald A.; Ruiz, S.; Stuck, Bruce E.

1995-05-01

88

Bilateral metachronous periosteal osteosarcoma.  

PubMed

The first case of bilateral metachronous periosteal osteosarcoma (OS) is reported. A 14-year-old white boy presented with a 1-month history of pain and swelling in his right thigh. Periosteal OS was diagnosed on a basis of the radiologic and pathologic findings. Treatment was with local resection and total hip replacement after a short course of high-dose methotrexate; multi-agent chemotherapy was continued postoperatively for 3 months. He remained well for 3 years. He then represented with a mass in the left femur that had been slowly growing for about 1 year. Radiologic and biopsy studies showed periosteal OS. Full investigations showed no evidence of metastatic disease. Treatment consisted of local resection without chemotherapy. He remained well for 6 months after the second excision until developing multiple pulmonary metastases. All further therapy was refused. The question as to whether the second tumor was a new primary lesion or a metastasis is discussed, together with possible differential diagnoses. PMID:3460685

Howat, A J; Dickens, D R; Boldt, D W; Waters, K D; Campbell, P E

1986-09-01

89

Macular abnormalities in Italian patients with retinitis pigmentosa  

PubMed Central

Aim To investigate the prevalence of macular abnormalities in a large Caucasian cohort of patients affected by retinitis pigmentosa (RP). Methods A retrospective study was performed by reviewing the medical records and optical coherence tomography (OCT) scans in a cohort of 581 RP patients in order to assess the presence of macular abnormalities —that is, cystoid macular oedema (CMO), epiretinal membrane (ERM), vitreo-macular traction syndrome, and macular hole. Results Macular abnormalities were observed in 524 (45.1%) out of the 1161 examined eyes. The most frequent abnormality was CMO, observed in 237 eyes (20.4%) from 133 patients (22.9%), followed by ERM, assessed in 181 eyes (15.6%) from 115 patients (19.8%). Moreover, vitreo-retinal abnormalities were significantly (p<0.05) associated with older age, cataract surgery, or cataract. CMO appeared to be significantly (p<0.05) associated with female gender, autosomic dominant inheritance pattern, and cataract. Conclusions Macular abnormalities are more frequent in RP compared to the general population. For that reason, screening RP patients with OCT is highly recommended to follow-up the patients, evaluate the natural history of disease, and identify those patients who could benefit from current or innovative therapeutic strategies. PMID:24532797

Testa, Francesco; Rossi, Settimio; Colucci, Raffaella; Gallo, Beatrice; Di Iorio, Valentina; della Corte, Michele; Azzolini, Claudio; Melillo, Paolo; Simonelli, Francesca

2014-01-01

90

Idiopathic macular telangiectasia type 2: ?the progressive vasculopathy.  

PubMed

Purpose. To describe the complete sequence of the progressive vasculopathy in macular telangiectasia type 2.?Methods. This is a report of a case demonstrating the complete vasogenic sequence in macular telangiectasia type 2 over the course of 15 years, and representative images from a collective of 150 patients with macular telangiectasia type 2 employing fundus photography, fluorescein angiography, and optical coherence tomography.?Results. Macular telangiectasia may progress along a predictable vasogenic sequence which consists of nonproliferative stages, characterized by temporal loss of macular luteopigment and inner retinal volume loss in the absence of vascular changes, followed by a progressive proliferative vasculopathy, first involving the deep capillary plexus with eventual extension of the vascular changes circumferentially in the inner retinal capillary plexus. Late proliferative stages may become indistinguishable from advanced neovascular age-related macular degeneration.?Conclusions. While it is rare to observe the complete vasogenic sequence of macular telangiectasia type 2, a classification into nonproliferative and proliferative stages can be established, and may prove helpful as the mechanisms driving the pathogenic process through those stages are identified. PMID:23138663

Engelbert, Michael; Yannuzzi, Lawrence A

2012-11-01

91

Genetic and molecular studies of macular dystrophies: recent developments.  

PubMed

Macular degeneration is a heterogeneous group of disorders characterized by progressive central visual loss and degeneration of the macula and underlying retinal pigment epithelium (RPE) of the eye. Age-related macular degeneration (ARMD), the most common form of the disease, is the leading cause of legal blindness in the elderly population in the United States and in the many developed countries throughout the world. Despite its prevalence, its etiology and pathogenesis are poorly understood, and effective treatment options are limited for most patients. Inherited macular dystrophies share many important features with ARMD but are more readily studied by molecular genetic approaches. Over the past few years, significant progress has been made in the molecular genetics of inherited macular dystrophies. Genes responsible for dominant and recessive Stargardt's macular dystrophy as well as Best's disease have been localized to specific chromosomal regions. The peripherin/RDS gene when defective is associated with butterfly-shaped pattern dystrophy. Molecular studies of genes involved in macular dystrophies may yield insights into the mechanisms of pathogenesis of macular degeneration and provide new rationale for the management and treatment of patients with these diseases. PMID:8545803

Zhang, K; Nguyen, T H; Crandall, A; Donoso, L A

1995-01-01

92

Peripapillary and Macular Choroidal Thickness in Glaucoma  

PubMed Central

Purpose To compare choroidal thickness (CT) between individuals with and without glaucomatous damage and to explore the association of peripapillary and submacular CT with glaucoma severity using spectral domain optical coherence tomography (SD-OCT). Methods Ninety-one eyes of 20 normal subjects and 43 glaucoma patients from the UCLA SD-OCT Imaging Study were enrolled. Imaging was performed using Cirrus HD-OCT. Choroidal thickness was measured at four predetermined points in the macular and peripapillary regions, and compared between glaucoma and control groups before and after adjusting for potential confounding variables. Results The average (± standard deviation) mean deviation (MD) on visual fields was ?0.3 (±2.0) dB in controls and ?3.5 (±3.5) dB in glaucoma patients. Age, axial length and their interaction were the most significant factors affecting CT on multivariate analysis. Adjusted average CT (corrected for age, axial length, their interaction, gender and lens status) however, was not different between glaucoma patients and the control group (P=0.083) except in the temporal parafoveal region (P=0.037); nor was choroidal thickness related to glaucoma severity (r=?0.187, P=0.176 for correlation with MD, r=?0.151, P=0.275 for correlation with average nerve fiber layer thickness). Conclusions Choroidal thickness of the macular and peripapillary regions is not decreased in glaucoma. Anatomical measurements with SD-OCT do not support the possible influence of the choroid on the pathophysiology of glaucoma.

Hosseini, Hamid; Nilforushan, Naveed; Moghimi, Sasan; Bitrian, Elena; Riddle, Jay; Lee, Gina Yoo; Caprioli, Joseph; Nouri-Mahdavi, Kouros

2014-01-01

93

Bilateral Achilles tendon enlargement.  

PubMed

Cerebrotendinous xanthomatosis is a rare, autosomal-recessive, lipid-storage disease with accumulation of cholestanol in most tissues, particularly within the Achilles tendons. It has been characterized both clinically and biochemically, and recently from the molecular biological aspect as well. Juvenile cataract, childhood diarrhea, mental retardation, cerebellar ataxia, and tendon xanthomas are the most prominent features of this disease. Bilateral symmetrical firm masses of Achilles tendons may be the first symptom the patient recognizes because it can jeopardize his or her ability to walk. However, the treatment strategies for tendon tumors vary. In a recent case, we diagnosed the disease properly, according to the clinical manifestations and the radiological and laboratory examinations. The genetic mutation was characterized by analyzing sterol 27-hydroxylase from the patient's family (located on nucleotide 599) and led to a nonsense mutation. It is a unique type of mutation that has never been reported to our knowledge. Tendon lesions are characterized by the loss of muscle fibers and accumulation of lipid products. To help the patient regain the strength of the Achilles tendon and walking abilities, a large area of tendon tumor was excised, followed by reconstruction with a tibialis posterior allograft, which is the second strongest tendon in the foot and ankle. Although the use of this type of graft is uncommon, the final result was satisfactory. At the 10-month follow-up examination, the patient could walk easily without pain. This case report suggests that the surgical procedure will provide an alternative for the repair of large-area degenerative Achilles tendons. PMID:22146219

Huang, Lu; Miao, Xu-dong; Yang, Di-sheng; Tao, Hui-min

2011-12-01

94

Macular Oedema Related to Idiopathic Macular Telangiectasia Type 1 Treated with Dexamethasone Intravitreal Implant (Ozurdex)  

PubMed Central

A 65-year-old female presented with visual disturbance in her right eye lasting for over 2 months. Following investigations, she was diagnosed with MacTel type 1 in the right eye. Visual symptoms were refractory to initial treatment with intravitreal bevacizumab and thereafter intravtireal triamicinolone. The patient was then treated with Ozurdex, following which central macular thickness (CMT) decreased (from 397??m to 286??m) and visual acuity deteriorated (from logMAR 0.48 to 0.59). At 14 weeks posttreatment with Ozurdex, a recurrence of cystoid macular oedema (CMO) was observed. Following a second Ozurdex, visual acuity improved (from logMAR 0.7 to 0.64) and CMT decreased (from 349??m to 279??m). An additional recurrence of CMO was observed at eighteen weeks following the second Ozurdex. Following a third Ozurdex injection visual acuity deteriorated (from logMAR 0.74 to 0.78) and CMT decreased (from 332??m to 279??m). Conclusion. Treatment of macular oedema secondary to MacTel with Ozurdex demonstrated promising anatomical outcomes. However, visual outcomes continued to gradually deteriorate. PMID:25045562

Kamal, Ahmed

2014-01-01

95

Macular oedema related to idiopathic macular telangiectasia type 1 treated with dexamethasone intravitreal implant (ozurdex).  

PubMed

A 65-year-old female presented with visual disturbance in her right eye lasting for over 2 months. Following investigations, she was diagnosed with MacTel type 1 in the right eye. Visual symptoms were refractory to initial treatment with intravitreal bevacizumab and thereafter intravtireal triamicinolone. The patient was then treated with Ozurdex, following which central macular thickness (CMT) decreased (from 397??m to 286??m) and visual acuity deteriorated (from logMAR 0.48 to 0.59). At 14 weeks posttreatment with Ozurdex, a recurrence of cystoid macular oedema (CMO) was observed. Following a second Ozurdex, visual acuity improved (from logMAR 0.7 to 0.64) and CMT decreased (from 349??m to 279??m). An additional recurrence of CMO was observed at eighteen weeks following the second Ozurdex. Following a third Ozurdex injection visual acuity deteriorated (from logMAR 0.74 to 0.78) and CMT decreased (from 332??m to 279??m). Conclusion. Treatment of macular oedema secondary to MacTel with Ozurdex demonstrated promising anatomical outcomes. However, visual outcomes continued to gradually deteriorate. PMID:25045562

Loutfi, Mohamed; Papathomas, Thomas; Kamal, Ahmed

2014-01-01

96

Patterns of diabetic macular edema with optical coherence tomography  

Microsoft Academic Search

PURPOSE: We report cross-sectional images of diabetic macular edema and correlation between tomographic features and visual acuity with best correction by means of optical coherence tomography.METHOD: In a prospective study, optical coherence tomography was performed in 59 eyes of 42 patients with diabetic macular edema and in 10 eyes of 10 normal control subjects.RESULTS: Optical coherence tomography showed three patterns

Tomohiro Otani; Shoji Kishi; Yasuhiro Maruyama

1999-01-01

97

Age-related macular degeneration: a perspective on genetic studies  

Microsoft Academic Search

AimAge-related macular degeneration (AMD) is a common macular disease in the developed world and recent studies have shown that specific genes may be associated with it and may contribute to a higher risk of developing AMD.ObjectiveOur objective was to review systematically recent publications related to the genetics of AMD and provide relevant information that would help both scientists and clinicians

N Patel; T Adewoyin; N V Chong; Victor Chong

2008-01-01

98

Multiple extra macular branch retinal vein occlusions in hyperhomocysteinemia  

PubMed Central

Hyperhomocysteinemia is a well-known modifiable risk factor for thromboembolism. Retinal vascular occlusion in patients having hyperhomocysteinemia is a known entity, particularly in young patients. However, multiple extra macular branch retinal vein occlusion (BRVO) is a rare condition, which can be a presentation of this disease. We present a patient who had multiple extra macular BRVO; on complete systemic workup, he was found to have raised homocysteine levels. PMID:24817751

Gore, Abhijit Diwakar; Rao, Girish Shiva; Gore, Mansi Abhijit; Desai, Abhishek R

2014-01-01

99

Prevention of age-related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. Although effective treatment modalities such as anti-VEGF treatment have been developed for neovascular AMD, there is still no effective treatment for geographical atrophy, and therefore the most cost-effective management of AMD is to start with prevention. This review looks at current evidence on preventive measures targeted at AMD. Modalities reviewed include (1) nutritional supplements such as the Age-Related Eye Disease Study (AREDS) formula, lutein and zeaxanthin, omega-3 fatty acid, and berry extracts, (2) lifestyle modifications, including smoking and body-mass-index, and (3) filtering sunlight, i.e. sunglasses and blue-blocking intraocular lenses. In summary, the only proven effective preventive measures are stopping smoking and the AREDS formula. PMID:20862519

Wong, Ian Yat Hin; Koo, Simon Chi Yan; Chan, Clement Wai Nang

2011-02-01

100

Prevention of age-related macular degeneration  

PubMed Central

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. Although effective treatment modalities such as anti-VEGF treatment have been developed for neovascular AMD, there is still no effective treatment for geographical atrophy, and therefore the most cost-effective management of AMD is to start with prevention. This review looks at current evidence on preventive measures targeted at AMD. Modalities reviewed include (1) nutritional supplements such as the Age-Related Eye Disease Study (AREDS) formula, lutein and zeaxanthin, omega-3 fatty acid, and berry extracts, (2) lifestyle modifications, including smoking and body-mass-index, and (3) filtering sunlight, i.e. sunglasses and blue-blocking intraocular lenses. In summary, the only proven effective preventive measures are stopping smoking and the AREDS formula. PMID:20862519

Koo, Simon Chi Yan; Chan, Clement Wai Nang

2010-01-01

101

Optical coherence tomography imaging of macular oedema  

PubMed Central

Macular oedema (ME) occurs in a wide variety of pathological conditions and accounts for different degrees of vision loss. Early detection of ME is therefore critical for diagnosis and therapeutic management. Optical coherence tomography (OCT) is a non-contact, diagnostic method that uses infrared light, which allows the analysis of the retinal structure by means of high-resolution tomographic cross sections. The identification, localisation, quantification and long-term follow-up of fluid collections are the most important capabilities of OCT. Since the introduction of OCT in clinical practice, it has become an invaluable diagnostic tool and different patterns of ME have been reported. The purpose of this manuscript is to review OCT profiles of ME according to the aetiology and describe what has been reported regarding intraretinal features in vivo. PMID:24934220

Trichonas, George; Kaiser, Peter K

2014-01-01

102

A comparison of pattern and multifocal electroretinography in the evaluation of age-related macular degeneration and its treatment with photodynamic therapy  

Microsoft Academic Search

This study compares pattern electroretinography (PERG) and multifocal electroretinography (mfERG) measures in 13 patients\\u000a with predominantly classic choroidal neovascularisation (CNV) associated with age-related macular degeneration (ARMD, 9\\/13\\u000a unilateral, 4\\/13 bilateral), assesses the usefulness of each test in monitoring disease progression, and identifies electrophysiological\\u000a predictors of outcome following treatment with photodynamic therapy (PDT). PERG and mfERGs were recorded at presentation,\\u000a 2 weeks

Magella M. Neveu; Adnan Tufail; Jonathan G. Dowler; Graham E. Holder

2006-01-01

103

Optical coherence tomography classification of diabetic cystoid macular edema  

PubMed Central

Purpose To propose a new classification of diabetic cystoid macular edema (CME) based on optical coherence tomography (OCT) findings and cover all new important findings. Patients and methods A retrospective study was carried out in the El-Minia Investigation Eye Center between January 2012 and November 2012. It included 104 eyes of 86 patients, aged between 50 and 71 years, all with type II diabetes mellitus of duration from 5 to 20 years. All patients were diagnosed to have CME, as assessed by OCT, with measurement of the vertical size of the largest macular cyst and maximum macular thickness, and the relation between them. Results Patients were divided into four groups. Eyes with cysts less than 30% of macular thickness were considered to have CME I (n = 4, 3.84%), while those between 30% and 60% were considered to have CME II (n = 62, 59.62%). Eyes with cysts between 60% and 90% of macular thickness were considered to have CME III (n = 36, 34.62%). CME IV was diagnosed when the size of the cyst became more than 90% of the macular thickness, and this was encountered in two eyes (1.92%). Conclusions OCT is a useful technique for quantitative measurement and helps in better anatomical characterization of CME, and this classification of diabetic CME may be of value in classification of CME due to causes other than diabetes. PMID:24039393

Helmy, Yasser M; Allah, Heba R Atta

2013-01-01

104

Perceptual learning in patients with macular degeneration  

PubMed Central

Patients with age-related macular degeneration (AMD) or hereditary macular dystrophies (JMD) rely on an efficient use of their peripheral visual field. We trained eight AMD and five JMD patients to perform a texture-discrimination task (TDT) at their preferred retinal locus (PRL) used for fixation. Six training sessions of approximately one hour duration were conducted over a period of approximately 3 weeks. Before, during and after training twelve patients and twelve age-matched controls (the data from two controls had to be discarded later) took part in three functional magnetic resonance imaging (fMRI) sessions to assess training-related changes in the BOLD response in early visual cortex. Patients benefited from the training measurements as indexed by significant decrease (p = 0.001) in the stimulus onset asynchrony (SOA) between the presentation of the texture target on background and the visual mask, and in a significant location specific effect of the PRL with respect to hit rate (p = 0.014). The following trends were observed: (i) improvement in Vernier acuity for an eccentric line-bisection task; (ii) positive correlation between the development of BOLD signals in early visual cortex and initial fixation stability (r = 0.531); (iii) positive correlation between the increase in task performance and initial fixation stability (r = 0.730). The first two trends were non-significant, whereas the third trend was significant at p = 0.014, Bonferroni corrected. Consequently, our exploratory study suggests that training on the TDT can enhance eccentric vision in patients with central vision loss. This enhancement is accompanied by a modest alteration in the BOLD response in early visual cortex. PMID:25368597

Plank, Tina; Rosengarth, Katharina; Schmalhofer, Carolin; Goldhacker, Markus; Brandl-Ruhle, Sabine; Greenlee, Mark W.

2014-01-01

105

Macular rotation with and without counter-rotation of the globe in patients with age-related macular degeneration  

Microsoft Academic Search

· Background: Macular rotation to treat exudative age-related macular degeneration (AMD) involves translocation of the fovea\\u000a to a site with intact retinal pigment epithelium. To avoid the inevitable postoperative cyclotropia we combined this procedure\\u000a with torsional muscle surgery.?· Patients and methods: In 30 eyes the macula was rotated upward by 30–50° following complete\\u000a artificial retinal detachment and a 360° retinotomy.

Claus Eckardt; Ute Eckardt; Hans-Georg Conrad

1999-01-01

106

Reversible parainfectious bilateral "striatal necrosis".  

PubMed

Bilateral striatal necrosis is usually associated with either endogenous or exogenous toxins, and with poor neurodevelopmental outcomes. We describe two patients with acute bilateral striatal clinical syndrome and magnetic resonance signal changes who made a complete clinical and radiologic recovery within 3 months. After an uneventful pregnancy, normal birth, and normal development, both boys presented at ages 3 and 5 years, respectively, after a viral illness with slurring of speech, bradykinesia, and an extrapyramidal movement disorder. On examination, both manifested bilateral cog wheel rigidity, with a broad-based gait and flexor plantar response. Cranial magnetic resonance imaging in both children indicated bilateral, symmetric, high signal changes in the lentiform nucleus, predominately in the putamen, with sparing of the globus pallidi bilaterally. The brain parenchyma was otherwise normal. Neurometabolic investigations produced normal results in both patients. The pathogenesis is uncertain, but could be immune-mediated. Both children, at 3-year and 1-year follow-ups, respectively, are doing well neurologically and academically. Our patients demonstrate that abnormal imaging findings during acute stages do not preclude good clinical and radiologic recovery. PMID:22196494

Nandish, Shalini; Khan, Rafeh; Connolly, Daniel J; Rittey, Christopher D; Mordekar, Santosh R

2012-01-01

107

Late-onset Stargardt-like macular dystrophy maps to chromosome 1p13  

SciTech Connect

Stargardt`s disease (MIM 248200), originally described in 1909, is an autosomal recessive condition of childhood, characterized by a sudden and bilateral loss of central vision. Typically, it has an early onset (7 to 12 years), a rapidly progressive course and a poor final outcome. The central area of the retina (macula) displays pigmentary changes in a ring form with depigmentation and atrophy of the retinal pigmentary epithelium (RPE). Perimacular yellowish spots, termed fundus flavimaculatus, are observed in a high percentage of patients. We have recently reported the genetic mapping of Stargardt`s disease to chromosome 1p13. On the other hand, considering that fundus flavimaculatus (MIM 230100) is another form of fleck fundus disease, with a Stargardt-like retinal aspect but with a late-onset and a more progressive course, we decided to test the hypothesis of allelism between typical Stargardt`s disease and late-onset autosomal recessive fundus flavimaculatus. Significant pairwise lod scores were obtained in each of four multiplex families (11 affected individuals, 12 relatives) with four markers of the 1p13 region (Z = 4.79, 4.64, 3.07, 3.16 at loci D1S435, D1S424, D1S236, and D1S415, respectively at {theta} = 0). Multipoint analysis showed that the best estimate for location of the disease gene is between D1S424 and D1S236 (maximum lod score of 5.20) as also observed in Stargardt`s disease. Our results are consistent with the location of the gene responsible of the late-onset Stargardt-like macular dystrophy in the 1p13 region and raise the hypothesis of either allelic mutational events or contiguous genes in this chromosomal region. The question of possible relationship with some age-related macular dystrophies in now open to debate.

Kaplan, J.; Gerber, S.; Rozet, J.M. [Hopital des Enfants Malades, Paris (France)] [and others

1994-09-01

108

Temporal Macular Thinning Associated With X-Linked Alport Syndrome  

PubMed Central

Importance Optical coherence tomography (OCT) findings of temporal macular thinning are important in the diagnosis and prognosis of X-linked Alport syndrome (XLAS). Objectives To report OCT findings and severity of temporal macular thinning in a cohort with XLAS and to correlate these and other ocular findings with mutation genotype. Design Patients with XLAS underwent genotyping for COL4A5 mutations and complete eye examinations with retinal imaging using spectral domain OCT and fundus photography. Temporal macular thinning was calculated from OCT measurements by comparing the ratio of the retinal thickness of the temporal to the nasal subfields with a published normative database. Setting University departments of ophthalmology and nephrology. Participants Thirty-two patients from 24 families. Main Outcome and Measures Temporal thinning index calculated from spectral domain OCT scans. Results All study patients had a mutation associated with the X-linked COL4A5 gene. Eleven different mutations were identified. Eleven of 32 patients (34%) expressed the L1649R mutation. Of a total of 63 eyes with available OCT scans, 44 (70%) had severe pathological temporal macular thinning. The L1649R mutation was associated with the least amount of severe temporal macular thinning and later onset of renal failure. Conclusions and Relevance Temporal macular thinning is a prominent sign associated with XLAS, suggesting that OCT measurements are essential in the diagnosis and prognosis of the disease. The L1649R mutation in the COL4A5 gene causes a relatively mild form of XLAS characterized by late-onset renal failure and less frequent, severe temporal macular thinning relative to other COL4A5 mutations. The pathological basis for the retinal abnormalities of XLAS remains to be established. PMID:23572034

Ahmed, Faisal; Kamae, Kandon K.; Jones, Denise J.; DeAngelis, Margaret M.; Hageman, Gregory S.; Gregory, Martin C.; Bernstein, Paul S.

2013-01-01

109

Two-wavelength fundus autofluorescence and macular pigment optical density imaging in diabetic macular oedema  

PubMed Central

Purpose To evaluate the application of 488 and 514?nm fundus autofluorescence (FAF) and macular pigment optical density (MPOD) imaging in diabetic macular oedema (DMO) and to demonstrate the typical imaging features. Patients and Methods A hundred and twenty-five eyes of 71 consecutive patients with diabetic retinopathy who underwent examination at a specialist university clinic employing a modified Heidelberg Retina Angiograph, using two different light sources of 488 and 514?nm wavelength, were retrospectively reviewed. MPOD images were calculated using modified Heidelberg Eye Explorer software. All images were evaluated by two independent masked graders. Features from FAF and MPOD images were correlated with optical coherence tomography (OCT) imaging findings and inter-grader variability, sensitivity and specificity were calculated using OCT as reference. Results Sixty-seven eyes had DMO on OCT. The inter-grader variability was 0.84 for 488?nm FAF, 0.63 for 514?nm FAF and 0.79 for MPOD imaging. Sensitivity and specificity for detection of DMO were 80.6 and 89.7% for 488?nm FAF; 55.2 and 94.8% for 514?nm FAF; and 80.6 and 91.4% for MPOD imaging. In 488?nm FAF and MPOD imaging, DMO was better visualised in comparison with 514?nm FAF imaging, P<0.01. MPOD revealed displacement of macular pigment by intraretinal cysts. Conclusion MPOD imaging, and particularly its combination with 488?nm and 514?nm FAF, provides a valuable addition to OCT in the evaluation of DMO and is clinically useful in rapid en-face assessment of the central macula. PMID:22699976

Waldstein, S M; Hickey, D; Mahmud, I; Kiire, C A; Charbel Issa, P; Chong, N V

2012-01-01

110

Staging of Macular Telangiectasia: Power-Doppler Optical Coherence Tomography and Macular Pigment Optical Density  

PubMed Central

Purpose. Two methods were used to study the stages of macular telangiectasia (MacTel): Power-Doppler optical coherence tomography (PD-OCT), which allows imaging of the retinal circulation in three dimensions, and macular pigment optical density (MPOD), which quantifies the distribution of macular carotenoids. Methods. Among 49 patients with MacTel identified, 12 eyes (6 patients) with MacTel and 7 age-matched control eyes (7 patients) were imaged with a custom-built Fourier-domain OCT instrument to acquire PD-OCT images. MPOD was measured using heterochromatic flicker photometry in 10 eyes (5 patients) with MacTel and compared with 44 age-matched control eyes (44 patients). Clinical staging of MacTel was based on best-corrected visual acuity, fundus biomicroscopy, fluorescein angiography, and OCT. Results. Stage 1 eyes (n = 2) had subtle punctate vascular signal confined to the inner portion of the outer plexiform layer (OPL) on PD-OCT. Stage 2 (n = 2) showed larger oblique vascular signal extending into deeper OPL. Stage 3 (n = 5) had disruption of outer retinal layers with abnormal vasculature extending into the outer nuclear layer. Stage 4 (n = 3) showed diffuse blurring of the retinal layers with vascular channels extending the full thickness of the retina. MPOD values in four eyes with stage 1 or 2 MacTel correlated well with age-matched controls. Six eyes with stage 3 or 4 MacTel had loss of MPOD especially at the fovea. Conclusions. PD-OCT shows penetration of the retinal capillaries into the deeper retinal layers in early stages of MacTel, with full thickness vascular proliferation in advanced disease. MPOD is commonly depleted but may appear normal in early stage MacTel. PMID:23716628

Chin, Eric K.; Kim, Dae Yu; Hunter, Allan A.; Pilli, Suman; Wilson, Machelle; Zawadzki, Robert J.; Werner, John S.; Park, Susanna S.

2013-01-01

111

Bilateral and symmetrical tinea mammae.  

PubMed

Tinea corporis has rarely been reported in some locations such as on the breast skin as unilaterally. Herein, we present a case of bilateral tinea mammae, which has not been reported before in English language literature to our knowledge. PMID:24050298

Yilmaz, Murat; Kavak, Ayse; Yamaner, Nalan Jale

2013-09-01

112

Indocyanine green staining and removal of internal limiting membrane in macular hole surgery: histology and outcome  

Microsoft Academic Search

PURPOSE: To report the surgical technique, outcome, and histologic findings involving indocyanine green staining and removal of internal limiting membrane in primary macular hole surgery.METHODS: Prospectively, consecutive patients with idiopathic macular hole or myopic macular hole with retinal detachment were recruited. After pars plana vitrectomy and epiretinal membrane removal, the internal limiting membrane was stained and removed. The specimens were

Alvin K. H Kwok; Winnie W. Y Li; C. P Pang; Timothy Y. Y Lai; Gary H. F Yam; Nongnart R Chan; Dennis S. C Lam

2001-01-01

113

Changes of macular sensitivity and morphology after pars plana vitrectomy for macular edema with central retinal vein occlusion: a case series  

PubMed Central

Background It is unclear how retinal ischemia influences the changes of visual acuity, macular sensitivity, macular thickness, and macular volume after the performance of pars plana vitrectomy (PPV) for macular edema in patients with central retinal vein occlusion (CRVO). Methods Ten patients (10 eyes) with CRVO and macular edema underwent PPV. Retinal ischemia was evaluated from the area of capillary nonperfusion on fluorescein angiography, and the patients were classified into ischemic or nonischemic groups. Microperimetry was performed with a Micro Perimeter 1. Macular thickness and volume were measured by optical coherence tomography. Results In both groups, the mean macular thickness within the central 4°, 10°, and 20° fields decreased significantly from baseline to 3 and 6 months after PPV (all P?macular sensitivity within the central 4°, 10°, and 20° fields increased from baseline to 3 and 6 months after PPV, but no significant difference was observed. Conclusions These results suggest that PPV may be effective for improving macular thickness, volume, and sensitivity in patients with macular edema secondary to ischemic CRVO, although there was no significant difference. PMID:23379834

2013-01-01

114

Bilateral spermatocytic seminoma: a case report  

PubMed Central

Spermatocytic seminoma (SS) is a rare entity, accounting for 2%–12% of all seminomas; amongst those, fewer than 10% are bilateral. These may occur synchronously or metachranously. We report here a case of bilateral SS in a 63-year-old patient, who initially presented with bilateral testicular masses. In our search of the literature, this represents the fifth documented case of synchronous, bilateral SS. PMID:25032177

Narins, Hadley; Chevli, Kent; Gilbert, Richard; Duff, Michael; Toenniessen, Andrew; Hu, Yan

2014-01-01

115

Progressive Macular Hypomelanosis in Korean Patients: A Clinicopathologic Study  

PubMed Central

Background Progressive macular hypomelanosis is characterized by ill-defined, non-scaly, hypopigmented macules primarily on the trunk of the body. Although numerous cases of progressive macular hypomelanosis have been reported, there have been no clinicopathologic studies of progressive macular hypomelanosis in Korean patients. Objective In this study we examined the clinical characteristics, histologic findings, and treatment methods for progressive macular hypomelanosis in a Korean population. Methods Between 1996 and 2005, 20 patients presented to the Department of Dermatology at Busan Paik Hospital with acquired, non-scaly, confluent, hypopigmented macules on the trunk, and with no history of inflammation or infection. The medical records, clinical photographs, and pathologic findings for each patient were examined. Results The patients included 5 men and 15 women. The mean age of onset was 21.05±3.47 years. The back was the most common site of involvement. All KOH examinations were negative. A Wood's lamp examination showed hypopigmented lesions compared with the adjacent normal skin. A microscopic examination showed a reduction in the number of melanin granules in the lesions compared with the adjacent normal skin, although S-100 immunohistochemical staining did not reveal significant differences in the number of melanocytes. Among the 20 patients, 7 received topical drug therapy, 6 were treated with narrow-band ultraviolet B phototherapy, 4 received oral minocycline, and 3 did not receive any treatment. Conclusion Most of the patients with progressive macular hypomelanosis had asymptomatic ill-defined, non-scaly, and symmetric hypopigmented macules, especially on the back and abdomen. Histologically, the number of melanocytes did not differ significantly between the hypopigmented macules and the normal perilesional skin. No effective treatment is known for progressive macular hypomelanosis; however, narrow-band ultraviolet B phototherapy may be a useful treatment modality. PMID:20523800

Hwang, Seon Wook; Hong, Soon Kwon; Kim, Sang Hyun; Park, Jeong Hoon; Seo, Jong Keun; Sung, Ho Suk

2009-01-01

116

Resolution of macular edema in idiopathic juxtafoveal telangiectasis using PDT.  

PubMed

A 57-year-old woman was treated by photodynamic therapy for macular edema due to idiopathic juxtafoveal telangiectasis (presumed type 1A) without subretinal neovascularization. Initial visual acuity of the treated eye was 20/200 and it improved to 20/40 by 3 months after the photodynamic therapy session. Visual acuity remained stable 32 months after the treatment. Color photographs and fundus fluorescein angiography before and after photodynamic therapy revealed regression of hemorrhages, exudates, and fluorescein leakage. Photodynamic therapy has long-term benefits for the patient with idiopathic juxtafoveal telangiectasis, presumed type 1A, because it can improve visual acuity and macular edema. PMID:19205501

Kotoula, Maria G; Chatzoulis, Dimitrios Z; Karabatsas, Constantinos H; Tsiloulis, Aristoteles; Tsironi, Evangelia E

2009-01-01

117

Reappraisal of Spontaneous Closure Rate of Idiopathic Full-Thickness Macular Holes  

PubMed Central

We retrospectively reviewed the records of 142 eyes of 138 patients with idiopathic full-thickness macular hole. Spontaneous closure of idiopathic full-thickness macular hole was observed in five eyes (3.5%) of four patients before the planned vitrectomy. In the era when surgical treatment was not available for macular hole, the rate of spontaneous closure of idiopathic full-thickness macular hole was reported as 6.2%. Among several case reports on spontaneous closure of idiopathic full-thickness macular hole based on the optical coherence tomography images only one study reported the rate of spontaneous closure as 2.7%. According to the previous reports and our results, small idiopathic full-thickness macular holes may close spontaneously in a few percent of all macular hole cases. The rate of spontaneous closure may be affected by the waiting time before vitrectomy. PMID:22934124

Sugiyama, Atsushi; Imasawa, Mitsuhiro; Chiba, Tatsuya; Iijima, Hiroyuki

2012-01-01

118

Volcano like pattern in optical coherence tomography in chronic diabetic macular edema.  

PubMed

In this article we herein report an interesting vitreo-macular interface abnormality associated with chronic diabetic cystoid macular edema. It is an observational case study of three diabetic patients examined in the diabetic clinic. All the patients had proliferative diabetic retinopathy with chronic macular edema. A serial cross sectional OCT examination and tracking of both the longitudinal progression of macular thickening and vitreo-macular interface revealed cystoid macular edema with a characteristic hyperreflective vitreous shadow emerging from the vitreofoveal interface. All the patients had dehiscence of inner retinal layers. This particular morphological feature at the vitreo-foveolar interface, which we name as "volcano sign", has not been described earlier. The probable mechanism of such a finding probably could be due to slow progressive leakage of chronic cytoid fluid into the vitreous with condensation of the overlying vitreous. Vitreo-macular traction followed by posterior vitreous detachment probably would have contributed to such a morphological event. PMID:24843311

Pai, Sivakami A; Hussain, Nazimul; Hebri, Sudhira P; Lootah, Afra M; Dekhain, Moza A

2014-04-01

119

Traumatic bilateral vertebral artery dissection.  

PubMed

Traumatic vertebral artery dissection is not often seen by forensic pathologists, and cases investigated are scarce in the forensic literature. We present the case of a 40-year-old woman cyclist who was struck by a car while wearing a helmet, and was neurologically near normal immediately thereafter at Emergency. She presented 48 h later with acute right hemiparesis, decreasing level of consciousness, and unsteadiness. CT revealed massive cerebellar infarction. CT angiography was normal. The patient died in coma 7 days after injury and autopsy revealed bilateral edematous cerebellar infarction and bilateral vertebral artery dissection. Rotational neck injury and mural tear in the wall of the Atlantic parts of both vertebral arteries is suggested as the possible mechanism of the arterial injury. Head and neck injuries are reported as a precipitating cause of vertebral artery injury. The possible influence of trauma may be further underestimated if longer intervals between vessel dissection and ischemia occur. The current case illustrates that "talk-and-die" syndrome may be due to occult vertebral artery dissection, possibly bilateral. In forensic cases of delayed death after mild trauma to the head and neck, the vertebral arteries should be examined for the cause of death. PMID:21798679

Galtés, Ignasi; Borondo, Juan Carlos; Cos, Mònica; Subirana, Mercè; Martin-Fumadó, Carles; Martín, Carles; Castellà, Josep; Medallo, Jordi

2012-01-10

120

Comparison of Modified-ETDRS and Mild Macular Grid Laser Photocoagulation Strategies for Diabetic Macular Edema  

PubMed Central

Purpose To compare two laser photocoagulation techniques for treatment of diabetic macular edema (DME): modified-ETDRS direct/grid photocoagulation (mETDRS) and a, potentially milder, but potentially more extensive, mild macular grid (MMG) laser technique in which small mild burns are placed throughout the macula, whether or not edema is present, and microaneurysms are not treated directly. Methods 263 subjects (mean age 59 years) with previously untreated DME were randomly assigned to receive laser photocoagulation by mETDRS (N=162 eyes) or MMG (N=161 eyes) technique. Visual acuity, fundus photographs and OCT measurements were obtained at baseline and after 3.5, 8, and 12 months. Treatment was repeated if DME persisted. Main Outcome Measure Change in OCT measures at 12-months follow up. Results From baseline to 12 months, among eyes with baseline central subfield thickness ? 250 microns, central subfield thickening decreased by an average of 88 microns in the mETDRS group and decreased by 49 microns in the MMG group (adjusted mean difference: 33 microns, 95% confidence interval 5 to 61 microns, P=0.02). Weighted inner zone thickening by OCT decreased by 42 and 28 microns, respectively (adjusted mean difference: 14 microns, 95% confidence interval 1 to 27 microns, P=0.04), maximum retinal thickening (maximum of the central and four inner subfields) decreased by 66 and 39 microns, respectively (adjusted mean difference: 27 microns, 95% confidence interval 6 to 47 microns, P=0.01), and retinal volume decreased by 0.8 and 0.4 mm3, respectively (adjusted mean difference: 0.3 mm3, 95% confidence interval 0.02 to 0.53 mm3, P=0.03). At 12 months, the mean change in visual acuity was 0 letters in the mETDRS group and 2 letters worse in the MMG group (adjusted mean difference: 2 letters, 95% confidence interval ?0.5 to 5 letters, P=0.10). Conclusions At 12 months after treatment, the MMG technique is less effective at reducing OCT measured retinal thickening than the more extensively evaluated current mETDRS laser photocoagulation approach. However, the visual acuity outcome with both approaches is not substantially different. Given these findings a larger long-term trial of the MMG technique is not justified. Application to Clinical Practice Modified ETDRS focal photocoagulation should continue as a standard approach for treating diabetic macular edema. PMID:17420366

2008-01-01

121

Long-term effectiveness of ranibizumab for age-related macular degeneration and diabetic macular edema  

PubMed Central

Neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME) are major causes of visual impairment in the elderly population worldwide. With the aging population, the prevalence of neovascular AMD and DME has increased substantially over the recent years. Vascular endothelial growth factor (VEGF) has been implicated as playing an important role in the pathogenesis of both neovascular AMD and DME. Since its introduction in 2006, ranibizumab, a recombinant, humanized, monoclonal antibody fragment against all isoforms of VEGF-A, has revolutionized the treatment of neovascular AMD and DME. The efficacy and safety of ranibizumab in neovascular AMD has been demonstrated in the ANCHOR and MARINA trials. Further studies including the PIER, PrONTO, and SUSTAIN trials have also evaluated the optimal dosing regimen of ranibizumab in neovascular AMD. The CATT and IVAN trials compared the safety and efficacy of ranibizumab with off-label use of bevacizumab. Studies such as SUSTAIN and HORIZON have shown that ranibizumab has a good safety profile and is well tolerated for over 4 years with very few serious ocular and systemic adverse events. For DME, Phase II RESOLVE study and Phase III RISE and RIDE studies have demonstrated superiority of ranibizumab treatment in improving vision over placebo controls. Phase II READ and Phase III RESOLVE and REVEAL studies have shown that ranibizumab is more effective both as monotherapy and in combination with laser compared with laser monotherapy. The 3-year results from the DRCRnet protocol I study found that ranibizumab with deferred laser resulted in better long-term visual outcome compared with ranibizumab with prompt laser. This review summarizes various important clinical trials on the long-term efficacy and safety of ranibizumab in the treatment of neovascular AMD and DME. The pharmacological properties of ranibizumab, its cost effectiveness, and impact on quality of life will also be discussed. PMID:23766636

Fong, Angie HC; Lai, Timothy YY

2013-01-01

122

Long-term effectiveness of ranibizumab for age-related macular degeneration and diabetic macular edema.  

