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1

Bilateral macular dysplasia ('colobomata') and congenital retinal dystrophy.  

PubMed Central

Three unrelated patients with bilateral macular dysplasia ('colobomata') with no relevant family history were found to have absent or substantially abnormal electroretinograms, implying that there was an associated retinal dystrophy. This may suggest that the macular lesions are associated with a global failure of retinal development, with a regional preponderance rather than a purely localised cause such as an intrauterine infection. It is important to distinguish between congenital infections such as toxoplasmosis and developmental macular colobomata, which have a somewhat similar ophthalmoscopic appearance as a cause of bilateral macular abnormalities seen in young children, since they have different implications for genetic advice and future ophthalmic care. Images

Moore, A T; Taylor, D S; Harden, A

1985-01-01

2

Intravitreal versus Sub-Tenon Posterior Triamcinolone Injection in Bilateral Diffuse Diabetic Macular Edema  

Microsoft Academic Search

Purpose: To compare the efficacy of intravitreal and sub-Tenon (ST) posterior triamcinolone injection in the treatment of bilateral diabetic diffuse macular edema (DDME). Methods: 28 eyes of 14 diabetic patients with bilateral DDME were included in this prospective randomized study. One eye of each individual received a sub-Tenon (ST) posterior triamcinolone injection (ST group), whereas the fellow eye received an

Ozgur Yalcinbayir; Oner Gelisken; Berkant Kaderli; Remzi Avci

2011-01-01

3

Bilateral macular hemorrhage after laser in situ keratomileusis  

Microsoft Academic Search

Background: This is the first report of a bilateral submacular hemorrhage after LASIK surgery in an extreme myo pic patient.\\u000a A 31-year-old man underwent bilateral surgery for correction of –16.75+0.7570 and –16.50+0.5055.? Methods: Case report.?\\u000a Results: One day after surgery the patient’s uncorrected visual acuity was in the 20\\/50 range OU and by 17 days after surgery\\u000a his visual acuity

José Domingo Luna; Victor Eduardo Reviglio; Claudio Patricio Juárez

1999-01-01

4

Bilateral 'vitelliform-like' macular lesions in a patient with multiple myeloma  

PubMed Central

A 73-year-old woman was referred to the eye clinic in February 2005 with reduced vision in both eyes. On examination, her visual acuity was 20/40, N6 right eye and 20/64, N6 left eye. Bilateral unusual ‘vitelliform-like’ lesions at the macula (accumulation of yellow material in the subretinal space), which demonstrated blocked fluorescence on fluorescein angiography and a lack of increased autofluorescence signal on fundus autofluorescence imaging, were detected. The patient was followed-up until April 2007 when retinal haemorrhages were detected and blood work-up was undertaken; during this follow-up period the material present at the macula progressively disappeared. As a result of the blood work-up, the diagnosis of multiple myeloma was established; the macular lesions were thought to relate to the latter disease and represent subretinal deposition of immunoglobulin.

Khan, Javeed M; McBain, Vikki; Santiago, Cynthia; Lois, Noemi

2010-01-01

5

Change in visual function after macular translocation with 360° retinectomy for neovascular age-related macular degeneration  

Microsoft Academic Search

ObjectiveTo measure the change in vision and visual outcomes at 12 months after macular translocation with 360° retinectomy (MT360) and silicone oil tamponade in patients with bilateral vision loss resulting from subfoveal choroidal neovascular membranes in age-related macular degeneration (AMD).

Prithvi Mruthyunjaya; Sandra S. Stinnett; Cynthia A. Toth

2004-01-01

6

Macular Degeneration  

Microsoft Academic Search

Owing to the lack of an effective prevention and appropriate treatment, age-related macular degeneration (AMD) continues being\\u000a the leading cause of central vision loss in patients older than 65 yr of age in the first world, and the third cause in developing\\u000a countries. Despite a relatively low prevalence of choroideal neovascularization (CNV) in AMD, approximately a quarter of these\\u000a patients

Peter E. Liggett; Alejandro J. Lavaque

7

Macular hard exudates and scar formation after laser photocoagulation in retinopathy of prematurity.  

PubMed

The authors report the formation of hard exudates and macular scarring after laser photocoagulation therapy in patients with retinopathy of prematurity (ROP). Two premature neonates, the first born at 24 weeks and the second at 25 weeks gestational age, were diagnosed as having ROP that necessitated laser photocoagulation treatment at 32 and 36 weeks, respectively. Subretinal fluid and macular hard exudation developed in both patients that eventually caused bilateral macular scarring. Subretinal macular fluid with hard exudation could lead to macular scar formation in neonates with ROP after laser photocoagulation that could significantly affect the visual prognosis in preterm infants. PMID:23819953

Epstein, Ilan J; Aziz, Hassan A; Young, Ryan C; Berrocal, Audina M

2013-07-02

8

Pathophysiology of Macular Edema  

Microsoft Academic Search

Macular edema is defined as an accumulation of fluid in the outer plexiform layer and the inner nuclear layer as well as a swelling of Müller cells of the retina. It consists of a localized expansion of the retinal extracellular space (sometimes associated with the intracellular space) in the macular area. Macular edema is a common cause of a sudden

Stefan Scholl; Janna Kirchhof; Albert J. Augustin

2010-01-01

9

Macular edema: miscellaneous.  

PubMed

This article provides the reader with practical information to be applied to the various remaining causes of macular edema. Some macular edemas linked to ocular diseases like radiotherapy after ocular melanomas remained of poor functional prognosis due to the primary disease. On the contrary, macular edemas occurring after retinal detachment or after some systemic or local treatment use are often temporary. Macular edema associated with epiretinal membranes or vitreomacular traction is the main cause of poor functional recovery. However, the delay to observe a significant improvement of vision after surgery should be long, as usually observed in tractional myopic vitreoschisis. Finally, some circumstances of macular edemas such as hemangiomas or macroaneurysms should be treated, if symptomatic, with the treatments currently used in diabetic macular edema or exudative macular degeneration. PMID:23264332

Creuzot-Garcher, Catherine; Jonas, Jost; Wolf, Sebastian

2011-01-01

10

A Case of Cystoid Macular Edema Associated with Paclitaxel Chemotherapy  

PubMed Central

We encountered a patient with cystoid macular edema (CME) secondary to paclitaxel use. A 57-year-old man presented with gradual decreased bilateral vision. His chemotherapeutic regimen consisted of bevacizumab, paclitaxel (175 mg/m2 for 5 months), and carboplatin. Optical coherence tomography imaging revealed bilateral CME greater than 500 µm. However, one year later, visual acuity was improved, best-corrected Snellen visual acuity was 40 / 80 in each eye, and CME was spontaneously improved. Our study confirmed that macular edema associated with paclitaxel use shows spontaneous resolution and improvement of visual acuity after a change of chemotherapeutic regimen.

Ham, Dong Sik; Lee, Joo Eun; Yun, Il Han

2012-01-01

11

Concurrent macular corneal dystrophy and keratoconus.  

PubMed

A 21-year-old female presented with progressive bilateral visual loss for the past 8 years. The patient had no history of systemic disease, surgery or medications. Complete ophthalmologic examination and topography were performed. On ophthalmic examination, uncorrected visual acuity was counting fingers at 2.5 m (20/50 with pinhole) in the right and left eyes. Both corneas appeared hazy on gross examination. On slit-lamp biomicroscopy, focal grayish-white opacities with indistinct borders were noted in the superficial and deep corneal stroma of both eyes. Both corneas were thin and bulging. Corneal topography showed a pattern consistent with keratoconus. The patient underwent penetrating keratoplasty (PKP). Histopathologic studies after PKP confirmed the diagnosis of macular corneal dystrophy and keratoconus in the same eye. The patient was clinically diagnosed as a case of concurrent macular dystrophy and keratoconus, which is a very rare presentation. PMID:22623870

Mohammad-Rabei, Hossein; Shojaei, Ahmad; Aslani, Mehdi

12

Concurrent Macular Corneal Dystrophy and Keratoconus  

PubMed Central

A 21-year-old female presented with progressive bilateral visual loss for the past 8 years. The patient had no history of systemic disease, surgery or medications. Complete ophthalmologic examination and topography were performed. On ophthalmic examination, uncorrected visual acuity was counting fingers at 2.5 m (20/50 with pinhole) in the right and left eyes. Both corneas appeared hazy on gross examination. On slit-lamp biomicroscopy, focal grayish-white opacities with indistinct borders were noted in the superficial and deep corneal stroma of both eyes. Both corneas were thin and bulging. Corneal topography showed a pattern consistent with keratoconus. The patient underwent penetrating keratoplasty (PKP). Histopathologic studies after PKP confirmed the diagnosis of macular corneal dystrophy and keratoconus in the same eye. The patient was clinically diagnosed as a case of concurrent macular dystrophy and keratoconus, which is a very rare presentation.

Mohammad-Rabei, Hossein; Shojaei, Ahmad; Aslani, Mehdi

2012-01-01

13

Acute bilateral vision loss as the presenting feature of subacute sclerosing panencephalitis.  

PubMed

A 12-yr-old boy with an atypical presentation of subacute sclerosing panencephalitis (SSPE) is described. Bilateral macular chorioretinitis preceded the neurological symptoms by 3 weeks. Both visual and neurological features had an acute onset. Clinicians need to be aware that macular chorioretinitis in a child may be the heralding feature of SSPE. PMID:19904511

Sharma, Suvasini; Chanana, Bhuvan; Gulati, Sheffali; Venkatesh, Pradeep; Singh, Sarman

2009-11-04

14

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.

Rotsos, Tryfon G; Moschos, Marilita M

2008-01-01

15

Bilateral dacryops.  

PubMed

The clinical, radiologic, and histopathologic findings of a case of bilateral dacryops is reported in a 49-year-old man. The patient presented with cystic masses located in superior lateral orbits and underwent bilateral excisions of these without any postoperative complications. PMID:3178080

Monica, M; Long, D A; Karcioglu, Z A

1988-07-01

16

[Bilateral stellate neuroretinitis as presenting sign of pheochromocytoma].  

PubMed

We report the case of a 21-year-old male patient admitted emergently with progressive bilateral severe visual loss for 1month. Posterior segment examination revealed bilateral stellate neuroretinitis. Infectious serologies were negative, and brain CT was normal. Physical examination was remarkable for malignant hypertension of 220/150mmHg. Diagnostic work-up revealed a pheochromocytoma documented by histopathological exam upon adrenalectomy. The disc edema and macular exudates resolved once the hypertension was controlled. PMID:23790444

El Haddad, S; Benchekroun, N; Rhafour, A; Ahbeddou, S; Rhafour, I; Imdary, I; Idrissi Alami, S; Soufi, G; Berraho, A

2013-06-18

17

Vitreopapillary Adhesion in Macular Diseases  

PubMed Central

Purpose: The effect of vitreopapillary adhesion (VPA) in macular diseases is not understood. Spectral-domain optical coherence tomography/scanning laser ophthalmoscopy (SD-OCT/SLO) was used to identify VPA in macular holes, lamellar holes, macular pucker, and dry age-related macular degeneration (AMD). Methods: Ultrasonography and SD-OCT/SLO were performed in 99 subjects: 17 with macular holes, 11 with lamellar holes, 28 with macular pucker, 15 with dry AMD, and 28 age-matched controls. Outcome measures were the presence of total posterior vitreous detachment (PVD) by ultrasound and the presence or absence of VPA and intraretinal cystoid spaces by SD-OCT/SLO. Results: PVD was detected by ultrasound in 26 (92.9%) of 28 eyes with macular pucker, 6 (54.5%) of 11 eyes with lamellar holes (P = .01), and 4 (23.5%) of 17 eyes with macular holes (P = .000003). SD-OCT/SLO detected VPA in 15 (88.2%) of 17 eyes with macular holes, 11 (39.3%) of 28 age-matched controls (P = .002), 4 (36.4%) of 11 eyes with lamellar holes (P = .01), 4 (26.7%) of 15 eyes with dry AMD (P = .0008), and 5 (17.9%) of 28 eyes with macular pucker (P = .000005). Intraretinal cystoid spaces were present in 15 (100%) of 15 eyes with macular holes with VPA. In eyes with macular pucker, 4 (80%) of 5 with VPA had intraretinal cystoid spaces, but only 1 (4.3%) of 23 without VPA had intraretinal cystoid spaces (P = .001). Conclusions: VPA was significantly more common in eyes with macular holes than in controls or eyes with dry AMD, lamellar holes, or macular pucker. Intraretinal cystoid spaces were found in all eyes with macular holes with VPA. When present in macular pucker, VPA was frequently associated with intraretinal cystoid spaces. Although these investigations do not study causation directly, VPA may have an important influence on the vectors of force at the vitreoretinal interface inducing cystoid spaces and holes.

Sebag, J.; Wang, Michelle Y.; Nguyen, Dieuthu; Sadun, Alfredo A.

2009-01-01

18

Treatment of idiopathic macular hole with silicone oil tamponade  

PubMed Central

Purpose We analyzed the anatomical and visual outcomes after surgical treatment of idiopathic macular holes with pars plana vitrectomy, internal limiting membrane (ILM) peeling using Brilliant Blue dye, and silicone oil tamponade without postoperative posturing. Methods This was a retrospective interventional study of 10 eyes in eight patients who underwent surgical treatment of idiopathic macular holes using pars plana vitrectomy, ILM peeling using Brilliant Blue dye, and silicone oil tamponade without postoperative posturing. The preoperative staging of macular holes and postoperative anatomic outcomes were assessed using spectral-domain optical coherence tomography. Results All patients were women with a mean age of 66.86 ± 4.8 years. In two patients, bilateral macular holes were present and both eyes were operated on. Stage 2 macular hole was diagnosed in three eyes, three eyes had stage 3, and four eyes had stage 4 macular holes. Anatomical success and closure of the macular hole was achieved in nine eyes (90%) after one operation. In one eye, the macular hole was closed after reoperation. The preoperative mean best-corrected visual acuity (BCVA) was 0.15 decimal units (0.8 logMAR units). Until the end of the follow-up period, BCVA was 0.25 decimal units (0.6 logMAR units). Visual acuity was improved in seven patients (70%). In two patients (20%), visual acuity remained at the same level, and in one eye (10%), visual acuity decreased. Postoperatively, all patients reported a significant reduction of metamorphopsia. Conclusion Initial results after 20G pars plana vitrectomy with peeling of the ILM, use of dye (Brilliant Blue), and tamponade with silicone oil without postoperative posturing gave good anatomical and functional outcome in terms of visual acuity and reduction of metamorphopsia. Taking into account the age of the patients, this method, which does not require prolonged postoperative face-down posturing, was well tolerated by the patients. Because the anatomical and visual outcome as well as the rate of postoperative complications are comparable to those when gas is used as a tamponading agent, silicone oil tamponade can also be safely used as a first option in surgery of macular holes. However, a longer period of follow-up of the operated eyes, as well as a larger group of operated eyes, will be required to identify long-term outcomes of this surgical treatment.

Ivanovska-Adjievska, Biljana; Boskurt, Salih; Semiz, Faruk; Yuzer, Hakan; Dimovska-Jordanova, Vesna

2012-01-01

19

Bilateral dacryoadenitis  

PubMed Central

Acute dacryoadenitis is an uncommon condition that involves inflammation of the lacrimal gland. In rare instances, dacryoadenitis may be bilateral. A delay in proper treatment of an otherwise simple case of dacryoadenitis may lead to significant soft tissue morbidity such as cellulitis, lacrimal gland abscess, or orbital abscess. We report the case of a 24-year-old male who presented to the emergency department with acute bilateral dacryoadenitis. The patient's symptoms did not respond to oral antibiotics and he subsequently required admission for intravenous antibiotics. During his hospitalization the patient had diagnostic testing to try to determine the etiology for his symptoms. The unique aspects of managing a case of bilateral dacryoadenitis as well as treatment recommendations are discussed in this case report.

Derr, Charlotte; Shah, Ankit

2012-01-01

20

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.

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

2013-01-01

21

Therapeutic Approaches to Macular Oedema  

Microsoft Academic Search

The current treatment of macular oedema remains unsatisfactory. The dissection of the molecular mechanisms responsible for\\u000a the formation of macular oedema will lead to the identification of specific therapeutic targets, and the successful application\\u000a of this knowledge will result in the generation of more effective treatment modalities.

Antonia M. Joussen; Bernd Kirchhof

22

Macular amyloidosis: a case report.  

PubMed

Macular amyloidosis is a major cause of skin pigmentation and a rare form of localized primary cutaneous amyloidosis in western countries, with a higher prevalence in Asia and South America. The etiopathogenesis of macular amyloidosis has not yet been fully clarified; a number of risk factors are involved, among them chronic friction in particular. A 54-year-old patient with macular amyloidosis is presented. The diagnosis of macular amyloidosis was based on history data on long-term persistence of the disorder, localized pruritus and constant scratching urge, grayish-brown pigmentation over the scapula, and detection of amyloid in histologic slides. Three-month tretinoin therapy resulted in pruritus alleviation, with no change in the appearance of hyperpigmentation. The exact incidence of macular amyloidosis in Croatia is not known, however, the issue appears to be underestimated or neglected in dermatology routine. PMID:18812063

Rados, Jaka; Marinovi? Kulisi?, Sandra; Lipozenci?, Jasna; Budimci?, Dragomir; Loncari?, Davorin

2008-01-01

23

Drug-induced macular edema.  

PubMed

Macular edema constitutes a serious pathologic entity of ophthalmology resulting in vision loss with a remarkable impact on the quality of life of patients. It is the final common pathway of various systemic diseases and underlying intraocular conditions, with diabetes mellitus being the most frequent cause. Other causes include venous occlusive disease, intraocular surgery, and inflammatory conditions of the posterior segment of the eye. Macular edema is a recognized side effect of various systemic and local medications and requires special consideration among ophthalmologists and other clinicians. Recently, antidiabetic thiazolidinediones have been implicated in the development of macular edema, and a review of the English literature revealed that other systemically administered drugs like fingolimod, recently approved for relapsing forms of multiple sclerosis, the anticancer agents tamoxifen and the taxanes, as well as niacin and interferons have been reported to cause macular edema. Ophthalmologic pharmaceutical agents, like prostaglandin analogs, epinephrine, timolol, and ophthalmic preparation preservatives have also been reported to cause macular edema as an adverse event. The purpose of this article is to provide a short, balanced overview of the available evidence in this regard. The available data and the possible pathophysiologic mechanisms leading to the development of macular edema are discussed. Possible therapeutic strategies for drug-induced macular edema are also proposed. PMID:23640687

Makri, Olga E; Georgalas, Ilias; Georgakopoulos, Constantine D

2013-06-01

24

Severe Macular Edema in Patients with Juvenile Idiopathic Arthritis-Related Uveitis  

PubMed Central

Purpose. To report the onset of severe macular edema in adolescent female patients affected by juvenile idiopathic arthritis (JIA). Methods. Four female patients affected by JIA-related chronic anterior uveitis (CAU), complicated by severe macular edema, were retrospectively analyzed. Macular area was evaluated by fluorescein angiography and optical coherence tomography (OCT). Results. CAU was bilateral in three patients. Mean age of uveitis and arthritis onset was, respectively, 4.5 ± 1.7 years and 6.0 ± 3.9 years. All patients underwent cataract extraction surgery. Despite ocular inflammation being controlled by topical/systemic therapy, during adolescence (mean age of appearance/diagnosis: 12.7 ± 3.9 years) patients developed severe unilateral macular edema. OCT revealed massive macular thickening (range from 550??m to 1214??m). Conclusions. Macular edema appeared in female adolescent patients in eyes with long-dating CAU submitted to cataract surgery. In such patients, in presence of age-related microvascular changes due to the enhancer effect of sex hormones, cataract extraction should be a factor triggering the retinal complication.

Paroli, Maria Pia; Fabiani, Claudia; Spinucci, Giovanni; Sapia, Alfredo; Spadea, Leopoldo

2013-01-01

25

[Measuring macular pigment in vivo].  

PubMed

Interest in macular pigment has been growing since it was first identified 200 years ago. Because of its antioxidant properties and putative protection against age-related macular degeneration (AMD), clinical, experimental, and epidemiologic studies have attempted to show a positive correlation between the high density of macular pigment and low risk for macular degeneration. Since the two main components of macular pigment, lutein and zeaxanthin, cannot be endogenously synthesized, oral supplementation may be an efficient means to increase macular pigment density. However, the ideal dosage for such supplementation remains to be determined, since absorption varies greatly from one subject to another. Hence, reliable quantitative measurement of macular pigment density is necessary before any beneficial effects of oral supplementation on AMD occurrence can be demonstrated; then at-risk subjects who would require such supplementation can be targeted. Several techniques can be used to measure macular pigment density noninvasively in vivo. Psychophysical methods are the most commonly used. They include heterochromatic flicker photometry and Raman spectroscopy. Heterochromatic flicker is the most widely used method and seems to be the easiest and least costly. However, because it requires very good cooperation from patients and a good grasp of the instructions, it is probably the least reliable and reproducible method. Raman spectroscopy, on the other hand, requires less cooperation on the part of the patient. Subjects are asked to overlap a blue disc and a red polka-dot pattern to ensure proper alignment of the eye. Since these instructions are simpler than those for heterochromatic flicker photometry, this technique is more reliable. Overall, the data obtained are more objective because they are based on the analysis of a signal emitted after an argon laser excitation of the macular pigment. Nevertheless, data are closely related to pupil diameter. Finally Raman spectroscopy requires expensive equipment. Physical methods are based on retinal excitation by an incident light and the analysis of the reflected signal obtained. These methods are mainly represented by autofluorescence measurement and fundus reflectance. These two techniques differ in the wavelength used in the incident light, because the reflected signal is itself related to the amount of incident light absorbed by retinal structures. Both techniques allow rapid and objective measurement of spatial distribution of macular pigment. The software of the modified Scanning Laser Ophthalmoscope (Heidelberg, Germany) further creates a density map image after digital subtraction of the log reflectance data obtained at two different wavelengths. Physical methods require little cooperation from patients and could be considered the most objective and high-performance technique available today. However, the instruments are still expensive and therefore cannot be widely used in clinical practice. PMID:18563047

Rougier, M B; Delyfer, M N; Korobelnik, J F

2008-04-01

26

Macular Photocoagulation Study: Manual of Procedures (Revised).  

National Technical Information Service (NTIS)

The Macular Photocoagulation Study (MPS) is a set of randomized, controlled clinical trials designed to evaluate the effectiveness of laser photocoagulation of neovascular lesions, secondary to age-related (senile) macular degeneration, ocular histoplasmo...

1989-01-01

27

Macular Photocoagulation Study: Data Monitoring Report, 1990.  

National Technical Information Service (NTIS)

The Macular Photocoagulation Study (MPS) is a set of randomized, controlled clinical trials designed to evaluate the effectiveness of laser photocoagulation of neovascular lesions, secondary to age-related (senile) macular degeneration (AMD or SMD), ocula...

1990-01-01

28

Dietary Modification of Human Macular Pigment Density  

Microsoft Academic Search

Purpose. The retinal carotenoids lutein (L) and zeaxanthin (Z) that form the macular pigment (MP) may help to prevent neovascular age-related macular degeneration. The purpose of this study was to determine whether MP density in the retina could be raised by increasing dietary intake of L and Z from foods. Methods. Macular pigment was measured psychophysically for 13 subjects. Serum

Billy R. Hammond; Elizabeth J. Johnson; Robert M. Russell; Norman I. Krinsky; Kyungjin Yeum; Ross B. Edwards; D. Max Snodderly

29

Diabetic Macular Edema: Pathogenesis and Treatment  

Microsoft Academic Search

Diabetic macular edema is a major cause of visual impairment. The pathogenesis of macular edema appears to be multifactorial. Laser photocoagulation is the standard of care for macular edema. However, there are cases that are not responsive to laser therapy. Several therapeutic options have been proposed for the treatment of this condition. In this review we discuss several factors and

Neelakshi Bhagat; Ruben A. Grigorian; Arthur Tutela; Marco A. Zarbin

2009-01-01

30

Age-related macular degeneration.  

PubMed

Age-related macular degeneration is a major cause of blindness worldwide. With ageing populations in many countries, more than 20% might have the disorder. Advanced age-related macular degeneration, including neovascular age-related macular degeneration (wet) and geographic atrophy (late dry), is associated with substantial, progressive visual impairment. Major risk factors include cigarette smoking, nutritional factors, cardiovascular diseases, and genetic markers, including genes regulating complement, lipid, angiogenic, and extracellular matrix pathways. Some studies have suggested a declining prevalence of age-related macular degeneration, perhaps due to reduced exposure to modifiable risk factors. Accurate diagnosis combines clinical examination and investigations, including retinal photography, angiography, and optical coherence tomography. Dietary anti-oxidant supplementation slows progression of the disease. Treatment for neovascular age-related macular degeneration incorporates intraocular injections of anti-VEGF agents, occasionally combined with other modalities. Evidence suggests that two commonly used anti-VEGF therapies, ranibizumab and bevacizumab, have similar efficacy, but possible differences in systemic safety are difficult to assess. Future treatments include inhibition of other angiogenic factors, and regenerative and topical therapies. PMID:22559899

Lim, Laurence S; Mitchell, Paul; Seddon, Johanna M; Holz, Frank G; Wong, Tien Y

2012-05-01

31

Age-related macular degeneration  

PubMed Central

Age-related macular degeneration is the leading cause of blindness in elderly populations of European descent. The most consistent risk factors associated with this ocular condition are increasing age and cigarette smoking. Genetic investigations have shown that complement factor H, a regulator of the alternative complement pathway, and LOC387715/HtrA1 are the most consistent genetic risk factors for age-related macular degeneration. Although the pathogenesis of this disease is unknown, oxidative stress might have an important role. Treatment with antioxidant vitamins and zinc can reduce the risk of developing advanced age-related macular degeneration by about a quarter in those at least at moderate risk. Intravitreal injections of ranibizumab, a monoclonal antibody that inhibits all forms of vascular endothelial growth factor, have been shown to stabilise loss of vision and, in some cases, improve vision in individuals with neovascular age-related macular degeneration. These findings, combined with assessments of possible environmental and genetic interactions and new approaches to modulate inflammatory pathways, will hopefully further expand our ability to understand and treat age-related macular degeneration.

Coleman, Hanna R; Chan, Chi-Chao; Ferris, Frederick L; Chew, Emily Y

2008-01-01

32

Diabetic macular edema: pathogenesis and treatment.  

PubMed

Diabetic macular edema is a major cause of visual impairment. The pathogenesis of macular edema appears to be multifactorial. Laser photocoagulation is the standard of care for macular edema. However, there are cases that are not responsive to laser therapy. Several therapeutic options have been proposed for the treatment of this condition. In this review we discuss several factors and mechanisms implicated in the etiology of macular edema (vasoactive factors, biochemical pathways, anatomical abnormalities). It seems that combined pharmacologic and surgical therapy may be the best approach for the management of macular edema in diabetic patients. PMID:19171208

Bhagat, Neelakshi; Grigorian, Ruben A; Tutela, Arthur; Zarbin, Marco A

33

Decreased Visual Acuity Associated With Cystoid Macular Edema in Neovascular Age-related Macular Degeneration  

Microsoft Academic Search

Objective: To determine the prevalence and visual sig- nificance of cystoid macular edema (CME) in eyes with subfoveal neovascular age-related macular degenera- tion using optical coherence tomography (OCT). Materials and Methods: The medical records of 61 consecutive patients initially seen with nondisciform sub- foveal neovascular age-related macular degeneration were retrospectively reviewed. All patients underwent fluo- rescein angiography and OCT imaging.

T. Daniel Ting; Mila Oh; Terry A. Cox; Carsten H. Meyer; Cynthia A. Toth

34

Macular retinoschisis in highly myopic eyes  

Microsoft Academic Search

PURPOSE: To describe the characteristics and evolution of macular retinoschisis in high myopia observed by optical coherence tomography (OCT).DESIGN: A consecutive, retrospective, observational case series.METHODS: Twenty-one highly myopic eyes (mean refractive error, ?15.2, range ?6 to ?25) of 17 patients presenting with the unusual feature of macular thickening without a macular hole and associated with a posterior staphyloma were examined

Nathanaël Benhamou; Pascale Massin; Belkacem Haouchine; Ali Erginay; Alain Gaudric

2002-01-01

35

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.

Wenick, Adam S.; Bressler, Neil M.

2012-01-01

36

Diagnostics and the therapeutics for macular degeneration  

US Patent & Trademark Office Database

The invention relates to diagnostics and therapeutics and animal models for macular degeneration, specifically as they relate to the association described herein between macular degeneration and arterial wall disruptive disorders. In one embodiment, the invention provides kits and methods for diagnosing macular degeneration comprising identifying a marker for an arterial wall disruptive disorder, including an aneurysm. In one embodiment, the invention provides therapeutics for treating macular degeneration comprising delivering to a subject an agent useful for treating an arterial wall disruptive disorder, including an aneurysm.

Hageman; Gregory S. (Coralville, IA)

2006-09-19

37

Laser therapy and macular degeneration  

NASA Astrophysics Data System (ADS)

Among macular diseases, choroidal neovascularization (CNV) is one of the most common causes of visual loss, especially in the form associated with age-related macular degeneration and pathologic myopia. Research on these diseases has recently evaluated new treatment modalities that use laser light differently; among these, photodynamic therapy (PDT) has been introduced in the clinical practice, allowing us to expand the possibility of reducing visual loss in patients affected by CNV. With PDT, a photosensitizer (verteporfin, VisudyneTM) is injected intravenously, and it selectively binds to new vessels; low-power laser light exposure then activates the drug, leading to oxidative damage of the endothelium and new vessels thrombosis. Yet, other therapies, such as transpupillary termotherapy, or the use of photocoagulation to cause feeder-vessel occlusion, could proof effective, but they need further investigation.

Menchini, Ugo; Virgili, Gianni; Giansanti, Fabrizio; Giacomelli, Giovanni; Cappelli, Stefania

2001-10-01

38

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

2010-07-29

39

Bilateral anterior shoulder dislocation  

PubMed Central

Shoulder dislocations are the most common major joint dislocations encountered in the emergency departments. Bilateral shoulder dislocations are rare and of these, bilateral posterior shoulder dislocations are more prevalent than bilateral anterior shoulder dislocations. Bilateral anterior shoulder dislocation is very rare. We present a case of 24-year-old male who sustained bilateral anterior shoulder dislocation following minor trauma, with associated greater tuberosity fracture on one side. Prompt closed reduction followed by immobilization in arm sling and subsequent rehabilitation ensured a good outcome.

Meena, Sanjay; Saini, Pramod; Singh, Vivek; Kumar, Ramakant; Trikha, Vivek

2013-01-01

40

Complications associated with limited macular translocation  

Microsoft Academic Search

PURPOSE: To report the ocular complications associated with the limited macular translocation procedure.METHODS: Retrospective review of 153 consecutive eyes of 151 patients that had the limited macular translocation procedure for subfoveal choroidal neovascularization between April 1996 and February 1999. The major study variables investigated included the incidence of specific ocular complications and their impact on visual acuity at 3 months

Gildo Y Fujii; Dante J Pieramici; Mark S Humayun; Andrew P Schachat; Sandra M Reynolds; Michele Melia; Eugene De Juan

2000-01-01

41

Stereochemistry of the Human Macular Carotenoids  

Microsoft Academic Search

Purpose. To complete identification of the major components of the human macular pigment. Methods. Chemical ionization mass spectra of the macular pigment components were obtained and compared with those of zeaxanthin and lutein standards. A comparison was also made using chiral column high-performance liquid chroinatography, which is capable of resolving individual stereoisomers of these carotenoids. Zeaxanthin and lutein from human

Richard A. Bone; John T. Landrum; George W. Hime; Araceli Cains

1993-01-01

42

Late reopening of successfully treated macular holes  

PubMed Central

BACKGROUND—Most idiopathic macular holes can be closed by a surgical procedure combining vitrectomy, posterior hyaloid ablation, and fluid-gas exchange followed by postoperative positioning. Reopening of closed macular holes has been reported, but its frequency is not known. Here the incidence of reopening after successful macular hole surgery is reported.?METHODS—77 consecutive cases of idiopathic macular holes operated with autologous platelet injection between July 1993 and October 1995 were reviewed. The procedure consisted of three port vitrectomy, posterior hyaloid removal, non-expansile fluid-gas exchange, and autologous platelet injection followed by face down positioning. The incidence of reopening was analysed in the cohort of the 72 anatomical successes.?RESULTS—Mean follow up was 12.3 months. The macular hole reopened in five eyes of five patients (five out of 72 patients, 6.9%), in four cases after cataract extraction. In four cases too, an epiretinal membrane was noted, either clinically or during reoperation, and fluorescein leakage in the macular area was present in two cases. Three of the five cases of reopening were reoperated and all three were anatomical successes.?CONCLUSION—Late macular hole reopening occurred in five out of 72 patient, and in four cases after cataract surgery. The presence of an epiretinal membrane around the hole in four of them suggested that tractional forces were responsible for the reopening. Reoperation, performed in three cases, again closed the macular holes.??

Paques, M.; Massin, P.; Santiago, P.; Spielmann, A.; Le Gargasson, J.-F.; Gaudric, A.

1997-01-01

43

The genetics of inherited macular dystrophies  

PubMed Central

The aim of this paper is to review current knowledge relating to the monogenic macular dystrophies, with discussion of currently mapped genes, chromosomal loci and genotype-phenotype relationships. Inherited systemic disorders with a macular dystrophy component will not be discussed.

Michaelides, M; Hunt, D; Moore, A

2003-01-01

44

Drusen in Age-Related Macular Degeneration  

Microsoft Academic Search

Drusen are subretinal pigment epithelial deposits that are characteristic of but not uniquely associated with age-related macular degeneration (AMD). Age-related macular degeneration is associated with two types of drusen that have different clinical appearances and different prognoses. Hard drusen appear as small, punctate, yellow nodules and can precede the development of atrophic AMD. Areolar atrophy of the retinal pigment epithelium

Ahmed Abdelsalam; Lucian Del Priore; Marco A Zarbin

1999-01-01

45

Macular hole surgery following accidental laser injury with a military rangefinder  

NASA Astrophysics Data System (ADS)

An active duty marine corps service member had bilateral full thickness macular holes induced following accidental Q-switched laser exposure from a hand held Neodymium range finder (ANGVS-5). The right eye had a large hole nasal to the fovea, while the left eye had a much smaller hole closer to the fovea centralis. Over the 18 months following the injury, the left eye demonstrated mild progressive degradation in visual function, but retained 20/20 final visual acuity. In contrast, the hole in the right eye increased in size, developed a localized retinal detachment with cystic changes in the fovea, and had atrophy of the retinal pigment epithelium. Within 6 months after injury, acuity declined to 20/100. Macular hole surgery was performed with a goal of sealing the edges of the hole in order to allow resolution of the localized detachment and cystic changes in the fovea. In spite of surgical techniques that are generally successful in the treatment of macular holes associated with other etiologies, the fundus findings remained unchanged and visual acuity declined to 20/400. To the best of our knowledge, this is the first case report of macular hole surgery for this condition.