PubMed

Neovascular age-related macular degeneration (AMD) and diabetic macular edema (DME) are major causes of visual impairment in the elderly population worldwide. With the aging population, the prevalence of neovascular AMD and DME has increased substantially over the recent years. Vascular endothelial growth factor (VEGF) has been implicated as playing an important role in the pathogenesis of both neovascular AMD and DME. Since its introduction in 2006, ranibizumab, a recombinant, humanized, monoclonal antibody fragment against all isoforms of VEGF-A, has revolutionized the treatment of neovascular AMD and DME. The efficacy and safety of ranibizumab in neovascular AMD has been demonstrated in the ANCHOR and MARINA trials. Further studies including the PIER, PrONTO, and SUSTAIN trials have also evaluated the optimal dosing regimen of ranibizumab in neovascular AMD. The CATT and IVAN trials compared the safety and efficacy of ranibizumab with off-label use of bevacizumab. Studies such as SUSTAIN and HORIZON have shown that ranibizumab has a good safety profile and is well tolerated for over 4 years with very few serious ocular and systemic adverse events. For DME, Phase II RESOLVE study and Phase III RISE and RIDE studies have demonstrated superiority of ranibizumab treatment in improving vision over placebo controls. Phase II READ and Phase III RESOLVE and REVEAL studies have shown that ranibizumab is more effective both as monotherapy and in combination with laser compared with laser monotherapy. The 3-year results from the DRCRnet protocol I study found that ranibizumab with deferred laser resulted in better long-term visual outcome compared with ranibizumab with prompt laser. This review summarizes various important clinical trials on the long-term efficacy and safety of ranibizumab in the treatment of neovascular AMD and DME. The pharmacological properties of ranibizumab, its cost effectiveness, and impact on quality of life will also be discussed. PMID:23766636

Fong, Angie H C; Lai, Timothy Y Y

2013-01-01

123

Enzymatic vitrectomy for diabetic retinopathy and diabetic macular edema  

PubMed Central

The aim of this paper is to determine the role of enzymatic vitrectomy performed by intravitreal injection of autologous plasmin enzyme (APE) in the management of diabetic retinopathy and diabetic macular edema (DME). Diabetic patients with proliferative diabetic retinopathy or DME and evident posterior hyaloid adherence to the retinal surface were included. All cases were treated with an initial intravitreal injection of APE and reevaluated one month later, measuring changes in best-corrected visual acuity (BCVA), macular thickness and the status of the posterior hyaloid. A second APE injection was performed in cases with no evident posterior vitreous detachment (PVD) after the initial treatment. Sixty-three eyes were included in the present review. A complete PVD appeared in 38% of cases (24 eyes) after one injection of plasmin and the total increased to 51% (32 eyes) after the second injection, separated at least by one month. The central macular thickness improved in all cases (100%) and BCVA in 89%. Finally, in 50% of eyes with proliferative diabetic retinopathy, a high reduction of new vessels regression was observed. Enzymatic vitrectomy could be considered a good therapeutic alternative in diabetic retinopathy and macular edema. PMID:24379923

Diaz-Llopis, Manuel; Udaondo, Patricia; Millan, Jose Maria; Arevalo, J Fernando

2013-01-01

124

Spectrum of ABCR gene mutations in autosomal recessive macular dystrophies  

Microsoft Academic Search

Stargardt disease (STGD) and late-onset fundus flavimaculatus (FFM) are autosomal recessive conditions leading to macular degenerations in childhood and adulthood, respectively. Recently, mutations of the photoreceptor cell-specific ATP binding transporter gene (ABCR) have been reported in Stargardt disease. Here, we report on the screening of the whole coding sequence of the ABCR gene in 40 unrelated STGD and 15 FFM

Jean-Michel Rozet; Sylvie Gerber; Eric Souied; Isabelle Perrault; Sophie Châtelin; Imad Ghazi; Corinne Leowski; Jean-Louis Dufier; Arnold Munnich; Josseline Kaplan; J-M Rozet

1998-01-01

125

Macular hole in juvenile X-linked retinoschisis  

PubMed Central

An 18 year-old male with no antecedent of trauma, systemic syndrome or myopia was referred for surgical treatment of a full thickness macular hole in the left eye. A more careful inspection revealed discrete foveal cystic changes in the fellow eye and subtle peripheral depigmented retinal pigment epithelial changes in both eyes. A spectral-domain optical coherence tomography (SD-OCT) scan confirmed, in addition to the full thickness macular hole in the left eye, microcystic spaces in the nuclear layers of both retinae. The diagnosis of X-linked retinoschisis was confirmed with a full field electroretinogram displaying the typical negative ERG. Macular holes are uncommon in the young and those complicating X-linked retinoschisis are rare. This report highlights the importance of investigating the presence of a macular hole in a young patient and illustrates the clinical and SD-OCT clues beyond the foveal center which led to the correct diagnosis of X-linked juvenile retinoschisis. PMID:24409088

Al-Swaina, Nayef; Nowilaty, Sawsan R.

2013-01-01

126

Non-invasive in vivo measurement of macular carotenoids  

NASA Technical Reports Server (NTRS)

A non-invasive in vivo method for assessing macular carotenoids includes performing Optical Coherence Tomography (OCT) on a retina of a subject. A spatial representation of carotenoid levels in the macula based on data from the OCT of the retina can be generated.

Lambert, James L. (Inventor); Borchert, Mark S. (Inventor)

2009-01-01

127

Macular pigment optical density in a midwestern sample  

Microsoft Academic Search

ObjectiveTo assess the distribution of the macular pigments (MPs) lutein (L) and zeaxanthin (Z) in a healthy sample more representative of the general population than past studies and to determine which dietary factors and personal characteristics might explain the large interindividual differences in the density of these MPs.

Thomas A Ciulla; Joanne Curran-Celantano; Dale A Cooper; Billy R Hammond; Ronald P Danis; Linda M Pratt; Karen A Riccardi; Thomas G Filloon

2001-01-01

128

Complement factor d in age-related macular degeneration  

Microsoft Academic Search

Purpose. To examine the role of complement factor D (CFD) in age-related macular degeneration (AMD) by analysis of genetic association, copy number variation, and plasma CFD concentrations. Methods. Single nucleotide polymorphisms (SNPs) in the CFD gene were genotyped and the results analyzed by binary logistic regression. CFD gene copy number was analyzed by gene copy number assay. Plasma CFD was

C. M. Stanton; J. R. W. Yates; A. I. den Hollander; J. M. Seddon; A. Swaroop; D. Stambolian; S. Fauser; C. B. Hoyng; Y. Yu; K. Atsuhiro; K. Branham; M. Othman; W. Chen; E. Kortvely; K. Chalmers; C. Hayward; A. T. Moore; B. Dhillon; M. Ueffing; A. F. Wright

2011-01-01

129

Inflammation in Dry Age-Related Macular Degeneration  

Microsoft Academic Search

Purpose: To summarize the current information regarding the role of immune and inflammatory response in the pathogenesis of dry age-related macular degeneration (ARMD). Methods: A Pubmed search was conducted of the period January 1999 to 2005. Relevant information in the literature on the role of inflammation in early dry ARMD was reviewed. Results: Some important evidence for inflammation in early

Eduardo B. Rodrigues

2007-01-01

130

Age-related macular degeneration among the Inuit in Greenland  

Microsoft Academic Search

Objectives. To investigate the clinical appearance and prevalence of Age-related Macular Degeneration (AMD) among the Inuit in Greenland, to investigate risk factors and to initiate the search for possible genetic markers. Study design. A cross-sectional population study including all individuals older than 60 years of age, born in Greenland and living in the communities of Nuuk and Sisimiut, was performed

Nis Andersen

2003-01-01

131

Keypathophysiologic pathways in age-related macular disease  

Microsoft Academic Search

Purpose To review current knowledge of key pathogenetic pathways in age-related macular disease (AMD). Methods Experimental evidence and clinical observations are reviewed. Results A number of common downstream pathophysiologic pathways appear to be relevant in AMD manifestations irrespective of primary heterogeneous etiologies. These include sequelae of oxidative damage, retinal pigment epithelium (RPE) cell dysfunction with accumulation of lipofuscin and impairment

Felix Roth; Almut Bindewald; Frank G. Holz

2004-01-01

132

Regression of diabetic macular edema after subcutaneous exenatide.  

PubMed

The aim of this study is to report a case of complete regression of diabetic macular edema after subcutaneous injection of exenatide in a patient with type 2 diabetes mellitus. This study is an interventional case report. Blood investigations, complete ophthalmic examinations and optical coherence tomography were performed. A 55-year-old female affected by poorly controlled type 2 diabetes mellitus presented with visual impairment due to macular edema in the right eye. The left eye showed mild edema without visual loss. Best-corrected visual acuity (BCVA) was 20/80 and 20/20, respectively. The patient was encouraged to improve metabolic control, and the antidiabetic therapy was modified combining exenatide 10 ?g subcutaneously twice daily to her regimen of oral metformin. The patient did not receive any ocular treatment. A complete tomographic resolution of macular edema was observed after 1 month and BCVA improved to 20/63. These findings were confirmed for the entire 6-month follow-up duration. No ocular or non-ocular adverse events were recorded. This is the first reported case of complete regression of macular edema in a diabetic patient after subcutaneous injection of exenatide. PMID:23925692

Sarao, Valentina; Veritti, Daniele; Lanzetta, Paolo

2014-06-01

133

Quantitative analysis of macular contraction in idiopathic epiretinal membrane  

PubMed Central

Background We aimed to quantify the displacement of macular capillaries using infrared fundus photographs and image processing software (ImageJ) in patients with idiopathic epiretinal membrane (ERM) who have undergone vitrectomy and to analyze the correlation between vessel displacement and retinal thickness. Methods This prospective study included 16 patients who underwent vitrectomy for idiopathic ERM. Ophthalmic examination and optical coherence tomography (OCT) were performed before and 3 months after surgery. The length of radial vessel segment included in each area (VLA) and the length from the foveola to the vessel branching point (FBL) depending on the superior, inferior, nasal, and temporal areas of the macula were measured using infrared fundus images and image processing software (ImageJ). Preoperative and postoperative parameters were compared and correlations between VLA, FBL, macular thickness, and visual acuity were assessed. Results The VLA of superior, inferior, and temporal areas showed a significant postoperative reduction. VLA differences showed a positive correlation with differences in macular thickness, which corresponded to the superior, inferior, and temporal areas; however, no correlation was observed in the nasal area. The FBL of the superior and inferior areas was significantly increased postoperatively. A positive correlation was observed between FBL differences and macular thickness differences in the superior area. Postoperative change in VLA and FBL did not show a significant correlation with postoperative best corrected visual acuity (BCVA) and BCVA differences. Conclusions Infrared fundus photographs and image processing software can be useful for quantifying progressive changes in retinal surface distortion after surgical removal of ERM. Macular edema and vascular distortion showed significant improvement after surgery. Furthermore, a correlation was observed between topographic and tomographic changes. PMID:24735324

2014-01-01

134

Bilateral internal thoracic artery grafting  

PubMed Central

The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

2013-01-01

135

Localization and Speech Understanding by a Patient With Bilateral Cochlear Implants and Bilateral Hearing Preservation  

PubMed Central

Objectives The authors describe the localization and speech-understanding abilities of a patient fit with bilateral cochlear implants (CIs) for whom acoustic low-frequency hearing was preserved in both cochleae. Design Three signals were used in the localization experiments: low-pass, high-pass, and wideband noise. Speech understanding was assessed with the AzBio sentences presented in noise. Results Localization accuracy was best in the aided, bilateral acoustic hearing condition, and was poorer in both the bilateral CI condition and when the bilateral CIs were used in addition to bilateral low-frequency hearing. Speech understanding was best when low-frequency acoustic hearing was combined with at least one CI. Conclusions The authors found that (1) for sound source localization in patients with bilateral CIs and bilateral hearing preservation, interaural level difference cues may dominate interaural time difference cues and (2) hearing-preservation surgery can be of benefit to patients fit with bilateral CIs. PMID:23183045

Dorman, Michael F.; Spahr, Anthony J.; Loiselle, Louise; Zhang, Ting; Cook, Sarah; Brown, Chris; Yost, William

2013-01-01

136

Characteristics of Incident Geographic Atrophy in the Complications of Age-related Macular Degeneration Prevention Trial  

PubMed Central

Objective To characterize the size, location, conformation, and features of incident geographic atrophy (GA) as detected by annual stereoscopic color photographs and fluorescein angiograms (FAs). Design Retrospective cohort study within a larger clinical trial Participants Patients with bilateral large drusen who developed GA during the course of the Complications of Age-related Macular Degeneration Prevention Trial (CAPT). Methods Annual stereoscopic color photographs and FAs were reviewed from 114 CAPT patients who developed GA in the untreated eye during 5-6 years of follow-up. Geographic atrophy was defined according to the Revised GA Criteria for identifying early GA23. Color-optimized fundus photographs were viewed concurrently with the FAs during grading. Main Outcome Measures Size and distance from the fovea of individual GA lesions, number of areas of atrophy, and change in visual acuity (VA) when GA first developed in an eye. Results At presentation, the median total GA area was 0.26mm2 (0.1 Disc area). GA presented as a single lesion in 89 (78%) of eyes. The median distance from the fovea was 395?m. Twenty percent of incident GA lesions were subfoveal and an additional 18% were within 250?m of the foveal center. Development of GA was associated with a mean decrease of 7 letters from the baseline visual acuity level compared to 1 letter among matched early age-related macular degeneration (AMD) eyes without GA. GA that formed in areas previously occupied by drusenoid pigment epithelial detachments (DPED) were on average larger (0.53 vs. 0.20 mm2; p=0.0001), more central (50 vs. 500 microns from the center of the fovea; p<0.0001), and associated with significantly worse visual outcome (20/50 vs. 20/25; p=0.0003) than GA with other drusen types as precursors. Conclusions Incident geographic atrophy most often appears on color fundus photographs and fluorescein angiograms as a small, singular, parafoveal lesion, though a large minority of lesions are subfoveal or multifocal at initial detection. The characteristics of incident geographic atrophy vary with precursor drusen types. These data can facilitate design of future clinical trials of therapies for GA. PMID:23622873

Brader, Hilary Smolen; Ying, Gui-shuang; Martin, E. Revell; Maguire, Maureen G.

2013-01-01

137

Bilateral gustatory sweating in the submandibular region after bilateral neck dissection successfully treated with botulinum toxin.  

PubMed

Gustatory sweating (or chorda tympani syndrome) in the submandibular region is a rare complication of cervical surgery. We report a 66-year-old patient who had been referred for the management of a squamous cell carcinoma of the mobile tongue. She was treated by bilateral neck dissection and bilateral resection of the submandibular glands. Bilateral gustatory sweating in the submandibular region developed 10 years later and was successfully treated with bilateral injections of botulinum toxin type A. PMID:24996697

Philouze, Pierre; Vertu, Delphine; Ceruse, Philippe

2014-10-01

138

Cost-effectiveness of smoking cessation to prevent age-related macular degeneration  

Microsoft Academic Search

BACKGROUND: Tobacco smoking is a risk factor for age-related macular degeneration, but studies of ex-smokers suggest quitting can reduce the risk. METHODS: We fitted a function predicting the decline in risk of macular degeneration after quitting to data from 7 studies involving 1,488 patients. We assessed the cost-effectiveness of smoking cessation in terms of its impact on macular degeneration-related outcomes

Susan F Hurley; Jane P Matthews; Robyn H Guymer

2008-01-01

139

Computer-assisted three-dimensional reconstruction and simulations of vestibular macular neural connectivities  

NASA Technical Reports Server (NTRS)

Results of computer-assisted research concerned with the three-dimensional reconstruction and simulations of vestibular macular neural connectivities are summarized. The discussion focuses on terminal/receptive fields, the question of synapses across the striola, endoplasmic reticulum and its potential role in macular information processing, and the inner epithelial plexus. Also included are preliminary results of computer simulations of nerve fiber collateral functioning, an essential step toward the three-dimensional simulation of a functioning macular neural network.

Ross, Muriel D.; Chimento, Thomas; Doshay, David; Cheng, Rei

1992-01-01

140

Successful Bilateral Composite Ear Reattachment  

PubMed Central

Summary: A successful bilateral ear composite graft nonmicrosurgical reattachment is presented. In cases where suitable vessels are unavailable for microsurgical revascularization, the reconstructive challenge can be formidable for salvaging the unique anatomic and aesthetic structure of the ear. The case is presented of an 18-year-old woman who was a victim of an assault wherein both of her ears were intentionally amputated by her attacker. She underwent successful surgical reattachment followed by a postoperative regimen of hyperbaric oxygen, cooling, and meticulous wound care. The patient achieved 100% survival of her left ear graft and 95% survival of her right ear graft. Clinical photographs at 18 months are presented, along with a discussion of the possible implications for other reconstructive applications. PMID:25289367

2014-01-01

141

Bilateral Wilms' tumors: changing concepts in management  

Microsoft Academic Search

Bilaterality is uncommon in Wilms' tumor, being present in 4% to 8% of the cases. We report the combined experience of two children's hospitals in one city over a 20-year period. We encountered nine cases of synchronous bilateral nephroblastoma (National Wilms' Tumor Study 3, stage V). Age at diagnosis ranged from 9 to 41 months (mean 23 months). There were

J. M. Laberge; L. T. Nguyen; Y. L. Homsy; D. P. Doody

1987-01-01

142

Intravitreal bevacizumab for macular edema due to occlusive vasculitis.  

PubMed

Systemic vasculitides can cause retinal vascular pathology, including cotton-wool spots, retinal hemorrhages, vascular occlusion, and capillary nonperfusion. Two main causes of visual decline include macular edema and retinal neovascularization. Presumably, both of these complications are caused by increased intraocular levels of vascular growth and permeability factors. We report a patient with occlusive retinal vasculitis associated with mixed connective tissue disease who was treated with intravitreal bevacizumab for chronic macular edema. One month after treatment, visual acuity improved from 20/80 to 20/60, and foveal thickness decreased from 543 microns to 306 microns. This effect persisted for at least 3 months after treatment. No complications, including increased retinal ischemia, were observed. PMID:17564933

Margolis, Ron; Lowder, Careen Y; Sears, Jonathan E; Kaiser, Peter K

2007-01-01

143

Fundus Imaging of Age-Related Macular Degeneration  

Microsoft Academic Search

\\u000a Digital fundus cameras and confocal scanning laser ophthalmoscopes have increased the efficiency and resolution of fundus\\u000a photography. Autofluorescent images yield information about the functional status of the outer retina and retinal pigment\\u000a epithelium (RPE). Fluorescein angiography remains invaluable for studying retinal vascular anatomy and physiology in eyes\\u000a with neovascular age-related macular degeneration (AMD). Optical coherence tomography (OCT) permits visualization of

Allen Chiang; Andre J. Witkin; Carl D. Regillo; Allen C. Ho

144

Immunopathological aspects of age-related macular degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) represents a leading cause of blindness worldwide. While the clinical and histopathological\\u000a aspects of AMD are well characterized, its etiology and pathogenesis remain unclear. Recent findings suggest a role for immunologic\\u000a processes in AMD pathogenesis, including the age-related generation of extracellular deposits inside the Brusch membrane and\\u000a beneath the retinal pigment epithelium, recruitment of macrophages for

Mrinali Patel; Chi-Chao Chan

2008-01-01

145

Intraocular lens iris fixation. Clinical and macular OCT outcomes  

PubMed Central

Background To assess the efficacy, clinical outcomes, visual acuity (VA), incidence of adverse effects, and complications of peripheral iris fixation of 3-piece acrylic IOLs in eyes lacking capsular support. Thirteen patients who underwent implantation and peripheral iris fixation of a 3-piece foldable acrylic PC IOL for aphakia in the absence of capsular support were followed after surgery. Clinical outcomes and macular SD-OCT (Cirrus OCT; Carl Zeiss Meditec, Germany) were analyzed. Findings The final CDVA was 20/40 or better in 8 eyes (62%), 20/60 or better in 12 eyes (92%), and one case of 20/80 due to corneal astigmatism and mild persistent edema. No intraoperative complications were reported. There were seven cases of medically controlled ocular hypertension after surgery due to the presence of viscoelastic in the AC. There were no cases of cystoid macular edema, chronic iridocyclitis, IOL subluxation, pigment dispersion, or glaucoma. Macular edema did not develop in any case by means of SD-OCT. Conclusions We think that this technique for iris suture fixation provides safe and effective results. Patients had substantial improvements in UDVA and CDVA. This surgical strategy may be individualized however; age, cornea status, angle structures, iris anatomy, and glaucoma are important considerations in selecting candidates for an appropriate IOL fixation method. PMID:23050659

2012-01-01

146

Retinal layer segmentation of macular OCT images using boundary classification.  

PubMed

Optical coherence tomography (OCT) has proven to be an essential imaging modality for ophthalmology and is proving to be very important in neurology. OCT enables high resolution imaging of the retina, both at the optic nerve head and the macula. Macular retinal layer thicknesses provide useful diagnostic information and have been shown to correlate well with measures of disease severity in several diseases. Since manual segmentation of these layers is time consuming and prone to bias, automatic segmentation methods are critical for full utilization of this technology. In this work, we build a random forest classifier to segment eight retinal layers in macular cube images acquired by OCT. The random forest classifier learns the boundary pixels between layers, producing an accurate probability map for each boundary, which is then processed to finalize the boundaries. Using this algorithm, we can accurately segment the entire retina contained in the macular cube to an accuracy of at least 4.3 microns for any of the nine boundaries. Experiments were carried out on both healthy and multiple sclerosis subjects, with no difference in the accuracy of our algorithm found between the groups. PMID:23847738

Lang, Andrew; Carass, Aaron; Hauser, Matthew; Sotirchos, Elias S; Calabresi, Peter A; Ying, Howard S; Prince, Jerry L

2013-07-01

147

Fully automated detection of diabetic macular edema and dry age-related macular degeneration from optical coherence tomography images  

PubMed Central

We present a novel fully automated algorithm for the detection of retinal diseases via optical coherence tomography (OCT) imaging. Our algorithm utilizes multiscale histograms of oriented gradient descriptors as feature vectors of a support vector machine based classifier. The spectral domain OCT data sets used for cross-validation consisted of volumetric scans acquired from 45 subjects: 15 normal subjects, 15 patients with dry age-related macular degeneration (AMD), and 15 patients with diabetic macular edema (DME). Our classifier correctly identified 100% of cases with AMD, 100% cases with DME, and 86.67% cases of normal subjects. This algorithm is a potentially impactful tool for the remote diagnosis of ophthalmic diseases. PMID:25360373

Srinivasan, Pratul P.; Kim, Leo A.; Mettu, Priyatham S.; Cousins, Scott W.; Comer, Grant M.; Izatt, Joseph A.; Farsiu, Sina

2014-01-01

148

Fully automated detection of diabetic macular edema and dry age-related macular degeneration from optical coherence tomography images.  

PubMed

We present a novel fully automated algorithm for the detection of retinal diseases via optical coherence tomography (OCT) imaging. Our algorithm utilizes multiscale histograms of oriented gradient descriptors as feature vectors of a support vector machine based classifier. The spectral domain OCT data sets used for cross-validation consisted of volumetric scans acquired from 45 subjects: 15 normal subjects, 15 patients with dry age-related macular degeneration (AMD), and 15 patients with diabetic macular edema (DME). Our classifier correctly identified 100% of cases with AMD, 100% cases with DME, and 86.67% cases of normal subjects. This algorithm is a potentially impactful tool for the remote diagnosis of ophthalmic diseases. PMID:25360373

Srinivasan, Pratul P; Kim, Leo A; Mettu, Priyatham S; Cousins, Scott W; Comer, Grant M; Izatt, Joseph A; Farsiu, Sina

2014-10-01

149

Preliminary Experience in Treatment of Papillary and Macular Retinoblastoma: Evaluation of Local Control and Local Complications After Treatment With Linear Accelerator-Based Stereotactic Radiotherapy With Micromultileaf Collimator as Second-Line or Salvage Treatment After Chemotherapy  

SciTech Connect

Purpose: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Methods and Materials: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. Results: The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Conclusions: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.

Pica, Alessia, E-mail: Alessia.Pica@chuv.ch [Department of Radiation Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Moeckli, Raphael [University Institute for Radiation Physics, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Balmer, Aubin [Department of Radiation Oncology, Jules Gonin Eye Hospital, Lausanne (Switzerland); Beck-Popovic, Maja [Unit of Pediatric Oncology, University of Lausanne, Lausanne (Switzerland); Chollet-Rivier, Madeleine [Department of Anesthesiology, University of Lausanne, Lausanne (Switzerland); Do, Huu-Phuoc [University Institute for Radiation Physics, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Weber, Damien C. [Department of Radiation Oncology, Geneva University Hospital, University of Geneva, Geneva (Switzerland); Munier, Francis L. [Department of Radiation Oncology, Jules Gonin Eye Hospital, Lausanne (Switzerland)

2011-12-01

150

Complement Factor H 402H Variant and Reticular Macular Disease  

PubMed Central

Objective To determine the association of high-risk alleles in the complement factor H (CFH; Y402H, rs1061170) and age-related maculopathy susceptibility (ARMS2; A69S, rs10490924) genes with reticular macular disease (RMD), a major clinical subphenotype of age-related macular degeneration (AMD). Methods Using retinal images from the Columbia Macular Genetics Study, we identified 67 subject individuals with RMD. A comparison group of 64 subjects with AMD without RMD was matched by ethnicity, age, sex, and AMD clinical stage. Results In the RMD group, 53 of 67 subjects (79.1%) were female, the mean age was 83 years, and 47 of 67 (70.1%) had late AMD, with closely matched values in the non-RMD group. The frequencies of the CFH 402H allele were 39.6% in the RMD group (53 of 134 individuals) and 58.6% in the non-RMD group (75 of 128 individuals) (?2=8.8; P=.003; odds ratio, 0.46 [95% confidence interval, 0.28–0.76]). The corresponding frequencies of the risk allele for ARMS2 were 44.0% (40 of 128 individuals) and 31.3% (40 of 128 individuals), respectively (?2=4.0; P=.045; odds ratio, 1.73 [95% confidence interval, 1.04–2.90]). Homozygosity for 402Hwas particularly associated with the absence of RMD, occurring in 8 of 67 subjects (11.9%) with RMD vs 24 of 64 subjects (37.5%) without RMD(P ?.001). Retinal macular disease also was associated with hypertension among male patients. Conclusions The AMD-associated CFH 402H risk variant is significantly associated with the absence of RMD but enhanced risk for RMD is conferred by the ARMS2 69S AMD risk allele. These results are consistent with the hypothesis that 402H may confer a survival benefit against certain infections, some of which may cause RMD. Clinical Relevance Reticular macular disease may be genetically distinct from the rest of AMD. PMID:21825189

Smith, R. Theodore; Merriam, Joanna E.; Sohrab, Mahsa A.; Pumariega, Nicole M.; Barile, Gaetano; Blonska, Anna M.; Haans, Raymond; Madigan, David; Allikmets, Rando

2013-01-01

151

Analysis of macular cone photoreceptors in a case of occult macular dystrophy  

PubMed Central

Purpose To investigate changes in cone photoreceptors with adaptive optics (AO) fundus imaging and spectral domain optical coherence tomography (SD-OCT) in a case of occult macular dystrophy (OMD). Patient and methods Both eyes of a 42-year-old woman diagnosed with OMD were examined. We used an AO fundus camera to obtain images of cone photoreceptors in the macula of the OMD subject and five healthy control subjects. Correlations between the AO images and the SD-OCT images were examined. Cone photoreceptors in eight areas in the macula of OMD and healthy control subjects were analyzed and compared. Results SD-OCT showed a loss of the cone outer-segment tips line outside of the fovea in both eyes of the subject with OMD. The left eye with decreased visual acuity showed a discontinuous photoreceptor inner-segment and outer-segment line and cone outer-segment tips line at the fovea in SD-OCT and loss of cone mosaics as a dark spot in the AO image. In panoramic AO images and cone-density maps, less cone density was observed in a ring-like region outside the fovea than in the peripheral retina. In most of the areas examined, the cone densities were lower in the OMD eyes than in the healthy control eyes. Conclusions Cone densities in the macula of the OMD patient were greatly decreased. AO images were found to be useful to evaluate morphologic changes in cone photoreceptors in patients with OMD. PMID:23696695

Tojo, Naoki; Nakamura, Tomoko; Ozaki, Hironori; Oka, Miyako; Oiwake, Toshihiko; Hayashi, Atsushi

2013-01-01

152

A One Year Study of the Macular Pigment: The Effect of 140 Days of a Lutein Supplement  

Microsoft Academic Search

A low density of macular pigment may represent a risk factor for age-related macular degeneration (AMD) by permitting greater blue light damage. This study was carried out to determine the effects on macular pigment optical density of dietary supplementation with lutein, one of the pigment constituents. Two subjects consumed lutein esters, equivalent to 30 mg of free lutein per day,

JOHN T LANDRUM; RICHARD A BONE; HILDA JOA; MARK D KILBURN; LINDA L MOORE; KATHLEEN E SPRAGUE

1997-01-01

153

Refining the locus for Best vitelliform macular dystrophy and mutation analysis of the candidate gene ROM1  

Microsoft Academic Search

Vitelliform macular dystrophy (Best disease) is an autosomal dominant macular dystrophy which shares important clinical features with age-related macular degeneration, the most common cause of legal blindness in the elderly. Unfortunately, understanding and treatment for this common age-related disorder is limited. Discovery of the gene which causes Best disease has the potential to increase the understanding of the pathogenesis of

B. E. Nichols; E. M. Stone; V. C. Sheffield; R. McInnes; R. Bascom; M. Litt

1994-01-01

154

Heterochronic bilateral ectopic pregnancy after ovulation induction.  

PubMed

Ectopic pregnancy is identified with the widely-applied assisted reproductive technology (ART). Bilateral ectopic pregnancy is a rare form of ectopic pregnancy which is difficult to be diagnosed at the pre-operation stage. In this paper, we presented an unusual case of heterochronic bilateral ectopic pregnancy after stimulated intrauterine insemination (IUI), where there has been a delay of 22 d between the diagnoses of the two ectopic pregnancies. Literature was reviewed on the occurrence of bilateral ectopic pregnancy during the past four years in the MEDLINE database. We found 16 cases of bilateral ectopic pregnancy reported since 2008, and analyzed the characteristics of those cases of bilateral ectopic pregnancy. We emphasize that ovulation induction and other ARTs may increase the risk of bilateral ectopic pregnancy. Because of the difficulty in identification of bilateral ectopic pregnancy by ultrasonography, the clinician should be aware that the treatment of one ectopic pregnancy does not preclude the occurrence of a second ectopic pregnancy in the same patient and should pay attention to the intra-operation inspection of both side fallopian tubes in any ectopic pregnancy case. PMID:25091994

Zhu, Bo; Xu, Gu-feng; Liu, Yi-feng; Qu, Fan; Yao, Wei-miao; Zhu, Yi-min; Gao, Hui-juan; Zhang, Dan

2014-08-01

155

Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction  

SciTech Connect

Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

Doody, O., E-mail: orla_doody@hotmail.co [Alfred Hospital, Department of Radiology (Australia); Adam, W. R. [University of Melbourne and Goulburn Valley Health, School of Rural Health (Australia); Foley, P. T.; Lyon, S. M. [Alfred Hospital, Department of Radiology (Australia)

2009-03-15

156

Bilateral reduction mammoplasty after heart transplantation.  

PubMed

We report a bilateral reduction mammoplasty in a 15 year old female who suffered increasing back and shoulder pain and chest wall discomfort associated with bilateral breast enlargement during a 17 month period following heart transplantation. Cardiologic evaluation confirmed a structurally normal heart with good systolic and diastolic function, and ejection fraction of 80%. We performed a bilateral mammoplasty using dermal suspension flap in vertical-scar reduction. The patient recovered satisfactorily without incident, and breast morphology was excellent at the 2 year 9 month follow-up, with no recurrence of her previous symptoms or further hyperplasia. PMID:25179978

Shi, Yue-Dong; Qi, Fa-Zhi; Feng, Zi-Hao

2014-08-01

157

[Triamcinolone acetonide bevacizumab performance in treatment and idiopathic macular spider veins].  

PubMed

This article evaluated the efficacy of intravitrean injection of anti VEGF agents and triamcinolon in the treatment of macular telangiectasis. The patients were followed six months. We practiced fluorescein angiography, optical coherence tomography. We measured the thickening of macular edema and best corrected of visual acuity. PMID:20540378

Cerbulescu, Beatrice; Taina, Ana-Lavinia; Dinita, Monica; Malaeanu, Raluca; Radocea, Robertina; Carstocea, B

2010-01-01

158

Automatic detection of age-related macular degeneration pathologies in retinal fundus images  

Microsoft Academic Search

Advanced techniques in image processing and analysis are being extensively studied to assist clinical diagnoses. Digital colour retinal fundus images are widely utilised to investigate various eye diseases. In this paper, we describe the detection of optic disc (OD), macula and age-related macular degeneration (ARMD) pathologies of the macular regions in colour fundus images. ARMD causes the loss of central

Ay?egül Güven

2012-01-01

159

Treatment of retinal detachment resulting from myopic macular hole with internal limiting membrane removal  

Microsoft Academic Search

PURPOSE: To examine the efficacy of vitrectomy with internal limiting membrane removal for retinal detachment resulting from a macular hole in highly myopic eyes.METHODS: Eleven consecutive highly myopic eyes (11 patients) with retinal detachment resulting from a macular hole were treated by vitrectomy with removal of the internal limiting membrane, which was stained with indocyanine green and sulfur hexafluoride gas

Kazuaki Kadonosono; Futoshi Yazama; Norihiko Itoh; Eiichi Uchio; Satoshi Nakamura; Junsuke Akura; Hajime Sawada; Shigeaki Ohno

2001-01-01

160

Visual function after removal of subretinal neovascular membranes in patients with age-related macular degeneration  

Microsoft Academic Search

Background: Retinal pigment epithelial (RPE) cells have been transplanted to replace the RPE cells lost after surgical excision of choroidal neovascular membranes (CNV) associated with age-related macular degeneration. The purpose of this study was to analyze the visual function of eyes with altered RPE after surgical excision of choroidal neovascular membranes (CNV) associated with age-related macular degeneration, and to determine

Toshiaki Abe; Madoka Yoshida; Tetsuya Kano; Makoto Tamai

2001-01-01

161

Effect of infusion air pressure on visual field defects after macular hole surgery  

Microsoft Academic Search

PURPOSE: A defect in the visual field is one of the serious complications of macular hole surgery. We investigated the relationship between the occurrence of visual field defect and the location of infusion cannula and air pressure during fluid–air exchange.METHODS: We studied 100 eyes from 90 patients with macular holes. All patients underwent preoperative and postoperative visual field testing. Vitreous

Akira Hirata; Naoko Yonemura; Tadashi Hasumura; Yasuhiro Murata; Akira Negi

2000-01-01

162

Associations between Lutein, Zeaxanthin, and Age-Related Macular Degeneration: An Overview  

Microsoft Academic Search

Age-related macular degeneration, the leading cause of blindness in the elderly, is a degenerative condition of the macula characterized by death or dysfunction of the photoreceptors. With the aging population growing, the incidence of age-related macular degeneration is expected to increase. This raises concern about the future of visual dysfunction related falls and the resulting injuries in the elderly population.

Shannon Carpentier; Maria Knaus; Miyoung Suh

2009-01-01

163

Retinal ultrastructure of murine models of dry age-related macular degeneration (AMD)  

Microsoft Academic Search

Age-related macular degeneration (AMD) is the most prevalent form of irreversible blindness worldwide in the elderly population. The pathology of dry AMD consists of macular degeneration of photoreceptors and the RPE, lipofuscin (A2E) accumulation, and drusen formation. Mice have been widely used for generating models that simulate human AMD features for investigating the pathogenesis, treatment and prevention of the disease.

Hema L. Ramkumar; Jun Zhang; Chi-Chao Chan

2010-01-01

164

Ranibizumab for Macular Edema Due to Retinal Vein Occlusions: Implication of VEGF as a Critical Stimulator  

Microsoft Academic Search

Macular edema is a major cause of vision loss in patients with central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). It is not clear how much of the edema is due to hydrodynamic changes from the obstruction and how much is due to chemical mediators. Patients with macular edema due to CRVO (n = 20) or BRVO

Peter A Campochiaro; Gulnar Hafiz; Syed Mahmood Shah; Quan Dong Nguyen; Howard Ying; Diana V Do; Edward Quinlan; Ingrid Zimmer-Galler; Julia A Haller; Sharon D Solomon; Jennifer U Sung; Yasmin Hadi; Kashif A Janjua; Nida Jawed; David F Choy; Joseph R Arron

2008-01-01

165

Unilateral recurrent macular hole in a patient with retinitis pigmentosa: a case report  

PubMed Central

Introduction Several macular complications related to abnormalities of the vitreoretinal interface have been classically attributed to retinitis pigmentosa of which cystoid macular edema is the most common. Other less frequent complications are as follows: epiretinal membranes, vitreomacular traction syndrome and macular holes. Case presentation A 64-year-old woman, with the previous diagnosis of retinitis pigmentosa, was referred to our department with a complaint of central visual loss in her left eye for 12?months. A fundoscopy and optical coherence tomography examination revealed the presence of a macular hole more than 500?microns in diameter. The patient underwent 20-gauge pars plana vitrectomy. Closure of the hole was observed after surgery, but reopening occurred at 2?years postoperatively. Conclusion The pathogenesis of macular hole formation in patients with retinitis pigmentosa is unclear. Surgical outcomes may not always be favorable, and the possibility of reopening must be taken into account, even after a long time. PMID:23497416

2013-01-01

166

Intravitreal Injection of Bevacizumab to Treat a Macular Edema Caused by Leber's Miliary Aneurysm  

PubMed Central

Purpose Leber's miliary aneurysm is a variant of Coats’ disease and similar to type 1 idiopathic macular telangiectasia. A recent report showed that an intravitreal injection of bevacizumab (IVB) was effective in an adult patient with type 1 idiopathic macular telangiectasia. We describe our experience with an adult patient with a macular edema caused by Leber's miliary aneurysm, which had not been resolved by prior retinal laser photocoagulation, who underwent IVB. Methods We investigated the ocular characteristics of the patient before and after a single administration of IVB. Results The macular edema had partially improved 1 month after IVB, but then it worsened. We performed laser photocoagulation to treat the aneurysms near the fovea. The macular edema improved, but there was no improvement in visual acuity. Conclusion In this patient, the effect of IVB was limited. PMID:23275795

Takeyama, Masayuki; Iwaki, Masayoshi; Zako, Masahiro

2012-01-01

167

Bilateral hippocampal dysfunction in schizophrenia.  

PubMed

The hippocampus has long been known to be important for memory, with the right hippocampus particularly implicated in nonverbal/visuo-spatial memory and the left in verbal/narrative or episodic memory. Despite this hypothesized lateralized functional difference, there has not been a single task that has been shown to activate both the right and left hippocampi differentially, dissociating the two, using neuroimaging. The transverse patterning (TP) task is a strong candidate for this purpose, as it has been shown in human and nonhuman animal studies to theoretically and empirically depend on the hippocampus. In TP, participants choose between stimuli presented in pairs, with the correct choice being a function of the specific pairing. In this project, TP was used to assess lateralized hippocampal function by varying its dependence on verbal material, with the goal of dissociating the two hippocampi. Magnetoencephalographic (MEG) data were collected while controls performed verbal and nonverbal versions of TP in order to verify and validate lateralized activation within the hippocampi. Schizophrenia patients were evaluated to determine whether they exhibited a lateralized hippocampal deficit. As hypothesized, patients' mean level of behavioral performance was poorer than controls' on both verbal and nonverbal TP. In contrast, patients had no decrement in performance on a verbal and nonverbal non-hippocampal-dependent matched control task. Also, controls but not patients showed more right hippocampal activation during nonverbal TP and more left hippocampal activation during verbal TP. These data demonstrate the capacity to assess lateralized hippocampal function and suggest a bilateral hippocampal behavioral and activation deficit in schizophrenia. PMID:21763438

Hanlon, Faith M; Houck, Jon M; Pyeatt, Clinton J; Lundy, S Laura; Euler, Matthew J; Weisend, Michael P; Thoma, Robert J; Bustillo, Juan R; Miller, Gregory A; Tesche, Claudia D

2011-10-15

168

Bilateral congenital pseudarthrosis of the clavicle  

Microsoft Academic Search

A case of bilateral congenital pseudarthrosis of the clavicle in a baby boy is described. The patient is fully asymptomatic, and no functional impairment is present. This is probably only the seventh case described of this rare congenital anomaly.

M. T. P. Russo; N. Maffulli

1990-01-01

169

[A case of bilateral ureteral triplication].  

PubMed

Ureteral triplication is a rare congenital anomaly of the urinary tract, although ureteral duplication is rather common. Bilateral ureteral triplications are even rare anomalies. A five-year-old girl with a history of urinary tract infection and episodes of fever and lower abdominal pain was admitted to our hospital for further examination of microscopic hematuria. An excretory urogram (IVP) revealed bilateral 3 pelves and ureters, and cystoscopic examination showed 2 ureteral orifices on each side. Both sides of bilateral ureteral triplications in our case belonged to type B of Smith's classification. Ureteral triplication was first reported by Wraný in 1870. Since then 84 cases have been reported and among them 3 cases had bilateral ureteral triplications. In this article, the classification and the development of ureteral triplication are reviewed briefly. PMID:4025084

Shoda, R; Ejiri, S; Fujita, T; Wada, N

1985-03-01

170

Angioleiomyomas in the bilateral broad ligaments.  

PubMed

The female genital tract is a rare site for angioleiomyoma. Here, we present an unusual case of bilateral large angioleiomyoma in the broad ligaments. A 52-year-old woman underwent total hysterectomy with bilateral salpingo-oophorectomy due to massive tumors in the bilateral adnexal regions. Gross examination revealed a hemangioma-like mass each in the bilateral broad ligaments. The right one extended into the uterine myometrium. Histologically, both tumors had a mixed pattern of prominent thick-walled blood vessels and cellular short spindle myoid cells throughout. The spindle cells often swirled around the vessels, displaying an overlapping feature with angiomyofibroblastoma or myopericytoma. Immunostaining demonstrated that the tumor cells were positive for alpha-smooth muscle actin, desmin, estrogen receptor, and progesterone receptor. We believe that angioleiomyoma should be recognized as a delineated variant of leiomyoma in the female genital tract. This rare benign tumor should be differentiated from other mesenchymal neoplasms with prominent blood vessels. PMID:19952939

Chen, Xiaoduan; Zhang, Xiaofei; Zhang, Suojiang; Lü, Bingjian

2010-01-01

171

Fetal alcohol syndrome and bilateral tibial exostoses  

Microsoft Academic Search

Maternal exposure to alcohol during pregnancy has been associated with fetal malformations referred to as the fetal alcohol syndrome. This paper describes, for the first time, the presence of bilateral tibial exostoses in a child with FAS.

E. M. Azouz; G. Kavianian; V. M. Der Kaloustian

1993-01-01

172

Bilateral Carotid Paraganglioma: Surgery and Radiotherapy  

PubMed Central

BACKGROUND Paragangliomas are relatively rare vascular tumors that develop from the neural crest cells of carotid bifurcation. They usually present as slow-growing, painless unilateral neck masses; bilateral presentation is rare and is mostly associated with familial forms. Bilateral total resection is not always possible for high-grade bilateral tumors, and radiotherapy is a good alternative, with cure rates similar to surgery. CASE REPORT A 35-year-old female patient was admitted with a chief complaint of a bilateral, painless mass located on her neck. Subsequent magnetic resonance imaging (MRI) and angiographic imaging revealed bilateral hypervascular masses surrounding her carotid at 360°, and they were interpreted as stage 3 carotid paragangliomas according to the Shamblin classification protocol. Surgery was carried out on the left carotid paraganglioma and the mass was totally resected. It was thought that the patient could not tolerate bilateral surgery. Primary radiotherapy was planned on the right carotid paraganglioma: 59.8 gray (Gy) conformal, Linac-based multileaf collimator radiotherapy with a 180 cGy daily dosage, and five fractions per week were planned. RESULTS Follow-up at 3 months following the conclusion of radiotherapy revealed no significant regression. A follow-up MRI 6 months and 24 months later revealed 59% regression. Grade 2 esophagitis and minimal neck edema were the only complications noted during the course of radiotherapy and during the 24-month follow-up period. No complications or relapse were observed except for edema following neck surgery. PMID:25057243

Kiziltan, Huriye S; Ozucer, Berke; Eris, Ali H; Veyseller, Bayram

2014-01-01

173

Squamous papillomatosis of the bilateral nasal cavities.  