Custis, Peter H.; Gagliano, Donald A.; Zwick, Harry; Schuschereba, Steven T.; Regillo, Carl D.

1996-04-01

46

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

47

Raman imaging of human macular pigments  

NASA Astrophysics Data System (ADS)

We have expanded our efforts to generate high spatial resolution images showing the distibution of carotenoid macular pigments in the human retina using Raman spectroscopy. A low level of macular pigments is associated with an increased risk of developing age-related macular degeneration, a leading cause of irreversible blindness. Using excised human eyecups and resonant excitation of the pigment molecules with narrow bandwidth blue light from a filtered arc lamp, we record Raman images originating from the carbon-carbon double bond stretch vibrations of lutein and zeaxanthin, the carotenoids comprising human macular pigments. Our Raman images reveal significnt differences among subjects, both in regard to absolute levels ss well as spatial distribution within the macula. Since the light levels used to obtain these images are well below established ssafety limits, this technique holds promise for developing a rapid screening diagnostic in large populations at risk for vision loss from age-realted macular degeneration.

Gellermann, Werner; Ermakov, Igor V.; McClane, Robert W.

2003-07-01

48

Intravitreal Cortisone Injection for Refractory Diffuse Diabetic Macular Edema  

Microsoft Academic Search

Purpose: The purpose of this study was to evaluate the safety and efficacy of intravitreal triamcinolone acetonide injection in patients with diffuse diabetic macular edema. We also compared the effect of intravitreal triamcinolone with macular grid laser photocoagulation in macular edema. Patients and Methods: Thirty patients with diabetic diffuse macular edema unresponsive to grid laser photocoagulation for at least 4

Hamdi Er

2005-01-01

49

Pediatric bilateral facial paralysis.  

PubMed

Bilateral facial paralysis is an unusual clinical entity that occurs in less than 1% of patients with facial paralysis. In children bilateral facial paralysis is even more rare, and establishing its etiology can be challenging. Four pediatric patients ranging in age from 3 to 17 years are presented who developed bilateral facial paralysis as a result of acute otitis media, Lyme disease, recurrent central nervous system leukemia, and acute disseminated encephalomyelitis. The diagnosis and treatment of pediatric bilateral facial paralysis are reviewed, as well as the pertinent literature. PMID:9546263

Smith, V; Traquina, D N

1998-04-01

50

Bilateral multifocal posterior pole lesions in Reiter syndrome.  

PubMed

Reactive arthritis is associated with conjunctivitis or iritis. Rarely reactive arthritis is accompanied by permanent visual loss from macular infarction or foveal scarring. We present the case of a rheumatologist who had a sudden onset of skin lesions, arthritis of several joints and bilateral visual loss. Most of these manifestations resolved after a course of oral corticosteroids. However he was left with decreased vision in the left eye and multiple lesions in the fovea over a follow-up of 2 years. PMID:23576664

Mansour, Ahmad M; Jaroudi, Mahmoud O; Medawar, Walid A; Tabbarah, Zuhayr A

2013-04-09

51

Macular changes after peeling of the internal limiting membrane in macular hole surgery  

Microsoft Academic Search

PURPOSE: To report the incidence of macular changes following pars plana vitrectomy with peeling of the internal limiting membrane (ILM) for idiopathic macular hole.DESIGN: Prospective consecutive series.METHODS: In a prospective study 105 eyes of 105 patients underwent vitrectomy for idiopathic macular holes. Surgery consisted of a standard three-port vitrectomy, induction of a posterior hyaloid detachment, removal of epiretinal membranes including

Christos Haritoglou; Carolin A Gass; Markus Schaumberger; Oliver Ehrt; Arnd Gandorfer; Anselm Kampik

2001-01-01

52

Macular full-thickness and lamellar holes in association with type 2 idiopathic macular telangiectasia  

Microsoft Academic Search

PurposeTo describe patients with full-thickness macular holes (FTMHs) and lamellar macular holes (LMHs) in association with type 2 idiopathic macular telangiectasia (type 2 IMT).MethodsSix patients with either FTMH or LMH and type 2 IMT were evaluated by means of optical coherence tomography (OCT) imaging, funduscopy, and fluorescein angiography.ResultsThe age of the examined patients ranged from 57 to 70 years (mean

P Charbel Issa; H P N Scholl; A Gaudric; P Massin; A E Kreiger; S Schwartz; F G Holz

2009-01-01

53

Spontaneous bilateral tubal pregnancy  

Microsoft Academic Search

With the increase in incidence of ectopic pregnancy over the decades, bilateral ectopic pregnancy is also increasing. It is usually associated with assisted reproductive techniques (ART) but in recent years few cases of spontaneous bilateral ectopic pregnancy have been reported. Gynaecologists should be aware of this and that ultrasonography has limitations in diagnosis. In cases of ectopic pregnancy where contralateral

Aisha Syed Wali; Rozilla Sadia Khan

2012-01-01

54

Bilateral congenital diaphragmatic hernia.  

PubMed

Bilateral congenital diaphragmatic hernia (CDH) is a rare birth defect, with a poor prognosis. We describe a case of bilateral CDH discovered while repairing the right sided CDH. Diaphragmatic defect was repaired and a silo was applied on the abdominal wound to avoid abdominal compartment syndrome. The patient however died postoperatively due to severe pulmonary hypertension. PMID:23061036

Dhua, Anjan Kumar; Aggarwal, Satish K; Mathur, Nb; Sethi, Gr

2012-09-01

55

Macular spectral domain optical coherence tomography findings in Tanzanian endemic optic neuropathy.  

PubMed

Bilateral optic neuropathy in Dar es Salaam is now considered endemic and is estimated to affect 0.3-2.4% of young adults. The condition is characterized by a subacute bilateral loss of central vision of unknown aetiology. Findings of spectral domain optical coherence tomography have not previously been reported for these patients. All patients diagnosed with endemic optic neuropathy over a 2-year period at the Muhimbili National Hospital underwent spectral domain optical coherence tomography macular imaging. Scans were graded qualitatively for severity of retinal nerve fibre layer loss as well as the presence of microcystic macular changes, which have not previously been described in this condition. Of the 128 patients included (54.7% male; median age 20 years), severe retinal nerve fibre layer loss was found in 185 eyes (74.0%). There was full concordance in retinal nerve fibre layer thickness between the two eyes in 113 (91.1%) patients. Microcystic macular spaces were found in 16 (12.5%) patients and were bilateral in nine (7.0%) individuals. These changes were typically more prominent in the nasal than the temporal macula, predominantly involving the inner nuclear layer, and often occurred in an annular configuration that was evident on en face infra-red imaging, though not discernible on colour fundus photography or clinically. All patients with microcystic macular changes had severe thinning of the retinal nerve fibre layer (P = 0.02). Four patients in whom cystic spaces were demonstrated had sequential scans, and there was no detectable alteration in the configuration of these changes over a period of up to 16 months. This is the first study to document optical coherence tomography findings in endemic optic neuropathy. We have observed symmetrical severe loss of the caeco-central projection (papillomacular bundle) with otherwise well-preserved macular architecture. Also, we have observed microcystic retinal changes in a significant proportion of patients, which were associated with severe retinal nerve fibre layer loss. Similar changes have recently been reported from optical coherence tomography images of patients with multiple sclerosis, relapsing isolated optic neuritis, dominant optic atrophy, Leber's hereditary optic neuropathy and a patient with a chronic compressive optic neuropathy, supporting the hypothesis that this may be a non-specific phenomenon secondary to ganglion cell death. The correspondence of the changes to an annulus discernible on infra-red en face imaging, but not using other conventional retinal imaging techniques highlights the potential usefulness of this modality. PMID:24018312

Kisimbi, John; Shalchi, Zaid; Mahroo, Omar A; Mhina, Celina; Sanyiwa, Anna J; Mabey, Denise; Mohamed, Moin; Plant, Gordon T

2013-09-09

56

North Carolina macular dystrophy: clinicopathologic correlation.  

PubMed Central

PURPOSE: To describe the clinical and histopathologic findings in a 72-year-old woman with North Carolina macular dystrophy. METHODS: Clinical examination was performed by slit-lamp biomicroscopy, indirect ophthalmoscopy, color fundus photography, and focal electroretinography. Histopathologic examination of the enucleated left eye consisted of light microscopy. RESULTS: Light microscopy demonstrated a discrete macular lesion characterized by focal absence of photoreceptor cells and retinal pigment epithelium. Bruch's membrane was attenuated in the center of the lesion and associated with marked atrophy of the choriocapillaris. Adjacent to the central lesion, some lipofuscin was identified in the retinal pigment epithelium. CONCLUSIONS: North Carolina macular dystrophy has both clinical and microscopic appearances of a well-demarcated retinal and pigment epithelial lesion confined to the macula. This is consistent with the clinical impression that it is a focal macular dystrophy.

Small, K W; Voo, I; Flannery, J; Udar, N; Glasgow, B J

2001-01-01

57

Inherited macular dystrophies and differential diagnostics.  

PubMed

The inherited macular dystrophies are characterized by different grade central visual loss and different character macula atrophy, because of retinal pigment epithelium lesion. The cause of photoreceptors degeneration is still not known. In this article, we review subjective and objective ophthalmological examines essential to diagnosis and differential diagnosis of inherited autosomal dominant and autosomal recessive macular dystrophies. It is known seven gene mutations (ABCA4, ELOVL4, PROML1, VMD2, Peripherin/RDS, TIMP3, XLRS), which may cause inherited macular dystrophies development. Inheritance type of inherited macular dystrophies, prevalence, beginning of disease, spread of the disease between female and male, clinic, electroretinography, electrooculography, differential diagnosis, genetic research and prognosis are also reviewed. PMID:23168924

Liutkevi?ien?, Rasa; Lesauskait?, Vaiva; Ašmonien?, Virginija; Gelžinis, Arvydas; Zali?nien?, Dalia; Jašinskas, Vytautas

2012-01-01

58

Composition and method for treating macular disorders  

US Patent & Trademark Office Database

A method and composition for treating macular disorders. A pharmologically effective amount of a carbonic anhydrase inhibitor is combined with a pharmologically effective amount of an ocular hypotensive agent sufficient to improve visual function.

2001-11-06

59

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

2010-03-09

60

Photos, Images, and Videos (Macular Degeneration)  

MedlinePLUS

Home » Photos, Images, and Videos » Search Results Photos, Images, and Videos Search Results Instructions for Downloading Photographs and Images Description: A fundus photo showing intermediate age-related macular degeneration. Credit: National ...

61

Spontaneous bilateral tubal pregnancy.  

PubMed

With the increase in incidence of ectopic pregnancy over the decades, bilateral ectopic pregnancy is also increasing. It is usually associated with assisted reproductive techniques (ART) but in recent years few cases of spontaneous bilateral ectopic pregnancy have been reported. Gynaecologists should be aware of this and that ultrasonography has limitations in diagnosis. In cases of ectopic pregnancy where contralateral adnexa is not clearly identified on ultrasound and fertility needs to be conserved, patient should be managed by experts in well equipped centres. A case of spontaneous bilateral tubal pregnancy that remained undiagnosed till laparotomy, is described. PMID:22313653

Wali, Aisha Syed; Khan, Rozilla Sadia

2012-02-01

62

MPS (Macular Photocoagulation Study): Data Monitoring Committee. Krypton Study.  

National Technical Information Service (NTIS)

The Macular Photocoagulation Study (MPS) is a set of randomized, controlled clinical trials designed to evaluate the effectiveness of laser photocoagulation of neovascular lesions, secondary to age-related (senile) macular degeneration (AMD or SMD), ocula...

1989-01-01

63

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.

Zhao, Wenchan; Wang, Sishuo; Lv, Jianhao

2012-01-01

64

[Macular translocation--first experience].  

PubMed

The age related macular degeneration (ARMD) is the most common cause of the central visual acuity loss in persons of age more than 60 years in the well developed countries. Rotation of the macula is nowadays a progressive method of choice of treatment of the exsudative form of ARMD. The aim of this surgical technique is to relocate the neuroretinal epithelium of the central region of the retina to a position situated outside the border of the subfoveolar lesion. Three eyes of three patients (2 woman and one man) were operated on during the period between March and May 2001 at the Department of Ophthalmology of the School of Medicine, Charles University in Pilsen. The method used was the scleral imbrication, which belongs to methods designated as "limited translocation". The mean age of the patients was 62 years and the follow up period was 2 years. After the surgery the relocation of the fovea was observed in all three eyes. In two eyes, the postoperative period was complicated by tractional retinal detachment that occurred three weeks after the surgery as a consequence of progressive proliferative vitreoretinopathy (PVR). Both eyes with the retinal detachment were re-operated. In both of them, the repeated pars plana vitrectomy, epiretinal membranes removal with relaxing retinectomy was performed and after maximal mobilization of the retina, the silicone oil implantation followed. In the second patient, the postoperative period was complicated by elevation of the intraocular pressure and a radial retinal fold running from the encircling buckle indentation up to the macula. Slightly improved function was noticed only in the first patient after following cataract surgery with intraocular lens implantation. In the two other eyes, as noticed at the last follow up check, the postoperative complications caused severe decrease of the central visual acuity although the retina remained attached. Macular translocation procedure is in stage of development and its surgical techniques are being further modified. The risk of postoperative complications with profound loss of central visual acuity corresponds to the level of the technical difficulty and extent of surgical intervention. PMID:15369259

Dolezalová, J; Rusnák, S

2004-07-01

65

Atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy: case reports  

PubMed Central

Background To report two cases of atypical vitelliform macular dystrophy misdiagnosed as chronic central serous chorioretinopathy. Case presentation Two patients with incidentally discovered abnormalities of the retina without specific symptoms were referred to our hospital for consultation. Bilateral macula atrophic lesions were observed and optical coherence tomography revealed serous retinal detachment in the macula. Fluorescein angiography showed multiple leakages around the central hypofluorescent area and indocyanine green angiography showed partially dilated choroidal vessels. Fundus autofluorescence (FAF) showed a decreasing pattern of autofluorescence in the subretinal fluid area, and increasing autofluorescence at the border of the serous retinal detachment. Both patients were diagnosed with chronic central serous chorioretinopathy. Photodynamic therapy and intravitreal bevacizumab injection were administered for engorged choroidal vessels during follow-up, but neither patient showed improvement in symptoms or ophthalmologic findings. Based on re-evaluation by fundus photography, optical coherence tomography, fluorescein angiography, and comparison of the results of FAF with the first visit, vitelliform macular dystrophy was suspected and a definite diagnosis was made by electrooculography and genetic testing. Conclusion In patients with continuous serous retinal detachment without response to photodynamic therapy or intravitreal bevacizumab injection, careful fundus exam and FAF can be used to diagnose atypical vitelliform macular dystrophy.

2012-01-01

66

[Truss-induced macular amyloidosis].  

PubMed

A 80-year-old male presented with a long time history of a localized red-brown macule with superficial lichenification and slight scaling in the right groin. An earlier skin biopsy revealed the presence of amyloid deposits. The patient therefore had a complete internal checkup including a rectal biopsy for exclusion of systemic amyloidosis. However, the laboratory data did not reveal any specific abnormalities including immunoglobulins and Bence-Jones protein. The rectal biopsy was also nonspecific. After skin examination, a rebiopsy was performed at our department showing acanthosis and spongiosis of the epidermis with parakeratosis. A homogenous eosinophilic deposit was present in the upper dermis and stained positive with thioflavine. At the second visit the patient wore a truss for a right inguinal hernia, perfectly matching the area of the skin lesion. Thus, the diagnosis of a localized macular amyloidosis was confirmed very likely due to permanent local friction. The classification of localized cutaneous amyloidoses should include local trauma as a cause to avoid unnecessary and exhausting internal checkups to exclude systemic involvement. PMID:11715396

Abels, C; Karrer, S; Landthaler, M; Szeimies, R M

2001-10-01

67

Traumatic macular hole from intentional basketball overinflation.  

PubMed

We report a new mechanism of ocular trauma. A basketball was intentionally overinflated until it exploded, resulting in corneal edema, hyphema, iritis, vitreous hemorrhage, commotio retinae, and a macular hole. The macular hole did not close after observation and subsequent pars plana vitrectomy with posterior hyaloid removal, but a repeat vitrectomy with internal limiting membrane peeling resulted in hole closure. Basketball overinflation to the point of explosion is a potentially blinding practice of which the public and manufacturers should be made aware. PMID:23676239

Yonekawa, Yoshihiro; Miller, John B; Turalba, Angela V; Eliott, Dean

68

An unusual presentation of macular amyloidosis.  

PubMed

Macular amyloidosis is a form of cutaneous amyloidosis characterized by dusky-brown lesions usually located on the upper back between the shoulder blades. This report describes the case of a 45 year-old female presenting with hyperpigmented macules and lace-like, non-pruritic erythema in the sacral and cervical region as well as on both arms and legs. Histology revealed amyloid deposits in the papillary dermis which exhibited apple-green birefringence after Congo red staining. There were no systemic findings. This is a case of macular amyloidosis with an unusual presentation. The literature on the subject is also reviewed. PMID:22068763

Melo, Bárbara Lima Araújo; Costa, Igor Santos; Goes, Clara de Assis Martins; Tigre, Celina Aguiar Frota; André, Nara Frota

69

Primary treatment of diabetic macular edema  

PubMed Central

Diabetic macular edema (DME) is a leading cause of vision loss in older Americans. Thermal laser treatment remains the mainstay of treatment for DME. Recently, alternative primary treatments for DME have been evaluated. These treatments include intravitreal injections of steroids as well as pharmaceuticals containing antibodies against vascular endothelial growth factor (VEGF). Surgical treatment has been shown to be appropriate in selected cases. We review the evidence and scientific rationale for various primary treatment options in patients with DME. Regular and timely ophthalmologic evaluation remains crucial to recognition and treatment of macular edema in diabetic patients.

Ranchod, Tushar M; Fine, Stuart L

2009-01-01

70

Bilateral globus pallidus lesions.  

PubMed

Following a hypoxic-ischemic insult, the globus pallidus is selectively spared from ischemic injury in contrast to the caudate and putamen. The known causes for hemorrhagic and necrotic lesions selective for injuring the globus pallidus are varied but few. The most widely known etiology is in fatal cases of carbon monoxide poisoning. Additionally reported associations include fatalities involving 3,4-methylenedioxymethamphetamine; cocaine; opiates; and cyanide poisoning. These bilateral globus palladus necrotic lesions have been reported to occur in 5-10% of opiate addicts. In this article, we present a striking photo of selective symmetrical bilateral globus pallidus necrosis following cocaine and opiate abuse. PMID:22866355

Alquist, Caroline Raasch; McGoey, Robin; Bastian, Frank; Newman, William

71

Bilateral temporalis hypertrophy.  

PubMed

Temporalis muscle hypertrophy is rare and may present unilaterally or bilaterally. Variable combinations with masseteric hypertrophy are also reported. It may be associated with a parafunctional habit or occur as an idiopathic entity. A host of modalities including CT, MRI, ultrasonography and muscle biopsy may be utilized for diagnosis. While surgical reduction remains an option, medical therapy with boutlinum type A toxin is the treatment of choice. A case of bilateral temporalis hypertrophy in a 38-year-old female is reported. PMID:19836926

Ali, K; Sittampalam, G; Malik, M A

2010-03-01

72

Macular translocation for subfoveal choroidal neovascularization in age-related macular degeneration: a prospective study  

Microsoft Academic Search

PURPOSE: To conduct a prospective study of macular translocation in patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration.METHODS: In 10 eyes of 10 patients with subfoveal choroidal neovascularization and best-corrected visual acuity ranging from 20\\/50 to 20\\/800 (median, 20\\/111), the fovea was relocated by means of scleral imbrication, intentional retinal detachment with small posterior retinotomies, and partial fluid-air

Hilel Lewis; Peter K Kaiser; Sharon Lewis; Marc Estafanous

1999-01-01

73

Quantification of reduced macular pigment optical density in the central retina in macular telangiectasia type 2  

Microsoft Academic Search

Recently, a unique distribution, namely a reduction of macular pigment optical density (MPOD) within the central retina with a surrounding ring-like structure of preserved MPOD at about 6 degrees eccentricity was suggested to be a common finding in macular telangiectasia (MacTel) type 2. In order to quantify this reduced MPOD, 28 eyes of 14 patients with MacTel type 2 were

Peter Charbel Issa; Rob L. P. van der Veen; Astrid Stijfs; Frank G. Holz; Hendrik P. N. Scholl; Tos T. J. M. Berendschot

2009-01-01

74

Macular slippage after macular hole surgery with internal limiting membrane peeling.  

PubMed

Abstract Purpose: To describe macular slippage toward the optic disc after macular hole surgery with internal limiting membrane (ILM) peeling. Materials and methods: A total of 27 eyes of 27 patients with idiopathic macular hole were included in this retrospective study. The fovea-to-disc distance (FDD) was measured from digital color fundus images before and at least six months after surgery. The position of the fovea was determined as the center of the macular hole before surgery and the center of the macular pigment area after surgery. The thickness of the nasal and temporal macula was measured using spectral-domain optical coherence tomography. The difference in thickness between the nasal and temporal macula was determined as the degree of parafoveal asymmetry (PFA). Results: The postoperative FDD was significantly shorter than the preoperative FDD: 4.00?±?0.33?mm and 3.82?±?0.34?mm, respectively (p?macular hole surgery. Macular slippage can be a reasonable cause for the macular alterations such as an appearance of DONFL and changes in asymmetrical parafoveal thickness. PMID:23885921

Nakagomi, Tomomi; Goto, Teruhiko; Tateno, Yasushi; Oshiro, Tomohiro; Iijima, Hiroyuki

2013-07-25

75

Bilateral endogenous fungal endophthalmitis.  

PubMed

Endogenous endophthalmitis is a rare and severe intraocular infection which can be vision-threatening. We describe a case of bilateral fungal endogenous endophthalmitis in a 64-year-old male which was successfully treated with systemic administration of fluconazole followed by pars plana vitrectomy with an intravitreous injection of amphotericin B. PMID:23640266

Michal, Wilczynski; Olena, Wilczynska; Wojciech, Omulecki

2013-05-01

76

Bilateral pisotriquetral loose bodies  

PubMed Central

Case reports detailing diagnosis and effective treatment of pisotriquetral loose bodies are scarce. This article describes an even rarer case of bilateral pisotriquetral joint loose bodies, explores the relative diagnostic roles of magnetic resonance imaging versus computed tomography, and outlines effective strategies used for the management of this condition drawn from the literature and our own experience.

Williams, GR; Holland, P; Beazley, J; Hyder, N

2012-01-01

77

Echinoderms Have Bilateral Tendencies  

Microsoft Academic Search

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

Chengcheng Ji; Liang Wu; Wenchan Zhao; Sishuo Wang; Jianhao Lv

2012-01-01

78

Bilateral temporalis hypertrophy  

Microsoft Academic Search

Temporalis muscle hypertrophy is rare and may present unilaterally or bilaterally. Variable combinations with masseteric hypertrophy are also reported. It may be associated with a parafunctional habit or occur as an idiopathic entity. A host of modalities including CT, MRI, ultrasonography and muscle biopsy may be utilized for diagnosis. While surgical reduction remains an option, medical therapy with boutlinum type

K. Ali; G. Sittampalam; M. A. Malik

2010-01-01

79

Unusual presentations of type 2 idiopathic macular telangiectasia.  

PubMed

Purpose: To report unusual presentations of type 2A idiopathic macular telangiectasia (IMT). Methods: A retrospective analysis of disease presentation was conducted in 32 patients with type 2A IMT. All patients underwent a complete ophthalmological examination, including spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA) and indocyanine green angiography (ICGA). Results: Three out of 32 study patients showed the simultaneous presentation of type 2 IMT and other retinal diseases. In the first patient, the ophthalmological examination revealed a proliferative IMT associated with late-onset Stargardt disease. The second patient presented bilateral nonproliferative IMT and chronic serous chorioretinopathy in the left eye. The examination of the third patient revealed basal laminar drusen and soft drusen associated with IMT in both eyes. Conclusions: Type 2 IMT may represent an unusual presentation of Stargardt disease, chronic serous chorioretinopathy and basal laminar drusen. These presentations are most likely coincidental and highlight the importance of FA, ICGA and SD-OCT in the diagnosis and treatment of such cases. © 2013 S. Karger AG, Basel. PMID:23969580

Atmani, K; Querques, G; Zourdani, A; Benhamou, N; Souied, E H

2013-08-20

80

Driving and Age-Related Macular Degeneration  

ERIC Educational Resources Information Center

|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,…

Owsley, Cynthia; McGwin, Gerald, Jr.

2008-01-01

81

Steroids and the Management of Macular Edema  

Microsoft Academic Search

Macular edema (ME) is a condition which is usually secondary to an underlying disease process. It is most commonly seen following venous occlusive disease, diabetic retinopathy and posterior segment inflammatory disease. The treatment of ME varies, depending upon the underlying etiology, and has led to varying degrees of success. Traditionally, the main treatment options have included topical and systemic steroids,

Shani Golan; Anat Loewenstein

2010-01-01

82

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.

Romero-Aroca, Pedro

2013-01-01

83

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

84

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.

Owsley, Cynthia; McGwin, Gerald

2009-01-01

85

Bilateral Hermaphroditism in a Dog.  

National Technical Information Service (NTIS)

Bilateral hermaphroditism was diagnosed in a 6-monthold Beagle. Histologically, bilateral ovotestes, epididymides, and fallopian tubes were identified. The dog also had a vagina, phallus, and bicornuate uterus. The dog was genetically a female as determin...

N. W. King C. H. Garvin

1964-01-01

86

Bilateral Wilms' tumor  

SciTech Connect

Twenty children with bilateral Wilms' tumor were presented to the Children's Hospital Medical Center and Children's Cancer Research Foundation, Sidney Farber Cancer Institute, and Joint Center for Radiation Therapy (CHMC-CCRF, SFCI, JCRT) from January 1, 1956 to December 31, 1976. Of these 20, 16 had simultaneous and 4 had metachronous disease on presentation. All patients were treated with surgery, radiation and chemotherapy. Of the 16 patients with simultaneous disease, 10 (63%) are alive and free of disease 12+ to 175+ months post diagnosis and treatment, with median follow-up of 121 months. There were no long-term survivors in the metachronous group; all were dead of disease within 21 months from initial presentation of original tumor. With these data we relate prognosis to extent of disease and discuss a general approach to the management of bilateral Wilms' tumor.

Malcolm, A.W.; Jaffe, N.; Folkman, M.J.; Cassady, J.R.

1980-02-01

87

Microperimetry and optical coherence tomography in a case of traumatic macular hole and associated macular detachment with spontaneous resolution  

PubMed Central

The association of macular detachment with posttraumatic macular hole is a known but rare occurrence. Spontaneously occurring resolution of the detachment and closure of the macular hole has been reported only once in the literature. We describe a similar rare event in a young male, the documentation of which was done serially by microperimetry (MP) and optical coherence tomography (OCT). A 17-year-old male presented with a decrease in vision following a closed globe injury to the left eye. A coexisting macular hole and macular detachment were detected in the affected eye. Serial follow-up with OCT and MP documented complete resolution of the macular hole and the macular detachment within 1 week of presentation. The case highlights that spontaneous resolution of traumatic macular hole and related macular detachment may occur and a waiting period is advisable before undertaking any corrective surgical procedure. The pathophysiologic mechanisms of causation and the resolution of posttraumatic macular hole-related retinal detachment are discussed.

Aalok, Lalit; Azad, Rajvardhan; Sharma, Yog R; Phuljhele, Swati

2012-01-01

88

Sequential Bilateral Negotiation  

Microsoft Academic Search

\\u000a For some B2C or B2B market places, such as electronic shopping malls, agents representing the buyers could ”go shopping” and\\u000a negotiate with several stores looking for the best deal. To develop agents capable to act in a scenario like this one, it\\u000a is necessary to deal with several issues that go beyond the bilateral negotiation or auction. In the agent

Orlando Pinho Jr.; Geber Ramalho; Gustavo De Paula; Patricia Azevedo Tedesco

2004-01-01

89

Comparison of the effect of unilateral intravitreal bevacizumab and ranibizumab injection on diabetic macular edema of the fellow eye.  

PubMed

Abstract Purpose: To find out whether intravitreally administered bevacizumab and ranibizumab affect the contralateral, untreated, eyes of patients with bilateral diabetic macular edema (DME). Methods: A retrospective review of patients with bilateral DME, who were treated with intravitreal bevacizumab or ranibizumab, was performed. All enrolled patients received intravitreal 1.25?mg bevacizumab or 0.5?mg ranibizumab in the eye with more severe macular edema. As outcome measures, best-corrected visual acuity (BCVA) was assessed with the Early Treatment Diabetic Retinopathy Study chart and central foveal thickness (CFT) measurement was obtained using optical coherence tomography-3 before and at 2 and 4 weeks after injections. Results: The study included 55 eyes of 55 patients who received bevacizumab (group 1) and 32 eyes of 32 patients who received ranibizumab (group 2). The mean age of the 55 patients [35 female (63.6%), 20 male (36.4%)] in group 1 was 54.31±12.67 years, and the mean age of the 32 patients [20 female (62.5%), 12 male (37.5%)] in group 2 was 56.01±13.29 years. The median BCVA in the uninjected eye showed no statistically significant change at any visit after either bevacizumab or ranibizumab injection (P=0.302, P=0.582, respectively). In group 1, the median CFT in the uninjected eye was 417??m at baseline; this was reduced to 401??m at 2 weeks and 372??m at 4 weeks. The change in CFT was found to be statistically significant (P=0.009). No statistically significant change was found in the median CFT of uninjected eyes of patients treated with ranibizumab (399, 403, and 407??m before and at 2 and 4 weeks after treatment, respectively). Conclusions: Compared with ranibizumab, intravitreal administration of bevacizumab resulted in a greater decrease in macular thickness in the untreated eye, in patients with bilateral DME. PMID:23848950

Bakbak, Berker; Ozturk, Banu Turgut; Gonul, Saban; Yilmaz, Mevlut; Gedik, Sansal

2013-07-13

90

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

91

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.

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

2013-01-01

92

Limited inferior macular translocation for the treatment of subfoveal choroidal neovascularization secondary to age-related macular degeneration  

Microsoft Academic Search

PURPOSE: To review a series of patients with age-related macular degeneration undergoing limited macular translocation for the treatment of subfoveal choroidal neovascularization, to determine short-term visual acuity outcomes, to measure amounts of attainable retinal movement, and to identify prognostic factors.METHODS: A retrospective review was conducted on a consecutive series of patients undergoing inferior limited macular translocation with scleral imbrication for

Dante J Pieramici; Eugene De Juan Jr; Gildo Y Fujii; Sandra M Reynolds; Michele Melia; Mark S Humayun; Andrew P Schachat; Craig D Hartranft

2000-01-01

93

[Treatment of retinal detachment with macular hole].  

PubMed

The authors presented 6 cases of macular hole retinal detachment in which pars plana vitrectomy with endo-tamponade was performed; in 4 cases SF6 gas and in 2, with PVR silicone oil was used. Retina was completely attached in 4 eyes. Visual acuity 1/50 to 2/50 was achieved in 5 eyes. Follow-up ranged from 5 to 9 months. PMID:8309195

Pikulski, Z; Nawrocki, J; Dziegielewski, K

1993-06-01

94

[Treatment of retinal detachment with macular hole].  

PubMed

The methods and results of surgery in 6 cases of retinal detachment with macular hole are presented. In all 6 cases pars plana vitrectomy was performed, in 4 with subsequent SF6 and in 2 with silicone oil tamponade. Retinal attachment was achieved in 4 eyes. Visual acuity 1/50-2/50 was found after surgery in 5 cases. The follow-up ranged from 6 to 9 months. PMID:8022169

Pikulski, Z; Nawrocki, J; Dziegielewski, K

95

A compact rarebit test for macular diseases  

Microsoft Academic Search

BackgroundRarebit testing implies probing for gaps in the neuro-retinal receptive field matrix, using bright microdots on a dark background. Previous reports have found rarebit testing useful for the detection of macular lesions. In its original implementation, the test requires darkroom facilities and a long test distance (2 m).MethodsA self-contained rarebit test device was realised using a modified miniature data projector

Christina Winther; Lars Frisén

2009-01-01

96

[Bilateral posterior scleritis].  

PubMed

Posterior scleritis is an inflammatory process of the posterior part of the sclera. Its prevalence is very low and its diagnosis can be complicated due to the absence of external ocular signs. It is more frequent in women. In young patients it does not usually have other associated pathologies, but in those over 55 years nearly one-third of the cases have a relation with some systemic disease, above all rheumatoid arthritis. The diagnosis of this pathology can require a multidisciplinary approach and the collaboration of ophthalmologists with neurologists, internists or rheumatologists. This article describes a case of idiopathic bilateral posterior scleritis. PMID:21904415

Zurutuza, A; Andonegui, J; Berástegui, L; Arruti, N

97

Bilateral renal aspergillosis.  

PubMed

The recent increased use of steriods, immunosuppressive agents and cytotoxic drugs has been associated with a rise in the incidence of significant fungal disease. The first case of bilateral renal aspergillosis without disseminated involvement is reported. A multitherapeutic approach, including surgical evacuation of masses of hyphae, parenteral antimycotic chemotherapy and topical instillations of amphotericin B, were necessary to clear the kidneys. Newer systemic agents such as 5-fluorocytosine and rifampicin were also used. Treatment of fungal infections of the urinary tract is discussed. PMID:1113403

Warshawsky, A B; Keiller, D; Gittes, R F

1975-01-01

98

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.

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

2011-01-01

99

Ischemic Bilateral Opercular Syndrome  

PubMed Central

Opercular syndrome, also known as Foix-Chavany-Marie syndrome, is a paralysis of the facial, pharyngeal, masticatory, tongue, laryngeal, and brachial muscles. It is a rare cortical form of pseudobulbar palsies caused by vascular insults to bilateral operculum. Its clinical presentations include anarthria, weakness of voluntary muscles involving face, tongue, pharynx, larynx, and masticatory muscles. However, autonomic reflexes and emotional activities of these structures are preserved. In the present case, an 81-year-old male presented with acute onset of anarthria with difficulties in chewing, speaking, and swallowing that was diagnosed with opercular syndrome.

Milanlioglu, Aysel; Ayd?n, Mehmet Nuri; Gokgul, Alper; Hamamc?, Mehmet; Erkuzu, Mehmet Atilla; Tombul, Temel

2013-01-01

100

Simultaneous bilateral elbow dislocation with associated bilateral radial head fracture  

Microsoft Academic Search

Bilateral elbow dislocation is a rare injury, with only a small number of case reports in the literature. The majority of\\u000a these reports describe associated ligamentous injuries only. Simultaneous bilateral radial head fracture in association with\\u000a bilateral elbow dislocation has only been described on one occasion previously. We present the case of a 54-year-old woman\\u000a who dislocated both elbows and

M. Leonard; D. Reidy

2008-01-01

101

Macular microcirculation before and after vitrectomy for macular edema with branch retinal vein occlusion  

Microsoft Academic Search

Background  The changes of perifoveal capillary blood flow velocity (BFV), visual acuity, and retinal thickness after pars plana vitrectomy\\u000a (PPV) have been unclear in patients with branch retinal vein occlusion (BRVO) and macular edema.\\u000a \\u000a \\u000a \\u000a Methods  In a prospective study, PPV was performed on six eyes of six consecutive BRVO patients with macular edema (two women and four\\u000a men; mean age: 66.3?±?5.0 years). Patients

Hidetaka Noma; Hideharu Funatsu; Kumi Sakata; Tatsuya Mimura; Sadao Hori

2010-01-01

102

Lamellar macular hole formation in chronic cystoid macular edema associated with retinal vein occlusion  

Microsoft Academic Search

Purpose  To report the formation of a lamellar macular hole (LMH) in four eyes with chronic cystoid macular edema (CME) associated\\u000a with retinal vein occlusion (RVO).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We reviewed retrospectively the medical records of four patients with chronic CME associated with RVO, in whom LMH formation\\u000a was observed by a series of examinations with optical coherence tomography.\\u000a \\u000a \\u000a \\u000a \\u000a Results  All eyes showed a large

Kayoko TsukadaAkitaka Tsujikawa; Akitaka Tsujikawa; Tomoaki Murakami; Ken Ogino; Nagahisa Yoshimura

103

Macular hole formation in a patient with Irvine-Gass syndrome: coincidence or rare complication?  

PubMed Central

Background Macular edema (ME) is caused by abnormal retinal capillary permeability and has also been described as a postoperative complication of cataract surgery (Irvine-Gass syndrome). Objective To present a patient with Irvine-Gass syndrome in the right eye complicated with a macular hole (MH) in the same eye and possible associations between these two entities. Case report A 72-year-old male with a history of uneventful bilateral cataract surgery was followed-up with biomicroscopy and optical coherence tomography (OCT). Four weeks after cataract surgery oculus dexter (OD), there was progressive visual deterioration (best corrected visual acuity [BCVA]: 0.5). OCT disclosed cystoid ME. A parabulbar triamcinolone injection, dexamethasone 0.1% and ketorolac 0.4% eye drops, both 4 times per day OD were administered. Six weeks later (BCVA OD: 0.2), OCT revealed cystoid ME and full-thickness MH. Conclusion ME secondary to diabetes or central retinal vein occlusion may lead to MH by inducing focal vitreomacular traction and by triggering inflammatory mechanisms which facilitate a marked thinning of the fovea. MH may occur even in cases of pseudophakic ME, representing a rare complication of Irvine-Gass syndrome.

Moschos, Marilita M; Gatzioufas, Zisis; Rotsos, Tryfon; Symeonidis, Chrysanthos; Song, Xuefei; Seitz, Berthold

2013-01-01

104

Inflammatory factors in major and macular branch retinal vein occlusion.  

PubMed

Concentrations of inflammatory factors were measured in 40 patients with macular edema due to major branch retinal vein occlusion (BRVO) or macular BRVO who were treated by pars plana vitrectomy. Vitreous fluid levels of vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), and pigment epithelium-derived factor (PEDF) were determined. Visual acuity and central macular thickness were significantly improved at 6 months in both groups. Vitreous fluid levels of VEGF and sICAM-1 were higher in the major BRVO group than the macular BRVO group, while the PEDF level was lower in the major group than the macular group. The mean visual acuity and central macular thickness at 6 months were not significantly different between the macular and major groups. In conclusion, patients with major BRVO had higher vitreous levels of inflammatory factors and lower vitreous levels of anti-inflammatory PEDF. Accordingly, regulating inflammatory factors might be more important in major BRVO than macular BRVO. PMID:22269605

Noma, Hidetaka; Funatsu, Hideharu; Mimura, Tatsuya; Eguchi, Shuichiro; Shimada, Katsunori

2012-01-20

105

Photoreceptor Loss in Age-Related Macular Degeneration  

Microsoft Academic Search

Purpose. The authors showed previously that parafoveal rods, but not cones, decrease during the course of adulthood in donor eyes that were screened to exclude the grossly visible macular drusen and pigmentary disturbances typical of age-related macular degeneration (AMD). Because AMD begins in the parafovea, this selective loss of rods actually may be subclinical AMD not yet visible in the

Christine A. Curcio; Nancy E. Medeiros; C. Leigh Millican

1996-01-01

106

Visual Outcomes Following Macular Translocation With 360° Peripheral Retinectomy  

Microsoft Academic Search

Objective: To evaluate visual outcomes following macu- lar translocation with 360° peripheral retinectomy in pa- tients with subfoveal choroidal neovascularization sec- ondary to age-related macular degeneration. Methods: In a prospective study, 15 consecutive pa- tients with large subfoveal choroidal neovascularization underwent macular translocation with 360° peripheral retinectomy and silicone oil tamponade. Preoperative and postoperative photographs and fluorescein angiograms were obtained

James C. Lai; Deborah J. Lapolice; Sandra S. Stinnett; Carsten H. Meyer; Luz M. Arieu; Melissa A. Keller; Cynthia A. Toth

2002-01-01

107

Fast assessment of the central macular pigment density with natural pupil using the macular pigment reflectometer.  

PubMed

We built a new macular pigment reflectometer (MPR) for fast and objective measuring of the optical density of macular pigment in the human eye, using the undilated eye. The design is based on the spectral reflectance from a spot of white light at the fovea. To evaluate its performance, we measured the macular pigment of 20 healthy subjects, ages 18 to 79 years, under four conditions: (1) natural pupil in the dark, (2) natural pupil with dim room light, (3) dilated pupil in the dark, and for comparison with a different technique, (4) heterochromatic flicker photometry (HFP) in dim room light with natural pupil. Condition 1 was repeated in a subset of 10 subjects after an interval of at least 3 days. Data analysis with a model of reflectors and absorbers in the eye provided the density of the macular pigment in conditions 1 to 3. Dim room light and pupil dilatation had no influence on measured density. Mean within subjects variation was typically 7%. Mean difference between test and retest after at least 3 days was 1%. Correlation between MPR and HFP was r=0.56 (p=0.012). Mean within subjects variation with HFP was 19%. The new instrument holds promise for specific applications such as epidemiological research. PMID:17212554

van de Kraats, Jan; Berendschot, Tos T J M; Valen, Suze; van Norren, Dirk

108

Reticular Macular Disease is Associated with Multilobular Geographic Atrophy in Age-Related Macular Degeneration  

PubMed Central

Purpose To investigate the incidence of reticular macular disease (RMD), a subphenotype of age-related macular degeneration (AMD), in multilobular geographic atrophy (GA) and its relation to GA progression. Methods 157 eyes of 99 subjects with AMD, primary GA, and good-quality autofluorescence (AF) and/or infrared (IR) images were classified into unilobular GA (1 lesion) or multilobular GA (>= 2 distinct and/or coalescent lesions). 34 subjects (50 eyes) had serial imaging. We determined the spatiotemporal relationships of RMD to GA and GA progression rates in 5 macular fields. Results 144/157 (91.7%) eyes had multilobular GA, 95.8% of which exhibited RMD. In subjects with serial imaging, the mean GA growth rate significantly differed between the unilobular and multilobular groups (0.40 mm2 /yrvs. 1.30 mm2 /yr, p< 0.001). Of the macular fields in these eyes, 77.1% of fields with RMD at baseline showed subsequent GA progression, while 53.4% of fields without RMD showed progression (p <0.001). Percentage of fields with RMD significantly correlated with GA progression rate(p=0.01). Conclusion AF and IR imaging demonstrates that RMD is nearly always present with multilobular GA in AMD. Further, GA lobules frequently develop in areas of RMD, suggesting progression of a single underlying disease process.

Xu, Luna; Blonska, Anna M.; Pumariega, Nicole M.; Bearelly, Srilaxmi; Sohrab, Mahsa A.; Hageman, Gregory S.; Smith, R. Theodore

2013-01-01

109

Idiopathic bilateral lipid keratopathy.  

PubMed Central

A 52-year-old Mexican man presented with asymptomatic, bilaterally symmetrical lipid infiltrates of the cornea and adjacent limbus. No evidence of previous ocular disease or systemic disorder of lipid metabolism could be detected. Penetrating keratoplasty of the right eye was required. The cornea was rigid and thick, with posterior bulging into the anterior chamber. Light microscopy revealed deep corneal lipid granules, foamy histiocytes, vascularisation, and chronic non-granulomatous inflammation. Transmission electron microscopy showed extracellular lipid spaces and numerous intracytoplasmic lipid vacuoles in histiocytes, keratocytes, conjunctival epithelium, and the endothelium of blood vessels in the corneal stroma and adjacent limbal conjunctiva. Histochemical analysis revealed the presence of neutral fats, free fatty acids, cholesterol, and phospholipids. Images

Alfonso, E.; Arrellanes, L.; Boruchoff, S. A.; Ormerod, L. D.; Albert, D. M.

1988-01-01

110

Optical coherence tomographic findings of macular holes and retinal detachment after vitrectomy in highly myopic eyes  

Microsoft Academic Search

PurposeMacular holes cause retinal detachments in highly myopic eyes. Because degenerative macular changes often coexist, biomicroscopic evaluation of macular hole status after retinal reattachment is sometimes difficult. We studied macular holes with retinal detachment after vitrectomy using optical coherence tomography and evaluated the anatomic status of the hole and factors associated with anatomic success.

Yasushi Ikuno; Kaori Sayanagi; Tetsuro Oshima; Fumi Gomi; Shunji Kusaka; Motohiro Kamei; Masahito Ohji; Takashi Fujikado; Yasuo Tano

2003-01-01

111

Alteration of the visual evoked potential by macular holes: Comparison with optic neuritis  

Microsoft Academic Search

Nine patients with maculopathy (macular holes, macular cysts, and lamellar holes) and ten patients with optic neuritis were examined in order to determine changes in the visual evoked potential (VEP) in response to pattern-reversal stimulation. Eyes with lamellar holes had normal P100 latency, but eyes with macular cysts and macular holes had prolonged P100 latency. Eyes with optic neuritis exhibited

L. N. Johnson; R. D. Yee; R. S. Hepler; D. A. Martin

1987-01-01

112

Pegaptanib Sodium versus Pegaptanib Sodium Combined with Macular Laser Photocoagulation or Laser Alone for Diabetic Macular Edema  

PubMed Central

Purpose. To report the outcomes after primary intravitreal pegaptanib sodium in patients with diabetic macular edema (DME). Methods. We conduced a retrospective analysis of eyes with DME treated with primary intravitreal pegaptanib sodium (Macugen) (intravitreal pegaptanib group). The results were compared with the ones of eyes treated with intravitreal pegaptanib sodium associated with macular laser photocoagulation (combined treatment group), and the ones of eyes treated with primary macular laser photocoagulation (macular laser photocoagulation group). Results. For the intravitreal pegaptanib group (13 eyes), we found significant changes in mean best-corrected visual acuity (BCVA) and reductions in mean central macular thickness (CMT) at the last follow-up visit (P = .0014 and P = .0001). For the macular laser photocoagulation group (15 eyes), we found no statistically significant changes in mean BCVA and CMT at the last follow-up visit (P > .05). For the combined treatment group (12 eyes), we found no significant changes in mean BCVA at the last follow-up visit (P > .05) despite significant reductions in mean CMT (P = .0188). Conclusion. Intravitreal pegaptanib treatment alone may be superior to macular laser photocoagulation alone and to combined intravitreal pegaptanib treatment associated with macular laser photocoagulation in patients with DME.

Querques, G.; Bux, A. V.; Fusco, A. R.; Iaculli, C.; Delle Noci, N.

2009-01-01

113

Silicosis with bilateral spontaneous pneumothorax  

PubMed Central

Presentation with simultaneous bilateral pneumothorax is uncommon and usually in the context of secondary spontaneous pneumothorax. The association of pneumothorax and silicosis is infrequent and most cases are unilateral. Bilateral pneumothorax in silicosis is very rare with just a few reports in medical literature.

Fotedar, Sanjay; Chaudhary, Dhruva; Singhla, Vikas; Narang, Rajat

2010-01-01

114

Intravitreal bevacizumab therapy for idiopathic macular telangiectasia  

Microsoft Academic Search

Purpose  To investigate the efficacy of intravitreal bevacizumab for the treatment of idiopathic macular telangiectasia (IMT).\\u000a \\u000a \\u000a \\u000a Methods  Ten eyes of eight consecutive patients with IMT were studied. Four eyes had type 1, and six had type 2 IMT according to Yannuzzi’s\\u000a classification. All patients were treated with intravitreal bevacizumab (1.25 mg) injections at baseline. Monthly fundus and\\u000a optical coherence tomography (OCT) examinations

Yoko Matsumoto; Mitsuko Yuzawa

2010-01-01

115

Spectral-Domain Optical Coherence Tomography Use in Macular Diseases: A Review  

Microsoft Academic Search

The introduction of spectral-domain optical coherence tomography (SD-OCT) has improved the clinical value for assessment of the eyes with macular disease. This article reviews the advances of SD-OCT for the diagnostic of various macular diseases. These include vitreomacular traction syndrome, cystoid macular edema\\/diabetic macular edema, epiretinal membranes, full-thickness macular holes, lamellar holes, pseudoholes, microholes, and schisis from myopia. Besides offering

Sebastian Wolf; Ute Wolf-Schnurrbusch

2010-01-01

116

Bilateral pseudogout 8 years after bilateral total knee arthroplasty.  

PubMed

This article presents the clinical features of crystal arthropathy after knee replacement. The current literature on pseudogout and gout after both total and partial knee replacement is summarized. A case of bilateral pseudogout 8 years after initial total knee arthroplasty (TKA) is used to highlight the clinical characteristics and treatment options for this underrecognized condition. Presentation mimicked a late septic joint arthroplasty with sudden onset of pain and effusion. The patient was treated successfully with an arthrotomy, debridement, synovectomy, polyethylene insert exchange, oral steroids, and nonsteroidal anti-inflammatories. There are no other reported cases of bilateral pseudogout after bilateral TKA. PMID:23102423

Levi, Gabriel S; Sadr, Kamran; Scuderi, Giles R

2012-09-27

117

Macular assessment using optical coherence tomography for glaucoma diagnosis.  

PubMed

Optical coherence tomography (OCT) is an interferometry-based imaging modality that generates high-resolution cross-sectional images of the retina. Circumpapillary retinal nerve fibre layer (cpRNFL) and optic disc assessments are the mainstay of glaucomatous structural measurements. However, because these measurements are not always available or precise, it would be useful to have another reliable indicator. The macula has been suggested as an alternative scanning location for glaucoma diagnosis. Using time-domain (TD) OCT, macular measurements have been shown to provide good glaucoma diagnostic capabilities. Performance of cpRNFL measurement was generally superior to macular assessment. However, macular measurement showed better glaucoma diagnostic performance and progression detection capability in some specific cases, which suggests that these two measurements may be combined to produce a better diagnostic strategy. With the adoption of spectral-domain OCT, which allows a higher image resolution than TD-OCT, segmentation of inner macular layers becomes possible. The role of macular measurements for detection of glaucoma progression is still under investigation. Improvement of image quality would allow better visualisation, development of various scanning modes would optimise macular measurements, and further refining of the analytical algorithm would provide more accurate segmentation. With these achievements, macular measurement can be an important surrogate for glaucomatous structural assessment. PMID:23018425

Sung, Kyung Rim; Wollstein, Gadi; Kim, Na Rae; Na, Jung Hwa; Nevins, Jessica E; Kim, Chan Yun; Schuman, Joel S

2012-09-27

118

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

119

Clinicopathologic findings in Best vitelliform macular dystrophy  

PubMed Central

Purpose To correlate the clinical and histopathologic features of Best vitelliform macular dystrophy (BVMD). Methods Two eyes were obtained postmortem from a patient with BVMD. The patient’s clinical information was reviewed. Series sections of the globes were performed and sequentially stained with hematoxylin-eosin, periodic acid-Schiff or Masson trichrome. A section of the left macula was submitted for electron microscopic processing. Histopathologic findings were reconstructed in a scaled two-dimensional map and compared with fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) images. Results The macular lesion of the right eye was identified as a well-demarcated region with pigment, elevated submacular yellow material and subretinal fluid. This corresponded histopathologically to a well-circumscribed area of RPE hyperplasia, accumulation of lipofuscin in the RPE, deposition of granular material in the photoreceptors, macrophages and drusen. The left eye displayed a 1 disc diameter chorioretinal scar with surrounding shallow fluid and submacular pigment. This corresponded to RPE changes and a fibrocellular proliferation in the choriocapillaris. Conclusion Histopathologic mapping revealed retinal edema, RPE abnormalities, drusen and a chorioretinal scar in BVMD that correlated with the fundus, FFA, FAF and OCT findings.

Zhang, Qing; Small, Kent W.

2012-01-01

120

Macular grid photocoagulation. An experimental study on the primate retina  

SciTech Connect

We studied the effect of macular grid photocoagulation on the retinal vessels, retina, retinal pigment epithelium, and choroid of normal cynomolgus monkeys. Argon blue-green laser photocoagulation, similar to that employed for treating macular edema due to branch retinal vein occlusion, resulted in a decreased retinal capillary area at both one and five months after treatment. The photoreceptors and retinal pigment epithelium between laser lesions were altered at three days after treatment, but their appearance returned to normal by five months. The significance of these findings is discussed with regard to resolution of macular edema and improvement in vision following grid photocoagulation.

Wilson, D.J.; Finkelstein, D.; Quigley, H.A.; Green, W.R.

1988-01-01

121

BILATERAL WASTEWATER LAND TREATMENT RESEARCH  

EPA Science Inventory

Diplomatic relations between the United States and China, established in 1979, opened the door for development of 1985 bilateral environmental research and technology transfer between the USEPA's Robert S. Kerr Environmental Research Laboratory, Ada, Oklahoma, and China's Beijing...

122

Bilateral internal laryngoceles mimicking asthma  

PubMed Central

Laryngocele is an air-filled, abnormal dilation of the laryngeal saccule that extends upward within the false vocal fold, in communication with the laryngeal lumen. A case of 43-year-old male with bilateral internal laryngoceles, who has been treated as asthma for 4 years, is presented. The patient had dyspnea, cough, and excessive phlegm for a month and a late onset stridor. Flexible nasopharyngolaryngoscopy showed bilateral cystic enlargements of the false vocal folds and true vocal folds could not be visualized. Laryngeal CT without contrast enhancement showed bilateral internal laryngoceles. Submucosal total excision of bilateral cystic masses including parts of false vocal folds was performed. The symptoms resolved immediately after surgery. Although the incidence of internal laryngocele is rare, it should be remembered in the differential diagnosis of upper airway problems and diagnostic flexible nasopharnygolaryngoscopy is routinely indicated for airway evaluation in at-risk patients.

Aksoy, Elif A.; Elsurer, Cagdas; Serin, Gediz M.; Unal, O. Faruk

2013-01-01

123

Intravitreal Bevacizumab May Increase Diabetic Macular Edema in Eyes with Attached Posterior Vitreous  

PubMed Central

Purpose To report 2 eyes of a patient which developed vitreomacular traction (VMT) 1 month after intravitreal bevacizumab (IVB) injection. Materials and Methods A 45-year-old female with bilateral diffuse diabetic macular edema (DME) received bilateral IVB. Results Her initial visual acuity (VA) was 0.15 and 0.2 in OD and OS, respectively. Central foveal thickness (CFT) was 568 and 662 µm in OD and OS, respectively, without any sign of VMT. Both eyes responded well initially but developed VMT at 1 month. This time, intravitreal triamcinolone (IVTA) injection was performed. One month after IVTA injection, VMT was released and CFT decreased to 163 and 181 µm in OD and OS, respectively. Six months after IVTA injection, CFT was 163 and 153 µm, and VA was 0.7 and 0.9 in OD and OS, respectively. Conclusion In eyes with DME and attached posterior vitreous, VMT may develop after IVB injection and increase edema. IVTA injection might be an option to release VMT before considering vitrectomy.

Ozsutcu, Mustafa; Gulkilik, Gokhan; Ayintap, Emre; Altinisik, Muhammed; Demirci, Goktug; Aras, Cengiz

2013-01-01

124

Intravitreal Injection of Dexamethasone Implant in Serous Macular Detachment Associated with Waldenstr?m's Disease  

PubMed Central

Purpose To evaluate the efficacy of one intravitreal injection of dexamethasone (Ozurdex®; Allergan, Inc., Irvine, Calif., USA) in serous macular detachment (SMD) of one eye, associated with bilateral central retinal vein occlusion (CRVO) in a patient affected by Waldenström's macroglobulinemia (WM). Patients and Methods A female patient, affected by WM, complained of a progressive decrease in visual acuity, mainly in the left eye (LE). SMD in the LE associated with bilateral CRVO was diagnosed. One intravitreal injection of dexamethasone was administered in the LE and the patient was tested 1, 2, and 6 months after the injection. Results 1, 2, and 6 months after the injection, the spectral domain optical coherence tomography (SD-OCT) showed a progressive slight reduction of foveal thickness that was not related to any improvement of visual function. Conclusions Treatment with dexamethasone (Ozurdex) induced a progressive slight reduction of SMD but no improvement of visual acuity, and it is possible that this is related to the condition of hematic hyperviscosity that is present in WM.

Fenicia, Vito; Balestrieri, Marco; Perdicchi, Andrea; Maraone, Giorgia; Recupero, Santi Maria

2013-01-01

125

A PROSPECTIVE STUDY OF RETICULAR MACULAR DISEASE  

PubMed Central

Purpose To determine the risk of progression to advanced age-related macular degeneration (AMD) conferred by reticular pseudodrusen (RPD), an imaging presentation of reticular macular disease (RMD), in high-risk fellow eyes of subjects with AMD and unilateral choroidal neovascularization (CNV) in a large prospective study. Design Cohort study. Participants 271 subjects with AMD; 94 with RPD and 177 without RPD. Methods We studied images from a cohort of 271 subjects with AMD in the NAT 2 Study, a 3-year prospective study of subjects with unilateral CNV and large soft drusen in the fellow eye. The fellow eye, at high risk for developing advanced AMD, was the study eye. There were 5 visits per subject. Imaging at each visit consisted of color, red free, and blue light photography and fluorescein angiography. We analyzed the images for the presence of RPD, following disease progression throughout the 3-year study. Main Outcome Measures The development of advanced AMD (CNV or geographic atrophy). Results For the 271 subjects who completed the full 3-year study, there was a significantly higher rate of advanced AMD (56% or 53/94) in fellow eyes with RPD at any visit compared to eyes without RPD (32% or 56/177; p = 7.7E-05, ?2 test; relative risk (RR) 1.8; 95% confidence interval (CI) 1.4–2.4). The chance of developing advanced AMD in the fellow eye in females with RPD (66%) was more than double compared to females without RPD (30%, p = 5.1E-06, RR 2.2, 95% CI 1.6–3.1). Conclusion To our knowledge, this is the first comprehensive prospective study of reticular macular disease (RMD), a distinct clinical phenotype of AMD which includes RPD. It provides strong confirmation that RMD, a disease entity with stereotypical presentations across imaging modalities, is associated with high risk of progression to advanced AMD, perhaps on an inflammatory or vascular basis. RMD deserves wider recognition and consideration by clinicians caring for patients with AMD.

Pumariega, Nicole M.; Smith, R. Theodore; Sohrab, Mahsa A.; LeTien, Valerie; Souied, Eric H.

2011-01-01

126

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

127

Macular retinal detachment associated with peripapillary detachment in pathologic myopia  

Microsoft Academic Search

Purpose A peripapillary detachment in pathologic myopia (PDPM) appears as a yellowish-orange lesion around the optic disc in highly\\u000a myopic eyes. We report a case in which a macular retinal detachment (RD) accompanied a PDPM. Method A case report was used in this study. Results The right eye in a 48-year-old man showed a macular RD and a PDPM. Fluorescein

Noriaki Shimada; Kyoko Ohno-Matsui; Yoichi Iwanaga; Takashi Tokoro; Manabu Mochizuki

2009-01-01

128

Tissue factor with age-related macular degeneration  

PubMed Central

Wet age-related macular degeneration which incidence increases year by year is a blinding eye disease, but current clinical methods of treatment on this disease are limited and the outcome is not ideal. Recent studies have found abnormally high expression of tissue factors which are targets for the treatment of wet age-related macular degeneration to achieve a certain effect in the choroidal neovascularization. Related literatures are reviewed as following.

Wang, Guan-Feng; Zou, Xiu-Lan

2012-01-01

129

The management of diabetic macular oedema  

PubMed Central

Diabetic macular oedema (DMO) is a significant cause of visual loss in the working population. Focal/grid photocoagulation remains an effective treatment for DMO and the benchmark to which clinicians compare other newer treatment modalities. There are, however, patients who do not respond adequately or who are refractory to laser photocoagulation. This has led to the development of newer treatments such as the intravitreal injection of vascular endothelial growth factor (VEGF) inhibitors as well as intravitreal corticosteroid releasing delivery systems. Cataract formation and raised intraocular pressure remain the major disadvantages of corticosteroid use. There is mounting evidence that intravitreal VEGF inhibitors with or without combined laser photocoagulation will become the gold standard treatment for DMO.

Ross, Adam H.; Clare Bailey, C.

2011-01-01

130

Idiopathic eruptive macular pigmentation with papillomatosis.  

PubMed

We present a case of an otherwise healthy 10-year-old girl who presented with asymptomatic brown macules over the trunk and proximal extremities, of three months' duration. The cutaneous examination revealed multiple, dark brown, discrete, round to oval macules and a few mildly elevated lesions over the trunk and proximal limbs. The individual lesion was 1-3 cm in diameter and a few showed velvety appearance over the surface. Darier's sign was negative. The histopathological study from the velvety lesion showed acanthosis, papillomatosis and increased melanin in the basal layer. The upper dermis showed sparse perivascular infiltrate of lymphocytes without any dermal melanophages. It fulfilled the criteria for idiopathic eruptive macular pigmentation with additional histological finding of papillomatosis. PMID:23130237

Verma, Shikha; Thakur, Binod Kumar

2011-07-01

131

Idiopathic eruptive macular pigmentation with papillomatosis  

PubMed Central

We present a case of an otherwise healthy 10-year-old girl who presented with asymptomatic brown macules over the trunk and proximal extremities, of three months’ duration. The cutaneous examination revealed multiple, dark brown, discrete, round to oval macules and a few mildly elevated lesions over the trunk and proximal limbs. The individual lesion was 1-3 cm in diameter and a few showed velvety appearance over the surface. Darier's sign was negative. The histopathological study from the velvety lesion showed acanthosis, papillomatosis and increased melanin in the basal layer. The upper dermis showed sparse perivascular infiltrate of lymphocytes without any dermal melanophages. It fulfilled the criteria for idiopathic eruptive macular pigmentation with additional histological finding of papillomatosis.

Verma, Shikha; Thakur, Binod Kumar

2011-01-01

132

Age-related macular degeneration: current treatments  

PubMed Central

Purpose: Although important progress has been made in understanding age-related macular degeneration (AMD), management of the disease continues to be a challenge. AMD research has led to a widening of available treatment options and improved prognostic perspectives. This essay reviews these treatment options. Design: Interpretative essay. Methods: Literature review and interpretation. Results: Current treatments to preserve vision in patients with non-exudative AMD include antioxidant vitamins and mineral supplementations. Exudative AMD is currently most often treated monthly with anti-VEGF intravitreal injections. However, investigators are beginning to experiment with combination therapy and surgical approaches in an attempt to limit the number of treatment and reduce the financial burden on the health care system. Conclusion: By better understanding the basis and pathogenesis of AMD, newer therapies will continue to be developed that target specific pathways in patients with AMD, with the hoped for outcome of better management of the disease and improved visual acuity.

Hubschman, Jean Pierre; Reddy, Shantan; Schwartz, Steven D

2009-01-01

133

The macular pigment. II. Spatial distribution in primate retinas.  

PubMed

The spatial density distribution of macular pigment in primate retinas was described by two-wavelength microdensitometry of retinal sections. The macular pigment is most dense along the path of the receptor axons in the center of the fovea. Another band of high density is present in the inner plexiform layer in many retinas. The density in both fiber layers declines to low, relatively constant levels within 1 mm eccentricity. Both the total retinal density of macular pigment and the contributions of subsets of the retinal layers were estimated by integrating along the path of light traversing the retina from the vitreal surface to the outer segments. The integrated densities were measured at several eccentricities to establish the profile of macular pigment density along a diameter through the fovea. The macular pigment profile was unimodal in some cases and trimodal in others. The main central peak always occurred in the center of the fovea. The total retinal density of the central peak ranged from 0.42-1.0 absorbance. Most of the pigment is interposed between the outer segments and the stimulating light and is effective as a visual filter. The macular pigment is dichroic, with the major axis of absorption oriented tangential to a circle centered on the fovea. This is consistent with commonly accepted explanations of Haidinger 's brushes. PMID:6724837

Snodderly, D M; Auran, J D; Delori, F C

1984-06-01

134

Macular thickness and volume parameters measured using optical coherence tomography (OCT) for evaluation of glaucoma patients.  

PubMed

The aim of this study was to evaluate macular thickness parameters in glaucoma patients and to compare them to normal subjects using Optical Coherence Tomography (OCT). This prospective, observational study included 20 primary open angle glaucoma patients (POAG) and 20 healthy subjects in control group. Exclusion criteria were diabetes and other macular pathology, like age-related macular degeneration, macular oedema, central serous retinopathy and high myopia >4.00 dsph. OCT imaging of peripapillar retina and macular area were performed using Cirrus HD OCT In these two groups of patients we analyzed changes of macular thickness parameters (central subfield thickness, macular volume, and average macular thickness). The group of glaucoma patients had decreased values of the two macular thickness parameters: macular volume and average macular thickness, compared to control group. There was no difference in central macular thickness, presumably because of the absence of the ganglion cells in this layer. Macular imaging can be a useful additional method to determine glaucoma status and has a potential for tracking glaucoma progression. PMID:22856228

Barisi?, Freja; Sicaja, Ana Jurin; Ravli?, Maja Malenica; Novak-Laus, Katia; Ivekovi?, Renata; Mandi?, Zdravko

2012-06-01

135

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

136

Macular Photocoagulation Study: Manual of Procedures (Revised October 1, 1989, Selected Chapters Revised January 1, 1991).  

National Technical Information Service (NTIS)

The Macular Photocoagulation Study (MPS) is a set of randomized, controlled clinical trials designed to evaluate the effectiveness of laser photocoagulation of neovascular lesions, secondary to age-related (senile) macular degeneration (AMD or SMD), ocula...

1991-01-01

137

Macular Photocoagulation Study: Data Monitoring Report, 1986. Krypton Ocular Histoplasmosis Study.  

National Technical Information Service (NTIS)

The Macular Photocoagulation Study (MPS) is a set of randomized, controlled clinical trials designed to evaluate the effectiveness of laser photocoagulation of neovascular lesions, secondary to age-related (senile) macular degeneration (AMD or SMD), ocula...

1986-01-01

138

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.

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

2013-01-01

139

Fingolimod treatment in multiple sclerosis leads to increased macular volume  

PubMed Central

Objective: To determine whether fingolimod, an oral sphingosine-1-phosphate receptor modulator approved for treatment of multiple sclerosis (MS), generally leads to increased retinal tissue volume. Methods: In this longitudinal observational study, we compared changes in macular volume on spectral-domain optical coherence tomography (OCT) between consecutive patients with MS who initiated fingolimod and a matched reference cohort of patients with MS never exposed to the drug. The primary reference cohort was matched based on time interval between OCT examinations. A secondary reference cohort was matched based on age and disease duration. Change in macular volume within each group was analyzed using the paired t test. Change in macular volume between groups was examined using multiple linear regression. Results: Macular volume increased by a mean of 0.025 mm3 (95% confidence interval [CI] +0.017 to +0.033, p < 0.001) in the 30 patients with MS who initiated fingolimod over a mean follow-up time of 5 months (SD 3). Macular volume did not significantly change over a mean follow-up time of 6 months (SD 4) in a comparison group of 30 patients with MS never treated with fingolimod (mean change of ?0.003 mm3, 95% CI ?0.009 to +0.004, p = 0.47). Overall, 74% of eyes in the fingolimod-treated group exhibited an increase in macular volume vs 37% of eyes in the comparison group. Conclusion: Initiation of fingolimod in MS is associated with a modest, relatively rapid increase in macular volume.

Nolan, Rachel; Gelfand, Jeffrey M.

2013-01-01

140

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.