PubMed

The term "papillomatosis" indicates the tendency towards multicentricity and recurrence that these tumors exhibit (Snyder et al. 1972). A typical squamous papilloma arises from the nasal vestibule and is characterized by the epithelial proliferation growing an exophytic manner. We report a rare case of squamous papillomatosis of the bilateral nasal cavities. A 65-year-old man presented with a 2-year-history of bilateral nasal obstruction. Computed tomographic (CT) scans revealed a soft density mass in the bilateral nasal cavities and ethmoid sinuses. Because the tumors were limited to the nasal cavities and anterior ethmoid sinuses, total removal of the tumors was performed endoscopically. On the basis of the clinicopathological findings, the tumors were diagnosed as squamous papillomas. His post-operative course was uneventful, and he is currently free from disease 13 months after surgery. Nasal papillomas usually arise from the unilateral nasal cavity or paranasal sinus. While some cases of inverted (inverting) papillomas arising from the bilateral nasal cavities have been reported, bilateralism of the nasal squamous papillomas is quite rare. Diagnosis, clinical behavior and treatment of squamous papillomatosis of the bilateral nasal cavities are reviewed. PMID:15942156

Kumagai, Masaki; Endo, Sohei; Matsunaga, Eiko; Kida, Akinori; Sakata, Hitomi; Yamamoto, Masahiro

2005-07-01

174

Comparison of Macular Thickness in Diabetic Macular Edema Using Spectral-Domain Optical Coherence Tomography and Time-Domain Optical Coherence Tomography  

PubMed Central

Purpose. To compare the macular thicknesses in diabetic macular edema (DME) measured with spectral-domain optical coherence tomography (SD-OCT) and time-domain (TD) OCT. Patients and Methods. The average macular thicknesses of 50 eyes of 29 patients with DME were measured using SD-OCT and TD-OCT. Results. The mean macular thicknesses measured with TD-OCT and SD-OCT were 401.5 ± 117.8??m (mean ± SD) and 446.2 ± 123.5??m, respectively. The macular thicknesses measured with the two devices were well correlated (Pearson's product moment correlation, r = 0.977, P < 0.001). A significant correlation was found between the best-corrected visual acuity and the retinal thickness measured by TD-OCT and SD-OCT (Pearson's product moment correlation, TD-OCT, r = 0.34; P < 0.05; SD-OCT, r = 0.32; P < 0.05). Discussion. The mean macular thickness measured with SD-OCT was about 45??m thicker than that measured with TD-OCT. Attention should be paid when comparing data obtained using different OCT machines. PMID:22315663

Kakinoki, Masashi; Miyake, Taichirou; Sawada, Osamu; Sawada, Tomoko; Kawamura, Hajime; Ohji, Masahito

2012-01-01

175

Evaluation of Macular Retinal Ganglion Cell-Inner Plexiform Layer Thickness after Vitrectomy with Internal Limiting Membrane Peeling for Idiopathic Macular Holes  

PubMed Central

Purpose. To evaluate macular retinal ganglion cell-inner plexiform layer (GCIPL) thickness changes after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole repair using a high-resolution spectral-domain optical coherence tomography (SD-OCT). Methods. 32 eyes from 32 patients with idiopathic macular holes who underwent vitrectomy with internal limiting membrane peeling between January 2011 and July 2012 were retrospectively analyzed. GCIPL thickness was measured before surgery, and at one month and at six months after surgery. Values obtained from automated and semimanual SD-OCT segmentation analysis were compared (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA). Results. No significant differences were found between average GCIPL thickness values between preoperative and postoperative analysis. However, statistical significant differences were found in GCIPL thickness at the temporal macular quadrants at six months after surgery. Quality measurement analysis performed by automated segmentation revealed a significant number of segmentation errors. Semimanual segmentation slightly improved the quality of the results. Conclusion. SD-OCT analysis of GCIPL thickness found a significant reduction at the temporal macular quadrants at 6 months after Brilliant Blue G-assisted internal limiting membrane peeling for idiopathic macular hole. PMID:25110679

Velazquez-Villoria, Alvaro; Zapata, Miguel A.; Figueroa, Marta S.; Suarez-Leoz, Marta; Arrevola, Luis; Teijeiro, Maria-Angeles; Garcia-Layana, Alfredo

2014-01-01

176

Fluorescein angiography vs. optical coherence tomography for diagnosis of uveitic macular edema  

PubMed Central

Objective To evaluate agreement between fluorescein angiography (FA) and optical coherence tomography (OCT) for diagnosis of macular edema in patients with uveitis. Design Multicenter cross-sectional study Participants Four hundred seventy-nine eyes with uveitis of 255 patients Methods The macular status of dilated eyes with intermediate, posterior or panuveitis was assessed via Stratus-3 OCT and FA. Kappa statistics evaluated agreement between the diagnostic approaches. Main Outcome Measures Macular thickening (center point thickness ?240 ?m per reading center grading of OCT images-“MT”) and macular leakage (central subfield fluorescein leakage ?0.44 disk areas per reading center grading of FA images-“ML”); agreement amongst these outcomes in diagnosing “macular edema.” Results OCT (90.4%) more frequently returned usable information regarding macular edema than FA (77%) and biomicroscopy (76%). Agreement in diagnosis of MT and ML (?=0.44) was moderate. ML was present in 40% of cases free of MT, whereas MT was present in 34% of cases without ML. Biomicroscopic evaluation for macular edema failed to detect 40% and 45% of cases of MT and ML respectively and diagnosed 17% and 17% of cases with macular edema which did not have MT or ML respectively; these results may underestimate biomicroscopic errors (ophthalmologists were not explicitly masked to OCT and FA results). Among eyes free of ML, phakic eyes without cataract rarely (4%) had MT. No factors were found that effectively ruled out ML when MT was absent. Conclusion OCT and FA offered only moderate agreement regarding macular edema status in uveitis cases, probably because what they measure (MT and ML) are related but non-identical macular pathologies. Given its lower cost, greater safety, and greater likelihood of obtaining usable information, OCT may be the best initial test for evaluation of suspected macular edema. However, given that ML cannot be ruled out if MT is absent and vice versa, obtaining the second test after a negative result on the first seems justified when detection of ML or MT would alter management. Given that biomicroscopic evaluation for macular edema frequently erred, ancillary testing for macular edema seems indicated when knowledge of ML or MT status would affect management. PMID:23706700

Kempen, John H.; Sugar, Elizabeth A.; Jaffe, Glenn J.; Acharya, Nisha R.; Dunn, James P.; Elner, Susan G.; Lightman, Susan L.; Thorne, Jennifer E.; Vitale, Albert T.; Altaweel, Michael M.

2013-01-01

177

Genetic and Epigenetic Regulation in Age-related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of irreversible blindness in the older population worldwide. While strong genetic risk factors have been associated with AMD etiology, environmental influences through epigenetic regulation are also likely to play a role. Recent advances in epigenetic studies have resulted in the development of numerous epigenetic drugs for the treatment of cancer and inflammation. Here, we review the current literature on the genetic and epigenetic mechanisms of AMD and suggest that understanding the cooperation of epigenetic and genetic mechanisms will greatly advance the clinical management of AMD. PMID:23997991

Wei, Lai; Chen, Ping; Lee, Joo Hyun; Nussenblatt, Robert B.

2013-01-01

178

Intravitreal Corticosteroids in the Management of Diabetic Macular Edema  

PubMed Central

Diabetic macular edema (DME) remains an important worldwide cause of visual loss. Corticosteroids have a role in the treatment of some patients with advanced or recurrent DME. The best studied steroids for this indication are triamcinolone acetonide, dexamethasone, and fluocinolone acetonide. All steroids are associated with risks of cataract and intraocular pressure elevation. In addition, intravitreal injection of any medication is associated with risks of infectious endophthalmitis, which has led to the investigation of various extended-release steroid implants. At this time, no steroid is approved by the United States Food and Drug Administration (FDA) for the treatment of DME. PMID:24224143

Flynn, Harry W.; Scott, Ingrid U.

2013-01-01

179

Present and Possible Therapies for Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the most common cause of blindness in the elderly population worldwide and is defined as a chronic, progressive disorder characterized by changes occurring within the macula reflective of the ageing process. At present, the prevalence of AMD is currently rising and is estimated to increase by a third by 2020. Although our understanding of the several components underpinning the pathogenesis of this condition has increased significantly, the treatment options for this condition remain substantially limited. In this review, we outline the existing arsenal of therapies available for AMD and discuss the additional role of further novel therapies currently under investigation for this debilitating disease. PMID:25097787

Kamal, Ahmed

2014-01-01

180

Dominant Stargardt Macular Dystrophy (STGD3) and ELOVL4.  

PubMed

Autosomal dominant Stargardt3 Macular Dystrophy (STGD3) results from mutations in the ELOVL4 gene. ELOVL4 protein localizes to the endoplasmic reticulum (ER), where it mediates the rate-limiting condensation reaction during very long-chain (VLC, ???C28) fatty acid biosynthesis. The defective gene product is truncated at the C-terminus, leading to mislocalization and aggregation in other organelles. In this review, we summarize our current understanding of the disease-causing mutation and its potential role in STGD3 pathogenesis. PMID:24664730

Logan, Sreemathi; Anderson, Robert E

2014-01-01

181

Diurnal variation of macular oedema in CRVO: prospective study  

Microsoft Academic Search

Introduction  Patients with central retinal vein occlusion (CRVO) may experience reduced vision in the morning. This may be due to increased\\u000a cystoid macular oedema (CMO), which can be measured on optical coherence tomography (OCT).\\u000a \\u000a \\u000a \\u000a Methods  A prospective study was performed on ten patients. Retinal thickness measurements were made with the Topcon 3D OCT-1000: at\\u000a 9 a.m., 11 a.m., 1 p.m., 3 p.m., 5 p.m. In addition, at

B. Gupta; J. Grewal; T. Adewoyin; L. Pelosini; T. H. Williamson

2009-01-01

182

Inflammation and Macular Oedema after Pars Plana Vitrectomy  

PubMed Central

Cystoid macular oedema (CMO) is a major cause of reduced vision following intraocular surgery. Although the aetiology of CMO is not completely clarified, intraocular inflammation is known to play a major role in its development. The macula may develop cytotoxic oedema when the primary lesion and fluid accumulation occur in the parenchymatous cells (intracellular oedema) or vasogenic oedema when the primary defect occurs in the blood-retinal barrier and leads to extracellular fluid accumulation (extracellular oedema). We report on the mechanisms of CMO formation after pars plana vitrectomy and associated surgical procedures and discuss possible therapeutic approaches. PMID:24288446

Romano, Vito; Angi, Martina; del Grosso, Renata; Romano, Davide; Vinciguerra, Paolo; Romano, Mario R.

2013-01-01

183

Macular Function in Macular Degenerations: Repeatability of Microperimetry as a Potential Outcome Measure for ABCA4-Associated Retinopathy Trials  

PubMed Central

Purpose. To measure macular visual function in patients with unstable fixation, to define the photoreceptor source of this function, and to estimate its test-retest repeatability as a prerequisite to clinical trials. Methods. Patients (n = 38) with ABCA4-associated retinal degeneration (RD) or with retinitis pigmentosa (RP) were studied with retina-tracking microperimetry along the foveo-papillary profile between the fovea and the optic nerve head, and point-by-point test-retest repeatability was estimated. A subset with foveal fixation was also studied with dark-adapted projection perimetry using monochromatic blue and red stimuli along the horizontal meridian. Results. Macular function in ABCA4-RD patients transitioned from lower sensitivity at the parafovea to higher sensitivity in the perifovea. RP patients had the inverse pattern. Red-on-red microperimetric sensitivities successfully avoided ceiling effects and were highly correlated with absolute sensitivities. Point-by-point test-retest limits (95% confidence intervals) were ±4.2 dB; repeatability was not related to mean sensitivity, eccentricity from the fovea, age, fixation location, or instability. Repeatability was also not related to the local slope of sensitivity and was unchanged in the parapapillary retina. Conclusions. Microperimetry allows reliable testing of macular function in RD patients without foveal fixation in longitudinal studies evaluating natural disease progression or efficacy of therapeutic trials. A single estimate of test-retest repeatability can be used to determine significant changes in visual function at individual retinal loci within diseased regions that are homogeneous and those that are heterogeneous and also in transition zones at high risk for disease progression. PMID:22247458

Swider, Malgorzata; Aleman, Tomas S.; Feuer, Willam J.; Schwartz, Sharon B.; Russell, Robert C.; Steinberg, Janet D.; Stone, Edwin M.; Jacobson, Samuel G.

2012-01-01

184

Quality of optometry referrals to neovascular age-related macular degeneration clinic: a prospective study  

PubMed Central

Objectives To evaluate the quality of referrals to a neovascular age-related macular degeneration clinic from optometrists using the standard Rapid Access Referral Form (RARF) from the Royal College of Ophthalmologists. Design A prospective study. Prospective data were gathered from all optometry referrals using the RARF, between the periods of December 2006 to August 2009. These were assessed for accuracy of history, clinical signs and final diagnosis as compared to a macula expert. Setting Highlands NHS Trust. Participants All patients referred to the eye department at NHS Highlands Trust using the RARF. Main outcome measures The symptoms of neovascular age-related macular degeneration correctly identified by optometrists, and the signs of neovascular age-related macular degeneration correctly identified by optometrists. Results Fifty-four RARFs were received during this period, there was an overall agreement with symptomatology in 57.4% of cases. Optometrists scored less well in recognizing the clinical signs of neovascular age-related macular degeneration, with the poorest scores for recognizing macular oedema (44.4%) and drusen (51.9%). Twenty (37%) patients referred had neovascular age-related macular degeneration. Conclusions RARFs make up the minority of referrals to the neovascular age-related macular degeneration clinic. Optometrists find it difficult to accurately elicit the signs of macula disease. PMID:21912730

Muen, Wisam J; Hewick, Simon A

2011-01-01

185

An unusual complication of blunt ocular trauma: A horseshoe-shaped macular tear with spontaneous closure  

PubMed Central

A case of horseshoe-shaped macular tear after blunt trauma with the course of the tear and the relevant findings obtained by spectral-domain optical coherence tomography (SD-OCT) is described. A 21-year-old man who had suffered blunt trauma 5 days previously visited our clinic complaining of vision loss in his left eye. Ophthalmic examination and SD-OCT images revealed a horseshoe-shaped macular tear. A month later at the second visit, the macular tear was found to have spontaneously closed. There have been many cases reported previously of the spontaneous closure of traumatic macular holes. A horseshoe-shaped macular tear is an atypical clinical presentation. However, the mechanism of spontaneous closure is hypothetically as same as that for a macular hole. High-resolution images and three-dimensional maps taken with SD-OCT can provide more details on macular diseases and are more useful than time-domain OCT images. PMID:24817754

Karaca, Umut; Durukan, Hakan A; Mumcuoglu, Tarkan; Erdurman, Cuneyt; Hurmeric, Volkan

2014-01-01

186

Bilateral isokinetic training reduces the bilateral leg strength deficit for both old and young adults  

Microsoft Academic Search

The bilateral limb deficit (BLD) describes the difference in maximal or near-maximal force generating capacity of muscles when they are contracted alone and in combination with the contralateral muscles. This study examined the effects of a 6-week (three times per week) bilateral leg strength training programme on BLD in younger and older adults. Data were collected from 33 subjects during

Usha Kuruganti; Philip Parker; Jeremy Rickards; Maureen Tingley; James Sexsmith

2005-01-01

187

Diabetic papillopathy with macular edema treated with intravitreal ranibizumab  

PubMed Central

We report a case of diabetic papillopathy that demonstrated a resolution of optic disk swelling and rapid visual recovery when intravitreal ranibizumab was administered. A 51-year-old male presented with acute painless visual loss in his right eye. His vision was 20/320 in the right eye and 20/50 in the left eye. Fundus examination of the right eye showed nonproliferative diabetic retinopathy with macular edema and a swollen optic disk. Fluorescein angiography showed dye leakage from the right optic disk. Optical coherent tomography revealed a significant increase in retinal nerve fiber-layer thickness. Magnetic resonance imaging of the brain was normal. The patient received a single intravitreal ranibizumab (0.5 mg) injection. Two weeks following injection, there was marked regression of the disk swelling and improvement of macular edema, with vision improving to 20/100. Three months following injection, there was complete resolution of the optic disk swelling. No further treatment was required. PMID:24348012

Kim, Moosang; Lee, Jang-Hun; Lee, Seung-Jun

2013-01-01

188

Macular Pigment Optical Density Measured by Heterochromatic Modulation Photometry  

PubMed Central

Purpose To psychophysically determine macular pigment optical density (MPOD) employing the heterochromatic modulation photometry (HMP) paradigm by estimating 460 nm absorption at central and peripheral retinal locations. Methods For the HMP measurements, two lights (B: 460 nm and R: 660 nm) were presented in a test field and were modulated in counterphase at medium or high frequencies. The contrasts of the two lights were varied in tandem to determine flicker detection thresholds. Detection thresholds were measured for different R:B modulation ratios. The modulation ratio with minimal sensitivity (maximal threshold) is the point of equiluminance. Measurements were performed in 25 normal subjects (11 male, 14 female; age: 30±11 years, mean ± sd) using an eight channel LED stimulator with Maxwellian view optics. The results were compared with those from two published techniques – one based on heterochromatic flicker photometry (Macular Densitometer) and the other on fundus reflectometry (MPR). Results We were able to estimate MPOD with HMP using a modified theoretical model that was fitted to the HMP data. The resultant MPODHMP values correlated significantly with the MPODMPR values and with the MPODHFP values obtained at 0.25° and 0.5° retinal eccentricity. Conclusions HMP is a flicker-based method with measurements taken at a constant mean chromaticity and luminance. The data can be well fit by a model that allows all data points to contribute to the photometric equality estimate. Therefore, we think that HMP may be a useful method for MPOD measurements, in basic and clinical vision experiments. PMID:25354049

Huchzermeyer, Cord; Schlomberg, Juliane; Welge-Lüssen, Ulrich; Berendschot, Tos T. J. M.; Pokorny, Joel; Kremers, Jan

2014-01-01

189

Light Distributions on the Retina: Relevance to Macular Pigment Photoprotection  

PubMed Central

Light exposure has been implicated in age-related macular degeneration (AMD). This study was designed to measure cumulative light distribution on the retina to determine whether it peaked in the macula. An eye-tracker recorded the subject's field of view and pupil size, and superimposed the gaze position. Fifteen naïve subjects formed a test group; 5 formed a control group. In phase 1, all subjects viewed a sequence of photographic images. In phase 2, the naïve subjects observed a video; in phase 3, they performed computer tasks; in phase 4, the subjects walked around freely. In phase 1, control subjects were instructed to gaze at bright features in the field of view and, in a second test, at dark features. Test group subjects were allowed to gaze freely for all phases. Using the subject's gaze coordinates, we calculated the cumulative light distribution on the retina. As expected for control subjects, cumulative retinal light distributions peaked and dipped in the fovea when they gazed at bright or dark features respectively in the field of view. The light distribution maps obtained from the test group showed a consistent tendency to peak in the macula in phase 3, a variable tendency in phase 4, but little tendency in phases 1 and 2. We conclude that a tendency for light to peak in the macula is a characteristic of some individuals and of certain tasks. In these situations, risk of AMD could be increased but, at the same time, mitigated by the presence of macular carotenoids. PMID:22428119

Bone, Richard A.; Gibert, Jorge C.; Mukherjee, Anirbaan

2012-01-01

190

Predicting visual outcomes for macular disease using optical coherence tomography  

PubMed Central

In recent years, the management of macular disease has undergone radical changes, in part because of new therapeutic approaches, but also due to the introduction of a new imaging modality – optical coherence tomography (OCT). The application of OCT imaging has clarified many aspects of chorioretinal disease pathophysiology and elucidated many hitherto unrecognized disease characteristics. From an early stage in its development, OCT has also been revolutionary in attempting to extract clinically useful measurements from image data in an automated fashion. As a result, OCT-derived measurements of retinal thickness have been rapidly embraced in clinical and research settings. However, as knowledge of OCT image analysis has developed, it has become increasingly clear that even accurate measurements of retinal thickness may fail to predict visual outcomes for many diseases. As a result, the focus of much current clinical imaging research is on the identification of other OCT-derived anatomic biomarkers predictive of visual outcomes – such biomarkers could serve as surrogate endpoints in clinical trials and provide prognostic information in clinical practice. In this review, we begin by highlighting the importance of accurate visual function assessment and describing the fundamentals of OCT image evaluation, before describing the current state-of-the-art with regard to predicting visual outcomes, for a variety of macular diseases, using OCT. PMID:23960916

Keane, Pearse A.; Sadda, Srinivas R.

2011-01-01

191

Analysis of macular OCT images using deformable registration  

PubMed Central

Optical coherence tomography (OCT) of the macula has become increasingly important in the investigation of retinal pathology. However, deformable image registration, which is used for aligning subjects for pairwise comparisons, population averaging, and atlas label transfer, has not been well–developed and demonstrated on OCT images. In this paper, we present a deformable image registration approach designed specifically for macular OCT images. The approach begins with an initial translation to align the fovea of each subject, followed by a linear rescaling to align the top and bottom retinal boundaries. Finally, the layers within the retina are aligned by a deformable registration using one-dimensional radial basis functions. The algorithm was validated using manual delineations of retinal layers in OCT images from a cohort consisting of healthy controls and patients diagnosed with multiple sclerosis (MS). We show that the algorithm overcomes the shortcomings of existing generic registration methods, which cannot be readily applied to OCT images. A successful deformable image registration algorithm for macular OCT opens up a variety of population based analysis techniques that are regularly used in other imaging modalities, such as spatial normalization, statistical atlas creation, and voxel based morphometry. Examples of these applications are provided to demonstrate the potential benefits such techniques can have on our understanding of retinal disease. In particular, included is a pilot study of localized volumetric changes between healthy controls and MS patients using the proposed registration algorithm. PMID:25071959

Chen, Min; Lang, Andrew; Ying, Howard S.; Calabresi, Peter A.; Prince, Jerry L.; Carass, Aaron

2014-01-01

192

Anti-VEGF for the Management of Diabetic Macular Edema  

PubMed Central

Diabetic retinopathy (DR) is an important cause of vision loss around the world, being the leading cause in the population between 20 and 60 years old. Among patients with DR, diabetic macular edema (DME) is the most frequent cause of vision impairment and represents a significant public health issue. Macular photocoagulation has been the standard treatment for this condition reducing the risk of moderate visual loss by approximately 50%. The role of vascular endothelial growth factor (VEGF) in DR and DME pathogenesis has been demonstrated in recent studies. This review addresses and summarizes data from the clinical trials that investigated anti-VEGF for the management of DME and evaluates their impact on clinical practice. The literature searches were conducted between August and October 2013 in PubMed and Cochrane Library with no date restrictions and went through the most relevant studies on pegaptanib, ranibizumab, bevacizumab, and aflibercept for the management of DME. The efficacy and safety of intravitreal anti-VEGF as therapy for DME have recently been proved by various clinical trials providing significantly positive visual and anatomical results. Regarding clinical practice, those outcomes have placed intravitreal injection of anti-VEGF as an option that must be considered for the treatment of DME. PMID:24741610

Stefanini, Francisco Rosa; Badaró, Emmerson; Falabella, Paulo; Koss, Michael; Farah, Michel Eid; Maia, Maurício

2014-01-01

193

Bilateral diaphragmatic defect and associated multiple anomalies.  

PubMed

Although congenital diaphragmatic hernia is one of the most common congenital anomalies, complete bilateral agenesis of the diaphragm is a very rare congenital malformation and frequently associated with other major anomalies. We report a case of bilateral diaphragmatic agenesis associated with major congenital anomalies. A 2,240-g male infant was born at 35 weeks of gestation to a 34-year-old mother with a history of minimal prenatal care. Polyhydramnios was reported on prenatal level 1 scan. The patient experienced early respiratory distress requiring intubation. Apgar scores were 2/1/1 at 1, 5 and 20 minutes, respectively, and efforts to resuscitate him were unsuccessful. He died at 2 hours of age. Autopsy revealed bilateral diaphragmatic agenesis associated with right pulmonary hypoplasia, left pulmonary agenesis, multiple cardiac abnormalities and gallbladder agenesis. Cytogenetic studies showed normal male karyotype. Bilateral agenesis of the diaphragm is a life-threatening malformation. Survival of these infants often depends on cardiopulmonary function. Bilateral agenesis of the diaphragm associated with gallbladder and unilateral pulmonary agenesis is a rare entity, and its clinical significance needs further investigation. PMID:19299227

Karadeniz, Leyla; Guven, Sirin; Atay, Enver; Ovali, Fahri; Celayir, Aysenur

2009-03-01

194

[Pathophysiology of macular diseases--morphology and function].  

PubMed

Ophthalmic fundus imaging plays an important role in the advances in the pathophysiology of retinal diseases. Using fundus imaging, we studied morphological changes in the choroid, subretinal pathophysiology and photoreceptor and retinal pigment epithelial (RPE) cell damage, and functional abnormalities of photoreceptor cells in macular diseases. To evaluate the choroidal changes, we performed enhanced depth imaging optical coherence tomography (EDI-OCT) for macular diseases. Choroidal thickness both in the affected eyes and in the fellow eyes with choroidal vascular hyperpermeability was thicker in patients with central serous chorioretinopathy (CSC). Photodynamic therapy (PDT) reduced the hyperpermeability and led to choroidal thinning in eyes with CSC, whereas laser photocoagulation did not result in any change in choroidal thickness, suggesting different mechanism of action for these two forms of treatment. PDT also decreased choroidal thickness in eyes with polypoidal choroidal vasculopathy. These findings will help to elucidate the pathophysiologic features of CSC as well as responses to treatment. Patients with acute Vogt-Koyanagi-Harada (VKH) disease have markedly thickened choroids. Both the choroidal thickness and the retinal detachment in these patients decreased quickly with corticosteroid treatment. EDI-OCT can be used to evaluate the choroidal involvement in VKH disease in acute stages and may prove useful in the diagnosis and management of this disease. Dome-shaped macula is the result of a localized thickening of the sclera under the macula in highly myopic patients, and it cannot be categorized into any known type of staphyloma. EDI-OCT is helpful in monitoring the proposed site of pathophysiologic changes in the choroid and the sclera, and provides noninvasively information not available by other means. To clarify the subretinal changes and the mechanism of cell damage in macular detachment, we studied the clinical characteristics of yellow deposits (multiple dot-like yellow precipitates and subretinal yellow material) seen in CSC using fundus autofluorescence and OCT. The yellow deposits had highly reflective tissue in the intraretinal and subretinal spaces seen on OCT and hyperfluorescence on short-wave autofluorescence (SW-AF) examinations during the follow-up period. These findings may indicate that formations of yellow deposits are associated with the accumulation of the photoreceptor outer segments and metabolism and phagocytosis by macrophages or RPE cells. SW-AF also demonstrated a hypofluorescence corresponding to the accumulated areas of yellow deposits during the long term followup period. Another study using infrared autofluorescence examination demonstrated that the yellow deposits induced a decrease in melanin and the functional decline of RPE cells in CSC. These may indicate that the existence of depositions in eyes with CSC is associated with photoreceptor and RPE cells damage. Similar yellow deposits can also be seen in eyes with macular detachment, e. g. branch retinal vein occlusion. We report a new method of retinal densitometry using SW-AF examination by scanning laser ophthalmoscope. We named the technique autofluorescence densitometry (AFD). This technique can evaluate photopigment density from serial SW-AF images during exposure to excitation light. This new technique can examine a much broader macular area and create a distribution map of optical density of the photopigments. It is also easy to compare the distribution of the photopigment densities with other retinal imaging devices such as OCT. To investigate functional abnormalities in eyes with CSC, we measured the optical density of the photopigments using AFD in both the acute and quiescent phase. The photopigment density decreased at the serous retinal detachment. The density remained decreased immediately after resolution and showed delayed recovery. The photopigments decreased even in eyes with a morphologic recovery of the outer retina. AFD could identify the functional impairment of the outer retina as characterized by

Iida, Tomohiro

2011-03-01

195

Measuring macular pigment optical density in vivo: a review of techniques  

Microsoft Academic Search

Background  Macular pigment has been the focus of much attention in recent years, as a potential modifiable risk factor for age-related\\u000a macular degeneration. This interest has been heightened by the ability to measure macular pigment optical density (MPOD) in\\u000a vivo.\\u000a \\u000a \\u000a \\u000a \\u000a Method  A systematic literature search was undertaken to identify all available papers that have used in vivo MPOD techniques. The\\u000a papers were

Olivia Howells; Frank Eperjesi; Hannah Bartlett

2011-01-01

196

The monochromatic green argon laser in the management of macular disorders.  

PubMed

The authors have been using an argon laser photocoagulator equipped with a green filter for about 21/2 years. Compared to the usual blue-green argon laser, the advantage of such an instrument is that green radiation is not absorbed to any significant degree by macular pigment. This ensures a selective action on hemoglobin and pigment epithelium. The green wavelength appears to be extremely useful in the management of macular disorders. The authors report the criteria they follow and the technique they use in the treatment of subretinal neovascular membranes and of macular edema arising from different retinal vascular disorders. PMID:4039398

Gazocchi, M; Fattori, C M; Gratton, I; Simonini, F; Citroni, M

1985-01-01

197

Bilateral Absence of the Superior Vena Cava  

PubMed Central

Bilateral absence of the superior vena cava (SVC) is a very rarely detected, mainly asymptomatic congenital vascular anomaly. Though usually innocent, this anomaly may complicate cardiothoracic surgery and certain procedures like central venous catheter insertion. This SVC anomaly is poorly known, and we assume that its incidence in the general population may be higher than detected. In this paper, we summarize current knowledge on this anomaly and its clinical implications. In addition, we present a neonatal case with bilateral absence of the SVC associated with a fetal cystic hygroma. Conclusion. Totally absent SVC can cause unexpected problems during cardiothoracic surgery. Suspicion of SVC absence should arise in basic echocardiography. Our paper suggests that, like other congenital anomalies, bilateral absent SVC may be associated with a fetal cyctic hygroma. PMID:24826253

Ylänen, Kaisa; Poutanen, Tuija; Savikurki-Heikkilä, Päivi; Uotila, Jukka; Korppi, Matti; Eerola, Anneli

2012-01-01

198

Bilateral Facial Nerve Palsy: A Diagnostic Dilemma  

PubMed Central

Introduction. Bilateral facial nerve palsy (FNP) is a rare condition, representing less than 2% of all cases of FNP. Majority of these patients have underlying medical conditions, ranging from neurologic, infectious, neoplastic, traumatic, or metabolic disorders. Objective. The differential diagnosis of its causes is extensive and hence can present as a diagnostic challenge. Emergency physicians should be aware of these various diagnostic possibilities, some of which are potentially fatal. Case Report. We report a case of a 43-year-old female who presented to the emergency department with sequential bilateral facial nerve paralysis which could not be attributed to any particular etiology and, hence, presented a diagnostic dilemma. Conclusion. We reinforce the importance of considering the range of differential diagnosis in all cases presenting with bilateral FNP. These patients warrant admission and prompt laboratory and radiological investigation for evaluation of the underlying cause and specific further management as relevant. PMID:23326715

Pothiawala, Sohil; Lateef, Fatimah

2012-01-01

199

Bilateral leukocoria in infant with afibrinogenemia  

PubMed Central

Purpose To report a bilateral leukocoria case in a patient suffering from afibrinogenemia. Methods An observational case where congenital afibrinogenemia was presented with bilateral retinal and vitreous hemorrhages that proceeded to vitreoretinal surgery was presented. In addition, complete ophthalmic and radiological examinations and vitreoretinal surgery were performed. Results Right eye had a complete recovery while the left eye showed serious proliferative vitreoretinopathy and shortened retina. Three years after the surgery clinical examination showed that the right eye was aphacic with an attached retina and clear ocular media while the left eye was phtysic. Conclusion We recommend broad clotting profile for infants suffering from vitreous or retinal hemorrhages with no obvious physical abuse. Our present case furthermore implies that afibrinogenemia can lie beneath the pathogenesis of bilateral leukocoria and should alert physician for the presence of an afibrinogenemia among several types of bleeding predispositions. PMID:19668740

Demir, M Necati; Acar, Mehmet Akif; Aral, Yusuf Ziya; Unlu, Nurten

2008-01-01

200

Magnetoencephalographic analysis of secondary bilateral synchrony.  

PubMed

To assess the clinical value of magnetoencephalography (MEG) in investigating the origin of secondary bilateral synchrony (SBS) in patients with partial epilepsy. MEG and simultaneous electroencephalography (EEG) were recorded with a 204-channel whole-head MEG system in 2 patients. The equivalent current dipoles (ECDs) for epileptic discharges on MEG were calculated according to a single dipole model. In patient 1, the ictal EEG showed bursts of bilateral synchronous 3-Hz spike-and-slow-wave complexes. ECDs obtained from the ictal MEG localized to the right medial frontal lobe. On the second patient's MEG recordings, epileptic discharges corresponding to prolonged EEG bursts of bilateral synchronous spike-and-slow-wave complexes were obtained. ECDs calculated from the prolonged bursts were clustered in the left medial frontal lobe. MEG detected the sources of SBS in the medial frontal lobe. MEG is extremely useful for the identification of the source of SBS. PMID:15574582

Tanaka, Naoaki; Kamada, Kyousuke; Takeuchi, Fumiya; Takeda, Youji

2005-01-01

201

Bilateral self-inflicted infectious dacryoadenitis.  

PubMed

Abstract The aim of this report is to present a case of a patient with bilateral lacrimal gland abscesses in the course of dacryoadenitis. A 45-year-old female patient with a long history of cocaine abuse presented with bilateral bacterial dacryoadenitis and upper lid inflammation with purulent discharge from a palpebral wound of the right upper lid. The diagnosis was confirmed with microbiology culture and an orbital CT scan, which revealed lacrimal gland abscesses. The patient admitted to vigorous eye scratching, which we believe was the mechanism responsible for the process. The infection resolved on targeted antibiotic therapy. This is the first reported case of bilateral infectious dacryoadenitis produced in a self-inflicted mechanism in a cocaine addict. PMID:25208047

Latasiewicz, Marta; Chang-Sotomayor, Meilin; Alonso-Caldarelli, Claudia; Farias-Plazas, Fabian; Leszczynska, Anna; Gonzalez-Candial, Miguel

2014-12-01

202

Spontaneous Bilateral Meningoencephalocoeles of the Temporal Bones  

PubMed Central

Spontaneous tegmen tympani defects are rare with even rarer bilateral cases. The symptoms are nonspecific; hence, a high index of suspicion is required to prevent serious intracranial complications. We present a case of spontaneous bilateral tegmen tympani defects with associated meningoencephalocoeles in a 54-year-old male who presented with the signs and symptoms of severe meningitis. After careful workup which included a lumbar puncture, CT and MRI scans, both defects were repaired using a middle fossa approach. The patient made an uneventful recovery with complete cessation of otorrhoea and improvement in his hearing. PMID:24288640

2013-01-01

203

Bilateral Metallic Stenting in Malignant Hilar Obstruction  

PubMed Central

Endoscopic palliative biliary drainage is considered as a gold standard treatment in advanced or inoperable hilar cholangiocarcinoma. Also, metal stents are preferred over plastic stents in patients with >3 months life expectancy. However, the endoscopic intervention of advanced hilar obstruction is often more challenging and complex than that of distal malignant biliary obstructions. In this literature review, we describe the issues commonly encountered during endoscopic unilateral (single) versus bilateral (multiple) biliary stenting for malignant hilar obstruction. Also, we provide technical guidance to improve the technical success rates and patient outcomes, focusing on bilateral metallic stenting techniques such as stent-in-stent or side-by-side deployment.

Moon, Jong Ho; Park, Sang-Heum

2014-01-01

204

Bilateral control of teleoperators with time delay  

NASA Technical Reports Server (NTRS)

A control law for teleoperators is presented which overcomes the instability caused by time delay. By using passivity and scattering theory, a criterion is developed which shows why existing bilateral control systems are unstable for certain environments, and why the proposed bilateral control law is stable for any environment and any time delay. The control law has been implemented on a single-axis force-reflecting hand controller, and preliminary results are shown. To keep the presentation clear, a 1-DOF linear time-invariant teleoperator system is discussed. Nevertheless, the results can be extended without loss of generality to an n-DOF nonlinear teleoperation system.

Anderson, Robert J.; Spong, Mark W.

1989-01-01

205

Bilateral common carotid occlusion without neurological deficit.  

PubMed

A 40-year-old man presented with pain and numbness in his right arm. On his clinical examination, no neurological deficit was found. Bilateral common carotid artery duplex sonography scan demonstrated no flow in either lumen. No abnormality was recognized on brain CT. On cerebral digital substraction angiogram, total occlusion of the brachiocephalic trunk and left carotid artery were shown. There was a modest stenosis in the left vertebral artery. Collateral circulation feeding the intracranial carotid system mainly originated from the left vertebrobasilar system. Previous cases of bilateral carotid occlusion are reviewed and discussed. PMID:12452914

Karaköse, Serdar; Karabacakoglu, Aydin; Solak, Hasan

2002-12-01

206

Factors Associated with Macular Thickness in the COMET Myopic Cohort  

PubMed Central

Purpose To determine whether macular thickness is associated with ethnicity, gender, axial length and severity of myopia in a cohort of young adults from the Correction of Myopia Evaluation Trial (COMET). Methods Eleven years after their baseline visit, 387/469 (83%) subjects returned for their annual visit. In addition to the protocol-specific measures of spherical equivalent refractive error (SER) and axial length (AL), high-resolution macular imaging also was performed with Optical Coherence Tomography (RTVue). From these scans, full thickness values for the central (1 mm), para- (1–3 mm), and peri-foveal (3–5 mm) annular regions were calculated. Gender, ethnicity, AL, and SER were examined for associations with macular thickness using univariate and multivariable linear regression analyses. Results In the 377 subjects with usable data (mean age=21.0 ±1.3 years) the mean SER±SD was ?5.0±1.9 D and mean AL was 25.4±0.9 mm. Mean foveal thickness was 252.0± 20.1 µm in the center, 315.6±14.0 µm in the para-fovea, and 284.4±12.9 µm in the peri-fovea. In the best-fit multivariable model that adjusted for gender, ethnicity, and AL, females had significantly thinner maculas than males for all three regions (p<0.0001), with the largest difference in the center (12.8 µm, 95%CI: 9.2 to 16.4). The effect of ethnicity was strongest in the central fovea, with African-Americans, Asians, Hispanics, and mixed ethnic groups thinner maculas than whites (all p-values < 0.005). Increased AL was significantly associated with slightly thicker central foveas (p=0.001) and thinner para- (p=0.02) and peri-foveal (p< 0.0001) regions. Conclusions In this ethnically diverse cohort of moderate and high myopes, females and African-Americans were found to have the thinnest central foveas. Whether such thinning in the macula as a young adult is a risk factor for future disease remains to be determined. PMID:22525127

Harb, Elise; Hyman, Leslie; Fazzari, Melissa; Gwiazda, Jane; Marsh-Tootle, Wendy

2012-01-01

207

Resolution of macular scotoma after radial optic neurotomy in central retinal vein occlusion.  

PubMed

Radial optic neurotomy was performed on a hypertensive 65-year-old man with decreased vision in the right eye secondary to ischemic central retinal vein occlusion. Three months later, his visual acuity improved to 20/50. There was improvement in disc and macular edema, and reduction in retinal hemorrhages clinically and angiographically. Liquid crystal display microperimetry revealed improvement in fixation stability and macular sensitivity. Radial optic neurotomy appears to be an effective treatment alternative for selected patients with ischemic central retinal vein occlusion, and results in rapid improvement in visual acuity, central fixation, and macular scotoma as measured by a liquid crystal display microperimeter. Liquid crystal display microperimetry is a good and reliable alternative to the scanning laser ophthalmoscope for macular perimetry. PMID:16468557

Chalam, Kakarla V; Shah, Vinay A

2006-01-01

208

Optical coherence tomography in the preoperative and postoperative management of macular hole and epiretinal membrane  

PubMed Central

Optical coherence tomography (OCT) imaging plays an essential role in the diagnosis and treatment of macular diseases, including those of the vitreomacular interface. OCT enables accurate diagnosis and differentiation of full thickness macular hole, lamellar macular hole and epiretinal membrane, with or without the presence of vitreomacular adhesion. This information enables earlier diagnosis and treatment when necessary, and can guide the choice of therapy. OCT is useful to facilitate discussions with patients and manage the visual expectations. Postoperatively, OCT can be helpful to optimise patient comfort and visual outcomes. As the technology continues to improve, OCT will become increasingly critical for all aspects of care for patients with macular hole and epiretinal membrane. PMID:24627250

Goldberg, Roger A; Waheed, Nadia K; Duker, Jay S

2014-01-01

209

Studies on the Singlet Oxygen Scavenging Mechanism of Human Macular Pigment  

PubMed Central

It is thought that direct quenching of singlet oxygen and scavenging free radicals by macular pigment carotenoids is a major mechanism for their beneficial effects against light-induced oxidative stress. Corresponding data from human tissue remains unavailable, however. In the studies reported here, electron paramagnetic resonance (EPR) spectroscopy was used to measure light-induced singlet oxygen generation in postmortem human macula and retinal pigment epithelium/choroid (RPE/choroid). Under white-light illumination, production of singlet oxygen was detected in RPE/choroid but not in macular tissue, and we show that exogenously added macular carotenoids can quench RPE/choroid singlet oxygen. When the singlet oxygen quenching ability of the macular carotenoids was investigated in solution, it was shown that a mixture of meso-zeaxanthin, zeaxanthin, and lutein in a ratio of 1:1:1 can quench more singlet oxygen than the individual carotenoids at the same total concentration. PMID:20678467

Li, Binxing; Ahmed, Faisal; Bernstein, Paul S.

2010-01-01

210

Use of Immunosuppressive Agents for Treatment of Age-related Macular Degeneration (AMD) and Diabetic Retinopathy  

Cancer.gov

The National Eye Institute, Laboratory of Immunology is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize immunosuppressive agents for the treatment of age related macular degeneration.

211

Comparison of Spectral/Fourier Domain Optical Coherence Tomography Instruments for Assessment of Normal Macular Thickness  

E-print Network

Purpose: The purpose of this study was to report normal macular thickness measurements and assess reproducibility of retinal thickness measurements acquired by a time-domain optical coherence tomography (OCT) (Stratus, ...

Sull, Alan C.

212

Residual abilities in age-related macular degeneration to process spatial frequencies during natural scene  

E-print Network

-related macular degeneration (AMD) is the first cause of central vision loss in the elderly population many daily activities (Mangione et al., 1999), such as reading (Legge et al., 1992; Fine & Peli, 1995

Alleysson, David

213

Reorganization of Visual Processing in Macular Degeneration Is Not Specific to the "Preferred Retinal Locus"  

E-print Network

Recent work has shown that foveal cortex, deprived of its normal bottom-up input as a result of macular degeneration (MD), begins responding to stimuli presented to a peripheral retinal location. However, these studies ...

Baker, Chris I.