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

2012-01-01

141

Joint Assessment of Intended and Unintended Effects of Medications: An Example Using Vascular Endothelial Growth Factor Inhibitors for Neovascular Age-Related Macular Degeneration  

PubMed Central

Objective. To estimate the net health benefits of pegaptanib and ranibizumab by considering the impact of visual acuity and unintended effects (cardiovascular and hemorrhagic events) on quality-of-life among persons with neovascular age-related macular degeneration. Methods. We designed a probabilistic decision-analytic model using published data. It employed 17 visual health states and three for unintended effects. We calculated incremental net health benefits by subtracting the harms of each medication from the benefit using the quality-adjusted life year (QALY). Results. In a hypothetical cohort of 1,000 75-year olds with new-onset bilateral age-related macular degeneration followed for ten years, the mean QALYs per patient is 3.7 for usual care, 4.2 for pegaptanib, and 4.3 for ranibizumab. Net benefits decline with increasing baseline rates of unintended effects. Interpretation. Net health benefits present a quantitative, potentially useful tool to assist patients and ophthalmologists in balancing the benefits and harms of interventions for age-related macular degeneration.

Levy, Adrian R.; Szabo, Shelagh; Briggs, Andrew; Pleil, Andreas; Davie, Alison; Zlateva, Gergana; Javitt, Jonathan

2009-01-01

142

Intravitreal Steroids for Macular Edema: The Past, the Present, and the Future  

Microsoft Academic Search

Macular edema, a condition usually associated with an underlying disease process, is a common cause of severe visual loss. There have been a variety of approaches to the treatment of macular edema; within the past few years, however, intravitreal corticosteroid treatments have emerged as an increasingly used treatment option for patients with macular edema. Intravitreal delivery allows the steroid to

Matthew A. Cunningham; Jeffrey L. Edelman; Shalesh Kaushal

2008-01-01

143

Intravitreal Bevacizumab and Cytokine Levels in Major and Macular Branch Retinal Vein Occlusion  

Microsoft Academic Search

Purpose: My aim was to evaluate the effect of intravitreal bevacizumab and to determine the concentrations of inflammatory cytokines in patients with macular edema due to branch retinal vein occlusion (BRVO), according to the site of the occlusion. Methods: In a prospective interventional case series, 46 eyes of patients with macular edema due to major (n = 30) or macular

Ji Won Lim

2011-01-01

144

Clinicopathological correlation in exudative age related macular degeneration: histological differentiation between classic and occult choroidal neovascularisation  

Microsoft Academic Search

AIMSTo analyse the histopathology of classic and occult choroidal neovascular membrane surgical specimens in age related macular degeneration.METHODS35 membranes, from a consecutive series of surgically removed choroidal neovascular membranes in age related macular degeneration, were classified as classic or occult following the guidelines of the Macular Photocoagulation Study. Membranes with classic as well as occult components were considered as mixed

B A Lafaut; K U Bartz-Schmidt; C Vanden Broecke; S Aisenbrey; J J De Laey; K Heimann

2000-01-01

145

Ultrastructure and Three-Dimensional Reconstruction of Several Macular and Papular Telangiectases  

Microsoft Academic Search

Eight types of telangiectases were studied by light and electron microscopy and by 3-dimensional reconstruction from photomicrographs. Five were macular: mat telangiectasia of scleroderma, generalized essential telangiectasia, nevus flammeus, and 2 macular types not previously described. Three were papular: cherry angioma, angiokeratoma (Fabry), and angiokeratoma (Fordyce). The macular telangiectases were produced by dilatation of postcapillary venules of the upper horizontal

Irwin M. Braverman; Agnes Keh-Yen

1983-01-01

146

135. AAV-Mediated Gene Delivery To Evaluate the Biology of an Inherited Macular Degeneration  

Microsoft Academic Search

Malattia Leventinese (ML) is an autosomal dominant inherited macular degeneration with a middle-age onset. Phenotypically, the disease closely resembles Age-related Macular Degeneration (AMD), a condition affecting 20% of the population over age 65 and the leading cause of blindness in the elderly in the Western world. There is no cure for macular degeneration, and the supportive treatments are limited. Patients

Nicholas W. Keiser; Daniel C. Chung; Waixing Tang; Zhanyong Wei; Albert Maguire; Jean Bennett; Jeannette L. Bennicelli

2005-01-01

147

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

148

Macular pigment response to a supplement containing meso-zeaxanthin, lutein and zeaxanthin  

Microsoft Academic Search

BACKGROUND: Age-related macular degeneration (AMD) is a disease with multiple risk factors, many of which appear to involve oxidative stress. Macular pigment, with its antioxidant and light-screening properties, is thought to be protective against AMD. A result has been the appearance of dietary supplements containing the macular carotenoids, lutein and zeaxanthin. More recently, a supplement has been marketed containing, in

Richard A Bone; John T Landrum; Yisi Cao; Alan N Howard; Francesca Alvarez-Calderon

2007-01-01

149

Bilateral trade in natural gas  

Microsoft Academic Search

Based on a March 1984 address to the Canadian-American Committee, Schlesinger notes that the American natural gas producer has been the main beneficiary of Canadian export policy, which has impeded Canadian exports. He reviews the history of bilateral gas exchanges and the 1954 Phillips decision, which set up conditions that were the inverse of a normal competitive market that no

1985-01-01

150

Bilateral teleoperation: An historical survey  

Microsoft Academic Search

This survey addresses the subject of bilateral teleoperation, a research stream with more than 50 years of history and one that continues to be a fertile ground for theoretical exploration and many applications. We focus on the control theoretic approaches that have been developed to address inherent control problems such as delays and information loss. Exposure to several concurrent applications

Peter F. Hokayem; Mark W. Spong

2006-01-01

151

Bilateral spontaneous hemotympanum: Case report  

Microsoft Academic Search

BACKGROUND: The most common causes of hemotympanum are therapeutic nasal packing, epistaxis, blood disorders and blunt trauma to the head. Hemotympanum is characterized as idiopathic, when it is detected in the presence of chronic otitis media. A rare case of spontaneous bilateral hemotympanum in a patient treated with anticoagulants is presented herein. CASE PRESENTATION: A 72-year-old male presented with acute

Dimitrios G Balatsouras; Panayotis Dimitropoulos; Alexandros Fassolis; Georgios Kloutsos; Nicolas C Economou; Stavros Korres; Antonis Kaberos

2006-01-01

152

Infrared imaging and spectral-domain optical coherence tomography findings correlate with microperimetry in acute macular neuroretinopathy: a case report  

PubMed Central

Introduction Spectral-domain optical coherence tomography findings in a patient with acute macular neuroretinopathy, and correlation with functional defects on microperimetry, are presented. Case presentation A 25-year old Caucasian woman presented with bitemporal field defects following an upper respiratory tract infection. Her visual acuity was 20/20 in both eyes and a dilated fundus examination revealed bilateral hyperpigmentary changes in the papillomacular bundle. Our patient underwent further evaluation with spectral-domain optical coherence tomography, infrared and fundus autofluorescence imaging. Functional changes were assessed by microperimetry. Infrared imaging showed the classic wedge-shaped defects and spectral-domain optical coherence tomography exhibited changes at the inner segment-outer segment junction, with a thickened outer plexiform layer overlying these areas. Fluorescein and indocyanine green angiography did not demonstrate any perfusion defects or any other abnormality. Microperimetry demonstrated focal elevation in threshold correlating with the wedge-shaped defects in both eyes. Conclusion Spectral-domain optical coherence tomography findings provide new evidence of the involvement of the outer plexiform layer of the retina in acute macular neuroretinopathy.

2011-01-01

153

X-linked recessive atrophic macular degeneration from RPGR mutation.  

PubMed

We mapped a new X-linked recessive atrophic macular degeneration locus to Xp21.1-p11.4 and show allelic involvement of the gene RPGR, which normally causes severe peripheral retinal degeneration leading to global blindness. Ten affected males whom we examined had primarily macular atrophy causing progressive loss of visual acuity with minimal peripheral visual impairment. One additional male showed extensive macular degeneration plus peripheral loss of retinal pigment epithelium and choriocapillaries. Full-field electroretinograms (ERGs) showed normal cone and rod responses in some affected males despite advanced macular degeneration, emphasizing the dissociation of atrophic macular degeneration from generalized cone degenerations, including X-linked cone dystrophy (COD1). The RPGR gene nonsense mutation G-->T at open reading frame (ORF)15+1164 cosegregated with the disease and may create a donor splice site. Identification of an RPGR mutation in atrophic maculardegeneration expands the phenotypic range associated with this gene and provides a new tool for the dissection of the relationship between clinically different retinal pathologies. PMID:12160730

Ayyagari, Radha; Demirci, F Yesim; Liu, Jiafan; Bingham, Eve L; Stringham, Heather; Kakuk, Laura E; Boehnke, Michael; Gorin, Michael B; Richards, Julia E; Sieving, Paul A

2002-08-01

154

Efficacy of autologous platelets in macular hole surgery.  

PubMed

The introduction of optical coherence tomography has allowed accurate measurement of the size of macular holes. A retrospective consecutive review was performed of 21 patients undergoing macular hole repair with vitrectomy, gas tamponade, and autologous platelet injection and we assessed the effect of macular hole parameters on anatomic and functional outcomes. We looked at the demographic features, final visual outcome, and anatomical closure. Twenty-one patients were included in the study. They underwent routine vitrectomy with gas tamponade (C3F8) and injection of autologous platelets. All patients were advised to maintain a facedown posture for 2 weeks. Anatomical closure was confirmed in all cases and 20 out of 21 of patients had improved postoperative visual acuity by two or more lines. In our series, the macular hole dimensions did not have much effect on the final results. The use of autologous platelets and strict facedown posture seems to be the deciding factor in good anatomical and visual outcome irrespective of macular hole dimensions. PMID:23626459

Konstantinidis, Aristeidis; Hero, Mark; Nanos, Panagiotis; Panos, Georgios D

2013-04-17

155

Age-related macular degeneration: choroidal ischaemia?  

PubMed Central

Aim Our aim is to use ultrasound to non-invasively detect differences in choroidal microarchitecture possibly related to ischaemia among normal eyes and those with wet and dry age-related macular degeneration (AMD). Design Prospective case series of subjects with dry AMD, wet AMD and age-matched controls. Methods Digitised 20?MHz B-scan radiofrequency ultrasound data of the region of the macula were segmented to extract the signal from the retina and choroid. This signal was processed by a wavelet transform, and statistical modelling was applied to the wavelet coefficients to examine differences among dry, wet and non-AMD eyes. Receiver operating characteristic (ROC) analysis was used to evaluate a multivariate classifier. Results In the 69 eyes of 52 patients, 18 did not have AMD, 23 had dry AMD and 28 had wet AMD. Multivariate models showed statistically significant differences between groups. Multiclass ROC analysis of the best model showed an excellent volume-under-curve of 0.892±0.17. The classifier is consistent with ischaemia in dry AMD. Conclusions Wavelet augmented ultrasound is sensitive to the organisational elements of choroidal microarchitecture relating to scatter and fluid tissue boundaries such as seen in ischaemia and inflammation, allowing statistically significant differentiation of dry, wet and non-AMD eyes. This study further supports the association of ischaemia with dry AMD and provides a rationale for treating dry AMD with pharmacological agents to increase choroidal perfusion. ClinicalTrials.gov registration NCT00277784.

Coleman, D Jackson; Silverman, Ronald H; Rondeau, Mark J; Lloyd, Harriet O; Khanifar, Aziz A; Chan, R V Paul

2013-01-01

156

Economic Considerations of Macular Edema Therapies  

PubMed Central

Purpose To relate costs and treatment benefits for macular edema due to diabetes (DME) and branch and central retinal vein occlusion (BRVO, CRVO). Design A model of resource utilization, outcomes, and cost effectiveness and utility. Participants none Methods Results from published clinical trials (index studies) of laser, intravitreal corticosteroids, intravitreal anti-vascular endothelial growth factor (VEGF) agents, and vitrectomy trials were used to ascertain visual benefit and clinical protocols. Calculations followed from the costs of one year of treatment for each treatment modality and the visual benefits as ascertained. Main Outcome measures Visual acuity (VA) saved, cost of therapy, cost per line saved, cost per line-year saved, and costs per quality adjusted life years (QALYs). Results The lines saved for DME (0.26 to 2.02), BRVO (0.74 to 4.92), and CRVO (1.2 to 3.75) yielded calculations of costs/line of saved VA for DME ($1329 to 11609), BRVO ($494 to 13039), and CRVO ($704 to 7611), costs/line-year for DME ($60 to 561), BRVO ($25 to 754), and CRVO ($45 to 473), and costs/QALY of $824 to $25566. Conclusion Relative costs and benefits should be considered in perspective when applying and developing treatment strategies.

Smiddy, William E.

2012-01-01

157

Animal models of age related macular degeneration  

PubMed Central

Age related macular degeneration (AMD) is the leading cause of vision loss of those over the age of 65 in the industrialized world. The prevalence and need to develop effective treatments for AMD has lead to the development of multiple animal models. AMD is a complex and heterogeneous disease that involves the interaction of both genetic and environmental factors with the unique anatomy of the human macula. Models in mice, rats, rabbits, pigs and non-human primates have recreated many of the histological features of AMD and provided much insight into the underlying pathological mechanisms of this disease. In spite of the large number of models developed, no one model yet recapitulates all of the features of human AMD. However, these models have helped reveal the roles of chronic oxidative damage, inflammation and immune dysregulation, and lipid metabolism in the development of AMD. Models for induced choroidal neovascularization have served as the backbone for testing new therapies. This article will review the diversity of animal models that exist for AMD as well as their strengths and limitations.

Pennesi, Mark E.; Neuringer, Martha; Courtney, Robert J.

2013-01-01

158

Mechanisms of age-related macular degeneration  

PubMed Central

Age-related macular degeneration (AMD), a progressive condition that is untreatable in up to 90% of patients, is a leading cause of blindness in the elderly worldwide. The two forms of AMD, wet and dry, are classified based on the presence or absence of blood vessels that have disruptively invaded the retina, respectively. A detailed understanding of the molecular mechanisms underlying wet AMD has led to several robust FDA-approved therapies. In contrast, there are not any approved treatments for dry AMD. In this review, we provide insight into the critical effector pathways that mediate each form of disease. The interplay of immune and vascular systems for wet AMD, and the proliferating interest in hunting for gene variants to explain AMD pathogenesis, are placed in the context of the latest clinical and experimental data. Emerging models of dry AMD pathogenesis are presented, with a focus on DICER1 deficit and the toxic accumulation of retinal debris. A recurring theme that spans most aspects of AMD pathogenesis is defective immune modulation in the classically immune-privileged ocular haven. Interestingly, the latest advances in AMD research highlight common molecular disease pathways with other common neurodegenerations. Finally, the therapeutic potential of intervening at known mechanisms of AMD pathogenesis is discussed.

Ambati, Jayakrishna; Fowler, Benjamin J.

2012-01-01

159

Quantification of reduced macular pigment optical density in the central retina in macular telangiectasia type 2.  

PubMed

Recently, a unique distribution, namely a reduction of macular pigment optical density (MPOD) within the central retina with a surrounding ring-like structure of preserved MPOD at about 6 degrees eccentricity was suggested to be a common finding in macular telangiectasia (MacTel) type 2. In order to quantify this reduced MPOD, 28 eyes of 14 patients with MacTel type 2 were investigated by fundus reflectometry and two wavelengths fundus autofluorescence (FAF; at 488 nm and 514 nm). Fundus reflectometry showed a reduced MPOD within the central 4 degrees eccentricity that was most absent temporal to the foveola. At 6 degrees, MP density was not different from normative values. Two wavelengths FAF was in accordance with these findings. Fundus reflectometry also allowed separate determination of lutein and zeaxanthin. The patients with MacTel type 2 showed a disproportionally high zeaxanthin reduction. The study suggests that in MacTel type 2, there might be an inability to accumulate MP in the central retina. This disease might serve as a model to further study abnormalities of MP distribution in retinal disorders and to elucidate the mechanisms of MP deposition in the retina. PMID:19233170

Charbel Issa, Peter; van der Veen, Rob L P; Stijfs, Astrid; Holz, Frank G; Scholl, Hendrik P N; Berendschot, Tos T J M

2009-02-21

160

Comparison of Natural Course, Intravitreal Triamcinolone and Macular laser photocoagulation for Treatment of Mild Diabetic Macular Edema  

PubMed Central

Purpose: To assess the natural course of the mild diabetic macular edema(DME) and to compare the visual outcomes with the patients with receiving either macular laser photocoagulation or intravitreal injection of triamcinolone acetonide(IVTA). Methods: 28 eyes with central macular thickness (CMT) of between 250 to 300µm were followed without treatment and 48 eyes with CMT between 300 to 500µm had been divided into 3 subgroups according to treatment. We evaluated the best corrected visual acuity (BCVA) and CMT of natural course group and compared the BCVA and CMT of the patients who had been treated with IVTA or macular laser treatment. Results: The eyes with DME between 250 to 300µm showed no significant change in BCVA and CMT at 6 month. Among the eyes with DME between 300 to 500µm, all 3 subgroups showed no statistically significant change of BCVA at any follow up period and no significant difference was revealed among the subgroups. All subgroups showed significant reduction of CMT after 1 month and maintained until final follow-up and there was no significant difference among subgroups. Conclusions: Mild DME between 250 to 500µm did not show significant worsening of BCVA or macular edema without any specific treatment.

Kwon, Soon Il; Baek, Sung Uk; Park, In Won

2013-01-01

161

Staining of internal limiting membrane in macular hole surgery.  

PubMed

Removal of internal limiting membranes (ILMs) is a potentially useful surgical approach to close an idiopathic macular hole. However, the removal of ILMs is difficult to perform because of poor visibility of the ILMs. We have developed a technique for staining the ILM with a solution of indocyanine green to facilitate the removal of ILMs in eyes with an idiopathic macular hole. Thirteen eyes of 13 patients (8 women and 5 men, aged from 54 to 68 years) with idiopathical macular hole stage 3 or stage 4 that underwent removal of ILMs using this technique had an anatomical closure rate of 92% and an improvement of visual acuity of 89% (>/=2 Snellen letter chart lines). The excised specimens were evaluated using transmission electron microscopy. Our results show that this technique is safe and useful in visualizing the ILM, leading to the performance of successful removal of an ILM with least damage to the retina. Arch Ophthalmol. 2000;118:1116-1118 PMID:10922208

Kadonosono, K; Itoh, N; Uchio, E; Nakamura, S; Ohno, S

2000-08-01

162

Resolution of macular edema in Coats' disease with intravitreal bevacizumab  

PubMed Central

A 13-year-old boy was referred because of visual deterioration in his right eye. The visual acuity was two meters of counting fingers. Indirect ophthalmoscopy and biomicroscopy revealed exudative macular edema as well as tumor-like telangiectatic vessels and exudation in temporal periphery. With diagnosis of Coats' disease (stage II) confirmed by fluorescein angiography, three intravitreal injections of bevacizumab were performed at 6-week intervals. One year after the last injection, there was a significant resolution of macular edema as well as visual acuity improvement to 20/20. This is the first case report in which a distinct improvement in macular edema was observed with intravitreal bevacizumab in Coats' disease.

Entezari, Morteza; Ramezani, Alireza; Safavizadeh, Ladan; Bassirnia, Nader

2010-01-01

163

Resolution of macular edema in Coats' disease with intravitreal bevacizumab.  

PubMed

A 13-year-old boy was referred because of visual deterioration in his right eye. The visual acuity was two meters of counting fingers. Indirect ophthalmoscopy and biomicroscopy revealed exudative macular edema as well as tumor-like telangiectatic vessels and exudation in temporal periphery. With diagnosis of Coats' disease (stage II) confirmed by fluorescein angiography, three intravitreal injections of bevacizumab were performed at 6-week intervals. One year after the last injection, there was a significant resolution of macular edema as well as visual acuity improvement to 20/20. This is the first case report in which a distinct improvement in macular edema was observed with intravitreal bevacizumab in Coats' disease. PMID:20029156

Entezari, Morteza; Ramezani, Alireza; Safavizadeh, Ladan; Bassirnia, Nader

164

Bilateral Clavicle Fracture in Two Newborn Infants  

PubMed Central

Background The fracture of clavicle is the most frequently observed bone fracture as birth trauma and it is usually unilateral. It is seen following shoulder dystocia deliveries or breech presentation of macrosomic newborns. Case Presentation We report two macrosomic newborns with bilateral clavicle fracture and brachial plexus palsy due to birth trauma. Chest X-rays confirmed bilateral fracture of clavicles. Both patients were recovered without any sequel. Conclusion Bilateral clavicular fracture should be considered in any neonate with bilateral absent Moro reflexes.

Kanik, Ali; Sutcuoglu, Sumer; Aydinlioglu, Halil; Erdemir, Aydin; Arun Ozer, Esra

2011-01-01

165

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.

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

2009-01-01

166

Bilateral Keratectasia 34 Years after Corneal Transplant  

Microsoft Academic Search

We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK) in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK.

Xavier Valldeperas; Martina Angi; Vito Romano; Mario R. Romano

2010-01-01

167

Hemodynamic response to intravitreal triamcinolone in eyes with macular edema  

Microsoft Academic Search

Purpose  To assess ocular hemodynamic response to intravitreal triamcinolone in patients with macular edema due to diabetes or retinal\\u000a vein occlusion.\\u000a \\u000a \\u000a \\u000a Methods  Forty-three patients that were injected by intravitreal triamcinolone acetonide (0.1 cc 4 mg) for unilateral macular edema\\u000a due to diabetes mellitus (n = 17) and occlusion of retinal vein (n = 26) underwent ocular hemodynamic evaluation by color Doppler imaging (CDI) before and one, two and

Osman Çekiç; Yavuz Bardak; ?ahin U. T??; Aykut Demirkol; Mustafa M. Ekim; Önem Alt?nta?; Ahmet Ye?ilda?; Orhan Oyar

2007-01-01

168

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

169

UNUSUAL PRESENTATION OF GENERALIZED MACULAR AMYLOIDOSIS IN A YOUNG ADULT  

PubMed Central

Macular amyloidosis is a common problem seen dermatology out-patient department. Generalized macular amyloidosis presenting with a poikilodermatous appearance is rare. In our case, an 18-year-old male presented with generalized hypopigmented macules with a poikilodermatous appearance of 10-year duration. His developmental milestones were normal with negative family history of similar complaints. Histopathology of hyperpigmented lesions revealed hyperkeratosis and acanthosis of epidermis and hypopigmented lesion showing only hyperkeratosis. Both lesions were showing the deposition of amorphous, hazy material in the tips of papillary dermis with perivascular inflammatory infiltrate. Congo red staining of the amorphous material was positive for amyloid.

Kudur, Mohan H; B, Sathish Pai; H, Sripathi; Prabhu, Smitha

2008-01-01

170

Surgical management of subfoveal choroidal neovascular membranes in age-related macular degeneration by macular relocation: experiences of an early-stopped randomised clinical trial (MARAN Study)  

Microsoft Academic Search

RationaleThe MARAN (Macular Relocation in Age-related Neovascular disease) trial was planned to assess the effectiveness of full macular relocation (MR) in patients with neovascular age-related macular degeneration (AMD).DesignRandomised, prospective, controlled clinical trial.MethodsPatients suffering from visual loss because of AMD were randomised to either surgery or a control group receiving standard treatment (observation or photodynamic therapy (PDT)). The primary end point

A M Joussen; D Wong; P Walter; B Kirchhof; J Dreyhaupt; C Bauer; J Munzinger; K Unnebrink; A Freiberger; M Seibert-Grafe; N Victor

2010-01-01

171

Bilateral in utero cerebellar infarction.  

PubMed

We report a case of complete bilateral cerebellar infarction diagnosed in utero by routine prenatal ultrasound and magnetic resonance imaging in a 26-week-old fetus. This posterior fossa ischemic stroke with secondary hemorrhage caused transient obstructive hydrocephalus and likely occurred subsequent to vertebrobasilar artery thrombosis. Such posterior fossa ischemic insults diagnosed in utero are rare with scarce clinical reports. The serial imaging characteristics, clinical, and developmental implications of this case are reviewed. PMID:21266324

Ansari, Safdar A; Hunter, Jill V; Nassif, Lisa M; Clark, Gary D; Ramocki, Melissa B

2011-01-24

172

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, Mňnica; Subirana, Mercč; Martin-Fumadó, Carles; Martín, Carles; Castellŕ, Josep; Medallo, Jordi

2011-07-27

173

Macular lesion resembling adult-onset vitelliform macular dystrophy in Kearns-Sayre syndrome with multiple mtDNA deletions.  

PubMed

We present the case of a 48-year-old woman with a clinically and histopathologically confirmed Kearns-Sayre syndrome who developed a maculopathy resembling an adult-onset vitelliform macular dystrophy in her right eye. DNA analysis identified the presence of multiple deletions in the mtDNA of the muscle sample, with the common deletion of 4977 bp the most abundant. To the best of our knowledge, there have been no previous reports of such macular lesion occurring in association with Kearns-Sayre syndrome. PMID:20497429

Ascaso, Francisco J; Lopez-Gallardo, Ester; Del Prado, Eduardo; Ruiz-Pesini, Eduardo; Montoya, Julio

2010-11-01

174

Multiresolution Bilateral Filtering for Image Denoising  

PubMed Central

The bilateral filter is a nonlinear filter that does spatial averaging without smoothing edges; it has shown to be an effective image denoising technique. An important issue with the application of the bilateral filter is the selection of the filter parameters, which affect the results significantly. There are two main contributions of this paper. The first contribution is an empirical study of the optimal bilateral filter parameter selection in image denoising applications. The second contribution is an extension of the bilateral filter: multiresolution bilateral filter, where bilateral filtering is applied to the approximation (low-frequency) subbands of a signal decomposed using a wavelet filter bank. The multiresolution bilateral filter is combined with wavelet thresholding to form a new image denoising framework, which turns out to be very effective in eliminating noise in real noisy images. Experimental results with both simulated and real data are provided.

Zhang, Ming; Gunturk, Bahadir K.

2008-01-01

175

Emerging Pharmacologic Therapies for Wet Age-Related Macular Degeneration  

Microsoft Academic Search

As researchers and clinicians are beginning to understand that wet age-related macular degeneration (AMD) is more than simply a vascular disease that includes angiogenic, vascular and inflammatory components, they are exploring new agents with different mechanisms of action addressing multiple targets in this complex pathophysiology. Some of them are already available in human trials or even approved vascular epithelial growth

Zhang Ni; Peng Hui

2009-01-01

176

Ranibizumab: in macular oedema following retinal vein occlusion.  

PubMed

Ranibizumab (Lucentis®), a recombinant humanized IgG(1) ? isotype monoclonal antibody fragment, is approved in the US for the treatment of macular oedema following retinal vein occlusion (RVO). It binds to the receptor-binding site of active forms of vascular endothelial growth factor-A, inhibiting its biological activity. In two large, well designed, phase III trials in patients with macular oedema following branch RVO (BRVO) or central RVO (CRVO), monthly intravitreal injections of ranibizumab 0.5 mg were associated with significantly greater improvement from baseline in mean best-corrected visual acuity letter score (measured on the Early Treatment Diabetic Retinopathy Study chart) in the study eye at 6 months (primary endpoint) than sham injections. Moreover, ranibizumab was significantly more effective than sham injections with regard to improvements in central foveal thickness at 6 months, as well as several other visual acuity measures. Ranibizumab was generally well tolerated in patients with macular oedema following CRVO or BRVO. Overall, the most common adverse events with ranibizumab were consistent with the adverse event profile previously reported in patients with age-related macular degeneration. PMID:21395358

Garnock-Jones, Karly P

2011-03-01

177

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

178

Prevention of visual field defects after macular hole surgery  

Microsoft Academic Search

BACKGROUND\\/AIMThe pathogenesis of visual field loss associated with macular hole surgery is uncertain but a number of explanations have been proposed, the most convincing of which is the effect of peeling of the posterior hyaloid, causing either direct damage to the nerve fibre layer or to its blood supply at the optic nerve head. The purpose of this preliminary prospective

Anthony B Cullinane; Philip E Cleary

2000-01-01

179

Biomarkers for Age-Related Macular Degeneration (AMD).  

National Technical Information Service (NTIS)

Provided are methods of using levels of markers of systemic inflammation, e.g., CRP, to predict a subject's risk of development or progression of Age-Related Macular Degeneration (AMD), and methods of treating, delaying or preventing the development or pr...

J. M. Seddon

2005-01-01

180

Preventing Depression in Age-Related Macular Degeneration  

Microsoft Academic Search

Context: Age-related macular degeneration is a preva- lent disease of aging that may cause irreversible vision loss, disability, and depression. The latter is rarely rec- ognized or treated in ophthalmologic settings. Objective: To determine whether problem-solving treat- ment can prevent depressive disorders in patients with recent vision loss. Design: Randomized, controlled trial. Setting: Outpatient ophthalmology offices in Philadel- phia, Pennsylvania.

Barry W. Rovner; Robin J. Casten; Mark T. Hegel; Benjamin E. Leiby; William S. Tasman

2007-01-01

181

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

182

Genetic Factors Associated with Age-Related Macular Degeneration  

Microsoft Academic Search

Age-related macular degeneration (AMD) is a complex, multifactorial disease associated with environmental and genetic factors. This review emphasizes the clinical impact of the major genetic factors mainly located in the complement factor H gene and on the 10q26 locus, and their current and future implications for the management of AMD.

Nicolas Leveziel; Julien Tilleul; Nathalie Puche; Jennyfer Zerbib; Franck Laloum; Giuseppe Querques; Eric H. Souied

2011-01-01

183

Submacular scar excision in age-related macular degeneration.  

PubMed

Disciform scars secondary to age-related macular degeneration were surgically removed in three patients. Postoperative visual acuity improved minimally in one case and decreased in the other two cases. The results suggest further investigation is needed with possible modifications of our technique for future studies. PMID:1917314

Blinder, K J; Peyman, G A; Paris, C L; Gremillion, C M

1991-07-01

184

Unraveling A Complex Genetic Disease: Age-related Macular Degeneration  

Microsoft Academic Search

In most of the Western world, age-related macular degeneration (AMD) remains the largest single cause of severe visual impairment, and its prevalence continues to increase. It is considered to be a complex disease, in which multiple genes and environment play a role in pathogenesis. Several environmental insults are implicated with smoking, serum cholesterol, hypertension, sunlight exposure, and many other factors

Matt Chamberlain; Paul Baird; Mohamed Dirani; Robyn Guymer

2006-01-01

185

The Evolving Treatment Options for Diabetic Macular Edema  

PubMed Central

Diabetic retinopathy (DR) is the leading cause of vision loss in working-age adults, and diabetic macular edema (DME) is the most common cause of visual impairment in individuals with DR. This review focuses on the pathophysiology, previous treatment paradigms, and emerging treatment options in the management of DME.

Jain, Atul; Varshney, Neeta; Smith, Colin

2013-01-01

186

Resolution of macular edema after systemic treatment with furosemide.  

PubMed

We report two cases of macular edema treated with the oral administration of furosemide. The first case presented here was a 78-year-old male patient with visual disturbance of the left eye. He had been taking an oral agent for diabetes and had chronic renal failure for 7 years. From 10 days prior to the visit, he had visual disturbance of the left eye accompanied by systemic edema. There were no specific findings in the anterior segment, but sub-retinal fluid was observed in the left fundus. Macular edema was observed on fluorescein angiography and optical coherence tomography; therefore, the oral administration of furosemide was initiated. After seven days, the sub-retinal fluid disappeared. The second case was a 43-year-old female patient with visual disturbance of the left eye who had been taking hypoglycemic agents for diabetes for 13 years. There were no specific findings in the anterior segment, but flame-shaped retinal hemorrhages were scattered over both posterior poles, neovascularization was observed in the left eye, and, of particular note, sub-retinal fluid was detected in the macula of the left eye. Macular edema was also observed on fluorescein angiography and optical coherence tomography, and oral administration of furosemide was initiated. After 3 weeks, the macular edema had significantly decreased. PMID:22870034

Koo, Nam Kyun; Kim, Yu Cheol

2012-07-24

187

NUTRITIONAL SUPPLEMENTATION, CATARACTS AND AGE-RELATED MACULAR DEGENERATION  

Technology Transfer Automated Retrieval System (TEKTRAN)

Age-related cataract and age-related macular degeneration (AMD) are the major causes of visual impairment and blindness in the aging population. Specific nutrients in the diet that are thought to be important in the prevention of these diseases are vitamins C and E, the carotenoids, lutein and zeaxa...

188

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

189

Intraoperative intravitreal triamcinolone decreases macular edema after vitrectomy with phacoemulsification  

PubMed Central

Background The purpose of this study was to evaluate the incidence and amount of macular edema by optical coherence tomography (OCT) after combined small gauge sutureless vitrectomy with phacoemulsification and intravitreal triamcinolone. Methods This retrospective case series included 194 consecutive eyes undergoing nonemergent vitrectomy with phacoemulsification and intravitreal triamcinolone. Ninety-one eyes had preoperative and postoperative OCT available and were included in the analysis. The eyes were evaluated for retinal thickness with preoperative and postoperative OCT, and for preoperative and postoperative best-corrected visual acuity. The main outcome measures were retinal thickness, OCT appearance, and best-corrected visual acuity. Results The incidence of macular edema in all eyes preoperatively was 64.8% and postoperatively was 50.5%. Mean central subfield and center point thickness in eyes with macular edema preoperatively were 361 ?m and 349 ?m, respectively, and postoperatively were 315 ?m and 304 ?m, respectively. In eyes without preoperative macular edema, mean preoperative central subfield and center point thickness were, respectively, 210 ?m and 181 ?m versus 220 ?m and 192 ?m postoperatively. Best corrected visual acuity improved from 20/190 preoperatively to 20/150 at postoperative month 1 and 20/110 at month 6. Postoperative intraocular pressure ? 25 mmHg was observed in 7.7% of eyes, none of which required surgical intervention for steroid-induced glaucoma. Conclusion Use of intravitreal triamcinolone with combined vitrectomy and phacoemulsification may play an important role in modulating postoperative macular edema. Adverse pressure rise is infrequent and usually limited.

Parke, D Wilkin; Sisk, Robert A; Murray, Timothy G

2012-01-01

190

Long-term course in type 2 idiopathic macular telangiectasia.  

PubMed

INTRODUCTION: To study the long-term course in patients with idiopathic macular telangiectasia and report the effect of anti VEGF and laser treatment. METHODS: A retrospective case series of 19 patients/38 eyes with symptomatic type 2 idiopathic macular telangiectasia was performed. Six eyes received intravitreal injections of bevacizumab (1-3 injections), four eyes received focal laser treatment. Follow up examinations comprised visual acuity, biomicroscopy, fluorescein angiography and assessment of macular morphology and thickness by time and spectral-domain optical coherence tomography (OCT). RESULTS: Mean follow-up time was 81 months (range 15-188 months) - the median added up to 80 months. Visual outcome at final visit varied substantially (20/200-20/20). On average visual acuity decreased 1,2 lines (range -0,5 to 6) by 3 years, 2 lines (range -0,5 to 7) by 5 years and 4,1 lines (range 0 to 12) by 10 years. Development of choroidal neovascularisation was observed in only one eye. There was no significant difference in visual acuity between eyes receiving no treatment, intravitreal bevacizumab or laser treatment after 3 and 5 years. Morphological studies by OCT revealed typical changes with retinal atrophy and intraretinal cysts. Visual acuity correlated with the eccentricity of the main manifestation-visual preservation was associated with mainly extrafoveal disease manifestation. DISCUSSION: Type 2 idiopathic macular telangiectasia is a chronic, often slowly progressing macular disease leading to retinal atrophy and visual impairment over decades. Thorough knowledge about the long term course of this disease is necessary to evaluate possible therapeutic options in the long run. PMID:23615764

Meyer-Ter-Vehn, Tobias; Herzog, Sina; Schargus, Marc; Göbel, Winfried; Guthoff, Rainer

2013-04-25

191

Bilateral cleft lip nasal deformity  

PubMed Central

Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM) too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it's management both at the time of cleft lip repair and also secondarily, at a later date. It also discusses the practices followed at our centre.

Singh, Arun Kumar; Nandini, R.

2009-01-01

192

Bilateral stroke following pituitary apoplexy.  

PubMed

Pituitary apoplexy followed by cerebral infarction is rare. We report a 59-year-old male with a known pituitary macroadenoma who was admitted to our emergency department for treatment of an acute myocardial infarction. He underwent coronary angioplasty and was subsequently treated with aspirin, clopidogrel and full-dose enoxaparin. He developed pituitary apoplexy with bilateral compression of both internal carotid arteries, and infarction of both anterior and middle hemispheres; consequently, he died. This patient illustrates the difficulties of administering aggressive anticoagulative and antiplatelet therapy to patients who have a known pituitary adenoma. PMID:19800239

Lill, C M; Hoch, H; Dieste, F-J; Vogel, H-P; Zipp, F; Paul, F

2009-10-01

193

Bilateral peroneal palsy after weightlifting.  

PubMed

: In a 48-year-old otherwise healthy man, a bilateral common peroneal palsy was diagnosed clinically and neurophysiologically. He reported on strength training with weights in both arms, lifting the weights and his upper body from a deep squatting position with broadly positioned legs akimbo in a hitherto unusual intensity. Regarding the pathophysiological mechanisms, 2 options are considered: first, stretching of the nerve at the fascia of the peroneal longus muscle and along the fibula neck, and second, compression of the nerve during squatting with weights loaded and with strongly activated anterior tibial and peroneal muscles. PMID:23615488

Kyavar, Leila; Heckmann, Josef G

2013-09-01

194

Amelogenesis imperfecta with bilateral nephrocalcinosis.  

PubMed

A 12-year-old patient presented with a severe delay of eruption in permanent maxillary and mandibular incisors. On examination, there was over-retained primary teeth and delayed eruption of permanent teeth. Retained primary teeth showed light yellow discolouration whereas permanent teeth were distinct yellow with thin or little enamel. Subsequent imaging revealed all the premolars except maxillary left first premolar showed signs of intra-alveolar coronal resorption, nephrocalcinosis with bilateral multiple calculi and small papillary tip calcifications, marked increase in alkaline phosphatase. Subsequent dental treatment for restoring the functional and aesthetic requirement followed by appropriate treatment for renal problem was undertaken. PMID:23709541

Poornima, P; Katkade, Shashikant; Mohamed, Roshan Noor; Mallikarjuna, Rachappa

2013-05-24

195

Spontaneous bilateral tubal ectopic pregnancy.  

PubMed

A 28-year-old woman presented at eight weeks and four days of gestation, according to her menstrual dates, complaining of painless vaginal bleeding for three days. Her urinary pregnancy test was positive. Initial transvaginal ultrasound demonstrated an irregular complex structure with a fluid filled centre in the right adnexum. Despite the diagnosis of a possible underlying unruptured right tubal ectopic pregnancy, she declined surgical intervention and was managed expectantly as an inpatient. When she complained of increasing abdominal pain with haemodynamic instability, an emergency laparotomy was performed and a diagnosis of bilateral tubal ectopic pregnancy was made. PMID:19391453

Marasinghe, Jeevan P; Condous, George; Amarasinghe, W I

2009-03-01

196

Initial experience of inferior limited macular translocation for subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration  

Microsoft Academic Search

PURPOSE: To report our initial experience of inferior limited macular translocation in patients with subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration.METHODS: We conducted a retrospective study of 23 eyes of 22 patients with choroidal neovascularization involving the foveal center secondary to pathologic myopia (11 eyes), ocular histoplasmosis syndrome (four eyes), angioid streaks (four eyes), idiopathic neovascularization

Gildo Y Fujii; Mark S Humayun; Dante J Pieramici; Andrew P Schachat; Kah-Guan Au Eong; Eugene de Juan Jr

2001-01-01

197

Agreement between Time-Domain and Spectral-Domain Optical Coherence Tomography in the Assessment of Macular Thickness in Patients with Idiopathic Macular Telangiectasia Type 2.  

PubMed

Purpose: To estimate the conversion factors to transpose macular thickness measurements on time-domain (TD) to various spectral-domain (SD) optical coherence tomography (OCT) machines in patients with macular telangiectasia type 2a (MacTel). Procedures: Macular scans on TD- and SD-OCT were performed on patients at the same visit. The retinal thickness values in various ETDRS subfields and macular volume were compared between different OCT machines. Results: The macular thickness and volume were significantly greater (p < 0.0001, r = 0.678-0.822) on SD-OCT. The mean differences in macular thickness between TD Stratus and SD-OCT by Spectralis, Cirrus and Topcon were 62, 41 and 20 ?m, respectively. The conversion factor of macular thickness from TD-OCT to Spectralis, Cirrus and Topcon were +65, +39 and +25 ?m, respectively. Conclusion and Message: The estimates of conversion of macular thickness from TD- to SD-OCT using simple mean differences between machines and those by linear regression were similar suggesting that the former may be used for the longitudinal follow-up of MacTel patients. © 2013 S. Karger AG, Basel. PMID:23989133

Mathew, Raeba; Sivaprasad, Sobha; Florea, Daniela; Leung, Irene; Sallo, Ferenc; Clemons, Traci; Bird, Alan C; Peto, Tunde

2013-08-24

198

Fourier domain OCT measurement of macular, macular ganglion cell complex, and peripapillary RNFL thickness in glaucomatous Chinese eyes.  

PubMed

Purpose. To evaluate and compare the glaucoma discrimination ability of macula, macular ganglion cell complex (mGCC), and peripapillary nerve fiber layer (ppNFL) thickness in Chinese patients using Fourier-domain optical coherence tomography (FD-OCT). Methods. A total of 64 normal subjects (N), 47 glaucoma suspects (GS), and 48 glaucoma patients (G) were enrolled in the study. The thickness of mGCC, ppNFL, and total macula were measured using RTVue-100 FD-OCT (software version: 4.0.7.5; Optovue). The GCC and ONH protocols were used for obtaining images in all subjects. For each binocular subject, one eye was chosen randomly for analysis. Results. The average thicknesses of macular, mGCC, and ppNFL in normal eyes were significantly different from those in GS or G eyes (p<0.001). The mGCC thickness correlated well with ppNFL thickness (correlation coefficients for N, GS, and G eyes are 0.397 [p=0.001], 0.822 [p<0.0001], and 0.865 [p<0.0001]). Areas under receiver operating characteristic curve of macular, mGCC, and ppNFL thickness are 0.940 (p<0.0001), 0.998 (p<0.0001), and 0.977 (p<0.0001), discriminating G from N eyes. There was no significant difference comparing the discriminating powers of NFL, GCC, and macular thickness. Conclusions. The mGCC measurements provide another measurement of neural loss in glaucoma, and may serve as a promising parameter for ppNFL thickness in the clinical assessment of glaucoma. For glaucomatous eyes, mGCC and ppNFL thicknesses performed better discriminating abilities compared with macular thickness. PMID:22467590

Chen, Junyi; Huang, Haili; Wang, Min; Sun, Xinghuai; Qian, Shaohong

2012-03-20

199

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.

2013-01-01

200

Bilateral orbital emphysema from compressed air injury  

Microsoft Academic Search

PURPOSE: To describe a patient who developed bilateral subconjunctival and orbital emphysema after an automobile tire explosion.METHOD: Case report.RESULTS: A 60-year-old man sustained bilateral ocular injury after a tire explosion. Ophthalmic examination disclosed bilateral subconjunctival air, with no visible conjunctival laceration. Computed tomography showed orbital emphysema, with no evidence of orbital fracture. Follow-up examination 2 weeks after the injury disclosed

Tina Li; Mahmood F Mafee; Deepak P Edward

1999-01-01

201

Macular Hole Progression after Intravitreal Bevacizumab for Hemicentral Retinal Vein Occlusion  

PubMed Central

Macular edema secondary to retinal vein occlusion is commonly being treated with off-label intravitreal bevacizumab with good outcomes. A significant reduction in macular edema and improvement in visual acuity is seen following such a treatment with no serious adverse effects. In the reported case, a full-thickness macular hole was noticed one month after intravitreal bevacizumab for macular edema secondary to hemicentral retinal vein occlusion. On a detailed review of the pre- and postoptical coherence tomography scans, it was realized that there was a preexisting stage 2-3 macular hole which was masked by the hemorrhages and edema at the fovea and the macular hole had progressed following the injection.

Nagpal, Manish; Mehta, Vikram; Nagpal, Kamal

2011-01-01

202

Influence of ischemia on visual function in patients with branch retinal vein occlusion and macular edema  

PubMed Central

Visual function and retinal morphology were investigated to elucidate the influence of ischemia in patients with branch retinal vein occlusion (BRVO) and macular edema. In 41 consecutive patients with BRVO aged 68.9 ± 10.0 years (22 women and 19 men), the area of capillary nonperfusion was measured by fluorescein angiography. Retinal thickness and retinal volume were measured by optical coherence tomography, and mean retinal sensitivity was calculated for each of 9 macular subfields. Mean visual acuity and macular sensitivity within the central subfield were not significantly correlated with the nonperfused area. However, the macular sensitivity within the central 5 subfields and all 9 subfields showed significant negative correlations with the nonperfused area. Also, macular thickness and volume within all 9 subfields were significantly correlated with the nonperfused area. In conclusion, evaluation of both the fovea and the entire macular region may be important in patients with ischemic BRVO.

Noma, Hidetaka; Funatsu, Hideharu; Mimura, Tatsuya; Shimada, Katsunori

2011-01-01

203

One day wonder: Fast resolution of macular edema following intravitreal ranibizumab in retinal venous occlusions.  

PubMed

Macular edema is a significant cause of vision loss in patients with central retinal vein occlusions and branch retinal vein occlusions. Vascular endothelial growth factor (VEGF) appears to be a key factor in the pathogenesis of this disease. Anti-VEGF therapy, such as intravitreal ranibizumab provides an effective treatment against vision-threatening macular edema. We report three patients of retinal vein occlusion with macular edema who demonstrated overnight resolution of macular edema following treatment with intravitreal ranibizumab (0.5 mg). 3D optical coherence tomography (Optovue) was used as a tool for comparison of the macular thickness before and after treatment. The significant reductions in the central foveal thickness demonstrated in these patients one night after intravitreal injections could have significant influence on modifying current treatment protocols. Early treatment of macular edema related to retinal venous occlusive disease with anti-VEGF injections could result in faster visual rehabilitation in these patients. PMID:24104718

Verma, Lalit; Chakravarti, Arindam; Gupta, Avnindra; Prakash, Smriti

2013-09-01

204

Brachial neuritis involving the bilateral phrenic nerves.  

PubMed

Brachial neuritis with bilateral hemidiaphragmatic paralysis has been reported in two previous cases in the literature. We report a patient who experienced severe right shoulder discomfort three weeks prior to hospital admission which evolved to include both shoulders. Two weeks prior to admission he noticed the onset of discomfort in breathing in the supine position and shortness of breath with minor exertion. The admitting diagnoses were myocardial infarction due to significant ECG changes and idiopathic elevated bilateral hemidiaphragms. The patient had findings significant for tachypnea, dyspnea, decreased breath sounds at the bases bilaterally, impaired motion of the bilateral lung bases on inspiration and paradoxical respirations. Comprehensive medical testing and evaluation revealed bilateral elevated hemidiaphragms and vital capacity 40% of normal. Weakness of the proximal shoulder girdle and bicep musculature bilaterally was noted. Electromyography was significant for reduced recruitment pattern in the bilateral shoulder girdle musculature. Nerve conduction studies suggested bilateral phrenic neuropathy. This case is an unusual presentation of brachial neuritis affecting the bilateral shoulder girdle with phrenic nerve involvement. The differential diagnosis of acute shoulder pain associated with respiratory symptomatology should therefore include brachial neuritis. PMID:3800625

Walsh, N E; Dumitru, D; Kalantri, A; Roman, A M

1987-01-01

205

[Massive bilateral adrenal hemorrhage: role of imaging].  

PubMed

Bilateral adrenal hemorrhage is a rare and potentially life threatening situation in adults. The clinical presentation is non-specific, and the diagnosis is based on imaging. The purpose of this report is to provide an illustrative case of spontaneous bilateral adrenal hemorrhage that occurred during pregnancy. The sonographic and computed tomographic findings included large bilateral adrenal hematomas with no evidence of underlying malignancy. Since bilateral adrenal hemorrhage is a rare but potentially life threatening situation, prompt laboratory and imaging evaluation are essential and may reduce both morbidity and mortality. PMID:15205660

Kably, M I; Zamiati, W; Benkirane, H; Kadiri, R

2004-05-01

206

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

207

Safety of Triamcinolone acetonide (TA)-assisted pars plana vitrectomy in macular hole surgery  

Microsoft Academic Search

AimTo evaluate whether Triamcinolone acetonide (TA)-assisted pars plana vitrectomy for visualisation of posterior hyaloid during macular hole surgery has any adverse effects on macular hole closure rate and intraocular pressure (IOP).MethodsCase series comparing outcomes and adverse effects in patients who had surgery for macular holes with ILM peel, with and without the use of TA-assisted vitrectomy.ResultsDuring the study period, 29

G Kampougeris; R Cheema; R McPherson; C Gorman

2007-01-01

208

Transient increase in macular edema following vitrectomy for retinal branch vein occlusion  

Microsoft Academic Search

Purpose We confirmed a transient increase in macular edema in some patients after simple vitrectomy for macular edema associated\\u000a with branch retinal vein occlusion (BRVO). Methods We studied 54 consecutive patients (54 eyes) with macular edema secondary to BRVO and preoperative visual acuity of 0.5 or\\u000a below, who underwent vitrectomy and were followed for at least 1 year. Visual acuity and

Hiroyuki Shimada; Hiroyuki Nakashizuka; Takayuki Hattori; Ryusaburo Mori; Yoshihiro Mizutani

2009-01-01

209

Evaluation of Changes of Macular Thickness in Diabetic Retinopathy after Cataract Surgery  

PubMed Central

Purpose To assess the macular thickness changes after cataract surgery in diabetic patients using optical coherence tomography (OCT). Methods We retrospectively reviewed the records of 104 diabetic patients who underwent cataract surgery. We examined the changes of macular thickness using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery. The central subfield mean thickness (CSMT) was used to evaluate macular edema which was defined as an increase of CSMT (?CSMT) > 30% from the baseline. The association between prior laser treatment or severity of diabetic retinopathy and macular thickness were also analyzed. Results Macular edema occurred in 19 eyes (18%) from the diabetic group and 63% of macular edema developed at 1 month after surgery. Thirteen (68%) out of 19 eyes with macular edema showed the resolution of macular edema by 6 months after surgery without treatment. ?CSMT of eyes without a history of laser treatment was statistically greater compared to eyes with a history of laser treatment in at 1- and 2-months after surgery, but was not different than eyes who had laser treatment at 6-months after surgery. The severity of diabetic retinopathy was not significantly correlated to macular edema, but there was statistical difference when patients who had a history of prior laser treatment were excluded. Conclusions The incidence of macular edema after cataract surgery in diabetic patients was 18%. Its peak incidence was at 1 month post surgery and it resolved spontaneously in 68% of patients by 6 months post surgery. Prior laser treatment might prevent postoperative macular edema until 2 months after cataract surgery in diabetic patients. However, macular edema did not affect the severity of diabetic retinopathy.

Kwon, Soon Il; Hwang, Duck Jin; Seo, Ji Young

2011-01-01

210

Peripheral visual field defects after macular hole surgery: a complication with decreasing incidence  

Microsoft Academic Search

AIMTo prospectively evaluate peripheral visual fields after vitrectomy for idiopathic macular holes.METHODSGoldmann perimetry was performed in 105 patients before, as well as 6 weeks and 12 months after macular hole surgery.RESULTSOnly one patient (<1%) with a stage III macular hole developed an asymptomatic postoperative visual field defect. The scotoma was wedge-shaped, peripherally located in the temporal quadrant, and remained unchanged

Carolin A Gass; Christos Haritoglou; Elisabeth M Messmer; Markus Schaumberger; Anselm Kampik

2001-01-01

211

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.

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

2013-01-01

212

Intravitreal pegaptanib for refractory macular edema secondary to retinal vein occlusion  

PubMed Central

Purpose To assess the efficacy of intravitreal Pegaptanib sodium (Macugen®) injection in the management of refractory macular edema secondary to branch retinal vein occlusion. Methods This is a prospective, nonrandomized, interventional case series. Five eyes of five patients with macular edema refractory to either bevacizumab or triamcinolone were treated with intravitreal injection of Pegaptanib sodium. Results After three months follow-up, both visual acuity and macular edema, measured by optical coherence tomography and fluorescence angiography, dramatically improved. Conclusion Pegaptanib sodium is a safe and efficacy treatment for macular edema secondary to branch retinal vein occlusion.

Udaondo, Patricia; Garcia-Delpech, Salvador; Salom, David; Garcia-Pous, Maria; Diaz-Llopis, Manuel

2011-01-01

213

Autofluorescence Imaging for Diagnosis and Follow-up of Cystoid Macular Edema  

PubMed Central

Lipofuscin results from digestion of photoreceptor outer segments by the retinal pigment epithelium (RPE) and is the principal compound that causes RPE fluorescence during autofluorescence imaging. Absorption of the 488-nanometer blue light by macular pigments, especially by the carotenoids lutein and zeaxanthin, causes normal macular hypo-autofluorescence. Fundus autofluorescence imaging is being increasingly employed in ophthalmic practice to diagnose and monitor patients with a variety of retinal disorders. In macular edema for example, areas of hyper-autofluorescence are usually present which are postulated to be due to dispersion of macular pigments by pockets of intraretinal fluid. For this reason, the masking effect of macular pigments is reduced and the natural autofluorescence of lipofuscin can be observed without interference. In cystic types of macular edema, e.g. cystoid macular edema due to retinal vein occlusion, diabetic macular edema and post cataract surgery, hyper-autofluorescent regions corresponding to cystic spaces of fluid accumulation can be identified. In addition, the amount of hyper-autofluorescence seems to correspond to the severity of edema. Hence, autofluorescence imaging, as a noninvasive technique, can provide valuable information on cystoid macular edema in terms of diagnosis, follow-up and efficacy of treatment.

Ebrahimiadib, Nazanin; Riazi-Esfahani, Mohammad

2012-01-01

214

Full-thickness macular hole formation associated with central serous chorioretinopathy.  

PubMed

Purpose. To report a case of full-thickness macular hole (FTMH) formation associated with central serous retinopathy (CSC). Method. Case report. Results. A 63-year-old woman with history of CSC diagnosed 8 years ago presented with vision loss. Clinical examination and optical coherence tomography found FTMH. Seven months following successful surgical repair of the macular hole, the patient presented with decreased vision, and was found to have CSC with closed macular hole. Discussion. Based on the hydration theory of macular hole formation, CSC and the associated retinal pigment epithelium and choriocapillaris dysfunctions may promote the progression of FTMH. PMID:22729443

Amde, Wendewessen; Tewari, Asheesh

2012-06-11

215

Bilateral shotgun pellet pulmonary emboli  

PubMed Central

Intravascular migration of bullets and other foreign bodies is a rare but known complication of penetrating trauma. Missile embolization can represent a diagnostic challenge because it may present in various and unexpected ways. We present the case of a 54-year-old female who sustained shotgun pellet emboli to the pulmonary arteries following a left upper extremity gunshot wound and related vascular surgery. The case illustrates bilateral embolization, and the embolic events occurred following surgery. Embolization should be considered in evaluating patients with gunshot wounds, particularly if there are anomalous symptoms or the projectile is not found in the original, or expected, location. Close attention to the location of the foreign bodies on serial radiographs may reveal the diagnosis of intravascular embolization.

Huebner, Stephen; Ali, Sayed

2012-01-01

216

Compact single-channel Raman detector for macular pigments  

NASA Astrophysics Data System (ADS)

Raman detection of macular pigments (MP) holds promise as a novel noninvasive technology for the quantification of lutein and zeaxanthin carotenoids, which are thought to prevent or delay the onset of age-related macular degeneration. Using resonant excitation in the visible, we measure the Raman signals that originate from the double-bond stretch vibrations of the p-conjugated carotenoid molecule's carbon backbone. In this paper we describe the construction and performance of a new, compact, and low-cost MP Raman instrument using dielectric, angle-tuned band-pass filters for wavelength selection and single-channel photo-multiplier detection of carotenoid Raman responses. MP concentration measurements are fast and accurate, as seen in experiments with model eyes and living human eyes. The ease and rapidity of Raman MP measurements, the relative simplicity of the instrumentation, the high accuracy of the measurements, and the lack of significant systematic errors should make this technology useful for widespread clinical research.

Ermakov, Igor V.; Ermakova, Maia R.; Gellermann, Werner

2004-07-01

217

Localized bi-nasal macular edema in optic chiasmal syndrome  

PubMed Central

A 28-year-old healthy male complaining of vision loss in his right eye was discovered to have localized bi-nasal macular edema in the presence of a pituitary adenoma. The presence of a junctional scotoma composed by a central scotoma in the right eye associated with superior temporal quadrantanopia in the fellow eye was seen. The pattern detected in the visual field suggested the presence of an expansive mass at the level of the optic chiasm. Optical coherence tomography findings also revealed subtle macular thickness beyond normal in the superior and nasal quadrants of both maculae. This report illustrates the importance of suspecting a pituitary adenoma in the light of uncharacteristic retinal alterations.

Lavaque, Alejandro J; Yilmaz, Taygan; Cordero-Coma, Miguel

2013-01-01

218

Macular phototoxicity caused by fiberoptic endoillumination during pars plana vitrectomy.  

PubMed

Three cases of retinal phototoxicity were caused by light from the endoilluminator used in vitrectomy. Preoperative clinical examination, color photography, and fluorescein angiography in all three cases failed to disclose retinal pigment epithelial changes. Postoperative clinical findings, photographs, and fluorescein angiograms are highly suggestive of the presence of retinal phototoxicity. The characteristics of these lesions and surgical conditions implicate the endoilluminator as the source of photic injury. The macular lesions were noted within one week of the surgical procedure, measured between 2 and 5 disk diameters in size, involved the fovea in two eyes, and resulted in marked decrease in visual acuity in two of three eyes, with persistence in one eye. Initially, whitening of the outer retina was present, but was replaced by pigmentary mottling at the level of the retinal pigment epithelium within a few weeks. Preventive measures to avoid macular phototoxicity associated with vitrectomy are discussed. PMID:1524116

Michels, M; Lewis, H; Abrams, G W; Han, D P; Mieler, W F; Neitz, J

1992-09-15

219

Age-related macular degeneration and the aging eye  

PubMed Central

Age-related macular degeneration (AMD) is an ocular disease that causes damage to the retinal macula, mostly in the elderly. Normal aging processes can lead to structural and blood flow changes that can predispose patients to AMD, although advanced age does not inevitably cause AMD. In this review, we describe changes that occur in the macular structure, such as the retinal pigment epithelium and Bruch’s membrane, with advancing age and in AMD. The role of genetics in AMD and age-related changes in ocular blood flow that may play a role in the pathogenesis of AMD are also discussed. Understanding the pathophysiology of AMD development can help guide future research to further comprehend this disease and to develop better treatments to prevent its irreversible central vision loss in the elderly.

Ehrlich, Rita; Harris, Alon; Kheradiya, Nisha S; Winston, Diana M; Ciulla, Thomas A; Wirostko, Barbara

2008-01-01

220

Therapy of Nonexudative Age-Related Macular Degeneration  

Microsoft Academic Search

\\u000a Age related macular degeneration (AMD) is the leading cause of blindness among adults over the age of 65 in the Western world.\\u000a The prevalence of AMD is expected to increase dramatically, from 1.75 million in 2000 to 2.95 million in 2020, due to the\\u000a rapidly aging population. Given the large and now increasing burden of disease, the identification of modifiable

Annal D. Meleth; Veena R. Raiji; Nupura Krishnadev; Emily Y. Chew

221

Intravitreal Ranibizumab for Macular Edema Secondary to Retinal Vein Occlusion  

Microsoft Academic Search

Background\\/Aims: To investigate the effects of intravitreal ranibizumab treatment for macular edema (ME) secondary to retinal vein occlusion (RVO) and the relationship between spectral-domain optical coherence tomography (SD-OCT) findings and visual outcome after successful resolution of ME. Methods: Forty consecutive eyes with ME secondary to branch RVO (BRVO; 29 eyes of 29 patients) or central RVO (CRVO; 11 eyes of

Moosang Kim; Seung-Young Yu; Eung-Suk Kim; So Hyun Bae; Jung Hyun Park; Hyeong Gon Yu; Hyung-Woo Kwak

2012-01-01

222

Mutations in IMPG1 Cause Vitelliform Macular Dystrophies.  

PubMed

Vitelliform macular dystrophies (VMD) are inherited retinal dystrophies characterized by yellow, round deposits visible upon fundus examination and encountered in individuals with juvenile Best macular dystrophy (BMD) or adult-onset vitelliform macular dystrophy (AVMD). Although many BMD and some AVMD cases harbor mutations in BEST1 or PRPH2, the underlying genetic cause remains unknown for many affected individuals. In a large family with autosomal-dominant VMD, gene mapping and whole-exome sequencing led to the identification of a c.713T>G (p.Leu238Arg) IMPG1 mutation, which was subsequently found in two other families with autosomal-dominant VMD and the same phenotype. IMPG1 encodes the SPACR protein, a component of the rod and cone photoreceptor extracellular matrix domains. Structural modeling indicates that the p.Leu238Arg substitution destabilizes the conserved SEA1 domain of SPACR. Screening of 144 probands who had various forms of macular dystrophy revealed three other IMPG1 mutations. Two individuals from one family affected by autosomal-recessive VMD were homozygous for the splice-site mutation c.807+1G>T, and two from another family were compound heterozygous for the mutations c.461T>C (p.Leu154Pro) and c.1519C>T (p.Arg507(?)). Most cases had a normal or moderately decreased electrooculogram Arden ratio. We conclude that IMPG1 mutations cause both autosomal-dominant and -recessive forms of VMD, thus indicating that impairment of the interphotoreceptor matrix might be a general cause of VMD. PMID:23993198

Manes, Gaël; Meunier, Isabelle; Avila-Fernández, Almudena; Banfi, Sandro; Le Meur, Guylčne; Zanlonghi, Xavier; Corton, Marta; Simonelli, Francesca; Brabet, Philippe; Labesse, Gilles; Audo, Isabelle; Mohand-Said, Saddek; Zeitz, Christina; Sahel, José-Alain; Weber, Michel; Dollfus, Hélčne; Dhaenens, Claire-Marie; Allorge, Delphine; De Baere, Elfride; Koenekoop, Robert K; Kohl, Susanne; Cremers, Frans P M; Hollyfield, Joe G; Sénéchal, Audrey; Hebrard, Maxime; Bocquet, Béatrice; García, Carmen Ayuso; Hamel, Christian P

2013-08-29

223

The complement system and age-related macular degeneration  

Microsoft Academic Search

PurposeAge-related macular degeneration (AMD) is the leading cause of blindness in the developed world. There are increasing evidences to suggest the complement system may play a significant role on the pathogenesis of AMD. In this review, we summarise the current research in this area.MethodsReview of literature.ResultsThe complement system is a complex system with several activation pathways. Complement factor H (CFH)

S Sivaprasad; N V Chong

2006-01-01

224

Metamorphopsia in patients with macular telangiectasia type 2  

Microsoft Academic Search

Purpose To assess metamorphopsia in patients with macular telangiectasia (MacTel) type 2. Methods In a prospective observational cohort study, 40 eyes of 20 patients with MacTel type 2 were investigated by funduscopy, fluorescein\\u000a angiography, optical coherence tomography and microperimetry. Metamorphopsia was assessed using Amsler grids following a standard\\u000a protocol and standardized questionnaire. Results Metamorphopsia was present in 30 (83%) out

Peter Charbel Issa; Frank G. Holz; Hendrik P. N. Scholl

2009-01-01

225

Intravitreal bevacizumab for type 1 idiopathic macular telangiectasia  

Microsoft Academic Search

PurposeTo evaluate the effect of intravitreal bevacizumab injection for treating type 1 idiopathic macular telangiectasia (IMT).MethodsRetrospective case series of five eyes of five male patients with type 1 IMT that were treated with 2–3 injections of intravitreal bevacizumab. Best-corrected visual acuity, foveal thickness obtained by optical coherence tomography, and fluorescein angiography (FA) were monitored over a period of up to

K Takayama; S Ooto; H Tamura; K Yamashiro; A Otani; A Tsujikawa; N Yoshimura

2010-01-01

226

[Surgical treatment of macular pucker--preliminary report].  

PubMed

The authors presented preliminary results of pars plana vitrectomy applied in 8 eyes with macular pucker. The aim of the surgery was to remove epiretinal membranes and it was achieved in 7 eyes; in one some fragments of the membrane remained. Visual acuity before surgery ranged from 1/50 to 3/50, after the treatment it was improved in 7 cases, in one being the same as before. PMID:8022170

Nawrocki, J; Pikulski, Z; Dziegielewski, K

227

Oral and silent reading performance with macular degeneration  

Microsoft Academic Search

Summary Previous studies have shown that reading rate for very large print (68, 1.86 logMAR character size) is a strong predictor of oral reading rate with low vision devices (LVDs). We investigated whether this would apply using large print sizes more readily available in clinical situations (e.g. 28, 1.4 logMAR), for subjects with macular degeneration. We assessed rauding rates—reading for

Jan E. Lovie-Kitchin; Alex R. Bowers; Russell L. Woods

2000-01-01

228

Propionibacterium acnes and the Pathogenesis of Progressive Macular Hypomelanosis  

Microsoft Academic Search

Background: Progressive macular hypomelanosis is a common hypopigmentation mainly on the central parts of the trunk, predominantly in young adults, especially women. It is often mistaken for pityriasis versicolor and pityriasis alba. It occurs in all races and has been de- scribed in many parts of the world. We discovered fol- licularredfluorescencerestrictedtolesionalskin.Wesus- pected a relation with a porphyrin-producing bacteria residinginsebumofthepilosebaceousduct,andwethere-

Wiete Westerhof; Germaine N. Relyveld; Melanie M. Kingswijk; Peter de Man; Henk E. Menke

229

Cystoid macular edema induced by nab-paclitaxel.  

PubMed

Cystoid macular edema (CME) is a rare complication of taxane-based chemotherapy. We encountered a patient who developed CME during treatment with nab-paclitaxel for metastatic breast cancer. Early detection of this disease enables continuation of appropriate treatment without reducing the quality of life for patients with end-stage disease. Physicians should be aware of this potential adverse effect, and should make changes to the treatment of patients as soon as possible. PMID:22592399

Tanaka, Yuko; Bando, Hiroko; Hara, Hisato; Ito, Yasuaki; Okamoto, Yoshifumi

2012-05-17

230

Geriatric vision loss due to cataracts, macular degeneration, and glaucoma.  

PubMed

The major causes of impaired vision in the elderly population of the United States are cataracts, macular degeneration, and open-angle glaucoma. Cataracts and macular degeneration usually reduce central vision, especially reading and near activities, whereas chronic glaucoma characteristically attacks peripheral vision in a silent way, impacting balance, walking, and driving. Untreated, these visual problems lead to issues with regard to taking medications, keeping track of finances and personal information, walking, watching television, and attending the theater, and often create social isolation. Thus, visually impaired individuals enter nursing homes 3 years earlier, have twice the risk of falling, and have 4× the risk of hip fracture. Consequently, many elderly with low vision exercise greater demands on community services. With the prospect of little improvement and sustained visual loss, in the face of poor tolerance of low-vision services and not accepting magnification as the only way to read, clinical depression is common. In many instances, however, early and accurate diagnosis can result in timely treatment and can preserve quality of life. This review will look at current diagnostic and therapeutic considerations. Currently, about 20.5 million people in the United States have cataracts. The number will reach 30 million by 2020. About 1.75 million Americans currently have some form of macular degeneration, and the number is estimated to increase to 2.95 million in 2020. Approximately 2.2 million Americans have glaucoma, and by 2020 that number is estimated to be close to 3.4 million people. It is projected that by 2030 there will be 72.1 million seniors. With some overlap of the above 3 groups conservatively estimated (if you add the 2030 cataract group to the macular degeneration and glaucoma groups), then about 1 in 2 senior individuals by 2030 may have some significant ocular disease, which could account for about 50% of the healthcare budget for the elderly. PMID:22499498

Eichenbaum, Joseph W

231

Submaximal Expression of the Bilateral Deficit  

ERIC Educational Resources Information Center

|Thirty-six participants performed bilateral and unilateral isometric elbow flexion trials at what they perceived to be 100, 75, 50, and 25% of maximal effort. Absolute bilateral deficits ranged from -16% at 25% effort to -10% at 100% effort. The deficit included a component independent of consciousness and a component inversely related to…

McLean, Scott P.; Vint, Peter F.; Stember, Amanda J.