214

Three Studies Point to Same Risk Gene for Age-Related Macular Degeneration  

MedlinePLUS

... macular degeneration NIH-funded research helps unravel the biology of AMD Three studies reported in Nature Genetics ... to provide more specific clues to the underlying biology of the disease. "Compared to common variants, rare ...

215

Spontaneous closure of macular holes secondary to posterior uveitis: case series and a literature review  

PubMed Central

The occurrence of a macular hole due to posterior uveitis is infrequently reported. We report the evolution of three cases of macular holes secondary to posterior segment inflammation. A complete inflammatory and infectious assessment found one case of toxocariasis, one of sarcoidosis, and one of syphilis. After medical etiological treatment, macular hole closure was rapidly obtained in all the cases and confirmed by spectral domain optic coherence tomography, with visual acuity improvement. Fibrous scarring developed in two cases, and foveal photoreceptor complex normalization was observed in the sarcoidosis case. These observations demonstrate that macular holes secondary to posterior uveitis frequently resolve without surgical intervention and so could be underdiagnosed if the patient is not evaluated at the time of onset before spontaneous hole closure. PMID:23514634

2013-01-01

216

Atraumatic bilateral scapular spine fracture several months after bilateral reverse total shoulder arthroplasty.  

PubMed

We report an 89-year-old woman with bilateral atraumatic scapular spine fracture several months after bilateral reverse total shoulder arthroplasty (RTSA). Recently, RTSA has gained popularity in the surgical treatment of complex shoulder disorders such as cuff tear arthropathy. However, scapular fractures may occur several months after surgery as a late complication of this procedure. In this case report we focus on a relatively uncommon subtype, the scapular spine fracture. Although well-known in the orthopedic literature, radiologists are less familiar with this complication. To the best of our knowledge, bilateral scapular fractures have not yet been reported. PMID:24276680

Nicolay, Simon; De Beuckeleer, Luc; Stoffelen, Daniël; Vanhoenacker, Filip; Pouillon, Marc

2014-05-01

217

Bilateral dacryoceles associated with bilateral alacrimia with punctal and canalicular agenesis  

PubMed Central

To report a rare case of a 19 year old female presenting with bilateral dacryocele and punctal and canalicular agenesis without epiphora. After clinical and radiological examination, the patient was found to have bilateral lacrimal gland agenesis as well. No other dental, otological or systemic abnormality suggestive of lacrimo-auricular-dento-digital syndrome was detected. She was managed with bilateral dacryocystectomy. Algorithm for managing such nonconventional lacrimal outflow dysgenesis based on presenting symptoms and co existing epiphora is proposed. Rationale of preferring lacrimal sac excision instead of dacryocystorhinostomy in this case is also discussed. PMID:24526864

Gupta, Himika; Kane, Shubhada; Balasubramaniam, Vidyashankar

2013-01-01

218

Efficacy and retention times of intravitreal triamcinolone acetonide for macular edema  

Microsoft Academic Search

Purpose  To evaluate the retention of intravitreal triamcinolone acetonide (TA) particles and the efficacy of TA therapy for patients\\u000a with cystoid macular edema in branch retinal vein occlusion (BRVO) or diabetic macular edema (DME). We monitored the TA particles\\u000a until absorption from the vitreous cavity was complete. The correlation between the intravitreal retention time of TA and\\u000a its efficacy was evaluated

Akiko Kogure; Kishiko Ohkoshi; Shunsuke Kogure; Tatsuo Yamaguchi; Shoji Kishi

2008-01-01

219

Macular translocation with 360° retinotomy for management of retinal pigment epithelial tear: long-term results  

Microsoft Academic Search

BackgroundTo determine long-term functional and morphological changes after full macular translocation (FMT) with 360° retinotomy in patients with retinal pigment epithelium (RPE) tears, in light of the increasing number of reports of this complication following vascular endothelial growth factor (VEGF)-modulating therapy.MethodsWe retrospectively reviewed a consecutive series of six patients with RPE tears secondary to neovascular age-related macular degeneration who underwent

A. Polito; M. Cereda; F. Romanelli; G. Pertile

2010-01-01

220

Exclusion of TIMP3 as a Candidate Locus in Age-Related Macular Degeneration  

Microsoft Academic Search

Purpose. Age-related macular degeneration (AMD) is a genetically complex disorder. Tissue inhibitor of metalloproteinases-3 (TIMP3) on chromosome 22 has been identified as a gene that is mutated in Sorsby's fundus dystrophy, an autosomal-dominant macular dystrophy that phenotypically resembles AMD. The purpose of this study was to determine whether TIMP3 is a major susceptibility gene for the AMD phenotype. Methods. Thirty-eight

Margaret A. Pericak-Vance; X Felicia Lennon; Jonathan L. Haines; Johanna M. Seddon

1997-01-01

221

Late-onset retinal macular degeneration: clinical insights into an inherited retinal degeneration  

Microsoft Academic Search

Aim:This study describes, in detail, the phenotype of late-onset retinal macular degeneration (L-ORMD) an inherited condition affecting both the retina and anterior segment. A staging based on clinical characteristics is proposed, and the relevance of this condition to current understanding of age-related macular degeneration is discussed.Methods:A systematic review of the literature regarding this condition supports a detailed description of the

S Borooah; C Collins; A Wright; B Dhillon

2009-01-01

222

Diagnosis and classification of macular degenerations: an approach based on retinal function testing  

Microsoft Academic Search

The results from literature concerning some aspects of retinal function in macular degenerations (MDs) were reviewed in order to evaluate whether (a) specific patterns of retinal dysfunction may be linked to different clinical phenotypes, and (b) distinct functional profiles may help in orienting molecular diagnosis of diseases. Examined clinical phenotypes included: Stargardt disease\\/fundus flavimaculatus (St\\/FF), age-related maculopathy (ARM) and macular

Luigi Scullica; Benedetto Falsini

2001-01-01

223

Lack of fibulin-3 causes early aging and herniation, but not macular degeneration in mice  

Microsoft Academic Search

A mutation in the EFEMP1 gene causes Malattia Leventinese, an inherited macular degenerative disease with strong similarities to age-related macular degeneration. EFEMP1 encodes fibulin-3, an extracellular matrix protein of unknown function. To investigate its biological role, the murine Efemp1 gene was inactivated through targeted disruption. Efemp12\\/2 mice exhibited reduced reproductivity, and displayed an early onset of aging-associated phenotypes including reduced

Precious J. McLaughlin; Benjamin Bakall; Jiwon Choi; Zhonglin Liu; Takako Sasaki; Elaine C. Davis; Alan D. Marmorstein; Lihua Y. Marmorstein

2007-01-01

224

Short-wavelength sensitive visual field loss in patients with clinically significant diabetic macular oedema  

Microsoft Academic Search

Summary   The aim of the study was to compare the sensitivity of short-wavelength and conventional automated static threshold perimetry\\u000a for the psychophysical detection of abnormality in patients with clinically significant diabetic macular oedema. The sample\\u000a comprised 24 patients with clinically significant diabetic macular oedema (mean age 59.75 years, range 45–75 years). One eye\\u000a of each patient was selected. Exclusion criteria

C. Hudson; J. G. Flanagan; G. S. Turner; H. C. Chen; L. B. Young; D. McLeod

1998-01-01

225

Treatment of systemic hypertension is important for improvement of macular edema associated with retinal vein occlusion  

PubMed Central

Background We report our findings in three cases of unilateral macular edema associated with retinal vein occlusion (RVO) that improved after successful treatment of systemic hypertension alone. Methods All three cases had systemic hypertension but no diabetes mellitus or other ocular diseases associated with macular edema. All patients were treated only with medication for systemic hypertension. Optical coherence tomography was performed to determine the foveal thickness before and after treatment. Results Case one was a 72-year-old woman with a central RVO who had macular edema in her left eye and a visual acuity (VA) of 20/50. Her blood pressure (BP) was 169/96 mmHg. One month after the initiation of a calcium blocker to treat her systemic hypertension, her BP was decreased, macular edema was reduced, and her VA improved to 20/20. Case two was a 62-year-old woman with branch RVO. Her VA was 20/40 and her BP was 165/97 mmHg. Six weeks after initiation of medication to treat her systemic hypertension, her RVO-related macular edema had decreased and her VA improved to 20/20. Case three was a 71-year-old man with branch RVO. His VA was 20/50 and his BP was 165/87 mmHg. One month after initiation of treatment for systemic hypertension, his RVO-related macular edema had disappeared and his VA improved to 20/20. All three cases had nonischemic RVO by fluorescein angiography, and they did not develop ischemic changes for at least 1 year. Conclusion The reduction of macular edema following a decrease in the systemic hypertension suggests that the edema was most likely caused by leakage of fluids from the blood vessels. We recommend that the blood pressure should be measured in all patients with macular edema before initiating intravitreal anti-VEGF therapy. PMID:24876761

Kida, Teruyo; Morishita, Seita; Kakurai, Keigo; Suzuki, Hiroyuki; Oku, Hidehiro; Ikeda, Tsunehiko

2014-01-01

226

Intraocular bevacizumab for macular edema due to CRVO. A multifocal-ERG and OCT study  

Microsoft Academic Search

Purpose To evaluate by multifocal electroretinography (MFERG) and optical coherence tomography (OCT) the effectiveness of intravitreal\\u000a use of bevacizumab (Avastin) in the treatment of macular edema due to central retinal vein occlusion (CRVO). Methods A total of 10 eyes of 10 patients (six males and four females) with macular edema due to CRVO were studied before and after\\u000a intravitreal use

Marilita M. Moschos; Michael Moschos

2008-01-01

227

Pott's Spine with Bilateral Psoas Abscesses  

PubMed Central

A high degree of suspicion and appropriate imaging studies are required for the early diagnosis of Pott's spine. We describe a 4-year-old boy with Pott's disease of the lumbar spine with bilateral psoas abscesses. The child responded to conservative treatment with antituberculous treatment and ultrasonographically guided percutaneous drainage of the abscesses. PMID:23259114

Masavkar, Sanjeevani; Shanbag, Preeti; Inamdar, Prithi

2012-01-01

228

Fuzzy preferences in bilateral negotiation support systems  

Microsoft Academic Search

The paper presents a bilateral negotiation support system (NSS) based on a multi-attribute utility model that adapts a fuzzy set methodology in determining user's preference functions. The system can concurrently handle negotiations that span across multiple mediating issues in a manner that increases the joint utility of both parties. The NSS is expected to impart a more interactive and realistic

Tung Bui; Taracad Sivasankaran

1991-01-01

229

Silicosis presenting as bilateral hilar lymphadenopathy.  

PubMed Central

Classical radiographic features of patients presenting with silicosis are diffuse interstitial shadowing with subsequent enlargement of hilar nodes, sometimes with "eggshell" calcification. Five case histories are described of workers who were exposed to silica and presented initially with bilateral hilar lymphadenopathy without radiographic evidence of interstitial lung disease. One case progressed to show features of silicosis. Images PMID:8958905

Baldwin, D R; Lambert, L; Pantin, C F; Prowse, K; Cole, R B

1996-01-01

230

Bilateral pulmonary nodules caused by Dirofilaria immitis.  

PubMed

The unusual case of bilateral lung nodules caused by Dirofilaria immitis in a 44-year-old woman is presented. A brief discussion of the life cycle of this parasite, the clinical and epidemiological features of human infestation, and the roentgenographic and laboratory findings is given. PMID:2383125

Bradham, R R; Locklair, P R; Grimball, A

1990-08-01

231

Bilateral noncontemporary hip fractures. 31 cases reported  

Microsoft Academic Search

Hip fractures are one of the leading causes of morbidity and mortality among the elderly. Hip fracture is usually due to the combination of an acute event (a fall) with a chronic condition like osteoporosis. The literature is not very informative on the incidence of bilateral hip fracture. To investigate the consequences of the later fracture, we studied 31 patients

L. Galois; Y. Dausse; D. Mainard; J. P Delagoutte

2001-01-01

232

Bilateral subclavian steal syndrome with vertigo.  

PubMed

Subclavian steal syndrome (SSS) is usually caused by unilateral subclavian artery (SA) occlusion, and bilateral SSS is very rare. Takayasu's arteritis (TA) is a chronic granulomatous form of vasculitis that affects the SA, most commonly in women aged 15-40 years. We report a rare case of bilateral SSS due to TA in a 52-year-old woman, who exhibited severe vertigo. Although her blood pressure was within the normal range and did not differ between her arms, Doppler ultrasonography revealed low antegrade blood flow in the right SA and retrograde flow in the left SA. Computed tomography angiography demonstrated complete obstruction of the bilateral SA proximal to the vertebral artery origin. The more marked decrease in the blood flow of the vertebrobasilar artery experienced in bilateral SSS compared with unilateral SSS is considered to have caused the severe rotatory vertigo in the present patient. Since the vascular conditions of TA progressively deteriorate, delayed diagnosis and treatment could result in poor outcomes and unfavorable prognosis. We suggest that SSS with TA might require an early detection and treatment as well as careful follow-up for preventing vertigo and other neurological deficits in the vertebrobasilar arterial region. PMID:24206829

Yamanaka, Toshiaki; Sawai, Yachiyo; Hosoi, Hiroshi

2014-06-01

233

Achieving Bilateralism in Electroheat Stability Evaluations  

Microsoft Academic Search

The stability criteria for controlled electroheat processes, i.e., plastic extruders, arc furnaces, induction furnaces, plasma torches, fluidized beds, etc., is studied. A previous geometric approach was unilateral, in that stability criteria could be evaluated if the electroheat gain and the controller sensitivity were known, but the reverse procedure was not possible. Subsequent experience has shown that this lack of bilateralism

William K. Roots; Cheng-Mieng Wu

1969-01-01

234

Domestic Content Requirements with Bilateral Monopoly  

Microsoft Academic Search

This short paper models physical content policies in a bilateral monopoly setting using a cooperative game approach. For just binding or nonbinding content requirements, the policy does not induce any deadweight loss but alters the profit distribution in favor of the domestic supplier. This result holds as long as the inputs concerned by the policy are good substitutes in production,

John C Beghin; Daniel A Sumner

1992-01-01

235

"Ostrich sign" indicates bilateral vertebral artery dissection.  

PubMed

Vertebral artery dissections (VADs) comprise about 2% of ischemic strokes and can be associated with trauma, chiropractic manipulation, motor vehicle collisions, whiplash, amusement park rides, golfing, and other motion-induced injuries to the neck. We present a case of bilateral extracranial VAD as a complication of conducting an orchestra. To our knowledge, this has not been documented in the literature. Conceivably, vigorous neck twisting in an inexperienced, amateur conductor may place excessive rotational forces upon mobile portions of the verterbral arteries, tear the intima, deposit subintimal blood that extends longitudinally, and cause neck pain and/or posterior fossa ischemic symptoms. Magnetic resonance angiography examinations of axially oriented slices of bilateral VADs resemble the face of an ostrich. This observation is similar to the "puppy sign," in which bilateral internal carotid artery dissections resemble the face of a dog. Craniocervical dissections of either the carotid or vertebral arteries have the potential to form an aneurysm, cause artery-to-artery embolism, or completely occlude the parent artery, resulting in an ischemic stroke. Because bilateral VADs in axial magnetic resonance angiographic sections stand out like the eyes of an ostrich, and because the fast identification of VADs is so critical, we eponymize this image the "ostrich sign." PMID:21440457

Rose, David Z; Husain, M Rizwan

2012-11-01

236

[Borrelia burgdorferi infection with bilateral optic neuritis and intracerebral demyelinization lesions].  

PubMed

In September, 1987, the authors saw a 25-year-old female patient with retinal perivasculitis, cystoid macular edema and papilledema in her right eye. The left eye was normal. Visual acuity was 0.2 (OD), 1.2 (OS). After conventional infections had been ruled out systemic methylprednisolone therapy was instituted, but the patient's condition deteriorated. In May 1988 she presented with papilledema and a "neuroretinitis"-like finding in her left eye; in her right eye advanced optic nerve atrophy; visual acuity was 0.1 (OD) and 0.07 (OS). The laboratory workup revealed an acute phase of a chronic Borrelia burgdorferi infection, with total immunoglobulins (immunofluorescence test) of 1:1280 and an IgM of 1:650 (normal ranges: total Ig up to 1.80, IgM up to 1:40). MRI showed multiple paraventricular and subcortical demyelinating lesions. However, the cranial CT scan was normal. After 14 days' treatment with doxycycline 200 mg/d, visual fields and acuity improved to sc 0.2 (OD) and sc 0.1 (OS) (July, 1988). This case of intracranial demyelinizating lesions associated with bilateral optic neuritis in a serologically determined Borrelia burgdorferi infection is the first of its kind described in the literature. PMID:2796241

Bialasiewicz, A A; Huk, W; Druschky, K F; Naumann, G O

1989-08-01

237

The choriocapillaris in the macular area. Clinical and angiographic study.  

PubMed

Fluorescein fundus angiographies performed with the Cannon wide-angle fundus camera enable a good vascular definition, which improves our knowledge of the choroidal circulation. Owing to the better quality of filters, the choroidal arteriolar network can be seen more precisely. Our recent studies have enabled us to confirm the existence of a special avascular area in the central part of the submacular choroid, surrounded by a perimacular choriocapillaris ring. In the macular area, the choriocapillaris corresponds to a thin layer which is most probably supplied by several arterioles from the short posterior ciliary arteries near their site of entry into the eyeball. As stated by Hayreh, there may be a central area where the capillary pressure, while being well balanced, is very low. PMID:6832898

Amalric, P

1983-02-01

238

Surgery for macular holes associated with unusual concomitant pathologies  

PubMed Central

Macular hole (MH) is uncommonly seen in association with retinitis pigmentosa (RP), optic disc pit or choroidal coloboma. The visual disability in eyes with RP, optic disc pit or choroidal coloboma can range from mild to severe. However, the macula may not be involved in the primary pathology and hence, the central vision may be preserved in these eyes. If a MH develops in such eyes the central vision is lost, making the patient severely vision disabled. A perceived poor prognosis in such patients may lead to no intervention. However, an attempt should be made to repair and restore the macula in these situations in order to conserve the vision and limit disability. These eyes can however pose unique surgical challenges. We report our experiences of operating on cases of MH associated with unusual concomitant pathologies such as RP, choroidal coloboma, and optic pit. The outcomes and the surgical challenges differed greatly from the conventional idiopathic MH surgery. PMID:24082671

Ratra, Dhanashree; Raval, Vishal

2013-01-01

239

Today and Future of Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of blindness in people over 50 in developed countries. Understanding of the pathologic process, genetic mechanisms, and risk factors of this disease has the benefit of seeking newer and more effective treatment options. Current clinical therapy for AMD shows a dramatic change from a decade ago. Anti-VEGF drug therapy is regarded as the more effective treatment for neovascular AMD now, especially combining PDT therapy. In the future, the genetic and biochemical therapies may be the promising treatments for AMD. This paper will focus on the progress of pathology, candidate genes of AMD, risk factors, and the existing drugs or surgical therapies available, in order to present some new directions of care with the prospect of improved vision in many patients suffered from AMD. PMID:24558588

Liu, Kang; Xie, Bolin

2012-01-01

240

Molecular pathology of age-related macular degeneration  

PubMed Central

Age-related macular degeneration (AMD) is a leading cause of irreversible blindness in the world. Although the etiology and pathogenesis of AMD remain largely unclear, a complex interaction of genetic and environmental factors is thought to exist. AMD pathology is characterized by degeneration involving the retinal photoreceptors, retinal pigment epithelium, and Bruch’s membrane, as well as, in some cases, alterations in choroidal capillaries. Recent research on the genetic and molecular underpinnings of AMD brings to light several basic molecular pathways and pathophysiological processes that might mediate AMD risk, progression, and/or response to therapy. This review summarizes, in detail, the molecular pathological findings in both humans and animal models, including genetic variations in CFH, CX3CR1, and ARMS2/HtrA1, as well as the role of numerous molecules implicated in inflammation, apoptosis, cholesterol trafficking, angiogenesis, and oxidative stress. PMID:19026761

Ding, Xiaoyan; Patel, Mrinali; Chan, Chi-Chao

2009-01-01

241

Studying Age-Related Macular Degeneration Using Animal Models  

PubMed Central

ABSTRACT Over the recent years, there have been tremendous advances in our understanding of the genetic and environmental factors associated with the development of age-related macular degeneration (AMD). Examination of retinal changes in various animals has aided our understanding of the pathogenesis of the disease. Notably, mouse strains, carrying genetic anomalies similar to those affecting humans, have provided a foundation for understanding how various genetic risk factors affect retinal integrity. However, to date, no single mouse strain that develops all the features of AMD in a progressive age-related manner has been identified. In addition, a mutation present in some background strains has clouded the interpretation of retinal phenotypes in many mouse strains. The aim of this perspective was to describe how animals can be used to understand the significance of each sign of AMD, as well as key genetic risk factors. PMID:24978866

Fletcher, Erica L.; Jobling, Andrew I.; Greferath, Ursula; Mills, Samuel A.; Waugh, Michelle; Ho, Tracy; de Iongh, Robb U.; Phipps, Joanna A.; Vessey, Kirstan A.

2014-01-01

242

Next generation therapeutic solutions for age-related macular degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the primary cause of blindness among the elderly worldwide. To date, no cure is available, and the available palliative treatments only showed limited efficacy in improving visual acuity. The etiology of AMD remains elusive but research over the past decade has uncovered characteristic features of the disease. Known as the hallmarks of AMD, these features include (A) oxidative stress and RPE cytotoxicity; (B) loss of macromolecular permeability and hydraulic conductivity: (C) inflammation; (D) choroidal neovascularization and vascular leakage; and (E) loss of neuroprotection. Recent breakthrough in understanding the pathogenesis of AMD has spawned an array of novel therapeutic agents designed to address these hallmarks. Here we review the features of AMD and highlight the most promising therapeutic and diagnostic approaches based on the patents published from 2008 to 2011. Most likely, a next generation treatment for AMD will be developed from these emerging efforts. PMID:24040506

Cunnsamy, Khrishen; Ufret-Vincenty, Rafael; Wang, Shusheng

2013-01-01

243

Managing diabetic macular edema: The leading cause of diabetes blindness  

PubMed Central

Diabetic macular edema (DME) is the leading cause of blindness in young adults in developed countries, affecting 12% of type 1 and 28% of type 2 diabetic patients. The gold standard DME treatment should be based on a good control of glycemia along with control of lipids and renal function. However, despite the systemic metabolic control values being essential for patients with diabetic retinopathy (DR), it has proven to be insufficient for DME if it appears. With these patients, additional measures are needed in order to avoid the subsequent loss of vision. While laser treatment of DME has been the only valid treatment so far, it has been inadequate in chronic cases. The introduction of new treatments, such as intravitreal corticosteroids or anti-VEGF drugs, have recently shown their safety and efficacy and together with laser photocoagulation are becoming the treatments of choice in the management of DME. PMID:21860693

Romero-Aroca, Pedro

2011-01-01

244

Macular Hole Formation in Rhegmatogenous Retinal Detachment after Scleral Buckling  

PubMed Central

Purpose To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) after scleral buckling (SB) based on optical coherence tomography (OCT) findings. Methods The medical records and spectral domain OCT images of patients in whom MH developed after RRD repair were evaluated retrospectively. Results A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preserved photoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outer retinal tissues disappeared, resulting in the full-thickness MH. Conclusions Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thickness MHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial cone in the fovea. PMID:25276077

Byon, Ik Soo; Kwon, Han Jo; Park, Gun Hyung; Park, Sung Who

2014-01-01

245

Three-dimensional foveal shape changes after asymptomatic macular posterior vitreous detachment  

PubMed Central

Purpose To show a case in which the shape of the fovea changed after an asymptomatic macular posterior vitreous detachment (PVD). Methods The foveal shape was determined from the spectral-domain optical coherence tomography (OCT) images before and after a spontaneous macular PVD. Results A 66-year-old man with a unilateral macular hole in the right eye presented with a perifoveal PVD in the asymptomatic left eye. One year later, the left eye developed a macular PVD, and OCT measurements showed a 16.7% decrease in the central foveal thickness, and increases in the pit depth by 20.5%, foveola diameter by 14.7%, and pit volume by 19.4%. The thicknesses of the macular subfields of the Early Treatment Diabetic Retinopathy Study were decreased by 13.0% in the central subfield and by 1.4%–6.6% in the other subfields. Conclusion The deepening and widening of the fovea after a macular PVD indicate that a PVD can alter the shape of the fovea. PMID:23626460

Kumagai, Kazuyuki; Hangai, Masanori; Furukawa, Mariko; Larson, Eric; Ogino, Nobuchika

2013-01-01

246

Aqueous flare and inflammatory factors in macular edema with central retinal vein occlusion: a case series  

PubMed Central

Background The association of inflammatory factors and the aqueous flare value with macular edema in central retinal vein occlusion (CRVO) patients remains unclear. We investigated the relations between the aqueous flare value and vitreous levels of vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), and interleukin-6 (IL-6) in patients with CRVO and macular edema or patients with idiopathic macular hole (MH). Methods In 38 patients who underwent unilateral vitrectomy (21 CRVO patients and 17 MH patients), vitreous samples were obtained during vitrectomy to measure VEGF, sICAM-1, and IL-6. Retinal ischemia was evaluated from capillary non-perfusion on fluorescein angiography, and the CRVO patients were classified into nonischemic or ischemic groups. Aqueous flare values were measured with a laser flare meter and macular edema was examined by optical coherence tomography. Results The median aqueous flare value increased significantly across the three groups (MH group?macular edema in the CRVO group. Conclusions Inflammation and/or ischemia may increase vascular permeability and disrupt the blood-aqueous barrier by increasing levels of inflammatory factors in patients with CRVO and macular edema. PMID:24325604

2013-01-01

247

Bilateral Synergy: A Framework for Post-Stroke Rehabilitation  

PubMed Central

Background Unilateral stroke produces debilitating deficits in voluntary control in the contralesional arm, and significant motor coordination deficits in the ipsilesional arm. In addition, patients tend to avoid bilateral arm patterns and during performance of activities of daily living. Nevertheless, upper extremity physical rehabilitation predominantly focuses on motor training activities with only the paretic arm. This can be limiting because of persistent deficits in the ipsilesional arm, and because of the tendency of patients to avoid spontaneous bilateral arm patterns. Proposition Rehabilitation should focus on bilateral training to advance recovery of function in both arms of stroke patients, as well as to facilitate spontaneous bilateral arm use. This paper reviews the rationale for this approach, citing evidence for significant hemisphere specific bilateral motor deficits in stroke patients, which affect both the contralesional and the ipsilesional arm. The rationale for, and advantages of, training both arms simultaneously through bilateral tasks is reviewed. Although bilateral training has been employed to treat stroke patients previously, this has tended to focus on bimanual ‘coupling’ as a rationale for performing parallel, but not cooperative bilateral tasks. Bilateral synergy provides a more functional framework for structuring post-stroke upper extremity rehabilitation. Conclusion Bilateral synergy may be causally linked to spontaneous bilateral arm use, suggesting that rehabilitation should be focused on bilateral cooperative tasks, such as bilateral object transport. Further research is required to determine whether this approach could be efficacious for patients with hemiparesis, and whether both left and right hemisphere strokes can benefit from such intervention. PMID:24729985

Sainburg, RL; Good, D; Przybyla, A

2014-01-01

248

Fundus autofluorescence imaging of patients with idiopathic macular hole  

PubMed Central

AIM To investigate the role of fundus autofluorescence (FAF) both in the diagnosis and the preoperative and postoperative evaluation of patients with idiopathic macular hole (MH). METHODS Forty eyes of 40 patients diagnosed as idiopathic MH between May 2010 and May 2011 were included in this retrospective study. All patients underwent full ophthalmologic examinations and imagings including fluorescein angiography, fundus autofluorescence (FAF) and optical coherence tomography. Thirty of these patients underwent MH surgery. FAF findings were associated with duration of symptoms, visual acuity at presentation, stage of MH, and postoperative anatomical correction. RESULTS The mean duration of patients' symptoms was 3.8±2.0 (1–9) months. The MH was stage 2 in 4 (10%), stage 3 in 24 (60%) and stage 4 in 12 (30%) eyes. The median preoperative best corrected visual acuity was 20/200 (between 20/800 and 20/100). Twenty-eight of cases (70%) showed a stellate appearance with dark radiating striae. Having a visual acuity ?20/200 was significantly more common in eyes with stellate appearance (P<0.001). The mean duration of symptoms was significantly shorter in eyes with stellate appearance (2.75±0.8 vs 6.33±1.61 months) (P<0.001). The frequency of stage 4 MH was significantly higher in eyes with non-stellate appearance (P<0.001). Anatomical correction of MH was achieved in 91.3% (21/23) of eyes with stellate appearance and 71.4% (5/7) of eyes without this appearance (P=0.225). CONCLUSION Stellate appearance in FAF is associated with earlier stages of macular hole, better visual acuity at presentation, shorter duration of symptoms, thus more favorable prognosis. PMID:24195050

Teke, Mehmet Yasin; Cakar-Ozdal, Pinar; Sen, Emine; Elgin, Ufuk; Nalcac?oglu-Yuksekkaya, Pinar; Ozturk, Faruk

2013-01-01

249

Cost-Effectiveness of Treatment of Diabetic Macular Edema  

PubMed Central

Background Macular edema is the most common cause of visual loss among patients with diabetes. Objective To determine the cost-effectiveness of different treatments of diabetic macular edema (DME). Design Markov model. Data Sources Published literature and expert opinion. Target Population Patients with clinically significant DME. Time Horizon Lifetime. Perspective Societal. Intervention Laser treatment, intraocular injections of triamcinolone or a vascular endothelial growth factor (VEGF) inhibitor, or a combination of both. Outcome Measures Discounted costs, gains in quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). Results of Base-Case Analysis All treatments except laser monotherapy substantially reduced costs, and all treatments except triamcinolone monotherapy increased QALYs. Laser treatment plus a VEGF inhibitor achieved the greatest benefit, gaining 0.56 QALYs at a cost of $6975 for an ICER of $12 410 per QALY compared with laser treatment plus triamcinolone. Monotherapy with a VEGF inhibitor achieved similar outcomes to combination therapy with laser treatment plus a VEGF inhibitor. Laser monotherapy and triamcinolone monotherapy were less effective and more costly than combination therapy. Results of Sensitivity Analysis VEGF inhibitor monotherapy was sometimes preferred over laser treatment plus a VEGF inhibitor, depending on the reduction in quality of life with loss of visual acuity. When the VEGF inhibitor bevacizumab was as effective as ranibizumab, it was preferable to because of its lower cost. Limitation Long-term outcome data for treated and untreated diseases are limited. Conclusion The most effective treatment of DME is VEGF inhibitor injections with or without laser treatment. This therapy compares favorably with cost-effective interventions for other conditions. Primary Funding Source Agency for Healthcare Research and Quality. PMID:24573663

Pershing, Suzann; Enns, Eva A.; Matesic, Brian; Owens, Douglas K.; Goldhaber-Fiebert, Jeremy D.

2014-01-01

250

[Modern aspects of diabetic retinopathy and diabetic macular oedema treatment].  

PubMed

Main reasons of eyesight deterioration in diabetic patients are diabetic retinopathy (DR) and diabetic macular oedema (DMO). International multicenter studies have shown that retinal laser coagulation in the event of DMO decreases the risk of eyesight loss in 50%, though only in 16% patients it was also possible to improve their eyesight. Use of vascular endothelial growth factor inhibitor--Ranibizumab--have opened a new era in DMA treatment. It's efficacy and safety have been proven in several international studies. This article contains our own data upon the use of Lucentis in patients with DMO. Intravitreal Luzentis injections and subsequent retinal lasercoagulation in the macular zone were performed on 43 eyes; follow up period--6 months. Additional injections were required in 19 cases, average amount of injections--1,4. Mean corrected visual acuity before the treatment was 0,37 +/- 0,06, after 7 days, 1, 3 and 6 months. - respectively 0,41 +/- 0,06, 0,49 +/- 0,06, 0,51 +/- 0,07 and 0,52 +/- 0,07(p<0,05). Mean retina thickness in central zone was 428 +/- 125 mkm before treatment, 391 +/- 24 mkm 7 days after the last injection 349 +/- 23, 313 +/- 21 and 308 +/- 20 mkm (p<0,05) after 1, 3 and 6 months. In addition to that Luzentis use in preoperative period in patients with non-complicated proliferative DR allowed to decrease the risk of hemorrhagic complications. Thereby, intravitreal injections of Luzentis improve functional result of treatment of patients with DMO, increase efficacy and safety of surgical interventions in patients with complicated forms of proliferating DR. PMID:22550713

Neroev, V V

2012-01-01

251

The Relationship of Dietary ?-3 Long-Chain Polyunsaturated Fatty Acid Intake With Incident Age-Related Macular Degeneration AREDS Report No. 23  

PubMed Central

Objective To examine the association of dietary ?-3 long-chain polyunsaturated fatty acid and fish intake with incident neovascular age-related macular degeneration (AMD) and central geographic atrophy (CGA). Methods Multicenter clinic-based prospective cohort study from a clinical trial including Age-Related Eye Disease Study (AREDS) participants with bilateral drusen at enrollment. Main outcome measures were incident neovascular AMD and CGA, ascertained from annual stereoscopic color fundus photographs (median follow-up, 6.3 years). We estimated nutrient and food intake from a validated food frequency questionnaire (FFQ) at baseline, with intake of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), combined EPA and DHA, and fish as primary exposures. Results After controlling for known covariates, we observed a reduced likelihood of progression from bilateral drusen to CGA among people who reported the highest levels of EPA (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.23-0.87) and EPA+DHA (OR, 0.45; 95% CI, 0.23-0.90) consumption. Levels of DHA were associated with CGA in age-, sex-, and calorie-adjusted models (OR, 0.51; 95% CI, 0.26-1.00); however, this statistical relationship did not persist in multivariable models. Conclusions Dietary lipid intake is a modifiable factor that may influence the likelihood of developing sight-threatening forms of AMD. Our findings suggest that dietary ?-3 long-chain polyunsaturated fatty acid intake is associated with a decreased risk of progression from bilateral drusen to CGA. PMID:18779490

SanGiovanni, John Paul; Chew, Emily Y.; Agron, Elvira; Clemons, Traci E.; Ferris, Frederick L.; Gensler, Gary; Lindblad, Anne S.; Milton, Roy C.; Seddon, Johanna M.; Klein, Ronald; Sperduto, Robert D.

2009-01-01

252

Chromatin and transcriptional regulators act in a cascade to establish a bilateral asymmetry of the C. elegans nervous system  

E-print Network

Neuroanatomical bilateral asymmetry is a widespread feature in both vertebrates and invertebrates. Although mostly bilaterally symmetric, the nervous system of Caenorhabditis elegans displays bilateral asymmetry. Bilateral ...

Nakano, Shunji, Ph. D. Massachusetts Institute of Technology

2011-01-01

253

[Bilateral tumor of the nasal vestibule--a case report].  

PubMed

The authors report a case of a bilateral tumor of the nasal vestibule with a six-year history of progressive impairment of nasal breathing. After microsurgical transnasal excision, the finding was diagnosed as bilateral nasolabial cyst. PMID:16586277

Schütz, A G; Hermanns-Sachweh, B; Westhofen, M; Di Martino, E

2006-10-01

254

Mutations in the VMD2 gene are associated with juvenile-onset vitelliform macular dystrophy (Best disease) and adult vitelliform macular dystrophy but not age-related macular degeneration  

Microsoft Academic Search

Recently, the VMD2 gene has been identified as the causative gene in juvenile-onset vitelliform macular dystrophy (Best disease), a central retinopathy primarily characterised by an impaired function of the retinal pigment epithelium. In this study we have further characterised the spectrum of VMD2 mutations in a series of 41 unrelated Best disease patients. Furthermore we expanded our analysis to include

Franziska Krämer; Karen White; Daniel Pauleikhoff; Andrea Gehrig; Lori Passmore; Andrea Rivera; Günther Rudolph; Ulrich Kellner; Monika Andrassi; Birgit Lorenz; Klaus Rohrschneider; Anita Blankenagel; Bernhard Jurklies; Harald Schilling; Florian Schütt; Frank G Holz; Bernhard HF Weber

2000-01-01

255

Macular Edema After Cataract Surgery In Eyes Without Pre-operative Central-involved Diabetic Macular Edema  

PubMed Central

Objective To estimate the incidence of central-involved macular edema (ME)16 weeks following cataract surgery in eyes with diabetic retinopathy (DR) without definite central-involved diabetic macular edema (DME) preoperatively. Methods In a multicenter, prospective, observational study, participants (N = 293) with DR without definite OCT central subfield (CSF) thickening underwent cataract surgery. The primary outcome was development of central-involved ME defined as; (1) OCT CSF thickness ? 250?m (time domain) or ? 310?m (spectral domain) with ?1 step increase in logOCT CSF thickness pre-operative to the 16-week visit; (2) ?2-step increase in logOCT CSF pre-operative to 16-week visit; or (3) non-topical treatment for ME received before the 16-week visit with either of the OCT criteria met at the time of treatment. Results Median participant age was 64 years with median visual acuity letter score of 69 (Snellen equivalent 20/40). Forty-four percent of eyes had history of prior treatment for DME. Sixteen weeks postoperatively, central-involved ME was noted in 0% (95%CI: 0-20%) of 17 eyes with no pre-operative DME. Of eyes with non-central involved DME, 10% (95%CI: 5-18%) of 97 eyes without central involved DME and 12% (95%CI: 7-19%) of 147 eyes with possible central involved DME at baseline progressed to central-involved ME. History of DME treatment was significantly associated with central-involved ME development (P<0.001). Conclusion In eyes with DR without concurrent central-involved DME, presence of non-central DME immediately prior to cataract surgery, or history of DME treatment, may increase risk of developing central-involved ME 16 weeks after cataract extraction. PMID:23599174

Baker, Carl W.; Almukhtar, Talat; Bressler, Neil M.; Glassman, Adam R.; Grover, Sandeep; Kim, Stephen J.; Murtha, Timothy J.; Rauser, Michael E.; Stockdale, Cynthia

2014-01-01

256

[Bilateral testicular metastasis of cancer of the prostate].  

PubMed

Testicular metastasis of prostate cancer rarely occurs. Bilateral localization is exceptional. We report a new case of prostate adenocarcinoma with bilateral testicular metastasis. The diagnosis was made on clinical and ultrasonic arguments, and confirmed on the pathological specimen. Treatment consisted in a bilateral orchidectomy, associated with nonsteroid androgens. PMID:9765784

el Moussaoui, A; Sarf, I; Dakir, M; Zamiati, S; Benjelloun, S

1997-01-01

257

Morphoimmunohistochemical characteristics of synchronous bilateral breast cancer.  

PubMed

We performed a complex morphoimmunohistochemical study of synchronous bilateral breast cancer (diagnosed in 0.69% cases in women of the postproductive period after the age of 50). The molecular genetic characteristics of this cancer were detected and the algorithm of diagnostic studies was suggested. We have demonstrated that bilateral breast cancer was in 75% cases estrogen- and progesterone-positive, but androgen-negative. The HER-2/neu status of the tumor was negative in 75% cases, but expression of HER-2/neu was detected in the tumor of one mammary gland in 20% cases. Membrane expression of E-cadherin in infiltrative ductal cancer cells significantly decreased up to its complete disappearance with the decrease in tumor cell differentiation degree. The data provide new insight into prognostic value of the studied biomarkers and help to develop treatment protocol with consideration for the molecular biology of this group of tumors. PMID:25257431

Todorov, S S; Kit, O I; Bosenko, E S; Kas'yanenko, V N; Lushnikova, E L; Nepomnyashchikh, L M

2014-09-01

258

Presumed bilateral occipital neurosarcoidosis. A case report.  

PubMed

A 37-year-old man with a history of sarcoidosis, hypertension, asthma, depression and prior intravenous drug use presented with complaints of difficulty in finding his way around the house, headache, and blurred vision in both eyes. The symptoms had been increasing in severity over the prior several months. Physical examination showed normal visual acuity, pupil reactions, and fundi but severe, circumferential constriction of the visual fields bilaterally. The visual fields enlarged appropriately on increasing the distance from the patient to the tangent screen. Neuroimaging revealed bilateral, occipital meningeal involvement and parenchymal lesions consistent with sarcoidosis. Treatment with oral corticosteroids produced a mild subjective improvement in the patient's symptoms and stabilized the visual fields, without improving them. This case represents an unusual presentation of presumed neurosarcoidosis involving the visual pathways at the level of the occipital lobes. PMID:9532537

Givre, S J; Mindel, J S

1998-03-01

259

Bilateral Breast Masses with a Rare Etiology  

PubMed Central

Breast masses have a variety of benign and malignant etiologies. We present the case of a 28-year-old woman with bilateral large painful breast masses that developed rapidly in the three weeks before first presentation. Further investigation revealed bilateral ovarian masses. Biopsies of both ovarian masses were taken, and the pathology reported Burkitt's lymphoma. Additional staging with a PET scan was suggestive of bone marrow involvement, but bone marrow biopsy was negative. Examination of the cerebrospinal fluid did not identify malignant cells. The patient underwent CODOX-M/IVAC chemotherapy, and a complete response was demonstrated after one cycle of treatment. Six months after finishing chemotherapy the patient remained in complete remission. To our knowledge this is the first case reporting simultaneous involvement of breast, ovaries, and bones in Burkitt's lymphoma. Gynecologists and oncologists should be aware of this pattern. Polychemotherapy treatment must be initiated rapidly with curative intent. PMID:24066248

Sartorius, Gideon; Kalf, Katrin; Heinzelmann, Viola

2013-01-01

260

Bilateral Pneumothoraces Following Central Venous Cannulation  

PubMed Central

We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital “Buffalo chests” explaining bilateral pneumothoraces and a secondary tension pneumothorax. PMID:19901997

Pazos, F.; Masterson, K.; Inan, C.; Robert, J.; Walder, B.

2009-01-01

261

[Bilateral carpal tunnel syndrome with familial accumulation].  