2006-01-01

232

Bilateral retinal detachments in thrombotic thrombocytopenic purpura  

Microsoft Academic Search

Bilateral serous retinal detachments are rare complications of thrombotic thrombocytopenic purpura (TTP). We report the case of a 28-year-old woman with chronic relapsing TTP with bilateral serous retinal detachments, which resolved after prompt aggressive medical therapy. Unlike serveral previous reports, the retinal detachments in our patient were unrelated to systemic hypertension.

Richard E. Wyszynski; K. Ellen Frank; Hans E. Grossniklaus

1988-01-01

233

Bilateral Synchronous Breast Cancer in a Male  

Microsoft Academic Search

Breast cancer in males is rare, accounting for less than 1% of all cases. Bilateral male breast cancer is reported to occur in fewer than 2% of all the diagnosed cases of male breast cancer, and synchronous tumors are exceedingly rare. The authors report a case of male breast cancer that is bilateral and syn- chronous, and review the literature

PETER B. KAHLA; SEBASTIANO CASSARO; FELIX G. VLADIMIR; MICHAEL G. WAYNE; ANGELO CAMMARATA

234

Simultaneous-bilateral TKA: double trouble - affirms.  

PubMed

In this paper, we will consider the current role of simultaneous-bilateral TKA. Based on available evidence, it is our opinion that simultaneous bilateral TKA carries a higher risk of morbidity and mortality and should be reserved for select few. PMID:23118391

Parvizi, J; Rasouli, M R

2012-11-01

235

CT demonstration of bilateral adrenal hemorrhage  

SciTech Connect

Bilateral adrenal hemorrhage with subsequent adrenal insufficiency is a recognized complication of anticoagulant therapy. Because the clinical manifestations are often nonspecific, the antemortem diagnosis of adrenal hemorrhage has been a difficult clinical problem. Computed tomography (CT) provides detailed images of the adrenal glands that are not possible with conventional imaging methods. The CT findings of bilateral adrenal hemorrhage in an anticoagulated patient are reported.

Ling, D.; Korobkin, M.; Silverman, P.M.; Dunnick, N.R.

1983-08-01

236

Loss of Heterozygosity in Bilateral Breast Cancer  

Microsoft Academic Search

Women who develop bilateral breast cancer at an early age are likely to harbour germline mutations in breast cancer susceptibility genes. The aim of this study was to test for concordant genetic changes in left and right breast cancer of young women (age <50) with bilateral breast cancer that may suggest an inherited breast cancer predisposition. Microsatellite markers were used

J. Kollias; S. Man; M. Marafie; K. Carpenter; S. Pinder; I. O. Ellis; R. W. Blamey; G. Cross; J. D. Brook

2000-01-01

237

Bilateral parotid swelling: a radiological review  

PubMed Central

Bilateral parotid swelling is not an uncommon occurrence and may pose a challenge for clinicians and radiologists. Numerous causes of bilateral parotid swellings have been identified. The purpose of this pictorial review is to display this wide array with a focus on multimodality approach.

Gadodia, A; Bhalla, A S; Sharma, R; Thakar, A; Parshad, R

2011-01-01

238

Bilateral kidney stones with ureteropelvic junction obstruction  

Microsoft Academic Search

Background A 56-year-old male with bilateral flank pain was admitted following diagnosis of bilateral kidney stone disease. He had previously undergone four separate pyelolithotomy sessions (two per kidney), the latest being 14 years prior. At presentation the patient had two stones in the right kidney and seven in the left kidney. The right renal pelvis was dilated, indicating obstruction of

Yahya Murat U?ra?; Ali Güne?; Can Baydinç; Ahmet Soylu

2005-01-01

239

Visualization of Hyperspectral Images Using Bilateral Filtering  

Microsoft Academic Search

This paper presents a new approach for hyperspectral image visualization. A bilateral filtering-based approach is presented for hyperspectral image fusion to generate an appropriate resultant image. The proposed approach retains even the minor details that exist in individual image bands, by exploiting the edge-preserving characteristics of a bilateral filter. It does not introduce visible artifacts in the fused image. A

Ketan Kotwal; Subhasis Chaudhuri

2010-01-01

240

Congenital Bilateral Perisylvian Syndrome and Eating Epilepsy  

Microsoft Academic Search

Congenital bilateral perisylvian syndrome (CBPS), described by Kuzniecky et al. [1] in 1993, consists of developmental delay from childhood, mild to moderate mental retardation, particularly manifest as delays of language acquisition, tonic or atonic seizures and atypical absence seizures beginning in childhood, pseudobulbar palsy, manifest as dysarthria and a poor gag reflex, and bilateral perisylvian malformations on imaging. The most

Takamasa Kishi; Makoto Moriya; Yasuo Kimoto; Yohsuke Nishio; Takeo Tanaka

1999-01-01

241

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.

2012-01-01

242

Morphometric analyses of the visual pathways in macular degeneration.  

PubMed

INTRODUCTION: Macular degeneration (MD) causes central visual field loss. When field defects occur in both eyes and overlap, parts of the visual pathways are no longer stimulated. Previous reports have shown that this affects the grey matter of the primary visual cortex, but possible effects on the preceding visual pathway structures have not been fully established. METHODS: In this multicentre study, we used high-resolution anatomical magnetic resonance imaging and voxel-based morphometry to investigate the visual pathway structures up to the primary visual cortex of patients with age-related macular degeneration (AMD) and juvenile macular degeneration (JMD). RESULTS: Compared to age-matched healthy controls, in patients with JMD we found volumetric reductions in the optic nerves, the chiasm, the lateral geniculate bodies, the optic radiations and the visual cortex. In patients with AMD we found volumetric reductions in the lateral geniculate bodies, the optic radiations and the visual cortex. An unexpected finding was that AMD, but not JMD, was associated with a reduction in frontal white matter volume. CONCLUSION: MD is associated with degeneration of structures along the visual pathways. A reduction in frontal white matter volume only present in the AMD patients may constitute a neural correlate of previously reported association between AMD and mild cognitive impairment. PMID:23453791

Hernowo, Aditya T; Prins, Doety; Baseler, Heidi A; Plank, Tina; Gouws, Andre D; Hooymans, Johanna M M; Morland, Antony B; Greenlee, Mark W; Cornelissen, Frans W

2013-01-16

243

Retinal layer segmentation of macular OCT images using boundary classification  

PubMed Central

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.

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

2013-01-01

244

Multifocal electroretinography in patients with Stargardt's macular dystrophy  

PubMed Central

AIMS—To describe the topography of multifocal electroretinograms (ERGs) and to explore its diagnostic value in patients with Stargardt's macular dystrophy (SMD).?METHODS—51 patients with SMD were examined by means of the m-sequence technique to characterise the topography of electroretinographic responses in the central visual field. The results were compared with data from 30 normal volunteers.?RESULTS—In 49 of 51 patients with SMD, macular electroretinographic activity was markedly diminished or non-detectable. Towards more peripheral areas, ERG responses of the SMD patients approached those of normals. Implicit times were not markedly delayed at any eccentricity.?CONCLUSION—In contrast with Ganzfeld electroretinography, multifocal electroretinography is useful to detect foveal dysfunction in SMD. Areas of dysfunction were found to be usually larger than expected from psychophysical measurements and morphological alteration. In early stages of the disease it was possible to detect foveal dysfunction, even in patients lacking morphological fundus changes and with good visual acuity.?? Keywords: Stargardt's macular dystrophy; fundus flavimaculatus; electroretinography

Kretschmann, U; Seeliger, M; Ruether, K; Usui, T; Apfelstedt-Sylla, E; Zrenner, E

1998-01-01

245

Visual function 5 years or more after macular translocation surgery for myopic choroidal neovascularisation and age-related macular degeneration  

PubMed Central

Purpose To evaluate the changes in the best-corrected visual acuity (BCVA) after 1 year and after ?5 years after macular translocation for age-related macular degeneration (AMD) or myopic choroidal neovascularisation (mCNV). Methods The medical records of 61 consecutive patients who underwent macular translocation with 360° retinotomy for AMD (35 eyes) or mCNV (26 eyes) were reviewed. Overall, 40 patients, 17 mCNV and 23 AMD, were followed for at least 5 years. BCVA and area of the Goldmann visual field (VF) measured before, 12 months after surgery, and at the final visit. Results In the 23 AMD eyes followed for ?5 years, the mean preoperative BCVA was 1.149±0.105 logMAR units, which significantly improved to 0.69±0.06 logMAR units at 1 year (P<0.001). This BCVA was maintained at 0.633±0.083 logMAR units on their final examination. In the 17 eyes with mCNV followed for ?5 years, the mean preoperative BCVA was 1.083±0.119 logMAR units, which was significantly improved to 0.689±0.121 logMAR units at 1 year (P=0.001). This BCVA was maintained at 0.678±0.142 logMAR units on their final examination. The area of the VF was significantly decreased at 12 months and did not change significantly thereafter. Conclusions Our results show that macular translocation surgery significantly improves the BCVA and significantly decreases the VF area of eyes with mCNV or AMD after first 1 year. The BCVA and VF area do not change significantly from the values at 1 year for at least 5 years.

Takeuchi, K; Kachi, S; Iwata, E; Ishikawa, K; Terasaki, H

2012-01-01

246

Use of systemic steroid after successful macular surgery in eyes with epiretinal membrane: a randomized, controlled clinical study  

Microsoft Academic Search

PurposeTo evaluate the functional and morphological outcomes of postoperative systemic steroid therapy after successful macular surgery in eyes with macular edema due to idiopathic macular epiretinal membranes (ERMs).DesignProspective, randomized, investigator-masked, controlled clinical study.MethodsTwenty-eight patients scheduled for 23-gauge vitrectomy combined with ERM and inner limiting membrane (ILM) peeling for macular edema due to ERM were included in this single center trial.

M Ritter; S Sacu; G Matt; R Dunavölgyi; W Bühl; C Prünte; U Schmidt-Erfurth

2011-01-01

247

Bilateral Bone Conduction Devices: Improved Hearing Ability in Children With Bilateral Conductive Hearing Loss.  

PubMed

OBJECTIVES:: The aim of the study was to investigate whether children with bilateral conductive hearing loss benefit from their second device (i.e., the bilateral bone conduction device [BCD]). DESIGN:: Speech recognition in noise was assessed in 10 children fitted with bilateral BCDs during childhood. Speech recognition was measured in 2 conditions with both BCDs active. Spatial resolution was tested with the Minimum Audible Angle test in the bilateral and monaural listening conditions. RESULTS:: Children demonstrated an improvement in speech recognition when speech was presented from the front and noise was presented from the right-hand side as compared with both speech and noise being presented from the front. The minimum audible angle decreased from 57° in the best monaural condition to 13° in the bilateral condition. CONCLUSIONS:: The audiological outcomes demonstrate the advantage of bilateral BCD fitting in children with bilateral conductive hearing loss. PMID:23698625

Dun, Catharina A J; Agterberg, Martijn J H; Cremers, Cor W R J; Hol, Myrthe K S; Snik, Ad F M

2013-05-21

248

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.

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

249

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

250

Scleral Infolding Combined with Vitrectomy and Gas Tamponade for Retinal Detachment with Macular Holes in Highly Myopic Eyes  

Microsoft Academic Search

Purpose: To describe the effectiveness of a surgical procedure, scleral infolding combined with vitrectomy and gas tamponade, for retinal detachment caused by macular holes in highly myopic eyes.Methods: In a pilot study, scleral infolding was performed in 5 patients with macular holes, who were selected from 10 consecutive highly myopic patients with retinal detachment caused by macular holes (8 patients)

Toshihiko Matsuo; Fumio Shiraga; Ippei Takasu; Toshio Okanouchi

2001-01-01

251

Efficacy of Vitrectomy and Internal Limiting Membrane Removal for Macular Edema Associated with Branch Retinal Vein Occlusion  

Microsoft Academic Search

Aim: To compare the results of vitrectomy with internal limiting membrane (ILM) peeling to that without ILM peeling for macular edema associated with branch retinal vein occlusion (BRVO). Methods: The medical records of 47 eyes of 47 patients with BRVO-associated macular edema were examined. To treat the macular edema, a posterior vitreous detachment (PVD) was created, and the ILM was

Miyuki Arai; Shuichi Yamamoto; Yoshinori Mitamura; Eiju Sato; Takeshi Sugawara; Satoshi Mizunoya

2009-01-01

252

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

253

Shadow removal using bilateral filtering.  

PubMed

In this paper, we propose a simple but effective shadow removal method using a single input image. We first derive a 2-D intrinsic image from a single RGB camera image based solely on colors, particularly chromaticity. We next present a method to recover a 3-D intrinsic image based on bilateral filtering and the 2-D intrinsic image. The luminance contrast in regions with similar surface reflectance due to geometry and illumination variances is effectively reduced in the derived 3-D intrinsic image, while the contrast in regions with different surface reflectance is preserved. However, the intrinsic image contains incorrect luminance values. To obtain the correct luminance, we decompose the input RGB image and the intrinsic image. Each image is decomposed into a base layer and a detail layer. We obtain a shadow-free image by combining the base layer from the input RGB image and the detail layer from the intrinsic image such that the details of the intrinsic image are transferred to the input RGB image from which the correct luminance values can be obtained. Unlike previous methods, the presented technique is fully automatic and does not require shadow detection. PMID:22829402

Yang, Qingxiong; Tan, Kar-Han; Ahuja, Narendra

2012-07-16

254

Bilateral pneumothorax after orthognatic surgery  

PubMed Central

Among complications in orthognathic surgery, the insurgence of pneumothorax is very rare. Pneumothorax is the presence of air or gas in the pleural cavity and it is rare complications in the postoperative oral and maxillofacial surgery patient. The clinical results are dependent on the degree of collapse of the lung on the affected side. Pneumothorax can impair oxygenation and/or ventilation. If the pneumothorax is significant, it can cause a shift of the mediastinum and compromise haemodynamic stability. While 10% of pneumothoraces are asymptomatic, patients often complain of acute chest pain and difficulty breathing. There is a reduction in vital capacity, tachycardia, tachypnoea and a decrease in partial pressure of oxygen with an inability to maintain oxygen saturations. We observed this unusual surgical consequence in a 28-year-old female with negative clinical history and instrumental evaluation after Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). No further consequences, no neurological sequelae, no infections and no other osteotomies sequelae were seen. Sudden post-surgical dispnea associated to sub-cutaneous emphysema of the neck and of the thorax must be adequately observed with the aim of monitoring further severe sequelae. The anaesthetic management of the emergency difficult airway in any post-surgical orthognatic treatment can be extremely difficult requiring a multi-disciplinary approach.

Bertossi, Dario; Malchiodi, Luciano; Turra, Matteo; Bondi, Vincenzo; Albanese, Massimo; Lucchese, Alessandra; Carinci, Francesco; Nocini, Pierfrancesco

2012-01-01

255

Bilateral pneumothorax after orthognatic surgery.  

PubMed

Among complications in orthognathic surgery, the insurgence of pneumothorax is very rare. Pneumothorax is the presence of air or gas in the pleural cavity and it is rare complications in the postoperative oral and maxillofacial surgery patient. The clinical results are dependent on the degree of collapse of the lung on the affected side. Pneumothorax can impair oxygenation and/or ventilation. If the pneumothorax is significant, it can cause a shift of the mediastinum and compromise haemodynamic stability. While 10% of pneumothoraces are asymptomatic, patients often complain of acute chest pain and difficulty breathing. There is a reduction in vital capacity, tachycardia, tachypnoea and a decrease in partial pressure of oxygen with an inability to maintain oxygen saturations. We observed this unusual surgical consequence in a 28-year-old female with negative clinical history and instrumental evaluation after Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). No further consequences, no neurological sequelae, no infections and no other osteotomies sequelae were seen. Sudden post-surgical dispnea associated to sub-cutaneous emphysema of the neck and of the thorax must be adequately observed with the aim of monitoring further severe sequelae. The anaesthetic management of the emergency difficult airway in any post-surgical orthognatic treatment can be extremely difficult requiring a multi-disciplinary approach. PMID:23814593

Bertossi, Dario; Malchiodi, Luciano; Turra, Matteo; Bondi, Vincenzo; Albanese, Massimo; Lucchese, Alessandra; Carinci, Francesco; Nocini, Pierfrancesco

2012-12-01

256

Intravitreal vs. subtenon triamcinolone acetonide for the treatment of diabetic cystoid macular edema  

Microsoft Academic Search

BACKGROUND: To assess the efficacy of the intravitreal (IVT) injection of Triamcinolone Acetonide (TA) as compared to posterior subtenon (SBT) capsule injection for the treatment of cystoid diabetic macular edema. METHODS: Fourteen patients with type II diabetes mellitus and on insulin treatment, presenting diffuse cystoid macular edema were recruited. Before TA injection all focal lakes were treated by laser photocoagulation.

Mauro Cellini; Alberto Pazzaglia; Eugenio Zamparini; Pietro Leonetti; Emilio C Campos

2008-01-01

257

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

258

Treatment of Branch Retinal Vein Occlusion induced Macular Edema with Bevacizumab  

Microsoft Academic Search

BACKGROUND: Branch retinal vein occlusion is a frequent cause of visual loss with currently insufficient treatment options. We evaluate the effect of Bevacizumab (Avastin®) treatment in patients with macular edema induced by branch retinal vein occlusion. METHODS: Retrospective analysis of 32 eyes in 32 patients with fluorescein angiography proven branch retinal vein occlusion, macular edema and Bevacizumab treatment. Outcome measures

Mathias Abegg; Christoph Tappeiner; Ute Wolf-Schnurrbusch; Daniel Barthelmes; Sebastian Wolf; Johannes Fleischhauer

2008-01-01

259

Multiple Laser Treatments for Macular Edema Attributable to Branch Retinal Vein Occlusion  

Microsoft Academic Search

? PURPOSE: To report the visual outcome of multiple laser treatments for macular edema attributable to branch retinal vein occlusions (BRVO) and to determine if any prognostic factors exist for improvement. ? DESIGN: Retrospective chart review. ? METHODS: A private practice with four vitreoretinal surgeons performed laser treatments on 88 eyes of 88 patients with macular edema secondary to BRVO

ERICA ESRICK; MANJU L. SUBRAMANIAN; JEFFREY S. HEIER; ANAND K. DEVAIAH; TREXLER M. TOPPING; ALBERT R. FREDERICK; MICHAEL G. MORLEY

260

Genetic expression of Menkes disease in cultured astrocytes of the macular mouse  

Microsoft Academic Search

Summary The copper concentration was investigated in the cultured astrocytes from macular mice, an animal model of Menkes disease. An excessive amount of copper was accumulated in the astrocytes as copper-metallothionein. These results show that the underlying genetic defect of the macular mouse is expressed in the astrocytes. A similar situation may exist in Menkes disease and cause a failure

H. Kodama; Y. Meguro; T. Abe; M. H. Rayner; K. T. Suzuki; S. Kobayashi; M. Nishimura

1991-01-01

261

Preservation of Ganglion Cell Layer Neurons in Age-Related Macular Degeneration  

Microsoft Academic Search

PURPOSE. To determine the number of neurons remaining in the ganglion cell layer (GCL) of eyes with nonexudative and exu- dative age-related macular degeneration (NEAMD and EXAMD, respectively) in relation to photoreceptor loss in the same retinas. METHODS. The study design was a clinicopathologic correla- tion. Macular photoreceptors and GCL neurons were counted in unstained retinal wholemounts from eyes of

Nancy E. Medeiros; Christine A. Curcio

2001-01-01

262

Increased cone sensitivity to ABCA4 deficiency provides insight into macular vision loss in Stargardt's dystrophy  

Microsoft Academic Search

Autosomal recessive Stargardt macular dystrophy is caused by mutations in the photoreceptor disc rim protein ABCA4\\/ABCR. Key clinical features of Stargardt disease include relatively mild rod defects such as delayed dark adaptation, coupled with severe cone defects reflected in macular atrophy and central vision loss. In spite of this clinical divergence, there has been no biochemical study of the effects

Shannon M. Conley; Xue Cai; Rasha Makkia; Yalin Wu; Janet R. Sparrow; Muna I. Naash

263

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

264

Macular Pigment Optical Density in an Ageing Irish Population: The Irish Longitudinal Study on Ageing  

Microsoft Academic Search

Purpose: The 3 carotenoids lutein, zeaxanthin, and meso-zeaxanthin, which account for the ‘yellow spot’ at the macula and which are referred to as macular pigment (MP), are believed to play a role in visual function and protect against age-related macular degeneration (AMD) via their optical and antioxidant properties. This study was undertaken to compare MP optical density (MPOD) in a

John M. Nolan; Roseanne Kenny; Claire O’Regan; Hilary Cronin; James Loughman; Eithne E. Connolly; Patricia Kearney; Edward Loane; Stephen Beatty

2010-01-01

265

Quality of life in age-related macular degeneration: a review of the literature  

Microsoft Academic Search

BACKGROUND: The Age-related Macular Degeneration Alliance International commissioned a review of the literature on quality of life (QoL) in macular degeneration (MD) with a view to increasing awareness of MD, reducing its impact and improving services for people with MD worldwide. METHOD: A systematic review was conducted using electronic databases, conference proceedings and key journal hand search checks. The resulting

Jan Mitchell; Clare Bradley

2006-01-01

266

Macular translocation surgery with 360-degree peripheral retinectomy following ocular photodynamic therapy of choroidal neovascularization  

Microsoft Academic Search

PurposeTo determine the visual outcomes of eyes that underwent macular translocation surgery with 360 degrees peripheral retinectomy and silicone oil tamponade (MTS360) following ocular photodynamic therapy (OPT) with verteporfin for subfoveal choroidal neovascularization (CNV) associated with age-related macular degeneration (ARMD).

Carl H Park; Cynthia A Toth

2003-01-01

267

Recurrence of Retinal Pigment Epithelial Changes After Macular Translocation With 360° Peripheral Retinectomy for Geographic Atrophy  

Microsoft Academic Search

Objective: To assess the prevalence of recurrence of macular geographic atrophy (GA) of the retinal pig- ment epithelium (RPE) after macular translocation with 360° retinectomy (MT360) in one institution. Methods: A retrospective review of all cases of GA that were treated with MT360 in 1 institution. Demographic and clinical data including the duration of preoperative visual loss, preoperative and postoperative

Mark T. Cahill; Prithvi Mruthyunjaya; Catherine Bowes Rickman; Cynthia A. Toth

268

Recurrence of Retinal Pigment Epithelial Changes After Macular Translocation With 360  Peripheral Retinectomy for Geographic Atrophy  

Microsoft Academic Search

Objective: To assess the prevalence of recurrence of macular geographic atrophy (GA) of the retinal pig- ment epithelium (RPE) after macular translocation with 360° retinectomy (MT360) in one institution. Methods: A retrospective review of all cases of GA that were treated with MT360 in 1 institution. Demographic and clinical data including the duration of preoperative visual loss, preoperative and postoperative

Mark T. Cahill; Prithvi Mruthyunjaya; Catherine Bowes Rickman; Cynthia A. Toth

2005-01-01

269

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

270

Vitrectomy for diabetic macular edema: the role of posterior vitreous detachment and epimacular membrane  

Microsoft Academic Search

PURPOSE: To evaluate the surgical efficacy of pars plana vitrectomy on eyes with diabetic macular edema in the presence or absence of a complete posterior vitreous detachment and with or without an epimacular membrane.METHODS: Pars plana vitrectomy was performed on 30 eyes of 29 cases with diabetic macular edema. Visual acuity was measured, and retinal thickness was determined by optical

Teiko Yamamoto; Naoko Akabane; Shinobu Takeuchi

2001-01-01

271

Bilateral Congenital Lacrimal Fistula in Down Syndrome  

PubMed Central

Congenital lacrimal fistulae are rare in Down syndrome and bilateral presentation is very unusual. It can be associated with nasolacrimal duct obstruction. We report a 3-year-old female with Down syndrome who presented with watering and discharge from both eyes and bilateral fistulous openings present inferonasal to the medial canthus. Upon examination, the lacrimal sac regurgitation test was positive on both sides. Our case report documents a distinctive case of bilateral congenital lacrimal fistulae in association with Down syndrome. It was managed successfully by primary fistulectomy and nasolacrimal duct probing.

Singh, Manpreet; Singh, Usha

2013-01-01

272

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

273

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.

Takeyama, Masayuki; Iwaki, Masayoshi; Zako, Masahiro

2012-01-01

274

The Value of Measurement of Macular Carotenoid Pigment Optical Densities and Distributions in Age-Related Macular Degeneration and Other Retinal Disorders  

PubMed Central

There is increasing recognition that the optical and antioxidant properties of the xanthophyll carotenoids lutein and zeaxanthin play an important role in maintaining the health and function of the human macula. In this review article, we assess the value of non-invasive quantification of macular pigment levels and distributions to identify individuals potentially at risk for visual disability or catastrophic vision loss from age-related macular degeneration, and we consider the strengths and weaknesses of the diverse measurement methods currently available.

Bernstein, Paul S.; Delori, Francois C.; Richer, Stuart; van Kuijk, Frederik J. M.; Wenzel, Adam J.

2009-01-01

275

Decreased Thickness and Integrity of the Macular Elastic Layer of Bruch's Membrane Correspond to the Distribution of Lesions Associated with Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is a leading cause of blindness in the elderly. In its severest form, choroidal neovessels breach the macular Bruch’s membrane, an extracellular matrix compartment comprised of elastin and collagen laminae, and grow into the retina. We sought to determine whether structural properties of the elastic lamina (EL) correspond to the region of the macula that is predilected toward degeneration in AMD. Morphometric assessment of the macular and extramacular regions of 121 human donor eyes, with and without AMD, revealed a statistically significant difference in both the integrity (P < 0.0001) and thickness (P < 0.0001) of the EL between the macular and extramacular regions in donors of all ages. The EL was three to six times thinner and two to five times less abundant in the macula than in the periphery. The integrity of the macular EL was significantly lower in donors with early-stage AMD (P = 0.028), active choroidal neovascularization (P = 0.020), and disciform scars (P = 0.003), as compared to unaffected, age-matched controls. EL thickness was significantly lower only in individuals with disciform scars (P = 0.008). The largest gaps in macular EL integrity were significantly larger in all categories of AMD (each P < 0.0001), as compared to controls. EL integrity, thickness, and gap length in donors with geographic atrophy did not differ from those of controls. These structural properties of the macular EL correspond spatially to the distribution of macular lesions associated with AMD and may help to explain why the macula is more susceptible to degenerative events that occur in this disease.

Chong, N.H. Victor; Keonin, Jason; Luthert, Phil J.; Frennesson, Christina I.; Weingeist, David M.; Wolf, Rachel L.; Mullins, Robert F.; Hageman, Gregory S.

2005-01-01

276

Transconjunctival 25-gauge pars plana vitrectomy and internal limiting membrane peeling for chronic macular edema  

PubMed Central

Background The purpose of this study was to investigate the visual and anatomic outcomes in patients with chronic macular edema who underwent 25-gauge pars plana vitrectomy with internal limiting membrane peeling. Methods This study was a retrospective chart review of 24 eyes from 21 patients who underwent 25-gauge pars plana vitrectomy and indocyanine green-assisted internal limiting membrane peeling for chronic macular edema. Preoperative and postoperative spectral-domain optical coherence tomography (OCT) was examined for macular thickness and macular volume. Outcomes and variables were analyzed using the two-tailed t-test and Spearman’s rank correlation coefficient. Results Twenty-four eyes from 11 men and 10 women of mean age 69 (range 55–84) years were included. Four patients (17%) had chronic macular edema from uveitis, four (17%) from retinal vein occlusion, and 16 (67%) from diabetes. Mean visual acuity was 20/103 preoperatively and 20/87 postoperatively (P = 0.55). Sixty-three percent of the eyes had improved vision (47% better than 20/40), 21% maintained the same vision, and 17% had worse vision. Forty-seven percent of improved eyes and 30% of total eyes gained more than two lines of visual acuity (range ?9 to +7 lines). Mean macular thickness was 455 ?m preoperatively and 396 ?m postoperatively (P = 0.29). Mean macular volume was 7.9 mm3 preoperatively and 7.5 mm3 postoperatively (P = 0.51). The strongest predictor of postoperative visual acuity was initial visual acuity (r = 0.673, P = 0.0003). Conclusion Even though a majority of patients had improved vision and decreased macular thickening after 25-gauge pars plana vitrectomy with internal limiting membrane peeling for chronic macular edema of various etiologies, the difference in visual acuity or macular thickening did not reach statistical significance.

Cho, Minhee; D'Amico, Donald J

2012-01-01

277

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

2011-07-07

278

Bilateral thoracic paravertebral block: potential and practice.  

PubMed

Paravertebral nerve blocks (PVBs) can provide excellent intraoperative anaesthetic and postoperative analgesic conditions with less adverse effects and fewer contraindications than central neural blocks. Most published data are related to unilateral PVB, but its potential as a bilateral technique has been demonstrated. Bilateral PVB has been used successfully in the thoracic, abdominal, and pelvic regions, sometimes obviating the need for general anaesthesia. We have reviewed the use of bilateral PVB in association with surgery and chronic pain therapy. This covers 12 published studies with a total of 538 patients, and with varied methods and outcome measures. Despite the need for relatively large doses of local anaesthetics, there are no reports of systemic toxicity. The incidence of complications such as pneumothorax and hypotension is low. More studies on the use of bilateral PVB are required. PMID:21233114

Richardson, J; Lönnqvist, P A; Naja, Z

2011-02-01

279

Bilateral total renal dysplasia: a case report.  

PubMed

Bilateral total renal dysplasia is an extremely rare congenital anomaly associated with Potter's facies. We report an autopsy case of a stillborn male child. Histopathology is showing persistence of structures not seen in normal development. PMID:15471131

Zawar, M P; Kurdukar, M D; Mashal, S N; Inamdar, J S

2004-01-01

280

A Bilateral Nuclear-Weapon Freeze  

Microsoft Academic Search

A bilateral nuclear-weapons freeze to stop the arms race is, next to the economy, the major public issue. The author feels that a freeze would lessen the risk of launch-on-warning errors that could lead to nuclear war. Further, a bilateral freeze would preserve the parity of existing US-Soviet arms, but prevent the destabilization of a new counterforce capability. It must

Randall Forsberg

1982-01-01

281

Bilateral Renal Choriocarcinoma in a Postmenopausal Woman  

PubMed Central

Choriocarcinoma is the most malignant tumor of gestational trophoblastic neoplasia. It grows rapidly and metastasizes to the lung, liver, and less frequently, the brain. Metastases to the kidney are rare in the literature, and bilateral involvement is even more scarce. Renal involvement of choriocarcinoma is highly exceptional and may mimic renal cell carcinoma. Here we report a case of bilateral renal choriocarcinoma presenting 5 years after a history of a total anterior hysterectomy because of a hydatidiform mole.

Karadeniz, Tahir; Ozkaptan, Orkunt; Cak?r, Caglar

2011-01-01

282

Subconjunctival sirolimus in the treatment of diabetic macular edema  

PubMed Central

Background Diabetic macular edema (DME) is a leading cause of blindness in the developed world. Sirolimus has been shown to inhibit the production, signaling, and activity of many growth factors relevant to the development of diabetic retinopathy. This phase I/II study assesses the safety of multiple subconjunctival sirolimus injections for the treatment of DME, with some limited efficacy data. Methods In this phase I/II prospective, open-label pilot study, five adult participants with diabetic macular edema involving the center of the fovea and best-corrected ETDRS visual acuity score of ?74 letters (20/32 or worse) received 20 ?l (440 ?g) of subconjunctival sirolimus at baseline, month 2 and every 2 months thereafter, unless there was resolution of either retinal thickening on OCT or leakage on fluorescein angiography. Main outcome measures included best-corrected visual acuity and central retinal thickness on OCT at 6 months and 1 year, as well as safety outcomes. Results Repeated subconjunctival sirolimus injections were well-tolerated, with no significant drug-related adverse events. There was no consistent treatment effect related to sirolimus; one participant experienced a 2-line improvement in visual acuity and 2 log unit decrease in retinal thickness at 6 months and 1 year, two remained essentially stable, one had stable visual acuity but improvement of central retinal thickness of 1 and 3 log units at 6 months and 1 year respectively, and one had a 2-line worsening of visual acuity and a 1 log unit increase in retinal thickness at 6 months and 1 year. Results in the fellow eyes with diabetic macular edema, not treated with sirolimus, were similar. Conclusions Subconjunctival sirolimus appears safe to use in patients with DME. Assessment of possible treatment benefit will require a randomized trial.

Krishnadev, Nupura; Forooghian, Farzin; Cukras, Catherine; Wong, Wai; Saligan, Leorey; Chew, Emily Y.; Nussenblatt, Robert; Ferris, Frederick

2011-01-01

283

Bilateral Keratectasia 34 Years after Corneal Transplant.  

PubMed

We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK) in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 mum in the right eye and of 710 mum in the left eye, as well as an average paracentral pachymetry of 436 and 270 mum in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus. PMID:20737056

Valldeperas, Xavier; Angi, Martina; Romano, Vito; Romano, Mario R

2010-07-02

284

Bilateral Keratectasia 34 Years after Corneal Transplant  

PubMed Central

We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK) in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 ?m in the right eye and of 710 ?m in the left eye, as well as an average paracentral pachymetry of 436 and 270 ?m in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

Valldeperas, Xavier; Angi, Martina; Romano, Vito; Romano, Mario R.

2010-01-01

285

The canine bilateral groove model of osteoarthritis.  

PubMed

In studies aimed at local treatment of experimental osteoarthritis (OA) it is optimal to have an internal (untreated) OA control. Such an approach excludes interanimal variation, and allows paired statistical evaluation of treatment efficacy. For this purpose, we developed and characterized a bilateral version of the canine Groove model. We hypothesized that the bilateral version of the canine Groove model would show consistent and clear development of features of OA similar to those found in the unilateral version. In six Beagle dogs, grooves were surgically made in the articular cartilage of the femoral condyles of both knee joints. Six additional dogs underwent bilateral sham surgery. The degree of OA was quantified 20 weeks after surgery and was compared in retrospect to 23 animals that undergone the same procedure in a single knee joint with the contralateral knee serving as a non-OA control. Bilateral groove surgery resulted in OA. This was based on the observed ineffective repair response in which an increase in proteoglycan synthesis, a diminished retention of these newly formed proteoglycans, and an enhanced loss of resident proteoglycans resulted in a decreased cartilage proteoglycan content. These biochemical effects were corroborated by clear histological features of OA. All these effects were found in femor as well as in the (surgically untouched) tibia. Interestingly, features of OA were slightly more severe in the bilateral model than in the unilateral variant. The bilateral canine Groove model showed consistent and clear development of features of OA, comparable to the unilateral model. PMID:18473386

Intema, Femke; DeGroot, Jeroen; Elshof, Bram; Vianen, Marieke E; Yocum, Sue; Zuurmond, Annemarie; Mastbergen, Simon C; Lafeber, Floris P

2008-11-01

286

[Macular pathology as a cause of visual impairment?].  

PubMed

This article reports a case of a pituitary adenoma as the cause of unilateral visual impairment and concomitant unilateral macular pathology. Pituitary adenomas can be classified into hormone-secreting and inactive tumors of the adenohypophysis and lead to typical symptoms in cases of hypersecretion of hormones or hypopituitarism. A pituitary adenoma classically presents with bitemporal hemianopia when compression occurs at the optic chiasm. Imaging is crucial in diagnosing pituitary adenomas. Microsurgical or endoscopic transsphenoidal surgery, hormone therapy and radiotherapy are the treatment options. PMID:23765371

Matlach, J; Nowak, J; Pérez Tejón, J M; Göbel, W

2013-08-01

287

Multimodality imaging in clinical diagnosis and treatment of macular disease  

NASA Astrophysics Data System (ADS)

Accurate diagnosis and treatment of disease is a function of how well the pathology can be imaged. Coregistering images from different modalities can offer significant advantages. Multi-modal imaging is finding its place in Ophthalmology and we illustrate and analyze its use in macular disease. New technologies have provided the ability to simultaneously capture FA and OCT images, allowing dynamic analysis at the exact point of interest. We establish that the combined imaging protocol is easier and faster for both patient and technician, and ultimately and most importantly more capable of guiding the physician to a diagnosis and treatment.

Taibl, Jessica N.; Sayegh, Samir I.

2013-03-01

288

The combined occurrence of macular amyloidosis and prurigo nodularis.  

PubMed

The association of prurigo nodularis (PN) and macular amyloidosis (MA) has not been reported before. Although pruritus related frictional trauma is a well-known cause of PN, its role in the development of MA has always been questioned. We herein report two cases with chronic liver disease and iron deficiency who concomitantly developed MA and PN lesions. Pruritus was the preceding factor and both lesions were confined to scratched areas. The association of two otherwise uncommon dermatoses in pruritic patients and their characteristic distribution might indicate an important role for pruritus-induced scratching in the pathogenesis of MA, too. PMID:10846258

Baykal, C; Ozkaya-Bayazit, E; Gökdemir, G; Diz Küçükkaya, R

2000-06-01

289

Bevacizumab in the treatment of idiopathic macular telangiectasia  

Microsoft Academic Search

Background  To describe functional and morphological long-term follow-up results in patients with idiopathic macular telangiectasia (IMT)\\u000a treated with intravitreal bevacizumab.\\u000a \\u000a \\u000a \\u000a Methods  Retrospective case series of three consecutive male patients with IMT who were treated with intravitreal bevacizumab injections.\\u000a Best corrected visual acuity (BCVA) as well as fluorescein angiography (FA) and optical coherence tomography (OCT) were monitored\\u000a over the period of up to

Maria-Andreea Gamulescu; Andreas Walter; Helmut Sachs; Horst Helbig

2008-01-01

290

Vitreomacular adhesion and neovascular age-related macular degeneration.  

PubMed

We explore the hypothesis that vitreomacular adhesion (VMA) and vitreomacular traction (VMT) play a role in the pathogenesis and clinical course of neovascular ("wet") age-related macular degeneration (AMD). Several biological theories are offered to explain this possible association, including direct tractional force, altered vitreous oxygenation, altered diffusion coefficients of intravitreal molecules, and alterations in the pharmacokinetics of intravitreal drugs. Release of VMT may improve the clinical course of neovascular AMD, and a few case series suggest that vitrectomy can lead to both a functional and anatomic improvement. A large, randomized, controlled clinical trial is underway, investigating pharmacologic release of VMA in eyes with neovascular AMD. PMID:23068973

Simpson, Andrew R H; Petrarca, Robert; Jackson, Timothy L

2012-11-01

291

Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation  

PubMed Central

In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

Nehete, Rajendra; Nehete, Anita; Singla, Sandeep; Adhav, Harshad

2012-01-01

292

Increased macular choroidal blood flow velocity during systemic corticosteroid therapy in a patient with acute macular neuroretinopathy  

PubMed Central

Purpose The precise mechanism causing outer retinal damage in acute macular neuroretinopathy (AMN) remains unclear. In this study, choroidal blood flow velocity was quantitatively evaluated using laser speckle flowgraphy (LSFG) in a patient with AMN who received systemic corticosteroid therapy. Methods Corticosteroids were systemically administrated across 4 months for an AMN patient. LSFG measurements were taken ten consecutive times before treatment and at 1 week and 1, 3, and 10 months after the onset of therapy. The square blur rate, a quantitative index of relative blood flow velocity, was calculated using LSFG in three regions: Square 1, the macular lesion with findings of severe multifocal electroretinography amplitude reduction, and Squares 2 and 3, funduscopically normal-appearing retinal areas with findings of moderate and mild multifocal electroretinography amplitude reduction, respectively. Results The AMN lesion gradually decreased after treatment and improved results were detected on the Amsler chart, as well as on optical coherence tomography and scanning laser ophthalmoscopy. When the changing rates of the macular flow were compared with the mean square blur rate level before treatment (100%), 14.6%, 24.5%, 12.9%, and 16.3% increases were detected in Square 1 (macular lesion) at 1 week and 1, 3, and 10 months after treatment, respectively. Similarly, in Square 2 (normal-appearing area next to the lesion), 12.6%, 18.6%, 6.7%, and 8.3% increases were also noted at 1 week and 1, 3, and 10 months after treatment, respectively. In Square 3 (normal-appearing area apart from the lesion), 16.0%, 15.1%, 19.1%, and 3.8% increases were measured at 1 week and 1, 3, and 10 months after treatment, respectively. Conclusion In a patient with AMN, choroidal blood flow velocity at the lesion site, which was examined with LSFG, sequentially increased during systemic corticosteroid therapy, together with improvement of visual function. The present findings suggest that choroidal circulation impairment relates to the pathogenesis of AMN, extending over a wider area in the posterior pole than the site of an AMN lesion per se.

Hashimoto, Yuki; Saito, Wataru; Mori, Shohei; Saito, Michiyuki; Ishida, Susumu

2012-01-01

293

Sequential bilateral cochlear implantation in children: development of the primary auditory abilities of bilateral stimulation.  

PubMed

The advantages of sequential bilateral cochlear implantation were assessed in 29 children with a severe to profound hearing loss. The effect of age at second implantation and the effect of duration of bilateral implant use on the outcomes in speech perception and directional hearing were investigated. The children received their second cochlear implant at an age ranging from 2.8 to 8.5 years. Measurements were carried out preoperatively and postoperatively after 6, 12 and 24 months of bilateral implant use. A matched control group of 9 children with a unilateral implant were also measured over time and were compared with the study group after 12 and 24 months. Speech reception in both quiet and in noise and lateralization were measured. After 24 months, a minimum audible angle task was carried out. Bilateral advantages with regard to speech reception in quiet and in noise were already present after 6 months of bilateral implant use and improved thereafter. After 24 months, speech reception in noise had significantly improved with bilateral implants compared to that of children with a unilateral implant. The percentage of children that could accurately lateralize increased from 57% after 6 months to 83% after 24 months. With regard to the minimum audible angle task, loudspeakers were placed on average at ±42°. Age at second implantation did not have an influence on all outcomes. From the results it can be concluded that the advantages of bilateral hearing occur after sequential bilateral implantation and that age at second implantation does not influence the amount of bilateral advantage. Furthermore, it can be concluded that longer periods of bilateral implant use lead to greater bilateral advantages. PMID:20980740

Sparreboom, Marloes; Snik, Ad F M; Mylanus, Emmanuel A M

2010-10-27

294

Pars plana vitrectomy and internal limiting membrane peeling for macular edema secondary to retinal vein occlusion  

PubMed Central

Purpose: To evaluate the effects of vitrectomy and internal limiting membrane peeling for treatment of macular edema secondary to retinal vein occlusion (RVO). Methods: Nine cases of visual loss due to macular edema caused by central retinal vein occlusion or branch retinal vein occlusion underwent pars plana vitrectomy with removal of the preretinal hyaloid, peeling of the internal limiting membrane stained with indocyanine green dye, air–fluid exchange, and postoperative prone positioning. Best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography were measured pre- and postoperatively then compared to assess the outcome of surgery. Results: In all cases intraretinal blood and retinal thickening diminished within 2 months of surgery. Visual acuity improved in all of the central retinal vein occlusion cases and 3/6 branch retinal vein occlusion cases. The decrease in macular thickness was statistically significant (mean postoperative macular thickness 361 ± 61.1 versus mean preoperative macular thickness 563.9 ± 90.0, P = 0.001, t-test). The improvement in BCVA was not statistically significant (mean preoperative BCVA in LogMAR 1.23 ± 0.29 versus mean postoperative BCVA in LogMAR 1.06 ± 0.49, P = 0.09, t-test). Conclusion: In eyes with macular edema secondary to RVO, pars plana vitrectomy with internal limiting membrane peeling can resolve macular edema, but the improvement in BCVA was not statistically significant in this study.

Baharivand, Nader; Hariri, Amirhossein; Javadzadeh, Alireza; Heidari, Ebadollah; Sadegi, Karim

2011-01-01

295

Aqueous soluble vascular endothelial growth factor receptor-2 in macular edema with branch retinal vein occlusion.  

PubMed

Abstract Purpose/Aim: The aqueous humor level of soluble vascular endothelial growth factor receptor (sVEGFR)-2 may influence macular edema in patients with branch retinal vein occlusion (BRVO). The association of sVEGFR-2 with macular edema was investigated in this study. Materials and methods: A retrospective case-controlled study was performed in 22 patients with BRVO and macular edema, as well as 5 patients with non-ischemic ocular diseases as the control group. The severity of macular edema was examined by optical coherence tomography. Aqueous humor samples were obtained during intravitreous injection of anti-VEGF agents, triamcinolone acetonide, or combined vitrectomy and cataract surgery. sVEGFR-2 levels in aqueous humor were determined by enzyme-linked immunosorbent assay. Results: The aqueous humor level of sVEGFR-2 (median: 124.5?ng/ml) was significantly elevated in BRVO patients compared with the control group (78.1?pg/ml) (p?=?0.010). In addition, the sVEGFR-2 level was correlated with the severity of macular edema (p?=?0.033). Conclusions: sVEGFR-2 may be involved in the pathogenesis of macular edema associated with BRVO. Measurement of aqueous humor sVEGFR-2 levels may be helpful for understanding the disease status in BRVO patients with macular edema. PMID:23972086

Noma, Hidetaka; Mimura, Tatsuya

2013-08-23

296

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.

Muen, Wisam J; Hewick, Simon A

2011-01-01

297

Intravitreal Diclofenac for Refractory Uveitic Cystoid Macular Edema  

PubMed Central

Purpose To evaluate the effect of a single dose of intravitreal diclofenac on best- corrected visual acuity (BCVA) and central macular thickness (CMT) in patients with refractory uveitic cystoid macular edema (CME). Methods In this prospective non-comparative case series, 8 eyes of 8 patients with refractory CME secondary to chronic intermediate uveitis received a single intravitreal injection of diclofenac (500 µg/0.1ml) in addition to other systemic (oral prednisolone and methotraxate) and topical (betamethasone) remission maintaining drugs. Outcome measures were changes in BCVA and CMT after treatment. Results Mean BCVA remained relatively unchanged at 12, 24 and 36 weeks (0.69, 0.70 and 0.64 LogMAR, respectively) as compared to baseline (0.71 LogMAR). Mean CMT, however, decreased from 488 µm at baseline to 416 and 456 µm at 24 and 36 weeks, respectively. None of the changes were statistically significant. Conclusion In eyes with refractory uveitic CME, intravitreal injection of diclofenac insignificantly reduced CMT but this was not associated with visual improvement.

Ramezani, Alireza; Fard Esmaeilpour, Nassim; Eskandari, Armen; Rabbanikhah, Zahra; Soheilian, Roham; Soheilian, Masoud

2013-01-01

298

Present and future treatment possibilities in macular degeneration  

NASA Astrophysics Data System (ADS)

Purpose: To discuss present and future treatment possibilities in different types of choroidal neovascularisation. Methods: Presented are angiographic- and OCT-findings in patients with macular degeneration of different origin. Choroidal neovascularisations, which are not likely to respond positively to established procedures like thermal laser coagulation or photodynamic therapy will be discussed. Results and conclusions: Present study-guidelines and new methods of pharmacological intervention are analysed in different patterns of macular degeneration. Conventional laser coagulation in the treatment of classic, extrafoveal CNV and photodynamic therapy of predominantly classic subfoveal CNV still represent a gold standard. There are new recommendations, loosening the tight criteria of the TAP and VIP-guidelines, which cover, for instance, wider visual acuity ranges and the treatment of juxtafoveally located choroidal neovascularisations. Positive findings in literature confirm the role of PDT in pathologic myopia and other non-AMD CNV. Studies about surgical procedures, like macula- or RPE-translocation after surgical removal or thermal laser destruction of the CNV are in progress and are expected to show promising results. Phase II/III studies will soon point out the effect of anti-VEGF agents. The application of intravitreal (triamcinolone) or peribulbar (anecortave acetat) steroids could be useful. The combination with surgical or laser techniques could bring further benefit to the patient.

Fisher, E.; Wegner, A.; Pfeiler, T.; Mertz, M.

2005-11-01

299

Predicting visual outcomes for macular disease using optical coherence tomography.  

PubMed

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

2011-01-26

300

Macular diseases: update on diagnostic and therapeutic techniques  

NASA Astrophysics Data System (ADS)

Purpose of this course is to review the principles that guide the diagnosis and the classification of macular diseases, and the new options available for this purpose. Among new treatments modalities, photodynamic therapy (PDT) has been recently introduced in the clinical practice for treating subfoveal choroidal neovascularization (CNV). In age-related macular degeneration (AMD), eyes in which the classic CNV components covers at least 50% of the entire lesion, called predominantly classic lesions, benefit from a substantial reduction of the rate of moderate visual loss during the first year. Preliminary results in other types of CNV also indicate a possible efficacy. We will present the theoretical basis and mechanisms of action of PDT and then comment on the main results of the TAP study; the preliminary results available from the VIP will also be displayed. Numerous cases treated with PDT, one year after its introduction in the clinical practice, will be shown and discussed. The introduction of PDT has probably reduced the applicability of surgical techniques for treating CNV. Yet, surgeons are developing less invasive techniques to minimize the complications associated with membrane removal and the various types of translocation. This innovation will be illustrated, as well as the criteria for patients selection in the era of PDT.

Fortunato, P.; De Libero, C.; Donati, C.; La Torre, A.

2004-09-01

301

[Vision rehabilitation of patients with old-age macular degeneration].  

PubMed

Age-related degeneration of the macula retinae occurs in two forms: the serious form with invasion of blood vessels and leakage, and the atrophic form. Both forms ultimately lead to a central scotoma. The prevalence of the terminal stage of age-related macular degeneration varies from 1% in the age group 65-74 years to 11% in those 85 years or over. A total of 58,500 persons in the Netherlands have age-related macular degeneration and an estimated 22,000 persons depend on visual or optic aids. Aids for close vision are good illumination, magnification (reading glasses, magnifying glasses, telescopic lenses, television reading lenses (with possibility of changing contrast), large-letter books, playing cards with large symbols) and auditory aids. Aids for distant vision reduce troublesome light (sunglasses, filter) or enlarge the image (telescopic aids). Future new aids derive from modern computer technology (personal computer, integrated braille reader and speech synthesizer) or are based on opto-electronic image processing and presentation (mini-cameras with mini-VDUs in a sort of helmet). Effective use of aids depends on attention for the patient's desires and possibilities and on counselling in handling aids. Ophthalmological checkups remain useful for the prevention and (or) treatment of accessory disorders. PMID:9557020

Hoyng, C B; Verezen, C A; de Jong, P T

1998-01-24

302

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.

Keane, Pearse A.; Sadda, Srinivas R.

2011-01-01

303

[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

304

Bilateral osteoarthritis of the trapeziometacarpal joint treated by bilateral tendon interposition arthroplasty  

Microsoft Academic Search

Twenty-four flexor carpi radialis (FCR) tendon interposition arthroplasties of the trapezium for bilateral trapeziometacarpal osteoarthritis were reviewed. Pain was reduced in all cases. Function was improved in all right hands and in 92% of the left hands. FCR tendon interposition arthroplasty for bilateral trapeziometacarpal osteoarthritis yields satisfactory long-term results on both sides.

A. Damen; B. Van Der Lei; P. H. Robinson

1997-01-01

305

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

306

Bilateral paediatric cochlear implants: a critical review.  

PubMed

A recent trend has been the implantation of bilateral cochlear implants (CIs) for children with severe to profound hearing loss. A review of available research on bilateral CIs was conducted to determine the support for this trend. A replicable review was undertaken to evaluate published research studies that examined the effectiveness of bilateral paediatric cochlear implantation. Databases, reference lists, and journals were searched for relevant documents using a pre-determined search protocol. Twenty-nine articles met the review's inclusion criteria and were retrieved and reviewed. This review adds to the previously published reviews on the topic by identifying additional paediatric studies. Sound localization and speech recognition in noise appear to be improved with bilateral compared to unilateral cochlear implants. Similarly, evoked potential measures suggest improved morphology when the second CI is implanted early. Well-designed and controlled studies that explore a variety of outcomes including cost-effectiveness, quality of life, speech, language, and psycho-educational measures should be further explored in order to provide additional support for parents and clinicians confronted with the bilateral cochlear implant decision. PMID:19382017

Johnston, J Cyne; Durieux-Smith, Andrée; Angus, Douglas; O'Connor, Annette; Fitzpatrick, Elizabeth

2009-01-01

307

Laparoscopic simultaneous bilateral adrenalectomy for testosterone-secreting bilateral adrenal tumors.  

PubMed

Laparoscopic adrenalectomy is widely accepted as a safe and minimally-invasive procedure. Although it is a standard procedure for the surgical treatment of adrenal tumors, its simultaneous use with bilateral adrenalectomy is relatively rare. A 21-year-old woman was referred to Hamamatsu University School of Medicine University Hospital complaining of a deepening voice, hirsutism and secondary amenorrhea. Abdominal computed tomography showed bilateral adrenal tumors, and hormonal examinations showed that the tumors secreted excessive testosterone, resulting in virilizing symptoms. Laparoscopic simultaneous bilateral adrenalectomy was carried out. Postoperatively, serum testosterone levels immediately recovered to within the normal range. Menstruation began the month after the operation, and the hirsutism gradually regressed. This is the third reported case of bilateral virilizing adrenal tumors, and the first to be successfully treated with laparoscopic simultaneous bilateral adrenalectomy. PMID:23601096

Suzuki, Takahisa; Furuse, Hiroshi; Kurita, Yutaka; Ushiyama, Tomomi; Mugiya, Soichi; Ozono, Seiichiro; Oki, Yutaka

2013-04-21

308

Visual function and serous retinal detachment in patients with branch retinal vein occlusion and macular edema: a case series  

PubMed Central

Background The influence of serous retinal detachment (SRD) on retinal sensitivity in patients with branch retinal vein occlusion (BRVO) and macular edema remains unclear. This is despite the frequent co-existence of SRD and cystoid macular edema (CME) in BRVO patients on optical coherence tomography (OCT) and the fact that CME is the most common form of macular edema secondary to BRVO. We investigated visual function (visual acuity and macular sensitivity), macular thickness, and macular volume in patients with BRVO and macular edema. Methods Fifty-three consecutive BRVO patients (26 women and 27 men) were divided into two groups based on optical coherence tomography findings. Macular function was documented by microperimetry, while macular thickness and volume were measured by OCT. Results There were 15 patients with SRD and 38 patients with CME. Fourteen of the 15 patients with SRD also had CME. Visual acuity was significantly worse in the SRD group than in the CME group (P = 0.049). Also, macular thickness and macular volume within the central 4°, 10°, and 20° fields were significantly greater in the SRD group (P = 0.008, and P = 0.007, P < 0.001 and P < 0.001, and P < 0.001 and P < 0.001, respectively). However, macular sensitivity within the central 4°, 10°, and 20° fields was not significantly worse in the SRD group than in the CME group. Conclusions SRD itself may decrease visual acuity together with CME, because nearly all SRD patients also had CME. SRD does not seem to influence macular function on microperimetry.

2011-01-01

309

Bilateral facial nerve palsy: a diagnostic dilemma.  

PubMed

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

2012-01-23

310

Langerhans cell histiocytosis in bilateral mastoid cavity.  

PubMed

A 39-year-old male was admitted to our clinic with symptoms of headache, dizziness, nausea, otalgia, otorrhea, tinnitus, and hearing loss in both ears for 3 weeks. Physical examination revealed edema in the tympanic membrane and external ear canal, and pain by palpation in the mastoid area bilaterally. There was no nystagmus, and the rest of the physical examination was otherwise normal. Temporal bone high resolution computed tomography (CT) showed a lesion causing erosion in the mastoid cortex, tegmen tympani, ossicles, and in the bone covering the sigmoid sinus bilaterally. There was also erosion in the superior semicircular canal and petrous bone on the left side. Cortical mastoidectomy was performed under general anesthesia. Histopathologic examination of the tissue revealed Langerhans cell histiocytosis (LCH). In this paper a case with LCH, presenting with bilateral mastoid involvement which has been rarely reported in the literature, is discussed with the existing literature. PMID:23841005

Bozdemir, Kaz?m; Tarlak, Behçet; Cakar, Hasan; Doblan, Ahmet; Kutluhan, Ahmet; Dilek, Imdat; Ad?yaman Süngü, Nuran

2013-06-11

311

Fatal bronchial asthma with bilateral lung collapse.  

PubMed

Fatal bronchial asthma is classically characterized in pathology textbooks and journal articles as associated with lung hyperinflation at autopsy. The following is a report of a case of fatal bronchial asthma associated instead with bilateral lung collapse. This manifestation of asthma at autopsy has not been previously reported, to my knowledge. A 31-year-old man with a history of recurrent asthma was found in an unresponsive state in his automobile after a low-speed collision. Medical personnel during the resuscitation noted a decrease in breath sounds bilaterally and some wheezing. There was no escaping air with needle thoracostomies at the outset. Cardiac monitoring demonstrated pulseless electrical activity during most of the 30-minute resuscitation attempt. An autopsy disclosed collapsed lungs bilaterally. Microscopic examination of the lungs disclosed the characteristic histopathologic features of bronchial asthma. PMID:21030852

Young, Thomas W

2010-12-01

312

Multiple myeloma presenting as bilateral orbital proptosis  

PubMed Central

A 58-year-old-man presented with painful rapidly progressive bilateral proptosis with restricted ocular movements of 15 days duration. There was history of significant weight loss in the recent past. Computed tomography scan of the head and orbit revealed bilateral multiple, well-defined, round, soft tissue masses, isointense with muscles in intraconal and extraconal space. Fine needle aspiration cytology and incision biopsy from the lesion, urine for Bence-Jones proteins and immunofixation clinched the diagnosis of multiple myeloma. Skeletal survey did not reveal any bony involvement. The diagnosis of multiple myeloma should be kept in mind in cases of bilateral proptosis. Bony involvement is not universal in cases of orbital myeloma. Early diagnosis can be established with extensive biochemical and histopathological investigations and timely treatment is life saving for these patients.

Malik, Archana; Narang, Subina; Handa, Uma; Sood, Sunandan

2009-01-01

313

Bilateral Hypertrophic Olivary Degeneration in Wilson Disease  

PubMed Central

Hypertrophic olivary degeneration resulting from lesions of the dento-rubro-olivary pathway, also called Guillain-Mollaret-triangle, has been described previously in a number of cases. Reports about bilateral hypertrophic olivary degeneration of the inferior olivary nuclei are very limited, and the magnetic resonance imaging findings of hypertrophic olivary degeneration in Wilson disease have not yet been described to the best of our knowledge. Herein, we present the first report of bilateral hypertrophic olivary degeneration diagnosed by magnetic resonance imaging in a patient suffering from Wilson disease.

Guenther, Peter; Hoffmann, Karl-Titus

2013-01-01

314

Moxifloxacin and bilateral acute iris transillumination  

PubMed Central

Recent publications have alerted clinicians to a syndrome of uveitic transilluminating iris depigmentation associated with systemic fluoroquinolones and other antibiotics. Bilateral acute iris transillumination, which is associated with loss of the iris pigment epithelium and results in iris transillumination, differs from the previously described bilateral acute depigmentation of the iris, which is associated with atrophy of the iris stroma without transillumination. We present a case of fluoroquinolone-associated uveitis with anterior segment optical coherence tomography imaging to highlight some observations about this syndrome. We interpret pharmacokinetic data to help explain why oral, but not topical, moxifloxacin may cause fluoroquinolone-associated uveitis.

2013-01-01

315

Cutaneous metastasis of bilateral renal cell carcinoma.  

PubMed

Renal cell carcinoma (RCC) is a malignant lethal tumour with high potential of metastasis. However, metastasis from RCC to the skin is much less common. It is virtually a sign of poor prognosis. We represent a 42 years old man with bilateral RCC of clear cell type followed by metastasis to the scalp one month later. In this case the relatively young age of the patient, bilaterality of RCC and occurance of skin metastasis in the absence of recurrent kidney tumour are interesting. PMID:23865145

Abbasi, Fariba; Alizadeh, Mansur; Noroozinia, Farahnaz; Moradi, Amin

2013-01-01

316

Bilateral renal artery dissection following extreme exertion.  

PubMed

Dissection of a renal artery is rare and is usually associated with underlying arterial disease. Bilateral renal artery dissection following extreme exertion is exceptionally uncommon, and thus presents a diagnostic challenge. We report a case of a middle-aged, otherwise healthy man who presented to the hospital with left flank pain after a long bicycling trip. Initial laboratory tests and urinalysis were normal. Careful review of a contrast-enhanced computed tomography angiogram (CTA) with 3D reconstruction revealed bilateral segmental renal artery dissection and thrombosis with corresponding renal infarcts. He was treated medically and rapidly recovered. PMID:21955870

Baroudi, S; Bastani, B; Balci, N; Bieneman, B K; Sobti, P; Kudva, G C

2011-10-01

317

Prevalence and characteristics of foveal retinal detachment without macular hole in high myopia  

Microsoft Academic Search

PurposeTo report the prevalence of foveal retinal detachment without macular hole in a large number of highly myopic eyes using optical coherence tomography (OCT), and to clarify the demographic characteristics associated with foveal retinal detachment in these eyes.

Takayuki Baba; Kyoko Ohno-Matsui; Soh Futagami; Takeshi Yoshida; Kenjiro Yasuzumi; Ariko Kojima; Takashi Tokoro; Manabu Mochizuki

2003-01-01

318

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.

2013-01-01

319

The effect of indocyanine-green on functional outcome of macular pucker surgery  

Microsoft Academic Search

PurposeTo compare functional results after surgery for macular pucker either with or without indocyanine-green staining of the internal limiting membrane (ILM) and to evaluate the ultrastructure of the tissue removed.

Christos Haritoglou; Arnd Gandorfer; Carolin A Gass; Markus Schaumberger; Michael W Ulbig; Anselm Kampik

2003-01-01

320

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 ...

321

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

PubMed

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

Bonnin, Nicolas; Cornut, Pierre-Loďc; Chaise, Florian; Labeille, Elodie; Manificat, Helene Janin; Feldman, Audrey; Perard, Laurent; Bacin, Franck; Chiambaretta, Frédéric; Burillon, Carole

2013-02-11

322

Ethnicity, race, and clinically significant macular edema in the Veterans Affairs Diabetes Trial (VADT)  

Microsoft Academic Search

ObjectiveTo determine risk factors in clinically significant macular edema (CSME) and if increased CSME in minorities is due to ethnicity or other factors in the Veterans Affairs Diabetes Trial (VADT).

Nicholas Emanuele; Thomas Moritz; Ronald Klein; Matthew D. Davis; Kathleen Glander; Anuradha Khanna; Lizy Thottapurathu; Gideon Bahn; William Duckworth; Carlos Abraira

2009-01-01

323

Optical coherence tomography (oct) macular and peripapillary retinal nerve fiber layer measurements and automated visual fields  

Microsoft Academic Search

PurposeTo investigate the structure-function relationship between optical coherence tomography (OCT) macular retinal and peripapillary nerve fiber layer (NFL) thickness and automated visual field (VF) findings.

Gadi Wollstein; Joel S. Schuman; Lori L. Price; Ali Aydin; Siobahn A. Beaton; Paul C. Stark; James G. Fujimoto; Hiroshi Ishikawa

2004-01-01

324

Towards a model to predict macular dichromats' naming errors: effects of CIE saturation and dichromatism type.  

PubMed

Thirty macular dichromat children (12 protanopes + 18 deuteranopes) and 29 controls, between 5 and 9 years old, participated in a monolexemic denomination task. Their clinical status was determined after a repeated application of a chromatic test set (Ishihara, CUCVT, and TIDA). The stimuli to be named were 12 tiles from the Color-Aid set belonging to the green, blue, and purple basic categories. Results showed that: (a) Dichromats made more naming errors when low saturation stimuli were used; (b) protanopes made more errors that deuteranopes; and (c) pseudoisochromatic lines predicted accurately the type of most frequent naming errors but they underestimated macular dichromats' functional capacity to name colors. Results are consistent with a model of macular dichromats' vision that hypothesizes a residual third type of cone in the periphery of the retina. Implications of this fact for everyday use of colors by macular dichromats' and for the validity of standard clinical diagnoses are discussed. PMID:11705339

Lillo, J; Vitini, I; Caballero, A; Moreira, H

2001-05-01

325

Retinal detachment associated with a macular hole in severely myopic eyes  

Microsoft Academic Search

PURPOSE: To investigate factors associated with extensive retinal detachment in severely myopic eyes with a macular hole.METHOD: Fifty-two consecutive eyes with a macular hole and severe myopia were retrospectively studied.RESULTS: An extensive retinal detachment, defined as extending beyond the cuff of subretinal fluid, was observed in 37 eyes (71%). Extensive retinal detachment developed in 36 (95%) of 38 eyes with

Jun Akiba; Suguru Konno; Akitoshi Yoshida

1999-01-01

326

Intravitreal triamcinolone improves vision in eyes with chronic diabetic macular oedema refractory to laser photocoagulation  

Microsoft Academic Search

PurposeTo evaluate the clinical and visual outcome of an intravitreal injection of triamcinolone in patients with diabetic macular oedema refractory to laser treatment.Material and methodsProspective, interventional nonrandomised case series of 24 eyes of 24 patients that underwent intravitreal injection of 4 mg triamcinolone for chronic diabetic macular oedema refractory to previous laser treatment. All patients had best corrected visual acuity

A K Negi; S A Vernon; C S Lim; K Owen-Armstrong

2005-01-01

327

Intravitreal triamcinolone acetonide for macular oedema owing to retinal vein occlusion  

Microsoft Academic Search

PurposeTo assess the long-term safety and efficacy of intravitreal triamcinolone acetonide injection in the management of macular oedema caused by central, hemi-, and branch retinal vein occlusion (CRVO, HRVO, or BRVO).MethodsThis prospective, interventional case series included 13 patients (13 eyes) with retinal vein occlusion and macular oedema. They received an intravitreal injection of 4 mg triamcinolone acetonide. Follow-up was for

P J Patel; I Zaheer; N Karia

2008-01-01

328

Intravitreal triamcinolone acetonide vs bevacizumab for treatment of macular oedema secondary to branch retinal vein occlusion  

Microsoft Academic Search

PurposeTo compare the short-term visual and morphological results of intravitreal triamcinolone acetonide vsintravitreal bevacizumab for eyes with macular oedema secondary to branch retinal vein occlusion (BRVO).DesignRetrospective interventional consecutive case series.MethodsWe reviewed the clinical records of 29 patients (29 eyes) who had macular oedema due to BRVO with minimum follow-up of 6 months. A total of 16 patients were treated with

K-C Cheng; W-C Wu; K-J Chen

2009-01-01

329

A randomized, placebo-controlled clinical trial of intravitreal triamcinolone for refractory diabetic macular edema  

Microsoft Academic Search

Purpose To evaluate the effect of intravitreal triamcinolone acetonide (IVT) on refractory diabetic macular edema (DME). Methods In a prospective, placebo-controlled, randomized clinical trial, 88 eyes of 61 patients with clinically significant macular\\u000a edema that would have responded unfavourably to laser photocoagulation were randomly assigned to two groups. The treatment\\u000a group (45 eyes) received 4 mg IVT and the control group

Mohammad H. Dehghan; Hamid Ahmadieh; Alireza Ramezani; Morteza Entezari; Arash Anisian

2008-01-01

330

Complement factor H and hemicentin-1 in age-related macular degeneration and renal phenotypes  

Microsoft Academic Search

In this study, we investigated the associations of complement factor H (CFH) and hemicentin-1 (HMCN1) with age-related macular degeneration (AMD) and renal function. Three scales, measuring the course of AMD and drusen development, were examined in two samples: the Family Age-Related Macular degeneration Study (FARMS), consisting of families ascertained through a single individual with severe AMD, and an unascer- tained

Cheryl L. Thompson; Barbara E. K. Klein; Ronald Klein; Zhiying Xu; Jennifer Capriotti; Tripti Joshi; Dmitry Leontiev; Kristine E. Lee; Robert C. Elston; Sudha K. Iyengar

2007-01-01

331

Bevacizumab for neovascular age related macular degeneration (ABC Trial): multicentre randomised double masked study  

Microsoft Academic Search

Objectives To evaluate the efficacy and safety of intravitreous bevacizumab injections for the treatment of neovascular age related macular degeneration.Design Prospective, double masked, multicentre, randomised controlled trial.Setting Three ophthalmology centres in the United Kingdom.Participants 131 patients (mean age 81) with wet age related macular degeneration randomised 1:1 to intervention or control.Interventions Intravitreous bevacizumab (1.25 mg, three loading injections at six

Adnan Tufail; Praveen J Patel; Catherine Egan; Philip Hykin; Lyndon da Cruz; Zdenek Gregor; Jonathan Dowler; Mohammed A Majid; Clare Bailey; Quresh Mohamed; Robert Johnston; Catey Bunce; Wen Xing

2010-01-01

332

Improvement in near visual function after macular translocation surgery with 360-degree peripheral retinectomy  

Microsoft Academic Search

Background Information is limited on how specific near-vision skills are impacted by therapies such as macular translocation surgery with 360-degree retinectomy (MT360) for age-related macular degeneration (AMD). Methods Standardized tests of near vision were given to 25 consecutive patients with AMD who met entry criteria for this study, preoperatively and 6 and 12 months after MT360. Tests included: near acuity

Cynthia A. Toth; Deborah J. Lapolice; Avie D. Banks; Sandra S. Stinnett

2004-01-01

333

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

334

Decreased choriocapillaris perfusion following surgical excision of choroidal neovascular membranes in age-related macular degeneration  

Microsoft Academic Search

AIMS\\/BACKGROUNDTo evaluate macular changes following surgical excision of subfoveal choroidal neovascular membranes (CNVs) in age-related macular degeneration (AMD).METHODSThe clinical records, fluorescein angiograms, and CNV histopathology of 12 patients with AMD who underwent surgical excision of subfoveal CNV were reviewed.RESULTSNew areas of decreased choriocapillaris perfusion were noted by fluorescein angiography in the previous location of the CNV in 8\\/12 (75%) cases.