PubMed

We report on a six-year-old girl with bilateral carpal tunnel syndrome with familial accumulation. Parents and one grandmother had positive history for CTS, treated by surgical decompression. Following neurologic and radiologic evaluation and after failed conservative treatment in a plaster cast, open carpal tunnel release was performed in a two-stage procedure. Postoperatively symptoms diminished and now six months after surgery, all complaints disappeared completely. PMID:15997428

Moser, V L; Krimmer, H; Lanz, U

2005-06-01

262

Bilateral Filtering for Gray and Color Images  

Microsoft Academic Search

Proceedings of the 1998IEEE InternationalConference on Computer Vision, Bombay,IndiaBilateral filtering smooths images while preservingedges, by means of a nonlinear combination of nearbyimage values. The method is noniterative, local, and simple.It combines gray levels or colors based on both theirgeometric closeness and their photometric similarity, andprefers near values to distant values in both domain andrange. In contrast with filters that operate

Carlo Tomasi; Roberto Manduchi

1998-01-01

263

Bilateral Pregnancy Luteoma: A Case Report  

PubMed Central

Pregnancy luteoma is a non-neoplastic lesion of the ovary occurring during pregnancy and is usually discovered incidentally at the time of a cesarean section or during postpartum tubal ligation. An accurate diagnosis is important for the mother and the fetus as it can be confused with ovarian malignancy leading to unnecessary surgery. We report a case of a pregnant female who was discovered to have bilateral enlarged ovaries at the time of emergency cesarean section. PMID:25337317

Nanda, Annu; Gokhale, Uday A.; Pillai, G Rajasekharan

2014-01-01

264

Coping with systematic bias during bilateral movement  

Microsoft Academic Search

The present studies examined the nature of kinematic interlimb interference during bilateral elbow movements of 1:1, 2:1 and 3:1 frequency ratios and the manner in which subjects cope with coordination bias. Analysis of movement trajectories in the first experiment indicated progressively greater angular velocity assimilation across 2:1 and 3:1 conditions. The desired temporal relationship was maintained by slowing or pausing

Charles B. Walter; Stephan P. Swinnen; Daniel M. Corcos; Elisana Pollaton; Hong-Yan Pan

1997-01-01

265

Bilateral piriformis syndrome after total hip arthroplasty  

Microsoft Academic Search

We present the case of a 39-year-old man with bilateral piriformis syndrome 4 and 6 years after two cementless total hip\\u000a arthroplasties, respectively. During surgical exploration, each sciatic nerve was found to be entrapped by a tense piriformis\\u000a muscle and hypertrophic posterior hip capsule. The sciatic-type pain was relieved after sectioning each piriformis muscle\\u000a with external neurolysis. This is the

Y. Uchio; U. Nishikawa; M. Ochi; N. Shu; K. Takata

1998-01-01

266

Unilateral headache with bilateral internal ophthalmoplegia.  

PubMed

We describe the case of a young woman suffering from migraine. After some years, the headache started to be accompanied by internal ophthalmoplegia. Mydriasis was unilateral and after a few months became bilateral. The ophthalmoplegic migraine is a rare type of headache and it is characterized by paresis of one or more of the third, fourth or sixth cranial nerves. Migraine attacks associated with mydriasis (internal ophthalmoplegia) are extremely rare. Triptan therapy resolved mydriasis, but not the headache. PMID:22183266

Simonetto, Marco; Zanet, Luca; Capozzoli, Francesca; Gelli, Andrea; Masè, Giovanni

2012-10-01

267

Acute bilateral spontaneous forearm compartment syndrome.  

PubMed

Acute spontaneous compartment syndrome of the forearm is rarely reported in the literature. It is typically associated with trauma or thromboembolism in the acute setting and repetitive exertional stress in the chronic setting. However it is rare for it to present bilaterally with no apparent underlying cause. We report the case of a young 31-year-old lady who presented to our Emergency Department with bilateral compartment syndrome of the forearm. Her presenting complaints included acute severe pain and swelling of the forearms bilaterally, with a decreased range of movement of the wrist and fingers. She also complained of numbness in all fingers. She had no history of recent trauma and ultrasound scans showed no evidence of vascular compromise. Past medical history was notable only for idiopathic hypertension and coeliac disease. The patient was taken to theatre urgently where flexor and extensor compartments and carpal tunnel were decompressed. Pronator Teres was found to be dusky initially but turned pink after decompression. All other muscles were normal. An interesting fact of this case was that combination of the high compartment pressures and anaesthetic related hypotension caused the forearm pulses to become impalpable at induction, these returned intra-operatively. The patient has been seen in the outpatient department following discharge. She is well apart from some mildly reduced grip strength in her right hand likely due to carpal tunnel decompression. No cause was found for the scenario after extensive medical investigation. PMID:24641749

Dalton, David M; Munigangaiah, Sudarshan; Subramaniam, Tava; McCabe, John P

2014-01-01

268

Bilateral stenting methods for hilar biliary obstructions  

PubMed Central

OBJECTIVE: There is no consensus regarding the most appropriate methods (i.e., the side-by-side versus the stent-in-stent technique) for placing bilateral stents for malignant hilar biliary obstructions. We aimed to perform a quantitative review of the published data regarding the clinical efficacy of the side-by-side and stent-in-stent bilateral drainage techniques for hilar biliary obstructions. METHODS: A comprehensive search of several databases was conducted and a fixed-effects or random-effects model was used to pool the data from all of the study end-points. RESULTS: Four clinical trials were identified. A comparison of the side-by-side and stent-in-stent groups revealed no significant differences with respect to the rates of successful placement, successful drainage, early complications, late complications and stent occlusions. There were also no significant inter-group differences in stent patency and patient survival and no publication bias was observed. CONCLUSIONS: The performance of the side-by-side technique appears to be similar to that of the stent-in-stent technique for bilateral drainage in patients with malignant hilar biliary obstructions. PMID:25318098

Hong, Wandong; Chen, Shanxi; Zhu, Qihuai; Chen, Huichun; Pan, Jingye; Huang, Qingke

2014-01-01

269

High Performance, Three-Dimensional Bilateral Filtering  

SciTech Connect

Image smoothing is a fundamental operation in computer vision and image processing. This work has two main thrusts: (1) implementation of a bilateral filter suitable for use in smoothing, or denoising, 3D volumetric data; (2) implementation of the 3D bilateral filter in three different parallelization models, along with parallel performance studies on two modern HPC architectures. Our bilateral filter formulation is based upon the work of Tomasi [11], but extended to 3D for use on volumetric data. Our three parallel implementations use POSIX threads, the Message Passing Interface (MPI), and Unified Parallel C (UPC), a Partitioned Global Address Space (PGAS) language. Our parallel performance studies, which were conducted on a Cray XT4 supercomputer and aquad-socket, quad-core Opteron workstation, show our algorithm to have near-perfect scalability up to 120 processors. Parallel algorithms, such as the one we present here, will have an increasingly important role for use in production visual analysis systems as the underlying computational platforms transition from single- to multi-core architectures in the future.

Bethel, E. Wes

2008-06-05

270

Bilateral limbic system destruction in man  

PubMed Central

We report here a case study of a rare neurological patient with bilateral brain damage encompassing a substantial portion of the so-called “limbic system.” The patient, Roger, has been studied in our laboratory for over 14 years and the current article presents his complete neuroanatomical and neuropsychological profiles. The brain damage occurred in 1980 following an episode of herpes simplex encephalitis. The amount of destroyed neural tissue is extensive and includes bilateral damage to core limbic and paralimbic regions, including the hippocampus, amygdala, parahippocampal gyrus, temporal poles, orbitofrontal cortex, basal forebrain, anterior cingulate cortex, and insular cortex. The right hemisphere is more extensively affected than the left, although the lesions are largely bilateral. Despite the magnitude of his brain damage, Roger has a normal IQ, average to above average attention, working memory, and executive functioning skills, and very good speech and language abilities. In fact, his only obvious presenting deficits are a dense global amnesia and a severe anosmia and ageusia. Roger's case presents a rare opportunity to advance our understanding of the critical functions underlying the human limbic system, and the neuropsychological and neuroanatomical data presented here provide a critical foundation for such investigations. PMID:19763994

Feinstein, Justin S.; Rudrauf, David; Khalsa, Sahib S.; Cassell, Martin D.; Bruss, Joel; Grabowski, Thomas J.; Tranel, Daniel

2010-01-01

271

Diagnosis and management of bilateral nasolabial cysts.  

PubMed

Nasolabial cysts are painless, submucosal, non-odontogenic jaw cysts presenting as soft tissue swellings in the maxillary anterior mucolabial fold lateral to midline, leading to elevation of nasal ala. Present case documents bilateral nasolabial cysts in a 69-year-old Asian female patient. In the present case, extraoral swelling of maxillary lip and elevation of nasal ala was observed on right side of the face. Intraorally, soft and fluctuant bilateral cysts were observed. Straw-colored fluid was aspirated from the right cyst. Radiographically, erosion of bone in a "cupping" fashion was observed in the region of left cyst. The cysts were enucleated using intraoral approach. Histopathology of the right-sided cyst revealed a cystic cavity lined by stratified squamous cells along with a few mucosal cells. At few places, stratified squamous and pseudostratified columnar epithelia with many cilia and goblet cells were also evident. Capsule was loosely arranged with fibrous tissue and chronic inflammatory infiltrate. Left-sided cystic specimen showed two or more layered stratified squamous lining epithelium with thin capsule. Diagnosis of bilateral nasolabial/nasoalveolar cysts was confirmed. PMID:24574670

Parwani, Rajkumar; Parwani, Simran; Wanjari, Sangeeta

2013-09-01

272

Age-related macular degeneration: Beyond anti-angiogenesis  

PubMed Central

Recently, anti-vascular endothelial growth factor therapies for neovascular age-related macular degeneration have been developed. These agents, originally developed for their anti-angiogenic mechanism of action, probably also work through an anti-permeability effect in preventing or reducing the amount of leakage from submacular neovascular tissue. Other treatment modalities include laser photocoagulation, photodynamic therapy with verteporfin, and submacular surgery. In reality, these latter treatments can be similarly categorized as anti-angiogenic because their sole aim is destroying or removing choroidal neovascularization (CNV). At the cellular level, CNV resembles stereotypical tissue repair that consists of several matricellular components in addition to neovascularization. In the retina, the clinical term CNV is a misnomer since the term may more appropriately be referred to as aberrant submacular repair. Furthermore, CNV raises a therapeutic conundrum: To complete or correct any reparative process in the body, angiogenesis becomes an essential component. Anti-angiogenic therapy, in all its guises, arrests repair and causes the hypoxic environment to persist, thus fueling pro-angiogenesis and further development of CNV as a component of aberrant repair. However, we realize that anti-vascular endothelial growth factor therapy preserves vision in patients with age-related macular degeneration, albeit temporarily and therefore, repeated treatment is needed. More importantly, however, anti-angiogenic therapy demonstrates that we can at the very least tolerate neovascular tissue beneath the macula and preserve vision in contrast to our historical approach of total vascular destruction. In this clinical scenario, it may be possible to look beyond anti-angiogenesis if our goal is facilitating submacular repair without destroying the neurosensory retina. Thus, in this situation of neovascular tolerance, it may be timely to consider treatments that facilitate vascular maturation, rather than its arrest or destruction. This would neutralize hypoxia, thus removing the stimulus that drives neovascularization and in turn the need for repeated lifelong intravitreal therapy. A pro-angiogenic approach would eliminate neovascular leakage and ultimately complete repair and preserve the neurosensory retina. PMID:24426775

2014-01-01

273

Reproducibility of Nerve Fiber Thickness, Macular Thickness, and Optic Nerve Head Measurements Using StratusOCT  

PubMed Central

Purpose The measurement reproducibility of the third generation of commercial optical coherence tomography, OCT-3 (StratusOCT, software ver. A2, Carl Zeiss Meditec Inc., Dublin, CA) was investigated. The nerve fiber layer (NFL) thickness, macula thickness map, and optic nerve head (ONH) parameters in normal eyes were studied. Methods Ten normal subjects were imaged six times (three before and three after dilation) per day, and the series was repeated on three different days. The order of the scans before pupil dilation was randomized in each of the 3 days of scanning. After pupil dilation, the scans were also randomized in each of the 3 days of scanning. Each series was performed separately for standard-density (128 A-scans per macular and ONH image and 256 A-scans per NFL image) and high-density (512 A-scans per image for all three scan types) scanning. Results The mean macular thickness was 235 ± 9.8 ?m. A-scan density (or image acquisition speed) had a statistically significant effect (P < 0.05) on the reproducibility of the mean macular thickness, macular volume, and a few sectors of the macular map. No significant dilation effect was found for any of the macular parameters. The best intraclass correlation coefficient (ICC; 94%) for macular scans was found for dilated high-density scanning, with an intervisit SD of 2.4 ?m and an intravisit SD of 2.2 ?m. The mean NFL thickness for standard scanning was 98 ± 9 ?m. NFL reproducibility showed mixed results and had interactions between scan density and dilation for some parameters. For most of the NFL parameters, reproducibility was better with dilated standard-density scanning. The mean NFL thickness ICC for dilated standard scanning was 79%, with an intervisit SD of 2.5 ?m and an intravisit SD of 1.6 ?m. For the ONH analysis, the reproducibility was better for dilated standard-density scanning for almost all the parameters, except for disc area, horizontal integrated rim volume, and vertical integrated rim area, which were better before dilation. The best reproducibility was found for cup-to-disc ratio (ICC = 97%, with intervisit SD of 0.04 ?m and intravisit SD of 0.02 ?m). Conclusions StratusOCT demonstrated reproducible measurements of NFL thickness, macular thickness, and optic nerve head parameters. The best reproducibility was found for dilated standard scanning for NFL and ONH parameters and for dilated high-density scanning for macular parameters. PMID:15161831

Paunescu, Lelia A.; Schuman, Joel S.; Price, Lori Lyn; Stark, Paul C.; Beaton, Siobahn; Ishikawa, Hiroshi; Wollstein, Gadi; Fujimoto, James G.

2007-01-01

274

Lipofuscin accumulation, abnormal electrophysiology, and photoreceptor degeneration in mutant ELOVL4 transgenic mice: A model for macular degeneration  

Microsoft Academic Search

Macular degeneration is a heterogeneous group of disorders characterized by photoreceptor degeneration and atrophy of the retinal pigment epithelium (RPE) in the central retina. An autosomal dominant form of Stargardt macular degeneration (STGD) is caused by mutations in ELOVL4, which is predicted to encode an enzyme involved in the elongation of long-chain fatty acids. We generated transgenic mice expressing a

G. Karan; C. Lillo; Z. Yang; D. J. Cameron; K. G. Locke; Y. Zhao; S. Thirumalaichary; C. Li; D. G. Birch; H. R. Vollmer-Snarr; D. S. Williams; K. Zhang

2005-01-01

275

Structural changes in individual retinal layers in diabetic macular edema.  

PubMed

Optical coherence tomography (OCT) has enabled objective measurement of the total retinal thickness in diabetic macular edema (DME). The central retinal thickness is correlated modestly with visual impairment and changes paradoxically after treatments compared to the visual acuity. This suggests the clinical relevance of the central retinal thickness in DME and the presence of other factors that affect visual disturbance. Recent advances in spectral-domain (SD) OCT have provided better delineation of the structural changes and fine lesions in the individual retinal layers. Cystoid spaces in the inner nuclear layer and outer plexiform layer are related to quantitative and qualitative parameters in fluorescein angiography. OCT often shows vitreoretinal interface abnormalities in eyes with sponge-like retinal swelling. Serous retinal detachment is sometimes accompanied by hyperreflective foci in the subretinal fluid, which exacerbates the pathogenesis at the interface of the photoreceptors and retinal pigment epithelium. Photoreceptor damage at the fovea is thought to be represented by disruption of the external limiting membrane or the junction between the inner and outer segment lines and is correlated with visual impairment. Hyperreflective foci in the outer retinal layers on SD-OCT images, another marker of visual disturbance, are associated with foveal photoreceptor damage. PMID:24073417

Murakami, Tomoaki; Yoshimura, Nagahisa

2013-01-01

276

Bevacizumab for the management of diabetic macular edema  

PubMed Central

Diabetic retinopathy (DR) is a leading cause of vision loss in the working-age population and is relatedto 1%-5% of cases of blindness worldwide. Diabetic macular edema (DME) is the most frequent cause of DR vision loss and is an important public health problem. Recent studies have implicated vascular endothelial growth factor (VEGF) in DR and DME pathogenesis, as well as provided evidence of the benefits of anti-VEGF agents for the management of such conditions. Despite the benefits of intravitreal ranibizumab injection for the management of DME, the cost-effectiveness of intravitreal bevacizumab therapy has gained increasing interest in the scientific community. This review summarizes the studies examining bevacizumab for the management of DME, focusing on the efficacy and duration of the clinical benefits of decreasing DME and the improvement of best-corrected visual acuity (BCVA). There is strong evidence that intravitreal bevacizumab injection therapy has a good cost-effective profile in the management of DME and may be associated with laser photocoagulation; however, its clinical superiority in terms of the duration of DME regression and the improvement of BCVA compared with intravitreal ranibizumab and other intravitreal anti-VEGF therapies remains unclear and deserves further investigation. PMID:23593532

Stefanini, Francisco Rosa; Arevalo, J Fernando; Maia, Mauricio

2013-01-01

277

Selective Cone Photoreceptor Injury in Acute Macular Neuroretinopathy  

PubMed Central

Purpose To evaluate retinal structural and functional abnormalities in a patient with Acute Macular Neuroretinopathy (AMN). Methods An adaptive optics scanning light ophthalmoscope (AOSLO) was used to image the photoreceptor mosaic and assess rod and cone structure. Spectral domain optical coherence tomography (SD-OCT) was used to examine retinal lamination. Microperimetry was used to assess function across the macula. Results Microperimetry showed reduced function of localized areas within retinal lesions corresponding to subjective scotomas. SD-OCT imaging revealed attenuation of two outer retinal bands typically thought to reflect photoreceptor structure. AOSLO images of the photoreceptor mosaic revealed a heterogeneous presentation within these lesions. There were areas containing non-waveguiding cones and other areas of decreased cone density where the remaining rods had expanded to fill in the vacant space. Within these lesions, cone densities were shown to be significantly lower than eccentricity matched areas of normal retina, as well as accepted histological measurements. A 6-month follow up revealed no change in rod or cone structure. Conclusions Imaging of AMN using an AOSLO shows a preferential disruption of cone photoreceptor structure within the region of decreased retinal sensitivity (as measured by microperimetry). AO-based imaging tools provide a noninvasive way to assess photoreceptor structure at a level of detail that is not resolved by use of conventional SD-OCT or other clinical measures. PMID:23615345

Hansen, Sean O.; Cooper, Robert F.; Dubra, Alfredo; Carroll, Joseph; Weinberg, David V.

2014-01-01

278

Review of genetics in age related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is a degenerative disease of the retina and the leading cause of blindness in industrialized countries. AMD is a complex disease caused by the combination of genetic predisposition and environmental factors. The prevalence of AMD increases with age. The adverse effect of smoking is well established. Genetic predisposition has been demonstrated by familial aggregation studies and twin studies. Using genome linkage scan and association studies, multiple potentially causative genes have been identified. The chromosomes most commonly implicated are 1q25-31 and 10q26. In particular, variants in the gene for the complement factor H (CFH) and the genes PLEKHA1/LOC387715/HTRA1, Factor B (BF) and complement component 2 (C2) have been implicated as major risk or protective factors for the development of AMD. There have been some advances in the treatment of this condition; however, a complete cure remains remote but hopeful. Understanding the causative environmental and genetic interactions will facilitate the development of future preventive methods and treatments. PMID:18097986

Montezuma, Sandra R; Sobrin, Lucia; Seddon, Johanna M

2007-01-01

279

Structural Changes in Individual Retinal Layers in Diabetic Macular Edema  

PubMed Central

Optical coherence tomography (OCT) has enabled objective measurement of the total retinal thickness in diabetic macular edema (DME). The central retinal thickness is correlated modestly with visual impairment and changes paradoxically after treatments compared to the visual acuity. This suggests the clinical relevance of the central retinal thickness in DME and the presence of other factors that affect visual disturbance. Recent advances in spectral-domain (SD) OCT have provided better delineation of the structural changes and fine lesions in the individual retinal layers. Cystoid spaces in the inner nuclear layer and outer plexiform layer are related to quantitative and qualitative parameters in fluorescein angiography. OCT often shows vitreoretinal interface abnormalities in eyes with sponge-like retinal swelling. Serous retinal detachment is sometimes accompanied by hyperreflective foci in the subretinal fluid, which exacerbates the pathogenesis at the interface of the photoreceptors and retinal pigment epithelium. Photoreceptor damage at the fovea is thought to be represented by disruption of the external limiting membrane or the junction between the inner and outer segment lines and is correlated with visual impairment. Hyperreflective foci in the outer retinal layers on SD-OCT images, another marker of visual disturbance, are associated with foveal photoreceptor damage. PMID:24073417

Yoshimura, Nagahisa

2013-01-01

280

Ocular Surface Temperature in Age-Related Macular Degeneration  

PubMed Central

Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD) eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320). The ocular surface temperature (OST) of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA) test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value?>0.272). OST in AMD patients was significantly lower than in controls (P > 0.05). Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.

Sodi, Andrea; Giacomelli, Giovanni; Corvi, Andrea; Menchini, Ugo

2014-01-01

281

Seven New Loci Associated with Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is a common cause of blindness in older individuals. To accelerate understanding of AMD biology and help design new therapies, we executed a collaborative genomewide association study, examining >17,100 advanced AMD cases and >60,000 controls of European and Asian ancestry. We identified 19 genomic loci associated with AMD with p<5×10?8 and enriched for genes involved in regulation of complement activity, lipid metabolism, extracellular matrix remodeling and angiogenesis. Our results include 7 loci reaching p<5×10?8 for the first time, near the genes COL8A1/FILIP1L, IER3/DDR1, SLC16A8, TGFBR1, RAD51B, ADAMTS9/MIR548A2, and B3GALTL. A genetic risk score combining SNPs from all loci displayed similar good ability to distinguish cases and controls in all samples examined. Our findings provide new directions for biological, genetic and therapeutic studies of AMD. PMID:23455636

2013-01-01

282

Age-Related Macular Degeneration: Genetics and Biology Coming Together  

PubMed Central

Genetic and genomic studies have enhanced our understanding of complex neurodegenerative diseases that exert a devastating impact on individuals and society. One such disease, age-related macular degeneration (AMD), is a major cause of progressive and debilitating visual impairment. Since the pioneering discovery in 2005 of complement factor H (CFH) as a major AMD susceptibility gene, extensive investigations have confirmed 19 additional genetic risk loci, and more are anticipated. In addition to common variants identified by now-conventional genome-wide association studies, targeted genomic sequencing and exome-chip analyses are uncovering rare variant alleles of high impact. Here, we provide a critical review of the ongoing genetic studies and of common and rare risk variants at a total of 20 susceptibility loci, which together explain 40–60% of the disease heritability but provide limited power for diagnostic testing of disease risk. Identification of these susceptibility loci has begun to untangle the complex biological pathways underlying AMD pathophysiology, pointing to new testable paradigms for treatment. PMID:24773320

Fritsche, Lars G.; Fariss, Robert N.; Stambolian, Dwight; Abecasis, Goncalo R.; Curcio, Christine A.

2014-01-01

283

Macular injury by an Nd:YAG rangefinder  

NASA Astrophysics Data System (ADS)

The authors report the clinical findings of a civilian patient who unintentionally looked into the laser beam of a British range finder, obtained on the black market. The patient was investigated by fluorescein angiography. Indocyanine green angiography (ICG) and microperimetry both in the acute stage (2 hours) and four weeks later. Hundred mg prednisone tapered over 9 days was prescribed. Additionally 50 ?g tissue plasminogen activator (TPA) and 0.5 ml pure C2F6 were injected in the vitreous. In the acute phase hemorrhage was located beneath the retina, primarily beneath the retinal pigment epithelium. Retinal defects as seen initially over the subretinal blood, were reduced after four weeks, but a retinal defect ranging from the lasered site towards the fovea remained. Visual acuity slightly increased from 20/100 to 20/63. ICG showed a large hypofluorescent spot in the macula. The technical parameters of the range finder were: Nd:YAG laser (1064 nm), pulse duration 10 ns, beam divergence 1.5 mrad, energy 10 mJ. A range finder can produce severe macular injury. The primary laser tissue interaction mechanism seems to be explosive disruption of choroidal tissue. Intravitral injection of TPA and C2F6 may be an adjunct in the therapy of acute laser lesions. A late complication can be secondary choroidal neovascularization.

Roider, Johann; Buesgen, Patrick; Hoerauf, Hans; Laqua, Horst; Birngruber, Reginald

1999-06-01

284

Surgical Removal of Retained Subfoveal Perfluorocarbon Liquid through a Therapeutic Macular Hole with Intravitreal PFCL Injection and Gas Tamponade  

PubMed Central

We report two cases of surgical removal of a retained subfoveal perfluorocarbon liquid (PFCL) bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade. Two patients underwent pars plana vitrectomy with PFCL injection for rhegmatogenous retinal detachment. In both cases, a retained subfoveal PFCL bubble was noticed postoperatively by funduscopy and optical coherence tomography. Both patients underwent surgical removal of the subfoveal PFCL through a therapeutic macular hole and gas tamponade. The therapeutic macular holes were completely closed by gas tamponade and the procedure yielded a good visual outcome (best-corrected visual acuity of 20 / 40 in both cases). In one case, additional intravitreal PFCL injection onto the macula reduced the size of the therapeutic macular hole and preserved the retinal structures in the macula. Surgical removal of a retained subfoveal PFCL bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade provides an effective treatment option. PMID:24082781

Kim, Jae Min; Park, Kyu Hyung; Chung, Hum

2013-01-01

285

A Bilateral Advantage for Storage in Visual Working Memory  

PubMed Central

Various studies have demonstrated enhanced visual processing when information is presented across both visual hemifields rather than in a single hemifield (the bilateral advantage). For example, reported that observers were able to track twice as many moving visual stimuli when the tracked items were presented bilaterally rather than unilaterally, suggesting that independent resources enable tracking in the two visual fields. Motivated by similarities in the apparent capacity and neural substrates that mediate tracking and visual working memory (WM), the present work examined whether or not a bilateral advantage also arises during storage in visual WM. Using a recall procedure to assess working memory for orientation information, we found a reliable bilateral advantage; recall error was smaller with bilateral sample displays than with unilateral displays. To demonstrate that the bilateral advantage influenced storage per se rather than just encoding efficiency, we replicated the observed bilateral advantage using sequentially presented stimuli. Finally, to further characterize how bilateral presentations enhanced storage in working memory, we measured both the number and the resolution of the stored items and found that bilateral presentations lead to an increased probability of storage, rather than enhanced mnemonic resolution. Thus, the bilateral advantage extends beyond the initial selection and encoding of visual information to influence online maintenance in visual working memory. PMID:20659731

Umemoto, Akina; Drew, Trafton; Ester, Edward F.; Awh, Edward

2010-01-01

286

Full-thickness macular hole formation associated with pigment epithelial detachment: link or coincidence?  

PubMed

To report two cases of full-thickness macular hole (FTMH) formation associated with pigment epithelial detachment (PED). Two patients presenting with visual loss and metamorphopsia were evaluated with fundal fluorescein angiography (FFA) and optical coherence tomography (OCT). Case 1: Fundus examination and FFA revealed a small subfoveal PED. Subsequent serial OCT elucidated the progressive formation of a FTMH. Case 2: Fundus examination and FFA revealed a small PED and changes suggestive of central serous retinopathy (CSR). Subsequent OCT illustrated a FTMH with an underlying small PED at the base of the hole. It is possible that, in at least some cases of macular hole formation, there may be a causative link with PED. To my knowledge, this is the first report of full-thickness macular hole formation associated with pigment epithelial detachment. PMID:20517636

Cazabon, Sunildath

2010-12-01

287

Inverted Autologous Internal Limiting Membrane for Management of Optic Disc Pit with Macular Detachment  

PubMed Central

Macular detachment causes visual deterioration in 25-75% of patients with congenital optic disc pit. A number of treatment options have been reported to manage the macular detachment in optic pit. An optic disc pit represents a defect in the lamina cribrosa; theoretically, an ideal procedure to treat optic pit associated macular detachment would be one that prevents the flow of fluid across the pit by creating an additional barrier. We present a new surgical technique that employs an autologous internal limiting membrane (ILM) to create this barrier. The technique involves standard vitrectomy along-with ILM peeling. Subsequently, the peeled ILM was inverted and transplanted onto the optic disc pit to close the optic nerve pit. This technique showed satisfactory anatomic result with good functional improvement in visual acuity. PMID:24339690

Mohammed, Osman Abdelzaher; Pai, Anant

2013-01-01

288

Bilateral Wilms' tumors: changing concepts in management  

SciTech Connect

Bilaterality is uncommon in Wilms' tumor, being present in 4% to 8% of the cases. We report the combined experience of two children's hospitals in one city over a 20-year period. We encountered nine cases of synchronous bilateral nephroblastoma (National Wilms' Tumor Study 3, stage V). Age at diagnosis ranged from 9 to 41 months (mean 23 months). There were five girls and four boys. Associated findings include nephroblastomatosis in three cases (33%), one of which also had a familial history; undescended testis in two cases; and minor anomalies in two other cases. Surgical treatment consisted of unilateral nephrectomy with contralateral partial nephrectomy or tumorectomy in six cases, nephrectomy with contralateral biopsy only in two cases, and the other patient had bilateral biopsies initially, followed at a later date by partial nephrectomy on one side. All patients received chemotherapy; actinomycin D (AMD) only was used in the oldest case, vincristine and AMD in five cases, to which was added cyclophosphamide in one case and adriamycin in two. Seven patients received radiation therapy. Seven out of the nine patients survived more than 2 years (77%); five are well, off chemotherapy, with no evidence of disease from 4 to 11 years after diagnosis. Two patients suffered from chronic renal failure and one died from complications after renal transplantation more than 19 years after diagnosis. The two patients who died from their disease presented with more advanced tumor. Therefore, the agressiveness of multimodal therapy can be tailored according to stage and histology, and effective chemotherapy allows maximal preservation of renal parenchyma in patients with stage I and II tumors.

Laberge, J.M.; Nguyen, L.T.; Homsy, Y.L.; Doody, D.P.

1987-08-01

289

Bilateral total Descemet's membrane detachments after strangulation  

PubMed Central

The eyes of a 25-year-old male were collected by the Utah Lions Eye Bank after his suicide by hanging. Following dissection of the corneoscleral buttons from intact globes, bilateral detached Descemet’s membranes with subsequent scrolling in the periphery were observed. We believe these findings were caused by a large increase in intraocular pressure secondary to the hanging. Lens and anterior capsule fractures after hanging have been reported, but corneal damage has never been discussed. We invite transplant surgeons and eye bank recovery specialists to share their experience of similar corneal changes in donated eyes following strangulation or hanging. PMID:21966190

Moshirfar, Majid; Betts, Brent S; Hsu, Maylon; Holz, Huck A; McEntire, Wade

2011-01-01

290

Bilateral total Descemet's membrane detachments after strangulation.  

PubMed

The eyes of a 25-year-old male were collected by the Utah Lions Eye Bank after his suicide by hanging. Following dissection of the corneoscleral buttons from intact globes, bilateral detached Descemet's membranes with subsequent scrolling in the periphery were observed. We believe these findings were caused by a large increase in intraocular pressure secondary to the hanging. Lens and anterior capsule fractures after hanging have been reported, but corneal damage has never been discussed. We invite transplant surgeons and eye bank recovery specialists to share their experience of similar corneal changes in donated eyes following strangulation or hanging. PMID:21966190

Moshirfar, Majid; Betts, Brent S; Hsu, Maylon; Holz, Huck A; McEntire, Wade

2011-01-01

291

Bilateral Hydronephrosis and Cystitis Resulting from  

PubMed Central

Ketamine associated urinary dysfunction has become increasingly more common worldwide. Point-of-care ultrasound (POCUS) is an established modality for diagnosing hydronephrosis in the emergency department. We describe a case of a young male ketamine abuser with severe urinary urgency and frequency in which POCUS performed by the emergency physician demonstrated bilateral hydronephrosis and a focally thickened irregular shaped bladder. Emergency physicians should consider using POCUS evaluate for hydronephrosis and bladder changes in ketamine abusers with lower urinary tract symptoms. The mainstay of treatment is discontinuing ketamine abuse. PMID:25035738

Abuse, Chronic Ketamine; Tran, Vu Huy; Nelson, Mathew; Nogar, Joshua; Bramante, Robert M.

2014-01-01

292

Bilateral nasolacrimal duct atresia in a cria.  

PubMed

A 2-month-old, male alpaca had a 1-month history of mucoid ocular discharge from the left eye. Signalment, history and clinical findings were suggestive of a congenital nasolacrimal outflow obstruction. A dacryocystorhinogram confirmed bilateral nasolacrimal duct atresia, which involved the distal half of both nasolacrimal ducts. In order to establish alternative outflow, a conjunctivomaxillosinusotomy and conjunctivorhinostomy were performed on the right and left eye, respectively. The surgical openings remain patent after 11 months, and there have been no clinical signs of nasolacrimal disease. PMID:18190353

Mangan, Brendan G; Gionfriddo, Juliet R; Powell, Cynthia C

2008-01-01

293

Prophylactic bilateral mastectomy and contralateral prophylactic mastectomy.  

PubMed

With increasing public awareness of the risk for breast cancer and modern techniques of reconstruction, the option of surgical prophylaxis for risk reduction is becoming increasingly popular. Bilateral prophylactic mastectomy for women at increased risk of developing breast cancer and contralateral prophylactic mastectomy for those with unilateral breast cancer seeking symmetry, risk reduction, and ease of follow-up are acceptable options for many women. However, prophylactic surgery is not an inconsequential decision, and careful consideration should be given to the risks and benefits of such procedures. PMID:24882342

Chagpar, Anees B

2014-07-01

294

Bilateral Candida endophthalmitis in a premature infant.  

PubMed

Endogenous infantile Candida endophthalmitis is a rare but potentially devastating condition resulting from sequestration of the fungus within the lens after systemic infection. We report the case of a 20-week-old girl with a history of Candida sepsis who presented with bilateral Candida albicans endophthalmitis 15 weeks after completing a 6-week course of intravenous antifungal therapy. Prompt vitrectomy resulted in salvage of the right eye, although a total retinal detachment occurred. Cataract extraction and administration of intravenous and intravitreal amphotericin B preserved vision in the left eye. PMID:23522946

Manning, Rebecca A; Carlson, Joshua N; Hein, Eric W; Weaver, R Grey; Greven, Craig M

2013-04-01

295

Bilateral condylar resorption in down syndrome.  

PubMed

Asymptomatic idiopathic condylar resorption is a rare disease of difficult diagnosis and treatment. We review the literature about this rare condition and report a case of a patient, affected by Down syndrome, who underwent a complete untreated bilateral condylar resorption in adolescence and then developed pain on chewing only 20 years later. Despite a precise orthodontic and surgical therapeutic plan, treatment had to be discontinued because of patient lack of compliance. This case is the first of its kind to be reported and emphasizes the need for special attention in patients with disability. PMID:25376143

Grippaudo, Cristina; Grippaudo, Francesca Romana; Marianetti, Tito Matteo; Cacucci, Laura; Deli, Roberto; Pelo, Sandro

2014-11-01

296

Spontaneous Resolution of Vitreomacular Traction in Two Patients with Diabetic Macular Edema  

PubMed Central

The nature of the vitreoretinal interface in conditions like diabetic macular edema (DME) remains incompletely understood. Furthermore, it is not clear what the role of pharmacological enzymatic vitreolysis will play in cases of vitreomacular traction (VMT) associated with macular disease like DME. We describe the spontaneous resolution of VMT in 2 patients with DME. As both surgical and pharmacologic interventions have been suggested to treat DME in the setting of VMT, we feel that a clarification of the nomenclature and reporting of these cases of natural history may be useful in more fully understanding the complex decision-making involved when determining whether to treat this subset of patients. PMID:24707275

Almeida, David R.P.; Chin, Eric K.

2014-01-01

297

Spontaneous resolution of vitreomacular traction in two patients with diabetic macular edema.  

PubMed

The nature of the vitreoretinal interface in conditions like diabetic macular edema (DME) remains incompletely understood. Furthermore, it is not clear what the role of pharmacological enzymatic vitreolysis will play in cases of vitreomacular traction (VMT) associated with macular disease like DME. We describe the spontaneous resolution of VMT in 2 patients with DME. As both surgical and pharmacologic interventions have been suggested to treat DME in the setting of VMT, we feel that a clarification of the nomenclature and reporting of these cases of natural history may be useful in more fully understanding the complex decision-making involved when determining whether to treat this subset of patients. PMID:24707275

Almeida, David R P; Chin, Eric K

2014-01-01

298

Genetic Association of Apolipoprotein E with Age-Related Macular Degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is the most common geriatric eye\\u000a disorder leading to blindness and is characterized by degeneration of the\\u000a neuroepithelium in the macular area of the eye. Apolipoprotein E (apoE),\\u000a the major apolipoprotein of the CNS and an important regulator of\\u000a cholesterol and lipid transport, appears to be associated with\\u000a neurodegeneration. The apoE gene (APOE) polymorphism is a

Caroline C. W. Klaver; Mike Kliffen; Cornelia M. van Duijn; Albert Hofman; Marc Cruts; Diederick E. Grobbee; Christine van Broeckhoven

1998-01-01

299

Influence of macular pigment and melanin on incident early AMD in a white population  

Microsoft Academic Search

Background  The protective effect of macular pigment (MP) and melanin against age-related macular degeneration (AMD) is still controversial\\u000a from cross-sectional studies. In an attempt to clarify this issue, we performed a population-based longitudinal study.\\u000a \\u000a \\u000a \\u000a Methods  MP optical density (MPOD) and melanin optical density (MOD) data were collected during the second follow-up phase of the Rotterdam\\u000a Study in 1999 in a random subset

Martijn J. Kanis; Tos T. J. M. Berendschot; Dirk van Norren

2007-01-01

300

[Smartphone-operated detonation of a firecracker resulting in a macular hole].  

PubMed

A 22-year-old man presented to the emergency room on New Years Eve after a firecracker had exploded next to his left eye. Besides injuries to the eyelid, conjunctival and corneal trauma, a commotio retinae at the temporal periphery and the central retina were revealed funduscopically. A small full macular hole was detected by spectral domain optical coherence tomography scan (OCT). After topical treatment with tobramycin, fluorometholone and lubrication eye drops the best-corrected vision improved from 0.2 to 0.8 within 3 months and the follow-up OCT revealed a spontaneous closure of the macular hole. PMID:24833398

Papazoglou, A; Baumüller, S; Meyer, C

2014-11-01

301

Vitreous inflammatory factors in macular edema with central retinal vein occlusion  

Microsoft Academic Search

Purpose  To investigate the correlation of soluble intercellular adhesion molecule 1 (sICAM-1) and vascular endothelial growth factor\\u000a (VEGF) with macular edema in patients with central retinal vein occlusion (CRVO).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Twenty-nine patients who had CRVO with macular edema and 16 patients with non-ischemic ocular diseases (control group) participated.\\u000a Retinal ischemia was evaluated by measuring the area of capillary non-perfusion with fluorescein angiography

Hidetaka Noma; Hideharu Funatsu; Seiyo Harino; Tatsuya Mimura; Shuichiro Eguchi; Sadao Hori

2011-01-01

302

Intraocular triamcinolone acetonide for macular edema due to CRVO. A multifocal-ERG and OCT study  

Microsoft Academic Search

Purpose  To investigate the effectiveness of intravitreal triamcinolone acetonide in the treatment of cystoid macular edema due to\\u000a central retinal vein occlusion (CRVO). A noncomparative, prospective, interventional case series.\\u000a \\u000a \\u000a \\u000a Methods  In this study 15 eyes of 15 patients (9 males and 6 females) with macular edema due to non-ischemic CRVO were treated with\\u000a intravitreal injection of 4 mg triamcinolone acetonide and followed-up for

Marilita M. Moschos; Dimitrios Brouzas; Eleni Loukianou; Michael Apostolopoulos; Michael Moschos

2007-01-01

303

Bimodal spatial distribution of macular pigment: evidence of a gender relationship  

NASA Astrophysics Data System (ADS)

The spatial distribution of the optical density of the human macular pigment measured by two-wavelength autofluorescence imaging exhibits in over half of the subjects an annulus of higher density superimposed on a central exponential-like distribution. This annulus is located at about 0.7° from the fovea. Women have broader distributions than men, and they are more likely to exhibit this bimodal distribution. Maxwell's spot reported by subjects matches the measured distribution of their pigment. Evidence that the shape of the foveal depression may be gender related leads us to hypothesize that differences in macular pigment distribution are related to anatomical differences in the shape of the foveal depression.

Delori, François C.; Goger, Douglas G.; Keilhauer, Claudia; Salvetti, Paola; Staurenghi, Giovanni

2006-03-01

304

Urgent Bilateral Endoscopic Marsupialization for Respiratory Distress due to Bilateral Dacryocystitis in a Newborn  

PubMed Central

Abstract We describe an infant with respiratory distress due to bilateral dacryocystoceles and dacryocystitis who was successfully treated with urgent bilateral endoscopic marsupialization. A male infant was brought to our outpatient department 7 days after birth, with red, acutely inflamed swellings near the medial canthal area of both eyes. From birth, there had been bluish swelling near the medial canthal area, and redness and swellings developed within 3 days. On physical examination, the child was afebrile but showed respiratory distress with coarse breathing sound. That day, the infant was admitted and treated with intravenous cefotaxime 150 mg. After withholding oral intake for appropriate preoperative fasting, urgent bilateral probing with endoscopy was done. On endoscopy, huge bilateral congenital dacryocystoceles were found. Because of its huge size, the inferior surface of the cyst was touching the nasal floor, which made probe unable to perforate the wall of dacryocystocele. Therefore, an endoscopy-assisted marsupialization of dacryocystoceles and bicanalicular silicone intubation were performed. Both swellings and erythema subsided within 48 hours postoperatively, and the patient was discharged after 72 hours from treatment. PMID:24799096

Kim, Hochang; Park, Jongyeop; Jang, Jaeho; Chun, Junwoo

2014-01-01

305

Bilateral nodular lymphocytic conjunctivitis in a horse.  

PubMed

A Russian jumper horse presented because of an ocular perilimbal conjunctival mass and, on clinical examination, two bilateral conjunctival masses were found, of different size and conformation. Attempts at complete excision of the left eye mass and excisional biopsy of the right eye mass were performed. The left eye mass recurred rapidly, but resolved completely after topical corticosteroid therapy. The two lesions had similar histopathologic features, characterized by focal, chronic, primarily lymphocytic conjunctivitis with follicular lymphoid hyperplasia. Special histopathologic staining techniques (Gomori methenamine silver and acid fast stains) and immunohistochemistry (for CD3, BLA36 and lysozyme) failed to reveal any etiologic agents and indicated an inflammatory lesion composed of a heterogeneous population of lymphocytes and macrophages (nodular lymphocytic conjunctivitis). The lesions were indistinguishable, clinically and behaviorally, from what has been reported as 'conjunctival pseudotumor' in the horse. Equine conjunctival pseudotumor/nodular lymphocytic conjunctivitis has been reported to be unilateral and have a good prognosis after partial or complete surgical excision. This is the first reported case of bilateral nodular lymphocytic conjunctivitis in a horse and for which surgical excision alone was not curative. PMID:15762926

Stoppini, Riccardo; Gilger, Brian C; Malarkey, David E; Ratto, Alessandra; Brigati, Giampiero

2005-01-01

306

Noninvasive testing of asymptomatic bilateral hilar adenopathy  

SciTech Connect

The diagnostic strategy for asymptomatic patients with persistent bilateral bilar adenopathy often involves invasive procedures. The authors used Bayesian analysis to: (1) estimate the relative prevalences of diseases causing bilateral bilar adenopathy; (2) assess changes in the prevalence of disease by race, the presence of other clinical symptoms, and geography; and (3) determine the value of relevant noninvasive tests, including the angiotensin-converting enzyme (ACE) assay, gallium scan, and purified protein derivative (PPD), in order to assess when a strategy of watchful waiting is appropriate. The analysis indicated that the ACE assay, particularly when paired with the PPD, can identify many patients who might safely be managed without immediate invasive biopsy. Patients who are ACE+ and PPD- have an estimated probability of sarcoidosis of 0.95 or greater; patients who are ACE- and PPD+ have a probability of tuberculosis of 0.86 if black, 0.79 if white. In contrast, gallium scanning has no diagnostic role in this clinical situation. Bronchoscopic or mediastinoscopic biopsy has a limited role for patients who are ACE+ PPD- or ACE- PPD+ because of limited sensitivity. Patients who are both ACE- and PPD-, particularly if white, may have a high enough risk of lymphoma to consider invasive biopsy.

Carr, P.L.; Singer, D.E.; Goldenheim, P.; Bernardo, J.; Mulley, A.G. (Massachusetts General Hospital, Boston (USA))

1990-03-01

307

Bilateral angiosarcoma of breast in a young lady  

PubMed Central

We report a young lady with bilateral angiosarcoma of breast because of its rarity. A 29 year old unmarried female presented with bilateral breast lump. She underwent bilateral mastectomy with axillary dissection histopathology of which showed low grade angiosarcoma of left breast and high grade angiosarcoma of right breast. CT Thorax revealed right hilar and right mediastenal lymph nodes. She was treated with radiotherapy and chemotherapy postoperatively. PMID:22557784

Roy, Sanjoy; Devleena; Maji, Tapas; Choudhuri, Prabir; Biswas, Jaydip; Lahiri, Debarshi

2011-01-01

308

Case report: Three-trocar technique for bilateral laparoscopic nephropexy.  

PubMed

Nephroptosis is a rare syndrome, which affects the right kidney in the majority of cases. In the current report, a case of bilateral nephroptosis with an unusual presentation is presented. We performed bilateral laparoscopic nephropexy using a three-trocar approach. The intervention was successful, with a short operative time and minimal blood loss. The clinical presentation of our patient and the surgical technique for bilateral laparoscopic nephropexy are described. PMID:17263609

Chekulaev, Dimitri; Dayma, Thierry; Abecassis, Jean-Paul; Peyromaure, Michaël

2007-01-01

309

Bilateral struma ovarii: a case mimicking an ovarian neoplasm.  

PubMed

We present a case of bilateral struma ovarii which developed postoperatively and was histopathologically diagnosed after the patient was hospitalized for investigation and treatment of tumoral anexal bilateral formations. There was no evidence of clinical malignancy or metastases. Data from the literature, together with histopathologic, diagnostic and therapeutic aspects of the disease were checked again taking into account the scarcity of this lesion, especially bilaterally. PMID:18714585

Novac, L; Niculescu, M; Simionescu, C; Stanescu, M R; Novac, M

2008-01-01

310

Macular degeneration affects eye movement behavior during visual search  

PubMed Central

Patients with a scotoma in their central vision (e.g., due to macular degeneration, MD) commonly adopt a strategy to direct the eyes such that the image falls onto a peripheral location on the retina. This location is referred to as the preferred retinal locus (PRL). Although previous research has investigated the characteristics of this PRL, it is unclear whether eye movement metrics are modulated by peripheral viewing with a PRL as measured during a visual search paradigm. To this end, we tested four MD patients in a visual search paradigm and contrasted their performance with a healthy control group and a healthy control group performing the same experiment with a simulated scotoma. The experiment contained two conditions. In the first condition the target was an unfilled circle hidden among c-shaped distractors (serial condition) and in the second condition the target was a filled circle (pop-out condition). Saccadic search latencies for the MD group were significantly longer in both conditions compared to both control groups. Results of a subsequent experiment indicated that this difference between the MD and the control groups could not be explained by a difference in target selection sensitivity. Furthermore, search behavior of MD patients was associated with saccades with smaller amplitudes toward the scotoma, an increased intersaccadic interval and an increased number of eye movements necessary to locate the target. Some of these characteristics, such as the increased intersaccadic interval, were also observed in the simulation group, which indicate that these characteristics are related to the peripheral viewing itself. We suggest that the combination of the central scotoma and peripheral viewing can explain the altered search behavior and no behavioral evidence was found for a possible reorganization of the visual system associated with the use of a PRL. Thus the switch from a fovea-based to a PRL-based reference frame impairs search efficiency. PMID:24027546

Van der Stigchel, Stefan; Bethlehem, Richard A. I.; Klein, Barrie P.; Berendschot, Tos T. J. M.; Nijboer, Tanja C. W.; Dumoulin, Serge O.

2013-01-01

311

Modelling the Genetic Risk in Age-Related Macular Degeneration  

PubMed Central

Late-stage age-related macular degeneration (AMD) is a common sight-threatening disease of the central retina affecting approximately 1 in 30 Caucasians. Besides age and smoking, genetic variants from several gene loci have reproducibly been associated with this condition and likely explain a large proportion of disease. Here, we developed a genetic risk score (GRS) for AMD based on 13 risk variants from eight gene loci. The model exhibited good discriminative accuracy, area-under-curve (AUC) of the receiver-operating characteristic of 0.820, which was confirmed in a cross-validation approach. Noteworthy, younger AMD patients aged below 75 had a significantly higher mean GRS (1.87, 95% CI: 1.69–2.05) than patients aged 75 and above (1.45, 95% CI: 1.36–1.54). Based on five equally sized GRS intervals, we present a risk classification with a relative AMD risk of 64.0 (95% CI: 14.11–1131.96) for individuals in the highest category (GRS 3.44–5.18, 0.5% of the general population) compared to subjects with the most common genetic background (GRS ?0.05–1.70, 40.2% of general population). The highest GRS category identifies AMD patients with a sensitivity of 7.9% and a specificity of 99.9% when compared to the four lower categories. Modeling a general population around 85 years of age, 87.4% of individuals in the highest GRS category would be expected to develop AMD by that age. In contrast, only 2.2% of individuals in the two lowest GRS categories which represent almost 50% of the general population are expected to manifest AMD. Our findings underscore the large proportion of AMD cases explained by genetics particularly for younger AMD patients. The five-category risk classification could be useful for therapeutic stratification or for diagnostic testing purposes once preventive treatment is available. PMID:22666427

Grassmann, Felix; Fritsche, Lars G.; Keilhauer, Claudia N.; Heid, Iris M.; Weber, Bernhard H. F.

2012-01-01

312

Complement Factor D in Age-Related Macular Degeneration  

PubMed Central

Purpose. To examine the role of complement factor D (CFD) in age-related macular degeneration (AMD) by analysis of genetic association, copy number variation, and plasma CFD concentrations. Methods. Single nucleotide polymorphisms (SNPs) in the CFD gene were genotyped and the results analyzed by binary logistic regression. CFD gene copy number was analyzed by gene copy number assay. Plasma CFD was measured by an enzyme-linked immunosorbent assay. Results. Genetic association was found between CFD gene SNP rs3826945 and AMD (odds ratio 1.44; P = 0.028) in a small discovery case-control series (462 cases and 325 controls) and replicated in a combined cohorts meta-analysis of 4765 cases and 2693 controls, with an odds ratio of 1.11 (P = 0.032), with the association almost confined to females. Copy number variation in the CFD gene was identified in 13 out of 640 samples examined but there was no difference in frequency between AMD cases (1.3%) and controls (2.7%). Plasma CFD concentration was measured in 751 AMD cases and 474 controls and found to be elevated in AMD cases (P = 0.00025). The odds ratio for those in the highest versus lowest quartile for plasma CFD was 1.81. The difference in plasma CFD was again almost confined to females. Conclusions. CFD regulates activation of the alternative complement pathway, which is implicated in AMD pathogenesis. The authors found evidence for genetic association between a CFD gene SNP and AMD and a significant increase in plasma CFD concentration in AMD cases compared with controls, consistent with a role for CFD in AMD pathogenesis. PMID:22003108

Stanton, Chloe M.; Yates, John R.W.; den Hollander, Anneke I.; Seddon, Johanna M.; Swaroop, Anand; Stambolian, Dwight; Fauser, Sascha; Hoyng, Carel; Yu, Yi; Atsuhiro, Kanda; Branham, Kari; Othman, Mohammad; Chen, Wei; Kortvely, Elod; Chalmers, Kevin; Hayward, Caroline; Moore, Anthony T.; Dhillon, Baljean; Ueffing, Marius

2011-01-01

313

Outer Retinal Structure in Best Vitelliform Macular Dystrophy  

PubMed Central

Objective To characterize outer retinal structure in Best Vitelliform Macular Dystrophy (BVMD), using spectral domain optical coherence tomography (SD-OCT) and adaptive optics scanning light ophthalmoscopy (AOSLO). Methods Four symptomatic members of a family with BVMD with known BEST1 gene mutation were recruited. Thickness of two outer retinal layers corresponding to photoreceptor inner and outer segments were measured using SD-OCT. Photoreceptor mosaic AOSLO images within and around visible lesions were obtained, and cone density was assessed in two subjects. Results Each subject was at a different stage of BVMD, with photoreceptor disruption evident by AOSLO at all stages. When comparing SD-OCT and AOSLO images from the same location, AOSLO images allowed for direct assessment of photoreceptor structure. A variable degree of retained photoreceptors was seen within all lesions. The photoreceptor mosaic immediately adjacent to visible lesions appeared contiguous and was of normal density. Fine hyperreflective structures were visualized by AOSLO, and their anatomical orientation and size are consistent with Henle fibers. Conclusions AOSLO findings indicate substantial photoreceptor structure persists within active lesions, accounting for good visual acuity in these patients. Despite previous reports of diffuse photoreceptor outer segment abnormalities in BVMD, our data reveal normal photoreceptor structure in areas adjacent to clinical lesions. Clinical Relevance This study demonstrates the utility of AOSLO for understanding the spectrum of cellular changes that occur in inherited degenerations such as BVMD. Photoreceptors are often significantly affected at various stages of inherited degenerations, and these changes may not be readily apparent with current clinical imaging instrumentation. PMID:23765342

Kay, David B.; Land, Megan E.; Cooper, Robert F.; Dubis, Adam M.; Godara, Pooja; Dubra, Alfredo; Carroll, Joseph; Stepien, Kimberly E.

2014-01-01

314

Bilateral tubal and intrauterine pregnancies diagnosed at laparoscopy.  

PubMed

A 32-year-old woman had bilateral tubal and intrauterine pregnancies after hyperovulation with clomiphene citrate and subsequent artificial insemination with husband's semen. Laparoscopic surgery revealed bilateral tubal pregnancies. Salpingectomy was performed on the left tube and linear salpingotomy was performed on the right tube. The postoperative course was uneventful. The patient delivered a healthy girl vaginally at 39 weeks' gestation. Only eight cases with bilateral and intrauterine pregnancy have been reported. The live birth rate of bilateral tubal pregnancy and intrauterine pregnancy is 60% (6/10), which is similar to that of heterotopic pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and treating heterotopic pregnancy. PMID:25228435

Fukuda, Takanori; Inoue, Hiromi; Toyama, Yuina; Ichida, Tomoyuki; Uzawa, Yoshie; Monma, Mika; Kusaka, Tsuyoshi; Kohata, Yutaka

2014-10-01

315

Bilateral synchronous spermatocytic seminoma: a rare case report  

PubMed Central

Testicular tumors are very common among man under the age of 45 years. The case of bilateral synchronous testicular seminoma is very rare. We present a case of bilateral synchronous testicular seminoma stage-I in a 42-year old Indian male who came to our hospital with chief complaints of dull ache in the abdomen and groin, bilateral scrotal swelling and heaviness, left-sided scrotal swelling since last four years, and right-sided since last two years. He underwent bilateral orchidectomy followed by radiotherapy. In this case we throw light on this rare condition and discuss the management.

Yadav, Sankalp; Gupta, Nishant

2014-01-01

316

Intravitreal Bevacizumab Alone or Combined with Macular Laser Photocoagulation for Recurrent or Persistent Macular Edema Secondary to Branch Retinal Vein Occlusion  

PubMed Central

Background. To evaluate the efficacy of intravitreal bevacizumab (IVB) injection with or without macular laser photocoagulation (MLP) for recurrent or persistent macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. Thirty-four eyes underwent IVB injection for ME secondary to BRVO as a primary treatment. Twenty of the 34 eyes experienced recurrent or persistent ME after the first IVB. Nine of the 20 eyes (Group 1) were retreated with IVB combined with MLP. The remaining 11 eyes (Group 2) were retreated with IVB alone. Results. In Group 1, the postoperative best corrected visual acuity (BCVA) improved compared with the preoperative value at all follow-up visits, although no statistically significant improvement was observed at 6 months. In contrast, BCVA significantly improved from 0.53 to 0.40 at 6 months (P < 0.05) in Group 2. Conclusion. Combined therapy tended to have a smaller effect on visual acuity compared with IVB monotherapy. PMID:25114799

Chihara, Tomoyuki; Bun, Toshitaka; Utsumi, Takao

2014-01-01

317

Long-Term Outcome after Vitrectomy for Macular Edema with Retinal Vein Occlusion Dividing into the Occlusion Site  

PubMed Central

Purpose. To investigate the efficacy of treatment for macular edema secondary to retinal vein occlusion (RVO) with vitrectomy. Methods. This retrospective study identified patients with macular edema associated with RVO between January 2004 and April 2006. Inclusion criteria were eyes with (1) preoperative visual acuity (VA) of 20/40 or worse, (2) a central foveal thickness (CFT) greater than 250??m, and (3) vitrectomy with internal limiting membrane and intravitreal triamcinolone acetonide. Each patient had their RVO classified as a major or macular BRVO or hemispheric RVO (HSRVO). Results. Forty-six eyes with major BRVO, 18 eyes with macular BRVO, and 17 eyes with HSRVO were investigated. VA was significantly improved at 24 months after surgery for each group (P < 0.05). Vision in the macular BRVO group 24 months after surgery was significantly better than that in other groups (P < 0.05). For each group, a concomitant reduction of CFT was noted at every time point when compared to preoperative values (P < 0.001). Conclusions. In macular BRVO, the postoperative vision 24 months after surgery was significantly better than the other groups. These findings suggest that additional and earlier treatments might be more important for patients with major BRVO and HSRVO than for those with macular BRVO. PMID:25371814

Iwase, Takeshi; Oveson, Brian C.

2014-01-01

318

Macular dystrophy associated with the mitochondrial DNA A3243G mutation: pericentral pigment deposits or atrophy? Report of two cases and review of the literature  

PubMed Central

Background The A3243G point mutation in mitochondrial DNA (mtDNA) is associated with MELAS (mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes) and MIDD syndromes (maternally inherited diabetes and deafness). Both MELAS and MIDD patients can present with visual symptoms due to a retinopathy, sometimes before the genetic diagnosis is made. Case presentation Patient 1: 46 year-old woman with diabetes mellitus and hearing loss was referred for an unspecified maculopathy detected during screening evaluation for diabetic retinopathy. Visual acuity was 20/20 in both eyes. Fundus examination showed bilateral macular and peripapillary hyperpigmented/depigmented areas. Patient 2: 45 year-old woman was referred for recent vision loss in her left eye. History was remarkable for chronic fatigue, migraine and diffuse muscular pain. Visual acuity was 20/20 in her right eye and 20/30 in her left eye. Fundus exhibited several nummular perifoveal islands of retinal pigment epithelium atrophy and adjacent pale deposits in both eyes. Retinal anatomy was investigated with autofluorescence, retinal angiography and optical coherence tomography. Retinal function was assessed with automated static perimetry, full-field and multifocal electroretinography and electro-oculography. Genetic testing of mtDNA identified a point mutation at the locus 3243. Conclusion Observation of RPE abnormalities in the context of suggestive systemic findings should prompt mtDNA testing. PMID:24906873

2014-01-01

319

Blood Flow Velocity in the Choroid in Punctate Inner Choroidopathy and Vogt-Koyanagi Disease:. and Multifractal Analysis of Choroidal Blood Flow in Age-Related Macular Degeneration  

NASA Astrophysics Data System (ADS)

Recently, the important role of the choroidal circulation has been recognized in various fundus diseases, such as punctate inner choroidopathy (PIC), Vogt-Koyanagi-Harada (VKH) disease, and age-related macular degeneration (AMD). An apparatus based on the laser speckle phenomenon, which we call laser speckle flowgraphy (LSFG) has been used to measure the blood flow velocity in the retina and choroid with the diode laser. PIC presents in myopic women who complain of decreased visual acuity. VKH disease is a bilateral, granulomatous chorioretinitis. The composite map of the LSFG represent that blood flow velocity in the choroid was decreased in PIC and VKH. After the treatment, blood flow velocity in this area was increased in both disease and visual acuity recovered. LSFG appears to be a safe and sensitive means to evaluate these disease progression and response to therapy. A multifractal analysis has been performed for blood flow data in the composite map of the LSFG. In consequence, multifractality becomes clearly worse for the AMD patient compared to normal choroidal blood flows. The multifractal analysis of LSFG data represents an additional useful method to detect the early stage of AMD.

Yoshida, K.; Saito, W.; Fujii, H.; Yakubo, K.

2007-07-01

320

[Origin of bilateral-symmetrical animals (Bilateria)].  

PubMed

The paper is an attempt to attack the old problem of the origin of Bilateria by the methods of evolutionary tetrad (i.e. combination of comparative anatomy, comparative embryology, paleontology, and molecular biology). Three groups of theories of classical comparative anatomy (planulod-turbellarian, archicoelomate, and metameric) are discussed. Comparative embryology brings out clearly that the ventral side of embryo comes from the blastoporal region in all groups of Bilateria (except Chordata, where the blastoporal region corresponds to the dorsal side that is come out of the upside-down morphology of chordates) and mouth and anus comes from the anterior and posterior ends of elongated blastopore. From the point of view of paleontology, some of vendian metazoans demonstrate transitional conditions between the Radiata and Bilateria. Vendian bilaterians are metameric organisms with normal or asymmetric position of segments and could be pictured as "bilateral coelenterates" creeping on the oral surface. In Cnidaria, the expression of homologues of "Brachyury", "goosecoid", and "fork head" genes are revealed in the circular region around the mouth. In Bilateria, these genes are expressed along the elongated blastopore and around the mouth and anus. These results support the old conception on the amphistomic origin of mouth and anus as well as the homology between the oral disc of cnidarians and ventral side of Bilateria. The combination of four mentioned approaches enables us to propose the conception of the origin of Bilateria from vendian bilateral coelenterates with numerous metameric pouches of gastral cavity. Bilaterian ancestors crawled on the oral disc (= ventral side). These ancestors gave rise to both phanerosoic cnidarians and triploblastic bilaterians. Cnidarian ancestors attached to bottom by the aboral pole with the resulting degradation of aboral nerve ganglion. Bilateral symmetry of anthozoans is considered to be primitive feature for cnidarians. In case of triploblastic Bilateria, the elongated blastopore closed in the middle and subdivided into mouth and anus (amphistomy) and gastral pouches separated from the central part of gastral cavity and transformed to metameric coelomic chambers. The primary bilaterians are supposed to be complicated organisms having coelom and segmentation. The complexity of primary Bilateria provides an explanation for the abundance of highly organized organisms (arthropods, mollusks etc.) in Cambrian time. It is postulated that Ctenophora is the only group recent eumetazoans with primary axial symmetry. PMID:15559569

Malakhov, V V

2004-01-01

321

A very rare bilateral adrenal tumor.  

PubMed

We report a case of very rare adrenal tumor. A 54-year-old patient was classified as affected by bilateral adrenal incidentaloma that surprisingly, on histology resulted solitary fibrous tumors. Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm. Only five cases of localization of SFT in adrenal gland are reported in the literature, while the frequency of retroperitoneum localization is more frequent, about 30 cases. Immunohistochemically, SFT can be positive for CD34 antigen, vimentin, CD99, and bcl-2 and usually negative for cytokeratins, chromogranin A, NSE, neurofilaments, synoptophysin, and S-100. Surgical excision remains the main treatment in fact the recurrence is locoregional and correlated with positive margins due to incomplete excision, while distant metastases are correlated with atypical or malignant features. PMID:24146413

Toniato, Antonio; Boschin, Isabella Merante; Pelizzo, Maria Rosa

2014-04-01

322

Computed tomography findings in bilateral perinephric lymphangiomatosis  

PubMed Central

Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis. PMID:20842254

Hakeem, Aijaz; Gojwari, Tariq A; Reyaz, Sheikh; Rasool, Shubana; Shafi, Hakim; Mufti, Shahida

2010-01-01

323

Bilateral variant origin of pectoralis major.  

PubMed

The variable origin of muscles is not uncommon though the complete or partial absence of the clavicular head of pectoralis major muscle is rare. This paper deals with bilateral partial absence of clavicular head of pectoralis major muscle. The clavicular head was arising only in the middle of medial half of the clavicle and was separated from sternocostal head by a gap of 2.5cm and laterally from the origin of deltoid from clavicle by a gap of 2.5cm. Nerve supply of this muscle was from lateral and medial pectoral nerves as usual. The partial absence of the clavicular head of pectoralis major muscle becomes important in cases of reconstructive surgery as this head is required to cover the lateral acromioclavicular defect and in cases of established facial paralysis. PMID:16827097

Goyal, Neeru; Harjeet; Gupta, Madhur

2006-03-01

324

Computed tomography findings in bilateral perinephric lymphangiomatosis.  

PubMed

Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis. PMID:20842254

Hakeem, Aijaz; Gojwari, Tariq A; Reyaz, Sheikh; Rasool, Shubana; Shafi, Hakim; Mufti, Shahida

2010-01-01

325

Framing effect following bilateral amygdala lesion.  

PubMed

A paradigmatic example of an emotional bias in decision making is the framing effect, where the manner in which a choice is posed--as a potential loss or a potential gain--systematically biases an ensuing decision. Two fMRI studies have shown that the activation in the amygdala is modulated by the framing effect. Here, contrary to an expectation based on these studies, we show that two patients with Urbach-Wiethe (UW) disease, a rare condition associated with congenital, complete bilateral amygdala degeneration, exhibit an intact framing effect. However, choice preference in these patients did show a qualitatively distinct pattern compared to controls evident in an increased propensity to gamble, indicating that loss of amygdala function does exert an overall influence on risk-taking. These findings suggest either that amygdala does contribute to decision making but does not play a causal role in framing, or that UW is not a pure lesion model of amygdala function. PMID:20227427

Talmi, Deborah; Hurlemann, René; Patin, Alexandra; Dolan, Raymond J

2010-05-01

326

Bilateral adrenal gland haemorrhage: an unusual cause  

PubMed Central

Summary Our patient had drainage of a large amoebic liver abscess. This got complicated by a severe degree of hypotension, which required aggressive fluid resuscitation and hydrocortisone support. Computerised tomography (CT) of the abdomen revealed bilateral adrenal gland haemorrhage (BAH) resulting in primary adrenal gland failure, which was the cause for hypotension. Patient was on long-term warfarin for provoked deep vein thrombosis of lower limb, which was discontinued before the procedure. Thrombophilia profile indicated the presence of lupus anticoagulant factor with prolonged activated partial thromboplastin time (aPTT). Patient was discharged on lifelong warfarin. This case emphasises the need for strong clinical suspicion for diagnosing BAH, rare but life-threatening condition, and its association with amoebic liver abscess and anti-phospholipid antibody syndrome (APLS). Learning points Recognition of BAH as a rare complication of sepsis.APLS can rarely cause BAH. PMID:25276353

Shenoy, Vasant; Malabu, Usman; Cameron, Donald; Sangla, Kunwarjit

2014-01-01

327

Bilateral mechanical rotational vertebral artery occlusion.  

PubMed

Rotational vertebral artery occlusion, or bow hunter's stroke, is reversible, positional symptomatic vertebrobasilar ischemia. The typical mechanism of action is obstruction of a dominant vertebral artery with contralateral head rotation in the setting of baseline ipsilateral vertebral artery stenosis or occlusion. Here we present a rare case of mechanical occlusion of bilateral patent vertebral arteries manifesting as near syncope with rightward head rotation. Diagnostic cerebral angiography showed dynamic right C5 vertebral occlusion and left C2 vertebral occlusion. The patient underwent right C4/5 transverse process decompression. Postoperative angiogram showed patent flow through the right vertebral artery in neutral position and with head turn with resultant resolution of symptoms. PMID:23465174

Dargon, Phong T; Liang, Conrad W; Kohal, Anmol; Dogan, Aclan; Barnwell, Stanley L; Landry, Gregory J

2013-10-01

328

Bilateral balanced articulation: science or dogma?  

PubMed

For more than a hundred years, it has been supposed that canine guidance should be avoided in conventional complete dentures, since it would result in denture instability. Thus, bilateral balanced articulation has been held by many authors as fundamental for treatment success. However, randomized clinical trials have shown that balanced articulation is not as important as previously thought. The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant for both the dentist and dental technician. Therefore, the purpose of this study is to provide an evidence-based update on complete denture occlusion. Clinical Relevance: The issue about which occlusal concept is the most appropriate for individual needs is clinically and economically relevant. PMID:25073224

Farias-Neto, Arcelino; Carreiro, Adriana da Fonte Porto

2014-06-01

329

Candidate gene study of macular response to supplemental lutein and zeaxanthin?  

PubMed Central

Supplementation with carotenoids is proposed to protect against age-related macular degeneration. There is, however, considerable variability in retinal macular pigment response, which may be due to underlying genetic variation. The purpose of this study was to determine whether genetic factors, which have been previously associated with cross-sectional macular pigment levels in the retina or serum lutein, also influence response to supplementation. To this end we conducted an association study in 310 subjects from the TwinsUK cohort between variants in 8 candidate genes and serum lutein and retinal macular pigment optical density (MPOD) levels before and after supplementation. Four variants were associated with MPOD response to supplementation (p < 0.05): rs11057841 (SCARB1), rs4926339 (RPE65), rs1929841 (ABCA1) and rs174534 (FADS1). We also confirmed previous associations between rs6564851 near BMCO1 (p < 0.001) and rs11057841 within SCARB1 (p = 0.01) and baseline measures of serum lutein; while the latter was also associated with MPOD response, none of the BMCO1 variants were. Finally, there was evidence for association between variants near RPE65 and ELOVL2 and changes in lutein concentration after supplementation. This study is the first to show association between genetic variants and response to carotenoids supplementation. Our findings suggest an important link between MP response and the biological processes of carotenoids transport and fatty acid metabolism. PMID:23891863

Yonova-Doing, Ekaterina; Hysi, Pirro G.; Venturini, Cristina; Williams, Katie M.; Nag, Abhishek; Beatty, Stephen; Liew, S.H. Melissa; Gilbert, Clare E.; Hammond, Christopher J.

2013-01-01

330

Extreme retinal remodeling triggered by light damage: implications for age related macular degeneration  

Microsoft Academic Search

Purpose: Our objective was to comprehensively assess the nature and chronology of neural remodeling in retinal degenerations triggered by light-induced retinal damage (LIRD) in adult albino rodents. Our primary hypothesis is that all complete photoreceptor degenerations devolve to extensive remodeling. An hypothesis emergent from data analysis is that the LIRD model closely mimics late-stage atrophic age relared macular degeneration (AMD).

Robert E. Marc; B. W. Jones; C. B. Watt; F. Vazquez-Chona; D. K. Vaughan; D. T. Organisciak

2008-01-01

331

Subretinal Hemorrhages Secondary to Age-Related Macular Degeneration: Psychological and Vision-Related Functional Perspectives  

Microsoft Academic Search

Purpose: To assess psychological, visual and functional aspects associated with subretinal hemorrhages secondary to age-related macular degeneration (AMD). Method: In this prospective, comparative, longitudinal study, 90 eyes of 90 patients with a subretinal hemorrhage, secondary to AMD, of at least 1 disk diameter were treated with recombinant tissue plasminogen activator (rTPA) and gas, and compared to 25 eyes of 25

Maneli Mozaffarieh; Stefan Sacu; Thomas Benesch; Andreas Wedrich

2008-01-01

332

Fruits and vegetables that are sources for lutein and zeaxanthin: the macular pigment in human eyes  

Microsoft Academic Search

BACKGROUNDIt has been suggested that eating green leafy vegetables, which are rich in lutein and zeaxanthin, may decrease the risk for age related macular degeneration. The goal of this study was to analyse various fruits and vegetables to establish which ones contain lutein and\\/or zeaxanthin and can serve as possible dietary supplements for these carotenoids.METHODSHomogenates of 33 fruits and vegetables,

Olaf Sommerburg; Jan E E Keunen; Alan C Bird; Frederik J G M van Kuijk

1998-01-01

333

Angiographic findings in patients with exudative age-related macular degeneration  

Microsoft Academic Search

Purpose: Exudative age-related macular degeneration (ARMD) is the leading cause for severe visual loss in the elderly. A series of clinical trials has established the efficacy of laser photocoagulation and photodynamic therapy (PDT) in special subgroups of patients with exudative ARMD. We analyzed the fluorescein and indocyanine green angiograms (ICG) of patients with exudative ARMD to characterize the nature of

Jochen Bermig; Hans Tylla; Claudia Jochmann; Andrei Nestler; Sebastian Wolf

2002-01-01

334

Subthreshold (retinal pigment epithelium) photocoagulation in macular diseases: a pilot study  

Microsoft Academic Search

BACKGROUNDSubthreshold (retinal pigment epithelium) photocoagulation is a new photocoagulation method, which treats the retinal pigment epithelium (RPE) and avoids damage to the neural retina. The initial results in this prospective pilot study on various macular diseases are presented.METHODS12 patients with diabetic maculopathy (group I), 10 with soft drusen (group II), and four with central serous retinopathy (CSR) (group III) were

Johann Roider; Ralf Brinkmann; Christopher Wirbelauer; Horst Laqua; Reginald Birngruber

2000-01-01

335

Meta-Analysis of Chromovitrectomy with Indocyanine Green in Macular Hole Surgery  

Microsoft Academic Search

Purpose: To report a meta-analysis of the literature comparing internal limiting membrane (ILM) peeling with and without indocyanine green (ICG) staining in macular hole (MH) treatment. Methods: A Pubmed search was conducted from January 1999 to June 2004. Manuscripts describing the anatomical and functional outcomes of vitrectomy plus ILM peeling with and without ICG application in MH surgery were reviewed.

Eduardo B. Rodrigues; Carsten H. Meyer

2008-01-01

336

| 02 | Miniature Telescope Age-related macular degeneration (AMD) is a retinal disease  

E-print Network

| 02 | Miniature Telescope Age-related macular degeneration (AMD) is a retinal disease that affects, patients will frequently rely on low vision devices such as magnifiers and telescopes. Unfortunately, these tools can be bulky and difficult to use for some patients. The Implantable Miniature Telescope (IMT

Leistikow, Bruce N.

337

The Psychosocial Impact of Closed-Circuit Televisions on Persons with Age-Related Macular Degeneration  

ERIC Educational Resources Information Center

Closed-circuit televisions (CCTVs) are used by many elderly people who have age-related macular degeneration (AMD). The functional vision of 68 participants, which was measured immediately after they adopted CCTVs, suggested successful outcomes, but the psychosocial impact of the use of CCTVs did not peak until a month later. The findings help…

Huber, Jessica G.; Jutai, Jeffrey W.; Strong, J. Graham; Plotkin, Ann D.

2008-01-01

338

In vivo snapshot hyperspectral image analysis of age-related macular degeneration  

PubMed Central

Drusen, the hallmark lesions of age related macular degeneration (AMD), are biochemically heterogeneous and the identification of their biochemical distribution is key to the understanding of AMD. Yet the challenges are to develop imaging technology and analytics, which respect the physical generation of the hyperspectral signal in the presence of noise, artifacts, and multiple mixed sources while maximally exploiting the full data dimensionality to uncover clinically relevant spectral signatures. This paper reports on the statistical analysis of hyperspectral signatures of drusen and anatomical regions of interest using snapshot hyperspectral imaging and non-negative matrix factorization (NMF). We propose physical meaningful priors as initialization schemes to NMF for finding low-rank decompositions that capture the underlying physiology of drusen and the macular pigment. Preliminary results show that snapshot hyperspectral imaging in combination with NMF is able to detect biochemically meaningful components of drusen and the macular pigment. To our knowledge, this is the first reported demonstration in vivo of the separate absorbance peaks for lutein and zeaxanthin in macular pigment. PMID:21096261

Lee, Noah; Wielaard, J.; Fawzi, A. A.; Sajda, P.; Laine, A. F.; Martin, G.; Humayun, M. S.; Smith, R. T.

2014-01-01

339

Ranibizumab for the treatment of neovascular age-related macular degeneration: A review  

Microsoft Academic Search

Background: Choroidal neovascular (wet) age-related macular degeneration (ARMD) is becoming more prevalent worldwide as life expectancy continues to increase. Ranibizumab for intravitreal injection is an inhibitor of human vascular endothelial growth factor A approved by the US Food and Drug Administration for the treatment of ARMD in June 2006. The actions of ranibizumab result in reduced cell proliferation, reduced formation

Helen Kourlas; Paris Abrams

2007-01-01

340

Candidate gene study of macular response to supplemental lutein and zeaxanthin.  

PubMed

Supplementation with carotenoids is proposed to protect against age-related macular degeneration. There is, however, considerable variability in retinal macular pigment response, which may be due to underlying genetic variation. The purpose of this study was to determine whether genetic factors, which have been previously associated with cross-sectional macular pigment levels in the retina or serum lutein, also influence response to supplementation. To this end we conducted an association study in 310 subjects from the TwinsUK cohort between variants in 8 candidate genes and serum lutein and retinal macular pigment optical density (MPOD) levels before and after supplementation. Four variants were associated with MPOD response to supplementation (p < 0.05): rs11057841 (SCARB1), rs4926339 (RPE65), rs1929841 (ABCA1) and rs174534 (FADS1). We also confirmed previous associations between rs6564851 near BMCO1 (p < 0.001) and rs11057841 within SCARB1 (p = 0.01) and baseline measures of serum lutein; while the latter was also associated with MPOD response, none of the BMCO1 variants were. Finally, there was evidence for association between variants near RPE65 and ELOVL2 and changes in lutein concentration after supplementation. This study is the first to show association between genetic variants and response to carotenoids supplementation. Our findings suggest an important link between MP response and the biological processes of carotenoids transport and fatty acid metabolism. PMID:23891863

Yonova-Doing, Ekaterina; Hysi, Pirro G; Venturini, Cristina; Williams, Katie M; Nag, Abhishek; Beatty, Stephen; Liew, S H Melissa; Gilbert, Clare E; Hammond, Christopher J

2013-10-01

341

Autoantibodies to retinal astrocytes associated with age-related macular degeneration  

Microsoft Academic Search

Sera from 128 patients with age-related macular degeneration (AMD) were examined and profiles of a variety of serum constituents, including immunoglobulins, alpha and beta globulins and autoantibodies, were tabulated. A similar series of tests were carried out on 20 control sera. The results indicate a higher incidence of serum abnormalities, particularly involving alpha-2 globulin, in patients with disturbance of pigmentation

Philip L. Penfoldi; Jan M. Provis; Judith H. Furby; Paul A. Gatenby; Francis A. Billson

1990-01-01

342

Critical appraisal of ranibizumab in the treatment of diabetic macular edema  

PubMed Central

Diabetic retinopathy is the leading cause of blindness among individuals of working age in industrialized nations, with most of the vision loss resulting from diabetic macular edema (DME). The formation of DME depends on the action of several growth factors and inflammatory mediators, but vascular endothelial growth factor (VEGF) appears to be critical for breaking down the blood-retinal barrier and promoting the accumulation of macular edema. Laser photocoagulation has been the standard-of-care for three decades, and although it stabilizes vision, significant gains in visual acuity after treatment are unusual. Several VEGF inhibitors (pegaptanib, aflibercept, and ranibizumab) have been initially developed and tested for the treatment of age-related macular degeneration and subsequently for DME. In Phase I, II, and III trials for DME, ranibizumab has been shown to be superior to macular laser photocoagulation and intraocular triamcinolone acetonide injections for improving visual acuity and drying the macula. As a result, ranibizumab is the only anti-VEGF drug that has been approved by the United States Food and Drug Administration for the treatment of DME. Most experts now consider intravitreal anti-VEGF therapy to be standard-of-care for DME involving the fovea. PMID:23836955

Stewart, Michael W

2013-01-01

343

Rehabilitation of reading in older individuals with macular degeneration: A review of effective training programs  

Microsoft Academic Search

Macular degeneration (MD) is the most common cause of visual impairment among older adults. It severely affects reading performance. People with MD have to rely on peripheral vision for reading. In this review, we considered several training programs that aim to improve peripheral reading, with a focus on eccentric viewing, oculomotor control, or perceptual learning. There was no strong support

Judith Pijnacker; Peter Verstraten; Wim van Damme; Jo Vandermeulen; Bert Steenbergen

2011-01-01

344

Single nucleotide polymorphisms of the tenomodulin gene (TNMD) in age-related macular degeneration  

Microsoft Academic Search

Purpose: Tenomodulin (TNMD) is located in the X-chromosome encoding a putative angiogenesis inhibitor which is expressed in retina. Associations of single nucleotide polymorphisms of TNMD with the prevalence of age-related macular degeneration (AMD) were examined. Methods: Six markers covering 75% of the common sequence variation in the coding region of TNMD and 10 kb up- and downstream were genotyped in

Anna-Maija Tolppanen; Tanja Nevalainen; Marjukka Kolehmainen; Sanna Seitsonen; Ilkka Immonen

2009-01-01

345

Analysis of the stargardt disease gene ( ABCR) in age-related macular degeneration  

Microsoft Academic Search

PurposeAge-related macular degeneration (AMD) is a complex genetic disorder and the leading cause of severe vision loss in the elderly. The Stargardt disease gene (ABCR) has been proposed as a major genetic risk factor in AMD. The purpose of this study was to evaluate the authors’ AMD population for the specific ABCR variants proposed previously as genetic risk factors for

Vanessa K. Guy; Suzanne Abou-Donia; Ruth Heinis; Bekki Bracken; Jeffery M. Vance; John R. Gilbert; J. Donald M. Gass; Jonathan L. Haines; Margaret A. Pericak-Vance

1999-01-01

346

Understanding the Genetics of Age-Related Macular Degeneration: Some Insights into the Disease Pathogenesis  

Microsoft Academic Search

KEYWORDS AMD; genes; SNP; genotype; association; CFH ABSTRACT Age-related macular degeneration (AMD) is a late-onset complex disorder with multifactorial etiologies. Both genetic and environmental factors play a role in the disease pathogenesis. AMD is the third leading cause of blindness in the elderly. Familial aggregation, segregation studies and linkage analysis have provided both qualitative and quantitative evidence on the genetic

Inderjeet Kaur; Yashoda Ghanekar; Subhabrata Chakrabarti

2008-01-01

347

VEGF polymorphisms are associated with neovascular age-related macular degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is the most common cause of blindness in the elderly. Linkage has been shown to the vascular endothelial growth factor (VEGF) gene and ocular levels of VEGF are raised in individuals with the neovascular form of disease. To examine the role of VEGF further, we conducted a case-c ontrol study where 45 individuals with neovascular AMD

Amanda J. Churchill; James G. Carter; Helen C. Lovell; Conor Ramsden; Steven J. Turner; Anna Yeung; Julia Escardo; Denize Atan

2006-01-01

348

Autosomal Dominant Hemorrhagic Macular Dystrophy Not Associated With the TIMP3 Gene  

Microsoft Academic Search

Objective: To describe the ophthalmic and genetic find- ings of a large kindred (UM:H389) with autosomal domi- nant hemorrhagic macular dystrophy. Methods: The disease state of family members was docu- mented by dilated fundus examination, electroretinog- raphy, color vision tests, fluorescein angiography, mea- surement of visual fields, biomicroscopy, gonioscopy, and intraocular pressure measurement. Linkage and haplo- type analyses were carried

Radha Ayyagari; Irina B. Griesinger; Eve Bingham; Kurt K. Lark; Sayoko E. Moroi; Paul A. Sieving

2000-01-01

349

ABCR Gene Analysis in Familial Exudative Age-Related Macular Degeneration  

Microsoft Academic Search

PURPOSE. Identification of genetic factors in the pathogenesis of age-related macular degeneration (AMD) is of crucial importance in this common cause of blindness. Mutations in the Stargardt disease gene (ABCR) were previously reported in patients with atrophic forms of AMD. The purpose of this study was to analyze familial segregation of ABCR gene mutations in 52 unrelated multiplex cases of

Eric H. Souied; Dominique Ducroq; Jean-Michel Rozet; Sylvie Gerber; Isabelle Perrault; Arnold Munnich; Gabriel Coscas; Gisele Soubrane; Josseline Kaplan

2000-01-01

350

Cone Dysfunction in Patients With Late-Onset Cone Dystrophy and Age-Related Macular Degeneration  

Microsoft Academic Search

Objectives: To determine the clinical and functional findings in patients with late-onset cone dystrophy (LOCD) (after the age of 50 years), which is rare; and to compare them with those of patients with age-related macular degeneration (AMD). Methods: Eleven LOCD patients underwent ophthal- mologic and electroretinographic examinations. Full- field electroretinograms were recorded according to the International Society for Clinical Electrophysiology

Markus Ladewig; Hannelore Kraus; Michael H. Foerster; Ulrich Kellner

2003-01-01

351

V1 Projection Zone Signals in Human Macular Degeneration Depend on Task, not Stimulus  

Microsoft Academic Search

We used functional magnetic resonance imaging to assess abnormal cortical signals in humans with juvenile macular degeneration (JMD). These signals have been interpreted as indicating large-scale cortical reorganization. Subjects viewed a stimulus passively or performed a task; the task was either related or unrelated to the stimulus. During passive viewing, or while performing tasks unrelated to the stimulus, there were

Yoichiro Masuda; Serge O. Dumoulin; Satoshi Nakadomari; B. A. Wandell

2008-01-01

352

Cone Dysfunction in Patients With Late-Onset Cone Dystrophy and Age-Related Macular Degeneration  

Microsoft Academic Search

Objectives: To determine the clinical and functional findings in patients with late-onset cone dystrophy (LOCD) (after the age of 50 years), which is rare; and to compare them with those of patients with age-related macular degeneration (AMD). Methods: Eleven LOCD patients underwent ophthal- mologic and electroretinographic examinations. Full- field electroretinograms were recorded according to the International Society for Clinical Electrophysiology

Markus Ladewig; Hannelore Kraus; Michael H. Foerster; Ulrich Kellner

353

In vivo micropathology of Best macular dystrophy with optical coherence tomography  

Microsoft Academic Search

Best macular dystrophy (BMD) is an autosomal dominant retinopathy caused by mutations in the VMD2 gene that encodes a chloride channel in the basolateral membrane of the retinal pigment epithelium (RPE). BMD patients were studied using optical coherence tomography (OCT) to understand the disease process in the macula leading to vision loss. BMD patients (ages 5–61), representing four families with

Michael J. Pianta; Tomas S. Aleman; Artur V. Cideciyan; Janet S. Sunness; Yuanyuan Li; Betsy A. Campochiaro; Peter A. Campochiaro; Donald J. Zack; Edwin M. Stone; Samuel G. Jacobson

2003-01-01

354

Identification of spectral phenotypes in age-related macular degeneration patients  

NASA Astrophysics Data System (ADS)

The purpose of this study is to show that there exists a spectral characteristic that differentiates normal macular tissue from various types of genetic-based macular diseases. This paper demonstrates statistically that hyperspectral images of macular and other retinal tissue can be used to spectrally differentiate different forms of age-related macular degeneration. A hyperspectral fundus imaging device has been developed and tested for the purpose of collecting hyperspectral images of the human retina. A methodology based on partial least squares and ANOVA has been applied to determine the hyperspectral representation of individual spectral characteristics of retinal features. Each discrete tissue type in the retina has an identifiable spectral shape or signature which, when combined with spatial context, aids in detection of pathological features. Variations in the amount and distribution of various ocular pigments or the inclusion of additional biochemical substances will allow detection of pathological conditions prior to traditional histological presentation. Fundus imaging cameras are ubiquitous and are one of the most common imaging modalities used in documenting a patient's retinal state for diagnosis, e.g. remotely, or for monitoring the progression of an ocular disease. The added diagnostic information obtained with only a minor retro-fit of a specialized spectral camera will lead to new diagnostic information to the clinical ophthalmologist or eye-care specialist.

Davis, Bert; Russell, Steven; Abramoff, Michael; Nemeth, Sheila C.; Barriga, E. Simon; Soliz, Peter

2007-02-01

355

Adaptation to Low Vision Caused by Age-Related Macular Degeneration: A Case Study  

ERIC Educational Resources Information Center

One in eight Americans aged 65 and older has an eye disease resulting in low vision, and more women than men are visually impaired, mainly because women live longer. Age-related visual impairments are an indicator of a decline in activities of daily living and self-help skills. The top eye conditions that affect older adults are macular

Smith, Theresa Marie

2008-01-01

356

Bilateral cochlear implants in children R. Litovskya,*, P. Johnstonea  

E-print Network

patients has been bilateral implantation. To date, there is a growing number of bilateral adult CI users, participated in a series of binaural tasks at 3 and 9 months after activation of the second CI. Each child the second CI at the age of 8, but not for the older child whose second CI was received at the age of 12

Litovsky, Ruth

357

Case report: bilateral simultaneous tubeless and stentless percutaneous nephrolithotomy.  

PubMed

A 39-year-old man underwent percutaneous nephrolithotomy (PCNL) for bilateral renal stone without stent and tube insertion. To our knowledge, this is the first report of bilateral simultaneous tubeless and stentless PCNL. The advantage of this technique in renal stone surgery is discussed. PMID:18177242

Istanbulluoglu, Okan M; Ozturk, Bulent; Cicek, Tufan; Gonen, Murat; Ozkardes, Hakan

2008-01-01

358

Embarazo ectópico bilateral con embrión vivo en la trompa izquierda  

Microsoft Academic Search

Bilateral ectopic pregnancy with a live embryo is a rare occurrence. We report a case of bilateral ectopic pregnancy with live embryo in one tube and an interrupted gestation in the other tube, in a patient with no risk factors. When there is a unilateral ectopic pregnancy, even without risk factors, the other adnexal area and abdominal cavity should also

Aitziber Elvira Urdampilleta; Amaia Oyarzabal Urkiola; M. José Larraza Zandueta; Olatz Lizartza; Borja Rivero Torrejón; Juan Mari Landa Aranzabal; Miguel Ángel Giribet

2009-01-01

359

Bilateral Cochlear Implantation in Children: Experiences and Considerations  

ERIC Educational Resources Information Center

Between 2000 and 2006, the University Clinic for Ear Nose and Throat and Communication Disorders in Mainz, Germany, performed 41 bilateral cochlear implantations in children. This article addresses some of the factors to be considered in a decision to bilaterally implant a child, including the age of the child at the first implant, the length of…

Bohnert, Andrea; Spitzlei, Vera; Lippert, Karl L.; Keilmann, Annerose

2006-01-01

360

Congenital bilateral perisylvian syndrome: first report in a Japanese patient.  

PubMed

A Japanese boy with congenital bilateral perisylvian syndrome is described. He had oropharyngoglossal dysfunction and severe dysarthria. Magnetic resonance imaging of the brain disclosed bilateral perisylvian malformations suggesting polymicrogyria. The patient also showed mental retardation, epilepsy, and poor motor skills. PMID:8914634

Hattori, H; Higuchi, Y; Maihara, T; Jung, E Y; Furusho, K; Asato, R

1996-03-01

361

Congenital bilateral perisylvian syndrome: First report in a Japanese patient  

Microsoft Academic Search

Summary A Japanese boy with congenital bilateral perisylvian syndrome is described. He had oropharyngoglossal dysfunction and severe dysarthria. Magnetic resonance imaging of the brain, disclosed bilateral perisylvian malformations suggesting polymicrogyria. The patient also showed mental retardation, epilepsy, and poor motor skills.

Haruo Hattori; Yoshihisa Higuchi; Toshiro Maihara; Eun-Young Jung; Kenshi Furusho; Reinin Asato

1996-01-01

362

Congenital bilateral perisylvian syndrome with pituitary hypoplasia and ectopic neurohypophysis  

Microsoft Academic Search

Congenital bilateral perisylvian syndrome (CBPS) is a congenital neurological syndrome characterized by pseudobulbar palsy, cognitive deficits and bilateral perisylvian abnormalities observed on imaging. The described abnormality in CBPS is polymicrogyria located in the frontal, parietal, and\\/or occipital lobes. A few syndromes or abnormalities associated with this syndrome have been documented. Pituitary abnormalities are rare disorders. Association of CBPS with pituitary

Ensar Yekeler; Meral Ozmen; Hakan Genchellac; Memduh Dursun; Gulden Acunas

2004-01-01

363

Closed cervical spine trauma associated with bilateral vertebral artery injuries  

Microsoft Academic Search

Bilateral vertebral artery injuries in closed cervical spine injuries are uncommon, but early recognition and treatment are important to prevent neurological deterioration. A case of bilateral vertebral injuries in a 35-year-old motor vehicle accident victim is presented, and the current literature is reviewed.

P. Kloen; J. D. Patterson; B. I. Wintman; R. M. Ozuna; G. W. Brick

1999-01-01

364

Bilateral laparoscopic nephrectomy with simultaneous peritoneal dialysis: a new era  

Microsoft Academic Search

Peritoneal dialysis is the treatment of choice in children with end-stage renal failure who are awaiting renal transplantation. Traditionally patients requiring bilateral nephrectomy spent time on haemodialysis prior to being converted to peritoneal dialysis during a separate operation. Bilateral synchronous retroperitoneoscopic nephrectomy with the initiation of or return to peritoneal dialysis in the immediate postoperative period was performed on three

Caroline Booth; Imran Mushtaq; Susan Rigden

2004-01-01

365

Bilateral Central Retinal Vein Occlusion Associated with Multiple Myeloma  

Microsoft Academic Search

Purpose: To report a case of simultaneous bilateral central retinal vein occlusion (CRVO) associated with multiple myeloma. Methods: A 65-year-old woman had sudden, painless loss of vision in both eyes for 20 days. Ophthalmologic examination revealed bilateral CRVO. Appropriate medical workup was conducted, and multiple myeloma was diagnosed as the underlying cause. Results: Clinical support and chemotherapy effectively controlled paraprotein

Fabio B. Aggio; Angelino J. Cariello; Manuella S. S. Almeida; Celso A. Rodrigues; Nilva S. B. de Moraes; Gisele W. B. Colleoni; Michel E. Farah

2004-01-01

366

Topical Latanoprost Does Not Cause Macular Thickening after Uncomplicated Cataract Surgery  

PubMed Central

Purpose To explore changes in central macular thickness (CMT) after a two-month period of glaucoma therapy with topical latanoprost after uneventful phacoemulsification. Methods Forty-one eyes of 31 patients with primary open angle or pseudoexfoliative glaucoma who required glaucoma medications after cataract surgery were prospectively enrolled. All eyes had undergone uneventful phacoemulsification with intraocular lens implantation at least 4 months before initiation of latanoprost. After a complete ophthalmic examination, spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) were performed at baseline before starting latanoprost. All eyes received latanoprost for 2 months, and clinical examinations were repeated one and two months afterwards; OCT and FA were repeated after 2 months. Outcome measures were CMT and loss of more than 2 lines of best corrected visual acuity (BCVA). Results Mean patient age was 71.6±7.8 years. Intraocular pressure decreased from 21.5±3.4 mmHg to 14.4±2.6 mmHg (p<0.001) at 2 months. None of the eyes developed reduction of BCVA exceeding 2 lines, or angiographic cystoid macular edema (CME). Likewise no significant change was noted in CMT (249.9±29.8 vs 248.8±30.7µm), average macular thickness (274.5±15.0 vs 273.8±17.0µm), or macular volume (9.6±1.0 vs 9.6±1.1µm2) after treatment as compared to baseline (P>0.05 for all comparisons). Conclusion Topical use of latanoprost later than 4 months after uncomplicated cataract surgery does not seem to predispose to increased macular thickness or CME and may safely be used in this setting. PMID:23503128

Moghimi, Sasan; Zandian, Mehdi; Latifi, Golshan; Amini, Heydar; Eslami, Yadollah; Zarei, Reza; Fakhraie, Ghasem; Nouri-Mahdavi, Kouros

2012-01-01

367

Fear of falling in age-related macular degeneration  

PubMed Central

Background Prior studies have shown age-related macular degeneration (AMD) to be associated with falls. The purpose of this study is to determine if (AMD) and AMD-related vision loss are associated with fear of falling, an important and distinct outcome. Methods Sixty-five persons with AMD with evidence of vision loss in one or both eyes and 60 glaucoma suspects with normal vision completed the University of Illinois at Chicago Fear of Falling questionnaire. Responses were Rasch analyzed. Scores were expressed in logit units, with lower scores demonstrating lesser ability and greater fear of falling. Results Compared to glaucoma suspect controls, AMD subjects had worse visual acuity (VA) (median better-eye VA?=?20/48 vs. 20/24, p?

2014-01-01

368

A twin study on age-related macular degeneration.  

PubMed Central

A prospective twin study on age-related macular degeneration (AMD) recruited 83 monozygotic pairs, 28 dizygotic pairs, and one triplet set from 1986 through 1993. Zygosity was determined by genetic testing of red cell markers, HLA antigens, or specific DNA loci. There were no twin pairs in which I collected data on only one twin. To decrease ascertainment bias, after 1991 the recruitment notice did not mention AMD, and I did not ask about a history of eye disease before the eye examination. Because of this, twin pairs recruited from 1986 through 1991 were statistically analyzed separately from those after January 1, 1992. From 1986 through 1991, 23 twin pairs were recruited; 11 monozygotic and 2 dizygotic pairs had nonAMD retinal changes or no retinal abnormalities, 9 monozygotic pairs with AMD were all concordant, and 1 dizygotic pair was discordant for basal laminar drusen. The concordance rate of AMD did not differ significantly between monozygotic and dizygotic twin pairs (P = .10) for 1986 through 1991. In 1992 and 1993, 88 twin pairs and one triplet set were recruited; 49 monozygotic and 19 dizygotic pairs had nonAMD retinal changes or no retinal abnormalities, 14 monozygotic pairs with AMD were all concordant, and 2 of 7 dizygotic pairs were concordant for AMD. The nonidentical triplets (1 with and 2 without AMD) were categorized as one of the discordant dizygotic pairs in the statistical evaluation. In nontwin age-matched (within 2 or 5 years of age) or age- and sex-matched sibling pairs the concordance rate of AMD ranged from 16% to 25%. The concordance rate of AMD was significantly higher in monozygotic than in dizygotic twins (P = .001) for 1992 and 1993. The concordance rate was higher for monozygotic twin pairs recruited in 1992 and 1993 than in any of the four subsets of nontwin age-method or age- and sex-matched sibling pairs (P < .0001). Overall, from 1986 through 1993, 23 of 23 monozygotic and 2 of 8 dizygotic twin pairs were concordant for AMD; this included the one dizygotic pair which was discordant for basal laminar drusen. The data of this study strongly suggest a genetic predisposition to AMD. Images FIGURE 1 FIGURE 1 (cont.) FIGURE 2 FIGURE 2 (cont.) FIGURE 2 (cont.) FIGURE 3 FIGURE 3 (cont.) FIGURE 3 (cont.) FIGURE 3 (cont.) FIGURE 4 FIGURE 4 (cont.) FIGURE 5 FIGURE 5 (cont.) FIGURE 5 (cont.) FIGURE 6 FIGURE 6 (cont.) FIGURE 7 FIGURE 7 (cont.) FIGURE 8 FIGURE 8 (cont.) FIGURE 9 FIGURE 9 (cont.) FIGURE 9 (cont.) FIGURE 10 FIGURE 10 (cont.) FIGURE 11 FIGURE 11 (cont.) FIGURE 11 (cont.) FIGURE 12 FIGURE 12 (cont.) FIGURE 12 (cont.) PMID:7886884

Meyers, S M

1994-01-01

369

Complement factor I and age-related macular degeneration  

PubMed Central

Purpose The complement system has been implicated in the pathogenesis of age-related macular degeneration (AMD). Complement factor I (CFI) is a serum protease that inhibits all complement pathways. A previous multicenter study identified a single missense CFI mutation (p.Gly119Arg) in 20/3,567 (0.56%) of AMD cases versus 1/3,937 (0.025%) of controls, thus suggesting that this mutation confers a high risk of AMD. A second CFI mutation, p.Gly188Ala, was identified in one patient with AMD. Methods We screened 521 unrelated AMD cases and 627 controls for the p.Gly119Arg and p.Gly188Ala variants. All participants were Caucasian and >55 years, and recruited through Southampton Eye Unit or research clinics in Guernsey. All participants underwent dilated fundal examination by an experienced retinal specialist. SNP assays were performed using KASP™ biochemistry. Results The p.Gly119Arg mutation was identified in 7/521 AMD cases compared to 1/627 age-matched controls (odds ratio [OR] = 8.47, confidence interval [CI] = 1.04–69.00, p = 0.027). There was a varied phenotype among the seven cases with the mutation, which was present in 4/254 (1.6%) cases with active or end-stage wet AMD and 3/267 dry AMD cases (1.1%). The p.Gly188Ala substitution was identified in 1/521 cases and 1/627 controls. Conclusions Our results identified a much higher frequency of heterozygosity for p.Gly119Arg in both cases and controls than in previous studies. Of note is that our sub-cohort from Guernsey had a particularly high frequency of p.Gly119Arg heterozygosity in affected individuals (4%) compared to our sub-cohort from the mainland (0.71%). Although these data support the conclusions of van de Ven et al. that the p.Gly119Arg substitution confers a high risk of AMD, our data suggest that this missense mutation is not as rare or as highly penetrant as previously reported. There was no difference in frequency for a second CFI variant, p.Gly188Ala, between the cases and the controls. PMID:25352734

Alexander, Philip; Gibson, Jane; Cree, Angela J.; Ennis, Sarah

2014-01-01

370

Progress on retinal image analysis for age related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is the leading cause of vision loss in those over the age of 50 years in the developed countries. The number is expected to increase by ?1.5 fold over the next ten years due to an increase in aging population. One of the main measures of AMD severity is the analysis of drusen, pigmentary abnormalities, geographic atrophy (GA) and choroidal neovascularization (CNV) from imaging based on color fundus photograph, optical coherence tomography (OCT) and other imaging modalities. Each of these imaging modalities has strengths and weaknesses for extracting individual AMD pathology and different imaging techniques are used in combination for capturing and/or quantification of different pathologies. Current dry AMD treatments cannot cure or reverse vision loss. However, the Age-Related Eye Disease Study (AREDS) showed that specific anti-oxidant vitamin supplementation reduces the risk of progression from intermediate stages (defined as the presence of either many medium-sized drusen or one or more large drusen) to late AMD which allows for preventative strategies in properly identified patients. Thus identification of people with early stage AMD is important to design and implement preventative strategies for late AMD, and determine their cost-effectiveness. A mass screening facility with teleophthalmology or telemedicine in combination with computer-aided analysis for large rural-based communities may identify more individuals suitable for early stage AMD prevention. In this review, we discuss different imaging modalities that are currently being considered or used for screening AMD. In addition, we look into various automated and semi-automated computer-aided grading systems and related retinal image analysis techniques for drusen, geographic atrophy and choroidal neovascularization detection and/or quantification for measurement of AMD severity using these imaging modalities. We also review the existing telemedicine studies which include diagnosis and management of AMD, and how automated disease grading could benefit telemedicine. As there is no treatment for dry AMD and only early intervention can prevent the late AMD, we emphasize mass screening through a telemedicine platform to enable early detection of AMD. We also provide a comparative study between the imaging modalities and identify potential study areas for further improvement and future research direction in automated AMD grading and screening. PMID:24211245

Kanagasingam, Yogesan; Bhuiyan, Alauddin; Abràmoff, Michael D; Smith, R Theodore; Goldschmidt, Leonard; Wong, Tien Y

2014-01-01

371

Infliximab for Diabetic Macular Edema Refractory to Laser Photocoagulation  

PubMed Central

OBJECTIVE Because many patients with diabetic macular edema (DME) do not respond to focal/grid laser photocoagulation, the only currently approved treatment, alternatives are needed. Based on encouraging preliminary findings, we aimed to assess efficacy and safety of the anti–tumor necrosis factor (TNF) monoclonal antibody infliximab in this condition. RESEARCH DESIGN AND METHODS This was a single-center, double-blind, randomized, placebo-controlled, crossover study. Eleven patients with sight-threatening DME persisting after two sessions of laser photocoagulation received infliximab (5 mg/kg) intravenously at weeks 0, 2, 6, and 14, followed by placebo at weeks 16, 18, 22, and 30, or vice versa. Blinding was maintained to week 32, when the final assessments were performed. Best corrected visual acuity evaluated by a mixed-models approach for imbalanced crossover design using the percentage difference as the outcome variable was the primary study end point. Data were analyzed on an intention-to-treat basis. RESULTS Early Treatment of Diabetic Retinopathy Study (ETDRS) scores dropped from 31.6 ± 5.1 (mean ± SD) letters read at baseline to 28.8 ± 11.6 letters read at week 16 in six placebo-treated eyes and improved to 35.4 ± 11.2 letters read after infliximab. In contrast, visual acuity improved from 23.5 ± 10.3 at baseline to 30.4 ± 13.4 letters read at week 16 in eight infliximab-treated eyes and was sustained at completion of placebo treatment (31.4 ± 12.1 letters read). The excess visual acuity in infliximab-treated eyes was greater by 24.3% compared with that in placebo-treated eyes (95% CI 4.8–43.7; P = 0.017). Infliximab treatment was well tolerated. CONCLUSIONS The positive results of this small phase III study suggest that larger and longer term trials should be conducted to assess the efficacy of systemic or intravitreal anti-TNF agent administration for primary treatment of DME. PMID:20413522

Sfikakis, Petros P.; Grigoropoulos, Vlassis; Emfietzoglou, Ioannis; Theodossiadis, George; Tentolouris, Nicholas; Delicha, Evi; Katsiari, Christina; Alexiadou, Kleopatra; Hatziagelaki, Erifili; Theodossiadis, Panayiotis G.

2010-01-01

372

Misdiagnosis of bilateral tubal pregnancy: a case report  

PubMed Central

Introduction The incidence of bilateral tubal pregnancy is rising due to the increase of pelvic inflammatory disease and assisted reproductive techniques. Because the clinical manifestations of bilateral tubal pregnancy are not specific, we often ignore inspection of the other fallopian tube when focusing on the lesions, which may cause misdiagnosis. Case presentation A 33-year-old Chinese woman presented with vaginal bleeding after menopause and with an abnormality found by transvaginal ultrasound scan for which she underwent laparoscopy and salpingectomy. Unfortunately, she had to undergo a repetitive laparoscopic salpingotomy for the other tubal pregnancy due to misdiagnosis of her bilateral tubal pregnancy. Conclusions The incidence of unusual presentations of ectopic pregnancies has risen. Surgeons should always keep in mind the possibility of bilateral tubal pregnancy. An attentive examination of the pelvis, especially the two fallopian tubes, is necessary to avoid missing bilateral tubal pregnancy. PMID:25312677

2014-01-01

373

Bilateral Thoracic Ganglion Cyst : A Rare Case Report  

PubMed Central

Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis. PMID:23908708

Kazanci, Burak; Tehli, Ozkan; Guclu, Bulent

2013-01-01

374

Bilateral thoracic ganglion cyst : a rare case report.  

PubMed

Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis. PMID:23908708

Kazanci, Burak; Tehli, Ozkan; Türkoglu, Erhan; Guclu, Bulent

2013-05-01

375

Bilateral Spontaneous Hemotympanum Secondary to Chemotherapy-Induced Thrombocytopenia  

PubMed Central

Objective To present a case of spontaneous, bilateral hemotympanum secondary to chemotherapy-induced thrombocytopenia. Methods Case report and review of the literature. Results Bilateral spontaneous hemotympanum is an exceedingly rare event. We present the first case of nontraumatic bilateral hemotympanum secondary to chemotherapy-induced thrombocytopenia in a patient with acute myelogenous leukemia. The patient presented with a 7-day history of progressive bilateral hearing loss and a platelet count of 10 × 109/L after receiving his first dose of induction chemotherapy. A small, left-sided subdural hematoma was present in this patient though no extra-aural sources of bleeding to explain the bilateral hemotympanum were identified. Conclusion Full resolution of symptoms was achieved with conservative management. PMID:24179409

Wong, Peter; Xu, Caroline; Gomaa, Nahla; Ho, Allan

2013-01-01

376

A 2-Year, Phase IV, Multicentre, Observational Study of Ranibizumab 0.5 mg in Patients with Neovascular Age-Related Macular Degeneration in Routine Clinical Practice: The EPICOHORT Study  

PubMed Central

Purpose. To assess the safety profile of ranibizumab 0.5 mg in patients with neovascular age-related macular degeneration (nAMD) in routine clinical practice. Methods. This 2-year, multicentre, observational study was conducted to capture real-world early practice and outcomes across Europe, shortly after European licensing of ranibizumab for nAMD. Being observational in nature, the study did not impose diagnostic/therapeutic interventions/visit schedule. Patients were to be treated as per the EU summary of product characteristics (SmPC) in effect during the study. Key outcome measures were incidence of selected adverse events (AEs), treatment exposure, bilateral treatment, compliance to the EU SmPC, and best-corrected visual acuity (BCVA) over 2 years. Results. 755 of 770 patients received treatment. Ranibizumab was generally well tolerated with low incidence of selected AEs (0%–1.9%). Patients received 6.2 (mean) injections and 133 patients received bilateral treatment over 2 years. Protocol deviation to treatment compliance was reported in majority of patients. The observed decline in mean BCVA (Month 12, +1.5; Month 24, –1.3 letters) may be associated with undertreatment as suggested by BCVA subgroup analysis. Conclusion. The EPICOHORT study conducted in routine clinical practice reinforces the well-established safety profile of ranibizumab in nAMD. In early European practice it appeared that the nAMD patients were undertreated. PMID:24868458

Beatty, Stephen; Perez-Salvador Garcia, Eduardo; Reynders, Stefaan; Si Bouazza, Abdelkader; Pilz, Stefan

2014-01-01

377

Long-term effect of early intervention with single intravitreal injection of bevacizumab followed by panretinal and macular grid photocoagulation in central retinal vein occlusion (CRVO) with macular edema: A pilot study  

Microsoft Academic Search

PurposeTo evaluate the effect of single-dose intravitreal bevacizumab followed by panretinal and macular grid laser, early in the course of central retinal vein occlusion (CRVO).MethodsIt is a prospective, non-randomized, interventional study of nine eyes of nine patients with <10 days origin of CRVO who received 2.5 mg (0.1 ml) intravitreal bevacizumab, followed 3 weeks later by panretinal and macular grid

N J Shah; U N Shah

2011-01-01

378

Variations in Genes Can Influence the Risk of Developing Age-Related Macular Degeneration and Other Diseases Such as Cancer  

Cancer.gov

A team of researchers found that variations in certain genes involved in fighting infection can predict the risk of developing age-related macular degeneration (AMD), the leading cause of blindness in white Americans over the age of 60.

379

Evaluation of the Best disease gene in patients with age-related macular degeneration and other maculopathies  

Microsoft Academic Search

Vitelliform macular dystrophy (VMD2, Best disease, MIM153700) is an early onset, autosomal, dominant macular degeneration\\u000a characterized by the deposition of lipofuscin-like material within and below the retinal pigment epithelium (RPE); it is associated\\u000a with degeneration of the RPE and overlying photoreceptors. Recently, we cloned the gene bestrophin, which is responsible for\\u000a the disease, and identified a number of causative mutations

Rando Allikmets; Johanna M. Seddon; Paul S. Bernstein; Amy Hutchinson; Andrew Atkinson; Sanjay Sharma; Bernard Gerrard; Wen Li; Michael L. Metzker; Claes Wadelius; C. Thomas Caskey; Michael Dean; Konstantin Petrukhin

1999-01-01

380

Late-Onset Autosomal Dominant Macular Dystrophy with Choroidal Neovascularization and Nonexudative Maculopathy Associated with Mutation in the RDS Gene  

Microsoft Academic Search

PURPOSE. To examine the molecular genetic basis and pheno- typic characteristics of an unusual late-onset autosomal domi- nant macular dystrophy with features of age-related macular degeneration (AMD) in a large family (SUNY901), by using linkage and mutation analyses. METHODS. Blood samples were collected from 17 affected mem- bers, 17 clinically unaffected members, and 5 unrelated spouses. Clinical analyses included a

Shahrokh C. Khani; Athanasios J. Karoukis; Joyce E. Young; Rajesh Ambasudhan; Tracy Burch; Richard Stockton; Richard Alan Lewis; Lori S. Sullivan; Stephen P. Daiger; Elias Reichel; Radha Ayyagari

381

Case Reports: Symptomatic Bilateral Talonavicular Coalition  

PubMed Central

Congenital talonavicular coalition is reported less frequently than talocalcaneal or calcaneonavicular coalition and represent approximately 1% of all tarsal coalitions. Although reportedly transmitted as an autosomal-dominant disorder, tarsal coalition may be inherited as an autosomal-recessive trait. It has been associated with various orthopaedic anomalies, including symphalangism, clinodactyly, a great toe shorter than the second toe, clubfoot, calcaneonavicular coalition, talocalcaneal coalition, and a ball-and-socket ankle. Patients with talonavicular coalitions are usually asymptomatic and rarely undergo surgical treatment. We report the case of a 24-year-old woman with symptomatic bilateral talonavicular coalitions and previously unreported associated anomalies (nail hypoplasia and metatarsus primus elevatus) and review the relevant literature. The patient underwent surgery (calcaneocuboid joint distraction arthrodesis and a proximal plantar flexion osteotomy with a dorsal open wedge of the first metatarsal). At 1-year followup, she was pain-free with better alignment of both feet and showed radiographic consolidation of the arthrodesis. Although this condition is less likely to be clinically important than other tarsal fusions, it sometimes can be painful enough for the patient to undergo surgery. PMID:18791772

Migues, Atilio; Suarez, Esteban; Galan, Hernan L.

2008-01-01

382

Case reports: symptomatic bilateral talonavicular coalition.  

PubMed

Congenital talonavicular coalition is reported less frequently than talocalcaneal or calcaneonavicular coalition and represent approximately 1% of all tarsal coalitions. Although reportedly transmitted as an autosomal-dominant disorder, tarsal coalition may be inherited as an autosomal-recessive trait. It has been associated with various orthopaedic anomalies, including symphalangism, clinodactyly, a great toe shorter than the second toe, clubfoot, calcaneonavicular coalition, talocalcaneal coalition, and a ball-and-socket ankle. Patients with talonavicular coalitions are usually asymptomatic and rarely undergo surgical treatment. We report the case of a 24-year-old woman with symptomatic bilateral talonavicular coalitions and previously unreported associated anomalies (nail hypoplasia and metatarsus primus elevatus) and review the relevant literature. The patient underwent surgery (calcaneocuboid joint distraction arthrodesis and a proximal plantar flexion osteotomy with a dorsal open wedge of the first metatarsal). At 1-year followup, she was pain-free with better alignment of both feet and showed radiographic consolidation of the arthrodesis. Although this condition is less likely to be clinically important than other tarsal fusions, it sometimes can be painful enough for the patient to undergo surgery. PMID:18791772

Migues, Atilio; Slullitel, Gastón A; Suárez, Esteban; Galán, Hernan L

2009-01-01

383

Modified bilateral-filter for illumination equalization  

NASA Astrophysics Data System (ADS)

Variation in illumination conditions through a scene is a common issue for classification, segmentation and recognition applications. Traffic monitoring and driver assistance systems have difficulty with the changing illumination conditions at night, throughout the day, with multiple sources (especially at night) and in the presence of shadows. The majority of existing algorithms for color constancy or shadow detection rely on multiple frames for comparison or to build a background model. The proposed approach uses a novel color space inspired by the Log-Chromaticity space and modifies the bilateral filter to equalize illumination across objects using a single frame. Neighboring pixels of the same color, but of different brightness, are assumed to be of the same object/material. The utility of our algorithm is studied over day and night simulated scenes of varying complexity. The objective is not to provide a product for visual inspection but rather an alternate image with fewer illumination related issues for other algorithms to process. The usefulness of the filter is demonstrated by applying two simple classifiers and comparing the class statistics. The hyper-log-chromaticity image and the filtered image both improve the quality of the classification relative to the un-processed image.

Brisebois, Samuel; Gartley, M.

2011-06-01

384

Exploring the benefits of bilateral cochlear implants.  

PubMed

Several recent reports indicate that both localization and speech intelligibility in spatially separated noise are substantially improved by using cochlear implants (CIs) in both ears rather than in just one. Benefits appear to be largely derived from the effects of level variations at the two ears due to the head shadow whereas contributions from interaural time differences (ITDs) seem smaller than in normal hearing listeners. The effect of binaural unmasking estimated from speech studies to date varies from study to study and is possibly confounded by issues such as listening experience, bias or loudness effects when comparing the performance for the better ear with that using both ears. To improve the contribution from timing information at the two ears, it may be necessary to change present clinical sound-processing schemes that currently preserve only envelope cues so that they also preserve fine-timing information. However, recently published data show that basic psychophysical sensitivity to fine-timing ITDs in CI patients is very poor for rates beyond a few hundred hertz, suggesting that subjects do not actually hear ITD cues at those rates anyway. Data from a number of new studies are presented to discuss these and other issues related to the potential to benefit from bilateral implantation. PMID:15205551

van Hoesel, Richard J M

2004-01-01

385

Lack of association of mutations of the bestrophin gene with age-related macular degeneration in non-familial Japanese patients  

Microsoft Academic Search

Background: Heterozygous mutations of the bestrophin gene are associated with Best macular dystrophy (BMD). The bestrophin gene is specifically\\u000a expressed in the retinal pigment epithelium. BMD is a hereditary form of macular degeneration that may develop subretinal\\u000a neovascularisation similar to the wet type of age-related macular degeneration (AMD). Purpose: To study whether mutations of the bestrophin gene occur in non-familial

Akiko Akimoto; Masayuki Akimoto; Sachiko Kuroiwa; Takanobu Kikuchi; Nagahisa Yoshimura

2001-01-01

386

Bestrophin, the product of the Best vitelliform macular dystrophy gene (VMD2), localizes to the basolateral plasma membrane of the retinal pigment epithelium  

Microsoft Academic Search

Best vitelliform macular dystrophy is a dominantly inherited, early onset, macular degenerative disease that exhibits some histopathologic similarities to age-related macular degeneration. Although the vitelliform lesion is common in the fundus of individuals with Best disease, diagnosis is based on a reduced ratio of the light peak to dark trough in the electrooculogram. Recently, the VMD2 gene on chromosome 11q13,

Alan D. Marmorstein; Lihua Y. Marmorstein; Mary Rayborn; Xinxing Wang; Joe G. Hollyfield; Konstantin Petrukhin

2000-01-01

387

Spheniodal mucocele causing bilateral optic neuropathy and ophthalmoplegia  

PubMed Central

Sphenoid sinus mucocele comprises only 2% of all paranasal sinus mucoceles. In literature, there is a case report on sphenoidal mucocele causing bilateral optic neuropathy, with unilateral partial recovery and cranial nerve palsy, but we did not come across any literature with bilateral optic neuropathy and ophthalmoplegia together caused by spheno-ethmoidal mucocele. We present such a rare case of spheno-ethmoidal mucocele causing bilateral optic neuropathy and unilateral sixth nerve palsy who had postsurgery, unilateral good vision recovery, and complete resolution of sixth nerve palsy. PMID:23571243

Selvakumar, Ambika; Mahalaxmi, Balasubramanyam; Ananth, V; Gautam, Cugati

2014-01-01

388

Bilateral Tibial Tubercle Sleeve Fractures in a Skeletally Immature Patient  

PubMed Central

Tibial tubercle sleeve fracture is a rare injury. In concept, it is similar to the patellar sleeve fracture in a skeletally immature patient. We describe a unique case of simultaneous bilateral tibial tubercle sleeve fractures in a 12-year-old boy. Radiographs and MRI confirmed the injury. The patient underwent open surgical repair of bilateral sleeve fractures with suture anchor fixation. At the final followup, 3 years after his initial injury, the patient demonstrated full knee function bilaterally without radiographic evidence of growth disturbances. PMID:23691395

Desai, Rasesh R.; Parikh, Shital N.

2013-01-01

389

Male breast cancer: presenting as synchronous, large, bilateral masses.  

PubMed

Male breast cancer is a very rare neoplasm which accounts for 1% of all breast cancers. A 70-year-old male presented with a rapidly growing, bilateral breast masses with large size, surface ulceration and bloody discharge. Synchronous bilateral breast cancer was diagnosed by using fine needle aspiration cytology, mammography, ultrasonography and incisional biopsy. Histopathological studies revealed invasive ductal carcinoma (not otherwise specified), which was of grade III in left breast and of grade II in right breast. We are presenting this case with its clinico-pathological findings, as synchronous bilateral breast cancer occurs extremely rarely in males. PMID:24959456

Jagtap, Sunil Vitthalrao; Chougule, P G; Khatib, Wasim; Shukla, Dhirajkumar B; Jagtap, Swati Sunil

2014-04-01

390

Development of a Risk Score for Geographic Atrophy in Complications of Age-Related Macular Degeneration Prevention Trial  

PubMed Central

Objective To develop a risk score for developing geographic atrophy (GA) involving easily obtainable information among patients with bilateral large drusen. Design Cohort study within a multicenter randomized clinical trial. Participants 1052 participants with ?10 large (>125 ?) drusen and visual acuity ?20/40 in each eye. Methods In the Complications of Age-related Macular Degeneration (AMD) Prevention Trial (CAPT), one eye of each participant was randomly assigned to laser treatment and the contralateral eye was assigned to observation to evaluate whether laser treatment of drusen could prevent vision loss. Gradings by a reading center were used to identify three outcomes for GA: CAPT endpoint GA (total area of GA (>250 u) >1 disc area), GA (>175 u) involving the foveal center (CGA), and GA of any size and location (any GA). Four established risk factors (age, smoking status, presence of hypertension, Age-related Eye Disease Study (AREDS) simple severity scale score), both with and without a novel risk factor (night vision score), were used in assigning risk points. The risk scores were evaluated for the ability to discriminate and calibrate GA risk. Main Outcome Measures Development of endpoint GA, CGA and any GA. Results Among 942 CAPT participants who completed 5 years of follow-up and did not have any GA at baseline, 64 (6.8%) participants developed CAPT endpoint GA, 90 (9.6%) developed CGA, and 342 (34.4%) developed any GA. The 5-year incidence of endpoint GA in one or both eyes of a participant increased with the 15-point GA risk score, from 0.6% for <7 points to 15% for ?12 points. The 5-factor risk score predicted development of GA moderately well with the area under the receiver operating characteristic curve (AUC) 0.76 (95% confidence interval: 0.71–0.81) for endpoint GA; 0.76 (0.71–0.80) for CGA and 0.68 (0.65–0.72) for any GA. Prediction from the risk score without the night vision score had lower AUCs (range: 0.67 to 0.72). Conclusions If validated in other patients, the GA risk scores will be useful for identifying high risk patients for clinical trials of prevention of GA and for clinical assessment of GA risk in early AMD patients. PMID:20801521

Ying, Gui-shuang; Maguire, Maureen G.

2010-01-01

391

Synchronous bilateral neuroendocrine ductal carcinoma in situ.  

PubMed

Neuroendocrine ductal carcinoma in situ (NE-DCIS) is a breast malignancy that has characteristic clinicopathological features and can, therefore, be regarded as a distinct variant of DCIS. The patient was a 54-year-old premenopausal woman with hemorrhagic nipple discharge in her left breast. Magnetic resonance imaging and ultrasound (US) images of the left breast showed mass-like lesions, while concurrent images of the right breast showed non-mass-like lesions. These findings suggested the presence of both benign and malignant tumors. Pathological findings from US-guided core-needle biopsy of the left mass were highly suspicious of a malignant tumor. Excisional biopsy of both breasts was performed. We could define the diagnosis of breast cancer by the second opinion on pathological diagnosis. The tumor cells showed histological characteristics of NE-DCIS. Bilateral breast lesions had histopathological similarities and were composed of predominantly solid growth of carcinoma cells, frequently with well-developed vascular structures, in mammary ducts and ductules. Carcinoma cells were polygonal or occasionally spindle shaped and had fine-granular, relatively eosinophilic cytoplasm. The nuclei of these cells showed round to ovoid in shape and fine-granular chromatin pattern. There was not any invasive component, as confirmed by careful histological examination. Thus, additional immunohistochemical stainings for NE markers (chromogranin A and synaptophysin) were performed. Staining statuses of these markers were positive in almost all tumor cells from both breasts. Both tumors were therefore diagnosed as NE-DCIS. To our knowledge, this case is the first report of NE-DCIS diagnosed synchronously in both breasts. PMID:21735237

Honami, Hisae; Sotome, Keiichi; Sakamoto, Goi; Iri, Hisami; Tanaka, Yoichi; Fukamachi, Shigeru; Morozumi, Kyoei

2014-07-01

392

Laser-Based Strategies to Treat Diabetic Macular Edema: History and New Promising Therapies  

PubMed Central

Diabetic macular edema (DME) is the main cause of visual impairment in diabetic patients. The management of DME is complex and often various treatment approaches are needed. At the present time, despite the enthusiasm for evaluating several new treatments for DME, including the intravitreal pharmacologic therapies (e.g., corticosteroids and anti-VEGF drugs), laser photocoagulation still remains the current standard in DME. The purpose of this review is to update our knowledge on laser photocoagulation for DME and describe the developments in laser systems. And we will also discuss the new laser techniques and review the latest results including benefits of combined therapy. In this paper, we briefly summarize the major laser therapeutics for the treatment of diabetic macular edema and allude to some future promising laser therapies. PMID:25332833

Park, Young Gun; Kim, Eun Yeong; Roh, Young Jung

2014-01-01

393

Subthreshold Diode Micropulse Laser Photocoagulation (SDM) as Invisible Retinal Phototherapy for Diabetic Macular Edema: A Review  

PubMed Central

Purpose: To present the state-of-the-art of subthreshold diode laser micropulse photocoagulation (SDM) as invisible retinal phototherapy for diabetic macular edema (DME). Method: To review the role and evolution of retinal laser treatment for DME. Results: Thermal laser retinal photocoagulation has been the cornerstone of treatment for diabetic macular edema for over four decades. Throughout, laser induced retinal damage produced by conventional photocoagulation has been universally accepted as necessary to produce a therapeutic benefit, despite the inherent risks, adverse effects and limitations of thermally destructive treatment. Recently, SDM, performed as invisible retinal phototherapy for DME, has been found to be effective in the absence of any retinal damage or adverse effect, fundamentally altering our understanding of laser treatment for retinal disease. Summary: The discovery of clinically effective and harmless SDM treatment for DME offers exciting new information that will improve our understanding of laser treatment for retinal disease, expand treatment indications, and improve patient outcomes. PMID:22587512

Luttrull, Jeffrey K; Dorin, Giorgio

2012-01-01

394

Segmentation of the macular choroid in OCT images acquired at 830nm and 1060nm  

NASA Astrophysics Data System (ADS)

Retinal imaging with optical coherence tomography (OCT) has rapidly advanced in ophthalmic applications with the broad availability of Fourier domain (FD) technology in commercial systems. The high sensitivity afforded by FD-OCT has enabled imaging of the choroid, a layer of blood vessels serving the outer retina. Improved visualization of the choroid and the choroid-sclera boundary has been investigated using techniques such as enhanced depth imaging (EDI), and also with OCT systems operating in the 1060-nm wavelength range. We report on a comparison of imaging the macular choroid with commercial and prototype OCT systems, and present automated 3D segmentation of the choroid-scleral layer using a graph cut algorithm. The thickness of the choroid is an important measurement to investigate for possible correlation with severity, or possibly early diagnosis, of diseases such as age-related macular degeneration.

Lee, Sieun; Beg, Mirza F.; Sarunic, Marinko V.

2013-06-01

395

Indirect photocoagulation of subfoveal choroidal neovascularization in age-related macular degeneration.  

PubMed Central

Forty consecutive patients with age-related macular degeneration and a choroidal neovascular membrane in the center of the macula were treated by dye laser photocoagulation. After a mean 24 month follow-up period, 21 patients (52.5%) remained stable or improved in vision. Of 21 patients with initial visual acuity of 20/100 or better, 11 patients (52%) remained 20/100 or better. In the control group only four patients (25%) remained stable or improved, and only two (15%) remained 20/100 or better. The theoretical and clinical advantages of the indirect laser treatment of subfoveal choroidal neovascular membranes in age-related macular degeneration are discussed. Images Fig. 1a-d Fig. 2a-d Fig. 3a-d PMID:1714331

Angioletti, L. V.; Colquhoun, P. J.; Kulik, A. D.; Malpica, E. H.

1991-01-01

396

Association of electroretinogram and morphological findings in central retinal vein occlusion with macular edema  

PubMed Central

The objective of this study was to evaluate the relations among electroretinogram (ERG) parameters (cone a-wave, cone b-wave, and 30 Hz flicker), retinal thickness, and retinal volume in 16 patients with central retinal vein occlusion and macular edema. The amplitude and implicit time of the ERG parameters were extracted from the ERG traces. Retinal thickness and volume were measured by optical coherence tomography in nine macular subfields. Then the correlations among ERG parameters and morphological parameters were analyzed. The cone b-wave and 30 Hz flicker implicit time were correlated with retinal thickness and volume in seven out of nine subfields, excluding the temporal subfields. In addition, the amplitude of the cone b-wave was correlated with retinal thickness and volume in the nasal inner and nasal outer subfields. These findings suggest that retinal thickness and volume may be associated with outer and inner retinal function in central retinal vein occlusion patients. PMID:24531560

Noma, Hidetaka; Mimura, Tatsuya; Kuse, Manami; Shimada, Katsunori

2014-01-01

397

Reorganization of visual processing in macular degeneration: replication and clues about the role of foveal loss.  

PubMed

We previously reported large-scale reorganization of visual processing (i.e., activation of "foveal" cortex by peripheral stimuli) in two individuals with loss of foveal input from macular degeneration [Baker, C.I., Peli, E., Knouf, N., & Kanwisher, N. G. (2005). Reorganization of visual processing in macular degeneration. Journal of Neuroscience, 25(3), 614-618]. Here, we replicate this result in three new individuals. Further, we test the hypothesis that this reorganization is dependent on complete loss of foveal input. In two other individuals with extensive retinal lesions but some foveal sparing we found no evidence for reorganization. We conclude that large-scale reorganization of visual processing in MD occurs only in the complete absence of functional foveal vision. PMID:18620725

Baker, Chris I; Dilks, Daniel D; Peli, Eli; Kanwisher, Nancy

2008-08-01

398

Bilateral parotitis as the initial presentation of childhood sarcoidosis.  

PubMed

The differential diagnosis of bilateral parotid gland enlargement in children includes infectious, inflammatory, and neoplastic disorders. We present the case of a 13-year-old male who presented with a 5-week history of bilateral parotid swelling. On exam, both parotid glands were nontender, smooth, and diffusely enlarged. He had slightly elevated inflammatory markers, but other lab results were normal. A neck CT revealed symmetric enlargement of the parotid, submandibular, and sublingual glands. A chest CT revealed scattered peripheral pulmonary nodules and bilateral hilar adenopathy. A parotid gland biopsy showed multiple noncaseating granulomas with multinucleated giant cells surrounded by lymphocytes, consistent with the diagnosis of sarcoidosis. Special stains for acid-fast and fungal organisms were negative. Using this illustrative case, we discuss the differential diagnosis of bilateral salivary gland enlargement in children and review the etiology, diagnosis, clinical manifestations, and treatment of pediatric sarcoidosis. PMID:23102965

Banks, Gretchen C; Kirse, Daniel J; Anthony, Evelyn; Bergman, Simon; Shetty, Avinash K

2013-01-01

399

Ureteral triplication, contralateral duplication and bilateral extravesical ectopic ureter.  

PubMed

A case of ureteral triplication associated with contralateral ureteral duplication and bilateral extravesical ectopic ureter is reported. The child presented with urinary incontinence. The incidence, classification and embryology of triplication are reviewed. PMID:4032556

Youngson, G G

1985-09-01

400

Bilateral adrenal haemorrhagic infarction in a patient with antiphospholipid syndrome.  

PubMed

A 68-year-old woman with antiphospholipid syndrome presented with a 3-day history of bilateral loin pain, vomiting, fever and confusion. On examination she was febrile, hypotensive and tachycardic. Investigations revealed raised inflammatory markers, renal impairment and hyponatraemia. Abdominal ultrasound revealed two well-defined heterogeneous areas bilaterally in the region of the adrenal glands. This prompted serum cortisol measurement and a CT of the abdomen. Cortisol was low in the context of sepsis at 48?nmol/L, and CT confirmed bilateral heterogeneous adrenal pathology. The patient was managed for septic shock and adrenal insufficiency. She was recognised to have several risk factors for haemorrhagic infarction of the adrenals: antiphospholipid syndrome, sepsis, postoperative state and anticoagulant therapy. She was discharged well on glucocorticoid and mineralocorticoid therapy and a repeat CT at 4?weeks confirmed the diagnosis of bilateral adrenal infarct and haemorrhage. PMID:25410037

Godfrey, Rebecca Louise; Clark, James; Field, Benjamin

2014-01-01

401

Simultaneous Bilateral MIS-TKA Results in Faster Functional Recovery  

PubMed Central

Simultaneous bilateral TKAs subject patients to more arduous and painful functional recovery and increased risk of hemodynamic complications than staged bilateral TKAs. Minimally invasive TKA (MIS-TKA) reportedly results in more rapid return of function by limiting the amount of soft tissue disruption. We asked whether bilateral MIS-TKA had advantages over conventional TKA with respect to faster functional recovery. We prospectively randomized 30 patients into an MIS group (mini-medial parapatellar approach, 15 patients) and a conventional group (conventional medial parapatellar approach, 15 patients). We recorded range of motion and the time required to regain the ability to walk without assistance. Functional recovery in the MIS group was faster in rehabilitation milestones of walking without assistance and gain in range of motion. Minimally invasive TKA may benefit patients undergoing simultaneous bilateral procedures with faster functional recovery. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18351423

Han, Ilkyu; Seong, Sang Cheol; Lee, Sahnghoon; Yoo, Jae Ho

2008-01-01

402

Cooled Radiofrequency Ablation for Bilateral Greater Occipital Neuralgia  

PubMed Central

This report describes a case of bilateral greater occipital neuralgia treated with cooled radiofrequency ablation. The case is considered in relation to a review of greater occipital neuralgia, continuous thermal and pulsed radiofrequency ablation, and current medical literature on cooled radiofrequency ablation. In this case, a 35-year-old female with a 2.5-year history of chronic suboccipital bilateral headaches, described as constant, burning, and pulsating pain that started at the suboccipital region and radiated into her vertex. She was diagnosed with bilateral greater occipital neuralgia. She underwent cooled radiofrequency ablation of bilateral greater occipital nerves with minimal side effects and 75% pain reduction. Cooled radiofrequency ablation of the greater occipital nerve in challenging cases is an alternative to pulsed and continuous RFA to alleviate pain with less side effects and potential for long-term efficacy. PMID:24716017

Chhatre, Akhil

2014-01-01

403

Sound localization and interaural time sensitivity with bilateral cochlear implants  

E-print Network

Bilateral cochlear implantation is becoming more common as clinicians attempt to provide better sound-source localization and speech reception in noise for cochlear implant (CI) users. While some improvement over the ...

Poon, Becky Bikkei

2006-01-01

404

1112 Consecutive Bilateral Neck Explorations for Primary Hyperparathyroidism  

Microsoft Academic Search

Background  Bilateral neck exploration has been the standard approach for patients with primary hyperparathyroidism. Improved localization\\u000a studies and the availability of intraoperative parathyroid hormone monitoring have challenged the necessity of four-gland\\u000a exploration. In this series we report a single surgeon’s experience with bilateral neck exploration for primary hyperparathyroidism\\u000a in an effort to establish benchmark outcomes from which to evaluate minimally invasive

John Allendorf; Mary DiGorgi; Kathryn Spanknebel; William Inabnet; John Chabot; Paul LoGerfo

2007-01-01

405

Bilateral thecoma presenting as premenopausal hirsutism: Laproscopic removal  

PubMed Central

Hyperandrogenism is a common disorder among women in the reproductive age group. One of the rare causes for androgen excess is sex cord- stromal tumors of the ovary. These are usually unilateral. Here we report case of a 48 year old woman who presented with hyperandrogenism due to bilateral ovarian thecoma. Androgen levels normalized following resection of the tumor. This, to the best of our knowledge, is the first case of bilateral thecoma presenting as hirsutism in a premenopausal woman. PMID:24910832

Ramkumar, S.; Jyotsna, V. P.; Mallick, S.; Kachhawa, Garima; Kandasamy, D.; Kriplani, A.; Ammini, A. C.

2013-01-01

406

Bilateral keratocystic odontogenic tumor: A report of two cases  

PubMed Central

The designation “keratocyst” was used to describe any jaw cyst in which keratin was formed to a large extent. A rare incidence of bilateral mandibular cysts (odontogenic keratocysts) was related to third molar teeth. Herein, we report two cases of bilateral keratocystic odontogenic tumor in a 22-year-old male and 15-year-old female, which was diagnosed by a series of investigations and treated appropriately. PMID:25298727

Srivatsan, K. S.; Kumar, Vikas; Mahendra, Ashish; Singh, Preeti

2014-01-01

407

Bilateral eyelid agenesis repair in a captive Texas cougar.  

PubMed

Bilateral eyelid agenesis was presented with multiple ocular anomalies in a captive Texas cougar (Felis concolor). Corneal exposure resulted in substantial keratoconjunctivitis and blepharospasm. Bilateral inferopapillary fundic colobomas, persistent pupillary membranes, and an atypical iris coloboma OD were present. Surgical repair with a rotational pedicle flap resulted in functionally effective eyelids. Trichiasis was later treated with cryotherapy. Eyelid agenesis is reported infrequently in domestic cats and among large felids has only been reported in the snow leopard. PMID:12236863

Cutler, Tim J

2002-09-01

408

Bilateral thoracoscopic thymectomy using a novel positioning system.  

PubMed

Several techniques of bilateral video-assisted thoracoscopic extended thymectomy have been proposed, and each has its own proponents. We summarize our experience in 20 patients who underwent bilateral video-assisted thoracoscopic extended thymectomy, using a new patient positioning that amplifies the thoracoscopic view of the cardiophrenic regions which are often difficult to visualize with standard techniques. In all cases, en-bloc thymectomy with complete dissection of the mediastinal fatty tissue was achieved without sternal retractors or additional incisions. PMID:24887902

Caronia, Francesco; Fiorelli, Alfonso; Monte, Attilio Lo

2014-11-01

409

A case presentation of bilateral simultaneous Bell’s palsy  

Microsoft Academic Search

Bilateral simultaneous facial paralysis is an extremely rare clinical entity. Unlike the unilateral form, bilateral facial paralysis seldom falls into Bell’s category. It is most often a special finding in a symptom complex of a systemic disease; many of them are potentially life-threatening, and therefore the condition warrants urgent medical intervention. Lyme disease, Guillian-Barre syndrome, Bell’s palsy, leukemia, sarcoidosis, bacterial

Rahmi Kilic; Ali Ozdek; Sevim Felek; M. Asim Safak; Erdal Samim

2003-01-01

410

Bilateral necrotizing fasciitis of the breast following quadrantectomy  

Microsoft Academic Search

Necrotizing fasciitis (NF) is a rare and highly lethal soft-tissue infection that involves the skin, subcutaneous tissue,\\u000a and fascia. Although it can affect any part of the body, the breast is seldom involved. We describe a case of bilateral NF\\u000a of the breast following elective quadrantectomy, successfully treated with antibiotics, bilateral mastectomy, and a vacuum-assisted\\u000a wound closure system.

Fernando A. Angarita; Sergio A. Acuna; Lilian Torregrosa; Mauricio Tawil; Elio F. Sánchez; Oscar Heilbron; Luis Carlos Domínguez

411

Bilateral Q angle asymmetry and anterior knee pain syndrome  

Microsoft Academic Search

Objective. To determine whether quadriceps (Q) angles were bilaterally symmetric in individuals asymptomatic vs symptomatic for anterior knee pain.Design. Cross-sectional study.Background. Previous attempts to link excessive Q angles to the occurrence of knee pain have yielded equivocal results. Deriving unilateral rather than bilateral measures of the Q angle and thereafter analysing data using traditional between-group analysis-of-variance structural models may, however,

Lori A. Livingston; James L. Mandigo

1999-01-01

412

[Bilateral periventricular nodular heterotopia in a couple mother-infant].  

PubMed

Bilateral periventricular nodular heterotopia in a couple mother-infant. Bilateral periventricular nodular heterotopia (BPNH) is a malformation of neuronal migration, recently recognized X-linked. We report a case of BPNH associated with mega-cisterna magna diagnosed by ultrasound imaging at 27 weeks' gestation and confirmed by MR at 11 days of life. Similar findings in the mother's MR underlines the recurrency of this malformation in the same family. PMID:16922057

Stival, G; Braga, M; Di Marco, A; Riva, E

2005-01-01

413

Recurrent Bilateral Breast Abscess Due to Nontuberculous Mycobacterial Infection  

PubMed Central

Since recurrent bilateral breast infection due to nontuberculous mycobacterium (NTM) is rare, its diagnosis is easily overlooked; in addition, complete recovery is often difficult to achieve. We report a case of recurrent bilateral infection in a 35-year-old woman who had completed treatment for NTM. Although various infectious diseases show similar clinical conditions and imaging findings, recurrences should raise suspicion of NTM infection, and this possibility should be considered in differential diagnoses. PMID:25320630

Yoo, Hyunkyung; Choi, Sang Hyun; Kim, Sei Joong; Cho, Young Up; Choi, Suk Jin

2014-01-01

414

Ranibizumab (Lucentis) in neovascular age-related macular degeneration: evidence from clinical trials  

Microsoft Academic Search

Background:Neovascular age-related macular degeneration (AMD) has a poor prognosis if left untreated, frequently resulting in legal blindness. Ranibizumab is approved for treating neovascular AMD. However, further guidance is needed to assist ophthalmologists in clinical practice to optimise treatment outcomes.Methods:An international retina expert panel assessed evidence available from prospective, multicentre studies evaluating different ranibizumab treatment schedules (ANCHOR, MARINA, PIER, SAILOR, SUSTAIN

P Mitchell; J-F Korobelnik; P Lanzetta; F G Holz; C Prünte; U Schmidt-Erfurth; Y Tano; S Wolf

2010-01-01

415

The electroretinogram: a useful tool for evaluating age-related macular disease?  

Microsoft Academic Search

With an ageing population, the number of age-related macular disease (ARMD) cases will inevitably rise. This gives greater\\u000a impetus for the need to identify the disease earlier and assess treatments to slow disease progression. Differing electroretinogram\\u000a (ERG) modalities have been reviewed in relation to the objective assessment of retinal function in ARMD and for monitoring\\u000a the effectiveness of clinical interventions.

Emma J. BerrowHannah; Hannah E. Bartlett; Frank Eperjesi; Jonathan M. Gibson

2010-01-01

416

Subtenon Vs Intravitreal Triamcinolone injection in Diabetic Macular Edema, A prospective study in Chinese population  

PubMed Central

Objective: Purpose of this study was to validate that Subtenon (SB) Triamcinolone (TA) injection is an alternative to Intravitreal (IV) Triamcinolone (TA) injection for the treatment of diabetic macular edema (DME). Methods: Forty eyes were selected having DME due to type 1 or type 2 diabetes. All the patients were treated with photocoagulation. IVTA was administered in one eye and SBTA in following eye of same patient. Improvement in visual acuity, macular edema and intraocular pressure was assessed before treatment and on 2nd, 4th, 8th and 12th week after treatment. Results: After administration of IVTA, MVA was reduced from baseline value (0.805 ± 0.069Log/MAR) to (0.577 ± 0.091 Log/MAR, p<.001) at the end of treatment. Similar results were observed after SBTA administration. MVA was reduced from (0.814 ± 0.082Log/MAR) to (0.49 ± 0.080 Log/MAR, p<.001) at 12th week. After IVTA injection Central macular thickness was significantly reduced to (246.8 ± 25 µm, p<0.001) from (390.5 ± 17 µm). There were no significant (p=0.51) difference in both eyes receiving different routes of same treatment. After SBTA injection CMT was significantly reduced to lower values (241.5 ± 27 µm, p<0.001) from (394.4 ± 21 µm). Intraocular pressure after IVTA administration was high (2.32 ± 0.72 mm/Hg, p=0.04) as compared to baseline (1.82 ± 0.94 mm/Hg). Similar pattern was also seen after SBTA administration but to significant extent. Elevation of IoP was observed in both eyes. Conclusion: Subtenon Triamcinolone injection is an alternative to Intravitreal Triamcinolone Injection for Diabetic Macular Edema. PMID:25097510

Luo, Dawei; Zhu, Bijun; Zheng, Zhi; Zhou, Haidong; Sun, Xiaodong; Xu, Xun

2014-01-01

417

Focal Laser Photocoagulation in Non-Center Involved Diabetic Macular Edema  

PubMed Central

This study was performed to evaluate the functional and anatomic outcomes of focal macular laser photocoagulation in eyes with non-center involved macular edema (non-CI ME). Forty-nine eyes of 43 patients with non-CI ME were included. Focal macular laser photocoagulation was conducted on twenty-nine eyes of 25 patients, while 20 eyes of 18 patients with non-CI ME were followed without treatment and served as the control group. Data relating to best corrected visual acuity (BCVA; Early Treatment Diabetic Retinopathy Study) and central subfield thickness (CST), inner zone thickness (IZT), outer zone thickness (OZT), and total macular volume (TMV) as determined by optical coherence tomography (OCT) were collected and compared between the groups. At 12 months, VA decreased by a mean of 0.4 letters in the treatment group and 3.3 letters in the control group (p=0.03). Gain in VA ?5 letters was noted in 6 (21%) of the eyes in the treatment group versus 1 (5%) eye in the control group (p=0.12). At 12 months, average IZT decreased by 22.6 microns in the treatment group and increased by 10.9 microns in the control group (p<0.001). The treatment group revealed significant reduction in CST, average OZT, and TMV as compared to the control group at 12 months (all p<0.05).Generally, focal laser photocoagulation may have more favourable visual outcomes in this specific group of diabetic patients than does observation. In addition, focal laser treatment provided better outcomes with improvement in OCT parameters as compared to the control group. PMID:24804275

Perente, Irfan; Alkin, Zeynep; Ozkaya, Abdullah; Dardabounis, Doukas; Ogreden, Tulin Aras; Konstantinidis, Aristeidis; Kyratzoglou, Konstantinos; Yazici, Ahmet Taylan

2014-01-01

418

Author's personal copy The macular degeneration-linked C1QTNF5 (S163) mutation causes  

E-print Network

- like octadecamer. We found that a novel intermolecular hydrogen-bond network of S163 that glues adja Keywords: L-ORMD L-ORD Age-related macular degeneration Cellular adhesion CTRP5 C1QTNF5 a b s t r a c- lium (RPE) cellular adhesion. The C1QTNF5 gene is co-transcribed with the frizzled-related protein

Palczewski, Krzysztof

419

Visual fields after removal of subretinal hemorrhages and neovascular membranes in age-related macular degeneration  

Microsoft Academic Search

· Background: Surgical removal of subretinal hemorrhaging and membranes in eyes with age- related macular degeneration is\\u000a feasible from a technical point of view, but no advantage over the spontaneous course of the disease has been proven. Visual\\u000a acuity usually does not improve much. A realistic aim of surgical intervention may be diminution of the central scotoma size,\\u000a which has

J. Petersen; Wolfgang Meyer-Riemann; Ursula Ritzau-Tondrow; Dirk Bahlmann

1998-01-01

420

In vivo Imaging of Photoreceptor Disruption Associated with Age-Related Macular Degeneration: A Pilot Study  

PubMed Central

Background and Objective Age-related macular degeneration is one of the leading causes of vision loss in the developed world. As the disease progresses, the central part of the retina, called the macula, is compromised leading to a disruption of both structure and visual function. In this study, we investigate the disruption of macular photoreceptor cells in vivo as a function of disease stage in patients with the dry form of age-related macular degeneration AMD. Materials and Methods An investigational confocal Adaptive Optics Scanning Laser Ophthalmoscope (AO-SLO) was used to obtain high resolution images of the macular photoreceptor mosaic in patients previously diagnosed with AMD. Four patients were selected as representative cases, comprising each of the four clinical stages of AMD progression. Results AO-SLO imaging revealed slight disruption in the photoreceptor mosaic in early stage AMD due to focal drusen formation and identified several small drusen deposits that were not observed with standard clinical imaging techniques. An increase in photoreceptor disruption was visualized within the macula in direct correlation with the stage of AMD progression leading to a decrease in visual acuity. Large coalescent drusen and areas of geographic atrophy in advanced stage dry AMD exhibited a significant decrease in visible photoreceptor density. Significant decrease in photoreceptor counts (~35–50%) were observed when comparing earlier stages of AMD progression (Category I & II) to later stages of the disease (Category III & IV). Conclusions This study demonstrates the capabilities of adaptive optics retinal imaging to monitor disruption of individual photoreceptor cells as a function of disease progression yielding valuable diagnostic findings in early stage AMD beyond what can be learned about the health of photoreceptors using conventional retinal imaging techniques. PMID:22930575

Boretsky, Adam; Khan, Faraz; Burnett, Garrett; Hammer, Daniel X.; Ferguson, R. Daniel; van Kuijk, Frederik; Motamedi, Massoud

2013-01-01

421

Screening for age-related macular degeneration using nonstereo digital fundus photographs  

Microsoft Academic Search

Age-related macular degeneration (AMD) is a disease with significant visual morbidity and accounts for the majority of blind registrations in the developed world including the UK. Certain forms of neovascular AMD are amenable to treatment but require expeditious referral to a retinal specialist.AimTo evaluate the possibility of using nonstereo fundus photographs as a low-cost screening tool for neovascular AMD.DesignRetrospective review

S Jain; S Hamada; W L Membrey; V Chong

2006-01-01

422

Regulators of vascular permeability: potential sites for intervention in the treatment of macular edema  

Microsoft Academic Search

Rather than being a non-specific reaction to a noxious stimulus, breakdown of the capillary blood-retinal barrier causing\\u000a macular edema appears to be dependent on a number of active processes which may be open to pharmacological manipulation. Extracellular\\u000a influences which may affect barrier function include serum and neighboring cell types, which act though cytokines, such as\\u000a vascular endothelial growth factor and

Mark C. Gillies

1999-01-01

423

The role of the ERG in the diagnosis and treatment of Age-Related Macular Degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is affecting an increasing number of people, with 2.95 million people estimated to\\u000a be affected in the USA by 2020. Possible preventive agents, such as vitamins and supplements have been studied and new treatment\\u000a options for AMD have been developed in recent years. What role does electrophysiology play as a sensitive outcome measure?\\u000a The most commonly used

Christina Gerth

2009-01-01

424

Visual acuity and contrast sensitivity in patients with neovascular age-related macular degeneration  

Microsoft Academic Search

BackgroundPatients with advanced age-related macular degeneration (AMD) suffer not only from impairment in central visual acuity (VA), but also from reduction in contrast sensitivity (CS). We examined VA and CS changes over time in patients with subfoveal choroidal neovascularizations (CNV) as well as the correlation between the two parameters.MethodsVA was determined according to a standardized protocol with the Early Treatment

Caren Bellmann; Kristina Unnebrink; Gary S. Rubin; Daniel Miller; Frank G. Holz

2003-01-01

425

Exclusion of LCA5 locus in a consanguineous Turkish family with macular coloboma-type LCA  

Microsoft Academic Search

BackgroundLeber's congenital amaurosis (LCA) is an inherited retinal dystrophy, which causes severe visual impairment in early childhood. Recent molecular genetic studies have linked 11 loci (AIPL1, CRB1, CRX, GUCY2D, RPE65, RDH12, RPGRIP1, TULP1, LCA3, LCA5, and LCA9) to LCA. LCA5 is a new locus, which maps to the 6q11–q16 chromosomal region and was found to be associated with macular coloboma-type

R K Özgül; B Bozkurt; H K?ratl?; A Ö?ü?

2006-01-01

426

Genome-wide analysis of copy number variants in age-related macular degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is a complex genetic disease, with many loci demonstrating appreciable attributable\\u000a disease risk. Despite significant progress toward understanding the genetic and environmental etiology of AMD, identification\\u000a of additional risk factors is necessary to fully appreciate and treat AMD pathology. In this study, we investigated copy number\\u000a variants (CNVs) as potential AMD risk variants in a cohort

Kacie J. MeyerLea; Lea K. Davis; Emily I. Schindler; John S. Beck; Danielle S. Rudd; A. Jason Grundstad; Todd E. Scheetz; Terry A. Braun; John H. Fingert; Wallace L. Alward; Young H. Kwon; James C. Folk; Stephen R. Russell; Thomas H. Wassink; Edwin M. Stone; Val C. Sheffield

2011-01-01

427

Molecular Genetic Analysis of ABCR Gene in Japanese Dry Form Age-Related Macular Degeneration  

Microsoft Academic Search

Purpose: To explore whether the mutation in the retina-specific ATP-binding cassette transporter (ABCR) gene, the Stargardt's disease gene, contributes to the prevalence of the dry form of age-related macular degeneration (dry AMD) in Japanese unrelated patients.Methods: Twenty-five Japanese unrelated patients with dry AMD who were diagnosed by fluorescein angiography and indocyanine green angiography were chosen as the dry AMD group.

Nobuo Fuse; Takefumi Suzuki; Yuko Wada; Madoka Yoshida; Masahiko Shimura; Toshiaki Abe; Mitsuru Nakazawa; Makoto Tamai

2000-01-01

428

Evaluation of the G protein coupled receptor-75 (GPR75) in age related macular degeneration  

Microsoft Academic Search

BACKGROUNDA long term project was initiated to identify and to characterise genes that are expressed exclusively or preferentially in the retina as candidates for a genetic susceptibility to age related macular degeneration (AMD). A transcript represented by a cluster of five human expressed sequence tags (ESTs) derived exclusively from retinal cDNA libraries was identified.METHODSNorthern blot and RT-PCR analyses confirmed preferential

Christian G Sauer; Karen White; Heidi Stöhr; Tiemo Grimm; Amy Hutchinson; Paul S Bernstein; Richard Allan Lewis; Francesca Simonelli; Daniel Pauleikhoff; Rando Allikmets; Bernhard H F Weber

2001-01-01

429

Bisretinoids of RPE Lipofuscin: Trigger for Complement Activation in Age-Related Macular Degeneration  

Microsoft Academic Search

\\u000a Genetic association studies and investigations of the constituents of subretinal deposits (drusen) have implicated complement\\u000a dysregulation as one factor predisposing individuals to increased risk of age-related macular degeneration (AMD). Here we\\u000a review evidence that molecular fragments released by photooxidation of the bisretinoids of retinal pigment epithelial lipofuscin,\\u000a can activate complement. Complement activation by this mechanism is dependent on the alternative

Janet R. Sparrow

430

Age-related macular degeneration in grandparents of patients with Stargardt disease: genetic study  

Microsoft Academic Search

PURPOSE: To report clinical features and molecular genetic study in three unrelated families in which age-related macular degeneration was observed in grandparents of patients with Stargardt disease.METHODS: A complete ophthalmologic examination including best-corrected visual acuity measurement, fundus examination, and fluorescein angiography was performed on all members of the three families. The entire coding sequence of the ABCR gene was analyzed

Eric H Souied; Dominique Ducroq; Sylvie Gerber; Imad Ghazi; Jean-Michel Rozet; Isabelle Perrault; Arnold Munnich; Jean Louis Dufier; Gabriel Coscas; Gisèle Soubrane; Josseline Kaplan

1999-01-01

431

The ABCR Gene in Recessive and Dominant Stargardt Diseases: A Genetic Pathway in Macular Degeneration  

Microsoft Academic Search

Stargardt disease (STGD) is a juvenile-onset macular dystrophy and can be inherited in an autosomal recessive or in an autosomal dominant manner. Genes involved in dominant STDG have been mapped to human chromosomes 13q (STGD2) and 6q (STGD3). Here, we identify a new kindred with dominant STGD and demonstrate genetic linkage to the STGD3 locus. Because of a more severe

Kang Zhang; Marina Kniazeva; Amy Hutchinson; Min Han; Michael Dean; Rando Allikmets

1999-01-01

432

Factors Affecting Reading Speed in Patients with Diabetic Macular Edema Treated with Laser Photocoagulation  

PubMed Central

Purpose To study the factors that may affect reading speed in patients with diabetic macular edema previously treated with laser photocoagulation. Methods Consecutive patients with type II diabetes treated with laser photocoagulation for diabetic macular edema (DME) at least twelve months previously, with best corrected visual acuity of better than 65 letters (approximately 20/40) measured with Early Treatment Diabetic Retinopathy Study (ETDRS) charts were included in this study. Patients previously treated with pan-retinal photocoagulation, vitrectomy, intravitreal steroid or anti-VEGF therapy were excluded. Any other ocular co-morbidities that may influence reading ability such as cataract, glaucoma or macular degeneration were also excluded. All patients were refracted by a certified examiner, the following measurements were collected: best corrected visual acuity (BCVA), contrast sensitivity with Pelli-Robson chart, reading speed with MNREAD chart, microperimetry with Nidek MP1, and central subfield thickness with Zeiss spectral domain optical coherent topography. Results The slow reading group had poorer contrast sensitivity (p?=?0.001), reduced retinal sensitivity (p?=?0.027) and less stable fixation (p?=?0.013). Most interestingly the reduced retinal sensitivity findings were driven by the microperimetry value on the right subfield (p?=?0.033), (nasal to the fovea in the right eye and temporal to the fovea in the left eye). Multiple linear regression analysis showed that contrast sensitivity is probably the most important factor that affects reading speed (p?=?0.001). Conclusion Reduced retinal sensitivity after laser treatment is associated with reduced reading speed in patients with diabetic macular edema. PMID:25265280

Pearce, Elizabeth; Sivaprasad, Sobha; Chong, Ngaihang V.

2014-01-01

433

Decreased Fixation Stability of the Preferred Retinal Location in Juvenile Macular Degeneration  

PubMed Central

Macular degeneration is the main cause for diminished visual acuity in the elderly. The juvenile form of macular degeneration has equally detrimental consequences on foveal vision. To compensate for loss of foveal vision most patients with macular degeneration adopt an eccentric preferred retinal location that takes over tasks normally performed by the healthy fovea. It is unclear however, whether the preferred retinal locus also develops properties typical for foveal vision. Here, we investigated whether the fixation characteristics of the preferred retinal locus resemble those of the healthy fovea. For this purpose, we used the fixation-offset paradigm and tracked eye-position using a high spatial and temporal resolution infrared eye-tracker. The fixation-offset paradigm measures release from fixation under different fixation conditions and has been shown useful to distinguish between foveal and non-foveal fixation. We measured eye-movements in nine healthy age-matched controls and five patients with juvenile macular degeneration. In addition, we performed a simulation with the same task in a group of five healthy controls. Our results show that the preferred retinal locus does not adopt a foveal type of fixation but instead drifts further away from its original fixation and has overall increased fixation instability. Furthermore, the fixation instability is most pronounced in low frequency eye-movements representing a slow drift from fixation. We argue that the increased fixation instability cannot be attributed to fixation under an unnatural angle. Instead, diminished visual acuity in the periphery causes reduced oculomotor control and results in increased fixation instability. PMID:24937090

Bethlehem, Richard A. I.; Dumoulin, Serge O.; Dalmaijer, Edwin S.; Smit, Miranda; Berendschot, Tos T. J. M.; Nijboer, Tanja C. W.; Van der Stigchel, Stefan

2014-01-01

434

Optical coherence tomography in diabetic macular edema: patterns and related risk factors.  

PubMed

Introduction: Diabetic Macular Edema (DME) is an important cause of vision loss in diabetic retinopathy. Optical Coherence Tomography (OCT) is a non-invasive modality that produces high-resolution images of retinal layers. Objective: To evaluate the prevalence of DME patterns and their association with risk factors and visual acuity. Materials and Methods: In this cross-sectional study, type 2 diabetics with macular edema referred to our center during a ten-month period underwent OCT. Patients with macular edema due to causes other than diabetes and with OCT images of improper quality were excluded from the study. Four distinct patterns were found in the OCT images. A questionnaire including age, sex, duration of diabetes, serum TG and cholesterol, HbA1c, BMI and visual acuity, as well as the findings of OCT images were filled for the subjects. Results: Eighty-six eyes from 46 patients were evaluated. The most and the least common patterns were sponge-like retinal swelling (SLRS) and posterior hyaloidal traction (PHT) found in 64.0% and 5.8% of the subjects, respectively. A sub-retinal fluid pattern was more common in males (p=0.011) and in patients with serum TG > 200mg/dl (p=0.037). There were significant associations between central foveal (r=0.45, p less than 0.001), nasal (r=0.35, p=0.001) and temporal (r=0.32, p=0.003) thicknesses with visual acuity. Moreover, the highest thickness (462.4±119.2?m) and also the worst visual acuity (1.0±0.5logMAR) pertained to the cystoid macular edema (CME) pattern. Conclusion: Our study showed that the most common OCT pattern of DME is the sponge-like retinal swelling, while posterior hyaloidal traction has the lowest prevalence. A higher foveal thickness and a lower visual acuity are seen in the CME pattern. PMID:24172553

Ahmadpour-Baghdadabad, M; Manaviat, M; Shojaoddiny-Ardekani, A

2013-07-01

435

Aqueous levels of erythropoietin in acute retinal vein occlusion with macular edema  

PubMed Central

AIM To investigate the aqueous erythropoietin (EPO) levels and associated factors in patients with acute retinal vein occlusion (RVO). METHODS The aqueous EPO level was measured in patients with macular edema (ME) secondary to acute branched retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). Aqueous fluid from cataract patients served as the control. We also evaluated whether aqueous level of EPO was associated with factors such as serum EPO level, non-perfusion area, central macular thickness (CMT), and arterio-venous (AV) transit time RESULTS Twenty-seven RVO patients (16 BRVO, 11 CRVO) and 9 control subjects were enrolled in the study. The aqueous EPO level (mU/mL) was higher in RVO (68.2±54.3) than that in the control subjects (12.9±5.9). More specifically, the aqueous EPO level was higher in CRVO (118.9±52.1) than that in BRVO (33.3±10.8). However, no differences were found in serum EPO levels among three groups. CMT in RVO patients had a positive correlation with the aqueous EPO level (r=0.66). Also, in terms of non-perfusion area, the aqueous EPO levels were more elevated in the ischemic subgroup than in the non-ischemic subgroup in both BRVO and CRVO. CONCLUSION Aqueous EPO levels are elevated in patients with macular edema secondary to recent onset RVO. Patients with CRVO have higher EPO levels than those with BRVO. The aqueous EPO level in RVO has a positive correlation with CMT and is associated with non-perfusion area. These results suggest that the aqueous EPO level could be associated with retinal ischemia and may be involved in the pathogenesis of macular edema secondary to RVO. PMID:24967199

Shin, Hyun Jin; Kim, Hyung Chan; Moon, Jun Woong

2014-01-01

436

Pulsatile ocular blood flow study: decreases in exudative age related macular degeneration  

Microsoft Academic Search

BACKGROUNDPulsatile ocular blood flow (POBF) is a parameter for evaluating choroidal blood flow. POBF in the patients with non-exudative and exudative age related macular degeneration (AMD) was investigated.METHODSPOBF, pulse amplitude (PA), systolic and diastolic blood pressures, intraocular pressure (IOP), refractive error, and axial length were compared among 10 patients with non-exudative AMD, 11 patients with exudative AMD, and 69 age

Fumihiko Mori; Suguru Konno; Taiichi Hikichi; Yuji Yamaguchi; Satoshi Ishiko; Akitoshi Yoshida

2001-01-01

437

Functional outcomes following surgical treatment of bilateral mandibular condylar fractures.  

PubMed

Debate continues regarding unilateral or bilateral treatment for mandibular condylar fractures. This retrospective study evaluates the functional outcomes of bilateral condylar process fractures after surgical intervention. From May 1994 to December 2004, 51 adult patients with bilateral mandibular condylar process fractures were studied. There were 33 cases of bilateral condylar fractures (type I); 12 cases of condylar-subcondylar fractures (type II); and six cases of bilateral subcondylar fractures (type III). All patients underwent open reduction and internal fixation. Four patients had chin deviation, six had malocclusion, three had poor chewing function and eight had limited mouth opening. Type I patients had a significantly higher incidence of limited mouth opening (P=0.039) and associated maxillary fractures (n=12) and psychiatric disease (n=6) which yielded significantly poor functional outcomes. Complications included transient facial paresis (n=4), fracture and loosening of postoperative plates (n=3) and surgical wound infections (n=2). Open reduction with rigid fixation for bilateral condylar fractures provided satisfactory functional outcomes in this study. Concomitant maxillary fractures and underlying psychiatric problems are poor outcome factors. Aggressive rehabilitation in the first 9 months is important for early functional recovery. PMID:20961735

Chen, C-T; Feng, C-H; Tsay, P-K; Lai, J-P; Chen, Y-R

2011-01-01

438

Color vision and other parameters of macular function after retinal reattachment.  

PubMed

Patients with a preoperatively detached macula and operated upon between October 1976 and July 1978 were analyzed for three parameters of macular function after surgical repair. Reattachment was achieved by cryopexy, an external sponge plombage and nondrainage. The observation period was a minimum of 1 year. Visual acuity increased in all patients with a maximum improvement in the first 3 months after macular reattachment. Color vision was postoperatively defective in every second patient. In the majority of cases it was a trito disturbance. The disturbance in color vision was most prominent in patients over 60 years old. During the period of 1 year, normalization of color vision occurred for the most part only in patients under 60 years of age. Metamorphopsia proved to be the most sensitive indicator of an episode of previous macular detachment. It occurred in every patient independently of age and was still present at the end of 1 year. It could be considered as a 'scar in the Amsler grid.' The occurrence of metamorphopsia was independent of whether subretinal fluid was drained or allowed to absorb spontaneously. PMID:7262430

Kreissig, I; Lincoff, H; Witassek, B; Kolling, G

1981-01-01

439

Idiopathic vitreomacular traction and macular hole: a comprehensive review of pathophysiology, diagnosis, and treatment  

PubMed Central

Posterior vitreous detachment (PVD) is a common phenomenon in the aging eye. However, this may be complicated by persistent symptomatic vitreomacular adhesions that exert tractional forces on the macula (vitreomacular traction; VMT). VMT itself may be associated with epiretinal membrane formation and the development of idiopathic macular holes (IMH). Such pathologies may cause visual disturbances, including metamorphopsia, photopsia, blurred vision, and decreased visual acuity, which impact an individual's quality of life. Technologies such as optical coherence tomography allow an increasingly more accurate visualisation of the macular anatomy, including quantification of macular hole characteristics, and this facilitates treatment decision-making. Pars plana vitrectomy remains the primary treatment option for many patients with VMT or IMH; for the latter, peeling of the inner limiting membrane (ILM) of the retina has shown improved outcomes when compared with no ILM peeling. The development of narrow-gauge transconjunctival vitrectomy systems has improved the rate of visual recovery following surgery. Ocriplasmin, by degrading laminin and fibronectin at the vitreoretinal interface, may allow induction of PVD in a non-invasive manner. Indeed, clinical studies have supported its use as an alternative to surgery in certain patient populations. However, further research is still needed with respect to greater understanding of the pathophysiology underlying the development of VMT and IMH. PMID:24108069

Steel, D H W; Lotery, A J

2013-01-01

440

Evaluation of Cystoid Macular Edema Using Optical Coherence Tomography and Fundus Autofluorescence after Uncomplicated Phacoemulsification Surgery  

PubMed Central

Aim. To investigate the utility of fundus autofluorescence (FAF) and optical coherence tomography (OCT) in the evaluation of cystoid macular edema (CME) following cataract surgery. Materials and Methods. Forty eyes of 29 patients undergone phacoemulsification, with posterior chamber intraocular lens implantation surgery. Central macular thickness (CMT) of the patients was evaluated using OCT and FAF preoperatively and postoperative 1st, 30th, 60th, 90th, and 180th days. Results. CME was detected in three eyes (7.5%) of two patients using OCT. Hyperautofluorescence (HAF) was detected in two of these three eyes and resolved with treatment. In the remaining 37 eyes without CME, there was a significant increase in visual acuity when compared to preoperative values (P = 0.008) Mean macular thicknesses (MMT) of the eyes without CME were 174 ± 20??m preoperatively and 179 ± 22??m at day 1, 178 ± 19??m at 1st month, and 168 ± 10??m at 6th month postoperatively. In the eyes with CME, the MMTs, measured with OCT were 189 ± 23??m preoperatively and 432 ± 361 on day 1, 343 ± 123??m at 1st month, 345 ± 196 at 2nd month, and 200 ± 36??m at 6th month postoperatively. Conclusion. We found a moderate increase in CMT in the first 3 months postoperatively, in the eyes without CME which did not cause visual disturbances. FAF is a noninvasive, rapid method for the evaluation and follow-up of CME following cataract surgery. PMID:23738050

Sahin, Muhammed; Cingu, Abdullah Kursat; Gozum, Nilufer

2013-01-01

441

Multiple-object geometric deformable model for segmentation of macular OCT  

PubMed Central

Optical coherence tomography (OCT) is the de facto standard imaging modality for ophthalmological assessment of retinal eye disease, and is of increasing importance in the study of neurological disorders. Quantification of the thicknesses of various retinal layers within the macular cube provides unique diagnostic insights for many diseases, but the capability for automatic segmentation and quantification remains quite limited. While manual segmentation has been used for many scientific studies, it is extremely time consuming and is subject to intra- and inter-rater variation. This paper presents a new computational domain, referred to as flat space, and a segmentation method for specific retinal layers in the macular cube using a recently developed deformable model approach for multiple objects. The framework maintains object relationships and topology while preventing overlaps and gaps. The algorithm segments eight retinal layers over the whole macular cube, where each boundary is defined with subvoxel precision. Evaluation of the method on single-eye OCT scans from 37 subjects, each with manual ground truth, shows improvement over a state-of-the-art method. PMID:24761289

Carass, Aaron; Lang, Andrew; Hauser, Matthew; Calabresi, Peter A.; Ying, Howard S.; Prince, Jerry L.

2014-01-01

442

Correlation between macular changes and the peripapillary nerve fiber layer in primary open angle glaucoma  

PubMed Central

Glaucoma is a leading cause of blindness and the early diagnosis is crucial for treatment and follow-up in the progression of the disease. Objective: To evaluate the changes in mean macular thickness and volume and compare them with the mean thickness of the peripapillary nerve fiber layer in primary open angle glaucoma, using Time Domain (TD) optical coherence tomography ( OCT). Method: The examinations were conducted on 275 eyes of 138 patients, as it follows: 203 eyes of 102 patients diagnosed with primary open angle glaucoma in various stages of evolution, representing the study group, and 72 normal eyes from 36 patients, representing the control group. The study was conducted from March 2010 to December 2012. All the patients gave their consent, in accordance with the Helsinki Declaration. The study group showed a decrease in mean macular thickness and volume, as well as mean thickness of the peripapillary nerve fiber layer (RNFL) compared to the control group. According to the OCT measurements, the results of the study have shown that the decrease of the mean thickness of the RNFL is a better differentiator between glaucomatous and normal eyes compared to the decrease of the mean macular thickness and volume. PMID:24653759

Manasia, D; Voinea, L; Vasinca, ID; Alexandrescu, C

2014-01-01