Ma’an A Nasir; Ilene Sugino; Marco A Zarbin

1997-01-01

335

Macular translocation for surgical management of subfoveal choroidal neovascularizations in patients with AMD: first results  

Microsoft Academic Search

·   Background: At present no satisfying treatment for subfoveal choroidal neovascularization (CNV) secondary to age-related\\u000a macular degeneration (AMD) is available. Visual results after successful surgical removal of subfoveal CNV are disappointing.\\u000a This has been explained by a primary dysfunction of the retinal pigment epithelium (RPE) in the macular region and the surgical\\u000a trauma to the RPE in patients with AMD.

Sebastian Wolf; Alexandra Lappas; Andreas W. A. Weinberger; Bernd Kirchhof

1999-01-01

336

Lipids, Lipoproteins, and Age-Related Macular Degeneration  

PubMed Central

Age-related macular degeneration (AMD) is the leading cause of blindness among the elderly. While excellent treatment has emerged for neovascular disease, treatment for early AMD is lacking due to an incomplete understanding of the early molecular events. A prominent age-related change is the accumulation of neutral lipid in normal Bruch's membrane (BrM) throughout adulthood and also disease-related BrM accumulations called basal deposits and drusen. AMD lesion formation has thus been conceptualized as sharing mechanisms with atherosclerotic plaque formation, where low-density lipoprotein (LDL) retention within the arterial wall initiates a cascade of pathologic events. However, we do not yet understand how lipoproteins contribute to AMD. This paper explores how systemic and local production of lipoproteins might contribute to the pathogenesis of AMD.

Ebrahimi, Katayoon B.; Handa, James T.

2011-01-01

337

Therapeutic targets in age-related macular disease  

PubMed Central

Age-related macular disease (AMD) accounts for more than 50% of blind registration in Western society. Patients with AMD are classified as having early disease, in which visual function is well preserved, or late disease, in which central vision is lost. Until recently, there was no therapy available by which the course of the disorder could be modified. Now, the most common form of late-stage AMD — choroidal neovascularization — responds to treatment with anti-VEGF therapies; although visual loss is modified in a portion of these cases, no therapeutic approach exists that alters the evolution from early to late disease. However, as discussed in this Review, research over the last few years has demonstrated several features of AMD that are likely to be amenable to treatment. Potential targets for treatment are described, and possible therapeutic approaches are discussed.

Bird, Alan C.

2010-01-01

338

Fundus autofluorescence and progression of age-related macular degeneration.  

PubMed

Fundus autofluorescence imaging is an imaging method that provides additional information compared to conventional imaging techniques. It permits to topographically map lipofuscin distribution of the retinal pigment epithelial cell monolayer. Excessive accumulation of lipofuscin granules in the lysosomal compartment of retinal pigment epithelium cells represents a common downstream pathogenetic pathway in various hereditary and complex retinal diseases including age-related macular degeneration (AMD). This comprehensive review contains an introduction in fundus autofluorescence imaging, including basic considerations, the origin of the signal, different imaging methods, and a brief overview of fundus autofluorescence findings in normal subjects. Furthermore, it summarizes cross-sectional and longitudinal fundus autofluorescence findings in patients with AMD, addresses the pathophysiological significance of increased fundus autofluorescence, and characterizes different fundus autofluorescence phenotypes as well as fundus autofluorescence alterations with disease progression. PMID:19171212

Schmitz-Valckenberg, Steffen; Fleckenstein, Monika; Scholl, Hendrik P N; Holz, Frank G

339

The effect of caffeine on the human macular circulation.  

PubMed

The acute effect of caffeine on the retinal circulation was studied in 14 healthy volunteers using the blue field simulation technique, which provides measurements of the velocity of leukocytes flowing within the macular capillaries. Subjects adjusted the mean velocity (Vm) of computer-simulated leukocytes moving on a cathode ray tube screen to match that of their own entoptically perceived leukocytes before and 1 hr after a double-masked, randomized administration of 200 mg caffeine or placebo. Caffeine produced an average 13% +/- 5% (SEM) decrease in Vm (P less than 0.05) and a 9% +/- 3% increase in diastolic blood pressure (P less than 0.05). The decrease in Vm and, presumably, blood flow occurring despite the increased diastolic blood pressure probably is attributable to retinal vasoconstriction. This effect may result from caffeine's known inhibitory effect on adenosine, a potent vasodilator of the retinal vasculature. PMID:1938279

Lotfi, K; Grunwald, J E

1991-11-01

340

Simultaneous bilateral spontaneous pneumothorax with pleural window communicating with bilateral pleural spaces.  

PubMed

A pleural window communicating between bilateral pleural cavities is a serious condition in patients with pneumothorax, allowing air to leak from the affected lung into the contralateral pleural cavity and resulting in bilateral spontaneous pneumothorax. We treated a patient with a history of right-sided bullectomy for simultaneous bilateral spontaneous pneumothorax that subsequently recurred. A pleural window (1 cm long) was detected in the mid-mediastinum, and direct suture closure with localized pleural abrasion using argon beam coagulation on the circumference of the lesion was performed at video-assisted thoracoscopic surgery. PMID:18355546

Yamada, Shunsuke; Yoshino, Kazuho; Inoue, Hiroshi

2008-04-01

341

Management of macular edema secondary to central retinal vein occlusion: an evidence-based.  

PubMed

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. Decreased vision in patients afflicted with CRVO may result from retinal ischemia and/or the accumulation of fluid within the center of the retina (macular edema). The Central Vein Occlusion Study (CVOS) Group demonstrated that grid laser photocoagulation is not an effective treatment for decreased vision due to CRVO-related macular edema. Since publication of that report, the standard of care for patients with decreased vision due to CRVO-associated macular edema was observation. However, in the past 5 years, several major randomized controlled clinical trials have investigated new therapeutic modalities for the treatment of macular edema secondary to CRVO. This article aims to provide insight into current evidence-based approaches to the management of macular edema secondary to CRVO. A companion article reviews approaches for the management of macular edema secondary to BRVO. PMID:21153510

Aref, Ahmad A; Scott, Ingrid U

2010-12-09

342

Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update.  

PubMed

Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO. PMID:21153509

Aref, Ahmad A; Scott, Ingrid U

2010-12-09

343

OPTICAL COHERENCE TOMOGRAPHY-GUIDED FACEDOWN POSITIONING FOR MACULAR HOLE SURGERY  

PubMed Central

Purpose To use spectral domain optical coherence tomography–guided duration of facedown positioning to study anatomical macular hole closure rates. Methods Retrospective review of patients with macular holes undergoing 23-gauge pars plana vitrectomy and intraocular gas tamponade. Spectral domain optical coherence tomography imaging was done on postoperative Day 1. Patients remained facedown for 2 more days if the macular hole was closed or 6 more days facedown if the macular hole was open or indeterminate. Results There were 8 Stage 2, 12 Stage 3, and 12 Stage 4 macular holes. On postoperative Day 1, 24 holes were closed by spectral domain optical coherence tomography and instructed to remain facedown for two more days. Twenty-three of 24 holes remained closed during the postoperative period. Eight holes were open or indeterminate on postoperative Day 1 and remained facedown for 6 more days. Six of 8 holes (75%) were closed at their last follow-up. The overall closure rate was 29/32 (90.6%). Average follow-up was 334 days. Conclusion Confirming early closure of macular holes with spectral domain optical coherence tomography imaging can serve as an important guide to significantly shorten the duration of prone positioning while maintaining high closure rates.

SHAH, SUMIT P.; MANJUNATH, VARSHA; ROGERS, ADAM H.; BAUMAL, CAROLINE R.; REICHEL, ELIAS; DUKER, JAY S.

2013-01-01

344

[Age-related macular degeneration as a local manifestation of atherosclerosis - a novel insight into pathogenesis].  

PubMed

Age-related macular degeneration is the leading cause of irreversible visual impairment and disability among the elderly in developed countries. There is compelling evidence that atherosclerosis and age-related macular degeneration share a similar pathogenic process. The association between atherosclerosis and age-related macular degeneration has been inferred from histological, biochemical and epidemiological studies. Many published data indicate that drusen are similar in molecular composition to plaques in atherosclerosis. Furthermore, a great body of evidence has emerged over the past decade that implicates the chronic inflammatory processes in the pathogenesis and progression of both disorders. We speculate that vascular atherosclerosis and age-related macular degeneration may represent different manifestations of the same disease induced by a pathologic tissue response to the damage caused by oxidative stress and local ischemia. In this review, we characterise in detail a strong association between age-related macular degeneration and atherosclerosis development, and we postulate the hypothesis that age-related macular degeneration is a local manifestation of a systemic disease. This provides a new approach for understanding the aspects of pathogenesis and might improve the prevention and treatment of both diseases which both result from ageing of the human body. PMID:23885362

Machali?ska, Anna

2013-01-01

345

Unraveling a complex genetic disease: age-related macular degeneration.  

PubMed

In most of the Western world, age-related macular degeneration (AMD) remains the largest single cause of severe visual impairment, and its prevalence continues to increase. It is considered to be a complex disease, in which multiple genes and environment play a role in pathogenesis. Several environmental insults are implicated with smoking, serum cholesterol, hypertension, sunlight exposure, and many other factors being variously associated with disease pathogenesis. Until recently, there have been relatively few breakthroughs to further our understanding of the genetics of AMD, despite remarkable progress in molecular genetic techniques over the last 20 years, and the fact that many rare inherited macular diseases have had their causative genes mapped. Development of new tools such as high-density single-nucleotide polymorphism chips and microarrays have changed the face of genetic research, but have yet to directly translate into improved clinical outcomes in ophthalmology. However with the recent finding of the Tyr402His polymorphism in the complement factor H gene being implicated in AMD, we are about to witness a new wave of research in this disease. Not only does the identification of a biologically plausible gene identify a new pathway, but it also identifies new biological mechanisms for disease, avenues to pursue treatment, and a better understanding of how the environment interacts with the genetic background to create disease. This article aims to review the process of gene discovery in complex disease, why the search for genes remains difficult, how to translate laboratory findings to a clinical setting, and how these findings will impact on disease treatment and public health issues. PMID:17134647

Chamberlain, Matt; Baird, Paul; Dirani, Mohamed; Guymer, Robyn

346

Analysis of candidate genes for macular telangiectasia type 2  

PubMed Central

Purpose To find the gene(s) responsible for macular telangiectasia type 2 (MacTel) by a candidate-gene screening approach. Methods Candidate genes were selected based on the following criteria: those known to cause or be associated with diseases with phenotypes similar to MacTel, genes with known function in the retinal vasculature or macular pigment transport, genes that emerged from expression microarray data from mouse models designed to mimic MacTel phenotype characteristics, and genes expressed in the retina that are also related to diabetes or hypertension, which have increased prevalence in MacTel patients. Probands from eight families with at least two affected individuals were screened by direct sequencing of 27 candidate genes. Identified nonsynonymous variants were analyzed to determine whether they co-segregate with the disease in families. Allele frequencies were determined by TaqMan analysis of the large MacTel and control cohorts. Results We identified 23 nonsynonymous variants in 27 candidate genes in at least one proband. Of these, eight were known single nucleotide polymorphisms (SNPs) with allele frequencies of >0.05; these variants were excluded from further analyses. Three previously unidentified missense variants, three missense variants with reported disease association, and five rare variants were analyzed for segregation and/or allele frequencies. No variant fulfilled the criteria of being causal for MacTel. A missense mutation, p.Pro33Ser in frizzled homolog (Drosophila) 4 (FZD4), previously suggested as a disease-causing variant in familial exudative vitreoretinopathy, was determined to be a rare benign polymorphism. Conclusions We have ruled out the exons and flanking intronic regions in 27 candidate genes as harboring causal mutations for MacTel.

Parmalee, Nancy L.; Schubert, Carl; Merriam, Joanna E.; Allikmets, Kaija; Bird, Alan C.; Gillies, Mark C.; Peto, Tunde; Figueroa, Maria; Friedlander, Martin; Fruttiger, Marcus; Greenwood, John; Moss, Stephen E.; Smith, Lois E.H.; Toomes, Carmel; Inglehearn, Chris F.

2010-01-01

347

Age-related macular degeneration: Evidence of a major gene  

SciTech Connect

Age-related macular degeneration is a major cause of blindness in developing countries. It remains a very poorly understood disorder. Although environmental and genetic factors have been implicated in its pathogenesis, none have been firmly implicated. The purpose of this study was to use pedigree analysis to evaluate the possible role of a major gene as a determinant of familial aggregation. Information was collected regarding occupation, smoking, sun exposure, associated medical problems and family history. 50 probands with age-related macular degeneration (ARMD) and 39 age, race and sex-matched controls were included in the study. In the ARMD group 15/50 (30%) of probands reported a positive family history; 22 out of 222 first degree relatives over age 60 were reported to be affected. In the control groups, none of the 138 first degree relatives over age 50 had a history of ARMD. This difference is statistically significant (p = 0.0003), indicating that genetic factors may play an important role in the pathogenesis of ARMD. In the ARMD group more siblings as compared to parents (16/127 vs. 5/82) were affected. 5/50 (10%) of the ARMD probands also gave a history of a second degree relative affected with ARMD, compared to none known among the relatives of controls. Data from 50 pedigrees were analyzed by complex segregation analysis under a class A regressive logistic model using the REGD program implemented in the SAGE package. Preliminary results allow rejection of a polygenic model and suggest there is a major gene for ARMD in these families. The inheritance model most compatible with the observed familial aggregation is autosomal recessive. In conclusion, these results are suggestive of a major gene effect in the etiology of ARMD. Identification of a major gene effect is a first step to further pursue linkage analysis and to search for the gene(s) involved in the causation of ARMD.

Bhatt, S.; Warren, C.; Yang, H. [UCLA School of Medicine, Los Angeles, CA (United States)] [and others

1994-09-01

348

Fundus autofluorescence in exudative age-related macular degeneration  

PubMed Central

Aim To evaluate the distribution of fundus autofluorescence in patients with age?related macular degeneration and choroidal neovascularisation (CNV). Methods Colour fundus photographs, fundus fluorescein angiograms (FFA) and fundus autofluorescence images were obtained from a group of 40 patients (43 eyes) with age?related macular degeneration and purely classic or occult CNV. Only patients with newly diagnosed CNV and in whom autofluorescence images were obtained within 2?weeks from FFA were included. The distribution of autofluorescence was qualitatively evaluated, and the findings compared with those from colour fundus photographs and FFA. Results 29 (67%) eyes had classic CNV and 14 (33%) had occult CNV. In 26 (90%) eyes with classic CNV, a low autofluorescence signal was detected at the site of the CNV; in 7 (50%) eyes with occult CNV, multiple foci of low autofluorescence signal were detected. Outside the area affected by the lesion, homogeneous autofluorescence was observed in most of the cases (n?=?33, 77%). Similarly, homogeneous autofluorescence was commonly observed in fellow eyes (62%). A pattern of focal increased autofluorescence was rarely seen in eyes with CNV (n?=?4, 9%) or in fellow eyes (n?=?4, 15%). In 11 of 43 (25%) eyes, areas of increased autofluorescence, other than a pattern of focal increased autofluorescence, were detected. In four patients, autofluorescence images had been obtained before the development of CNV; in none was any increased autofluorescence detected before the formation of CNV. Conclusions Distinct patterns of autofluorescence were observed in eyes with pure classic and occult CNV. Increased autofluorescence was rarely seen in eyes with CNV and in fellow eyes, suggesting that increased autofluorescence, and thus, retinal pigment epithelium lipofuscin, may not play an essential part in the formation of CNV.

McBain, Vikki A; Townend, John; Lois, Noemi

2007-01-01

349

Bilateral parotid sialoadenitis with gonial hypertrophy.  

PubMed

Sialoadenitis is a non-inflammatory condition that affects mainly the parotid, and is characterised by bilateral, painless swelling, which is an appreciable problem in young women. A 28-year-old woman presented with parotid sialoadenitis with masseteric hypertrophy. She was treated by superficial parotidectomy and ostectomy of the mandibular angle and made an uncomplicated recovery. PMID:14649690

Kosaka, Masaaki; Enjo, Mitsuhiro; Kamiishi, Hiroshi

2003-01-01

350

Bilateral adrenal infarction in Crohn's disease  

PubMed Central

Adrenal infarction is an uncommon cause of adrenal insufficiency. We herein present unique occurrence of bilateral adrenal infarction detected on imaging in a young female with known history of Crohn's disease. The patient responded well to steroids and is on follow up. To our knowledge, this is the first case reported in English literature of adrenal infarct associated with Crohn's disease as extraintestinal manifestation.

Khandelwal, Ashish; Krishna, J. Sateesh; Khandelwal, Kanika; Virmani, Vivek; Ryan, John

2013-01-01

351

Bilateral Hand Transplantation: Result at 20 Months  

Microsoft Academic Search

On November 2006, a bilateral hand allotransplantation was performed for a 47-year-old female who had suffered radiocarpal amputations 28 years before. Technical aspects of the operation are detailed. Alemtuzumab induction, and triple therapy of tacrolimus, mycophenolate mofetil and prednisone were used to control rejection. The evolution of the result and functioning at 20 months are presented in detail. Two acute

P. C. CAVADAS; L. LANDIN; J. IBAŃEZ

2009-01-01

352

Bilateral inferior petrosal sinus sampling with desmopressin.  

PubMed

In this technical note, the use of desmopressin to stimulate pituitary adrenocorticotropic hormone secretion in place of the commercially available corticotropin releasing hormone (CRH) in bilateral inferior petrosal sinus sampling is described. Although the use of CRH is the standard of practice, it is currently unavailable in the USA and desmopressin provides reliable results with no additional observed side effects. PMID:22735860

Deipolyi, Amy R; Hirsch, Joshua A; Oklu, Rahmi

2012-06-26

353

Bilateral scalp necrosis with giant cell arteritis.  

PubMed

We present a patient with bilateral scalp necrosis caused by giant cell arteritis (temporal arteritis). A 67-year-old woman, who had been treated with 5 mg of oral prednisolone every other day for polymyalgia rheumatica, developed painful egg-sized regions of necrosis on both of her temples. Doppler pulsemetory revealed bilateral obstruction of the temporal arteries. Biopsy revealed ischemic necrosis of the skin and necrotic angiitis of the temporal arteries with giant cell infiltration. Bilateral stenosis of the internal carotid arteries and moderate retinal bleeding were revealed by angiography. Daily administration of prednisolone (20 mg/day) with intravenous and topical limaprost alphadex markedly improved her condition. The ulcers reepithelized without surgical treatment. There are few reports of bilateral scalp necrosis. Rapid and complete obstruction of the temporal artery may result in this condition. Simultaneous development of two ulcerative lesions in the ventro-parietal cranial regions is thought to correspond to systemic arterial involvement, including involvement of the internal carotid arteries. PMID:12692357

Matsushima, Midori; Yamanaka, Keiichi; Mori, Hitoshi; Murakami, Takaaki; Hakamada, Arata; Isoda, Ken-ichi; Mizutani, Hitoshi

2003-03-01

354

Bilateral thoracic paravertebral block for abdominoplasty.  

PubMed

Thoracic bilateral paravertebral block is a technique commonly used in the ambulatory setting for numerous plastic surgery procedures. Paravertebral block has not been reported with abdominoplasty surgery. This case series explores this anesthetic technique in the inpatient and day patient setting. PMID:18346612

Rudkin, Glenda E; Gardiner, Sarah E; Cooter, Rodney D

2008-02-01

355

Bilateral limbic system destruction in man  

Microsoft Academic Search

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

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

2010-01-01

356

The new bilateralism in the Asia Pacific  

Microsoft Academic Search

For most of the past half-century, Western Pacific countries largely eschewed preferential trade agreements. Their preferred form of trade liberalisation was unilateral action on a non-discriminatory basis. In the past four years, however, more than 20 preferential schemes involving two or more Western Pacific countries have been put forward. The new interest in bilateralism is explained by: an increasing awareness

John Ravenhill

2003-01-01

357

Bilateral hypoplasia of the internal carotid artery.  

PubMed

Agenesis and hypoplasia of the internal carotid artery (ICA) are rare congenital anomalies, occurring in less than 0.01% of the population. We report a rare case of bilateral hypoplasia of the ICA in a patient with post-traumatic subarachnoid hemorrhage. We describe the embryological development of the cerebral vasculature and present a review of literature. PMID:22223934

Bhat, Dhananjaya I; Somanna, Sampath; Kovoor, Jerry Me

2011-10-01

358

Botulinum toxin treatment of bilateral masseteric hypertrophy.  

PubMed

Botulinum toxin is a new and innovative method of treating bilateral masseteric hypertrophy which offers many advantages over conventional surgical treatment. Experience gained through the successful use of this drug when given as an intramuscular injection is reported. No significant side-effects have occurred and this technique is recommended for the routine treatment of masseteric hypertrophy. PMID:8136335

Smyth, A G

1994-02-01

359

Persistent bilateral proatlantal type II artery  

PubMed Central

Vascular anomalies and variants are common in patients undergoing imaging studies, and patients with these anomalies are generally asymptomatic. Remnants of fetal carotid-basilar circulation are rarely identified. We report a rare case of persistent type 2 bilateral proatlantal arteries, in which the patient presented with dizziness.

Zarghouni, Mehrzad; Marichal, Daniel

2013-01-01

360

Computed tomographic findings in bilateral adrenal tuberculosis  

SciTech Connect

The computed tomographic (CT) features of bilateral adrenal tuberculosis are reported in two cases that demonstrate two typical different clinical and morphological manifestations of the disease. The incidence and CT appearance of adrenal tuberculosis are discussed, with emphasis on differential diagnosis.

Wilms, G.E. (Katholicke Universiteit Leuven, Belgium); Baert, A.L.; Kint, E.J.; Pringot, J.H.; Goddeeris, P.G.

1983-03-01

361

Bilateral spinal accessory nerve palsy after rhytidectomy  

Microsoft Academic Search

A 64-year-old patient experienced palsy of the right spinal accessory nerve after rhytidectomy. She was evaluated 6 months after surgery for unexplained shoulder pain and weakness since the procedure. Electrophysiological testing showed bilateral spinal nerve palsy without abnormalities in the other shoulder nerves. The electrophysiological findings supported entrapment as the mechanism, rather than nerve section or pure axonal disease due to

Paul Seror; Henri Lellouche

2006-01-01

362

Mediating a Bilateral Multi-Issue Negotiation  

Microsoft Academic Search

In human decision making behaviors, people rely on random selection processes, such as flipping a coin, to handle a situation that involves so much uncertainty that it subsequently becomes difficult for them to rationally judge a decision. For bilateral multi-issue negotiations, given even bargaining power and two-sided uncertainty, negotiators are often faced with difficult decisions that cannot be handled through

Raymund J. Lin; Seng-cho Timothy Chou

2003-01-01

363

Lemierre syndrome causing bilateral cavernous sinus thrombosis.  

PubMed

Lemierre syndrome is an uncommon septic thrombophlebitis of the veins of the head and the neck usually occurring after a severe oropharyngeal infection. Although subsequent septic emboli most commonly affect distant sites, such as the lungs and joints, the authors present a case of Lemierre syndrome causing bilateral cavernous sinus syndrome. PMID:22868639

Miller, Brooke; Khalifa, Yousuf; Feldon, Steven E; Friedman, Deborah I

2012-12-01

364

Bilateral Mandibular Supernumerary Canines: A Case Report  

PubMed Central

Supernumerary teeth are defined as the teeth developed in excess of the number found in a normal dentition. Supernumerary canine is an extremely rare finding particularly in the mandible. This case report presents a 25-year-old female patient with the unique feature of bilateral mandibular supplemental supernumerary canines. The patient was non-syndromic without any other supernumerary teeth.

Abouei Mehrizi, Ehsan; Semyari, Hassan; Eslami Amirabadi, Gholamreza

2010-01-01

365

Pars plana vitrectomy and removal of the internal limiting membrane in the treatment of chronic macular oedema  

Microsoft Academic Search

BackgroundTo evaluate the results of pars plana vitrectomy with peeling of the internal limiting membrane (ILM) in eyes with chronic macular oedema.MethodsPPV with indocyanine green (ICG) assisted peeling of the ILM was performed in 33 eyes with diabetic (21 eyes) or non-diabetic (12 eyes) macular oedema. Postoperatively, resolution of macular oedema, improvement of visual acuity (VA) and complications were documented.

Remzi Avci; Berkant Kaderli; Berrin Avci; Saban Simsek; Mehmet Baykara; Zeynep Kahveci; Oner Gelisken; Ahmet Ali Yucel

2004-01-01

366

Vitreous levels of interleukine-8 and monocyte chemoattractant protein-1 in macular oedema with branch retinal vein occlusion  

Microsoft Academic Search

PurposeTo investigate whether interleukine-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) are related with macular oedema in patients with branch retinal vein occlusions (BRVOs).DesignRetrospective case–control study.ParticipantsNineteen patients who had macular oedema due to BRVO and nine patients with non-ischaemic ocular diseases (control group).MethodsMacular oedema was examined by optical coherence tomography. Both venous blood and vitreous samples were obtained at the time

A Fonollosa; J Garcia-Arumi; E Santos; C Macia; P Fernandez; R M Segura; M A Zapata; R Rodriguez-Infante; A Boixadera; V Martinez-Castillo

2010-01-01

367

Changes in foveal thickness after vitrectomy for macular edema with branch retinal vein occlusion and intravitreal vascular endothelial growth factor  

Microsoft Academic Search

Purpose To examine the outcome of vitrectomy for macular edema associated with branch retinal vein occlusion (BRVO) and determine\\u000a the relationship between the severity of macular edema and the concentration of vascular endothelial growth factor (VEGF)\\u000a and interleukin-6 (IL-6) in the vitreous fluid. Design Prospective observational case series. Patients and Methods Thirty-four consecutive patients (34 eyes) with macular edema associated

Makiko Yamasaki; Hidetaka Noma; Hideharu Funatsu; Atsushi Minamoto; Tatsuya Mimura; Katsunori Shimada; Hidetoshi Yamashita; Yoshiaki Kiuchi

2009-01-01

368

Comparison of focal macular cone ERGs in complete-type congenital stationary night blindness and APB-treated monkeys  

Microsoft Academic Search

Focal macular cone electroretinograms (ERGs) and multifocal ERGs were recorded to study the macular function in patients with the complete-type of congenital stationary night blindness (cCSNB). The waveforms of the focal macular cone ERGs and the on- and off-responses of the multifocal ERGs in the cCSNB patients were similar to those recorded from monkey retinas treated with L-2 amino-4-phosphonobutyric acid

Mineo Kondo; Shinji Ueno; Chang-Hua Piao; Yozo Miyake; Hiroko Terasaki

2008-01-01

369

Perioperative Morbidity and Mortality Following Bilateral Total Hip Arthroplasty.  

PubMed

There is concern about safety of bilateral total hip arthroplasty (THA).This study aims to compare in-hospital complication rates between unilateral, simultaneous and staged bilateral THAs. The Nationwide Inpatient Sample from 2002-2010 was used. Patients and complications were identified using ICD-9-CM codes. In multivariate analysis, bilateral THA had higher risk of systemic complications (Odds ratio (OR): 2.1, P<0.001) compared to unilateral procedure, whereas no significant difference existed between simultaneous and staged bilateral THAs. The rate of local complications was higher in bilateral versus unilateral (4.96% versus 4.54%, P=0.009) and in staged versus simultaneous bilateral THAs (OR: 1.75, P=0.05). Bilateral THA increases risk of systemic complications compared to unilateral surgery and simultaneous bilateral THA appears to be safer than staging during one hospitalization. PMID:23664280

Rasouli, Mohammad R; Maltenfort, Mitchell G; Ross, David; Hozack, William J; Memtsoudis, Stavros G; Parvizi, Javad

2013-05-01

370

Bilateral botryoid nephroblastoma: a rare cause of renal failure.  

PubMed

The authors describe the case of a 16-month-old girl who presented with bilateral hydronephrosis and renal failure secondary to bilateral renal pelvic botryoid Wilms' tumour (nephroblastoma). The term 'botryoid' describes an intrapelvic polypoid renal Wilms tumour, either extending from the renal parenchyma or primarily pelvis-based tumour. Both tumours filled the renal pelvis and extended down the proximal ureter, with no intraparenchymal tumour seen. Bilateral intralobar nephrogenic rests were present. Histological examination demonstrated triphasic nephroblastoma, with focal rhabdomyomatous differentiation of the stromal element bilaterally. Postchemotherapy, the patient underwent bilateral nephrectomy. Post complete resection of her bilateral disease, this patient has had an excellent outcome. This is only the third reported case of bilateral botryoid Wilms' tumour. While the condition is extremely rare, it should be included in the differential diagnosis of a young child with bilateral renal pelvic masses. PMID:22962373

Conlon, Niamh; Teoh, Chia Wei; Pears, Jane; O'Sullivan, Maureen

2012-09-07

371

One-stage clipping of bilateral middle cerebral artery aneurysms via the bilateral pterional keyhole approach.  

PubMed

Five patients aged 55 to 73 years (mean 63 years) underwent one-stage clipping for unruptured aneurysms in the bilateral middle cerebral arteries (mean size 4.5 mm, range 2 to 7 mm) via the bilateral pterional keyhole approach in our institute. Important points are as follows: the head is affixed with no rotation; one side manipulation is started 5 minutes after the other side to avoid conflict of surgical instruments; a 5-cm curvilinear skin incision is made inside the hairline and pterional keyhole craniotomy is made bilaterally using 2 burr holes; the whole operating table is rotated 15 degrees to one side to facilitate the microsurgical trans-sylvian approach and aneurysm clipping; the operating table is rotated to the other side for the contralateral procedure; and particular care is taken to avoid bilateral brain injury. This approach provided minimum but sufficient working space required for trans-sylvian dissection. Aneurysm neck clipping was safely performed in a mean operation time of 5 hours 17 minutes. No complications occurred and satisfactory cosmetic results were obtained in all patients. Postoperative neuroimaging studies exhibited bilateral complete clipping with minimal intracranial air content and minimum consequences of brain retraction. One-stage clipping via the pterional keyhole approach is a safe and effective therapeutic option for small bilateral aneurysms. PMID:23524497

Maruyama, Keisuke; Kurita, Hiroki; Yamaguchi, Ryuichi; Noguchi, Akio; Shiokawa, Yoshiaki

2013-01-01

372

Sequential Bilateral Cochlear Implantation in a Patient with Bilateral Meniere's Disease  

PubMed Central

This case study describes a 45 year old female with bilateral, profound sensorineural hearing loss due to Meniere’s disease. She received her first cochlear implant in the right ear in 2008 and the second cochlear implant in the left ear in 2010. The case study examines the enhancement to speech recognition, particularly in noise, provided by bilateral cochlear implants. Speech recognition tests were administered prior to obtaining the second implant and at a number of test intervals following activation of the second device. Speech recognition in quiet and noise as well as localization abilities were assessed in several conditions to determine bilateral benefit and performance differences between ears. The results of the speech recognition testing indicated a substantial improvement in the patient’s ability to understand speech in noise and her ability to localize sound when using bilateral cochlear implants compared to using a unilateral implant or an implant and a hearing aid. In addition, the patient reported considerable improvement in her ability to communicate in daily life when using bilateral implants versus a unilateral implant. This case suggests that cochlear implantation is a viable option for patients who have lost their hearing to Meniere’s disease even when a number of medical treatments and surgical interventions have been performed to control vertigo. In the case presented, bilateral cochlear implantation was necessary for this patient to communicate successfully at home and at work.

Holden, Laura K.; Neely, J. Gail; Gotter, Brenda D.; Mispagel, Karen M.; Firszt, Jill B.

2012-01-01

373

Bilateral Synchronous Breast Cancer and HER2\\/ neu Overexpression  

Microsoft Academic Search

Bilateral synchronous breast cancer appears to have a worse prognosis than comparable unilateral breast cancer. HER-2\\/neu expression in bilateral breast cancer has not been reported. The purpose of this study was to review the characteristics\\u000a of patients with bilateral synchronous breast cancer and to report the incidence of HER-2\\/neu overexpression. Between 1984 and 1998, 58 patients were diagnosed with bilateral

Malek Safa; Elyse E. Lower; P. O. Hasselgren; Eric S. Hungness; Paula Gazder; Bernard Aron; Elizabeth A. Shaughnessy; Rawia Yassin

2002-01-01

374

Bilateral staged thoracotomy for multiple lung hydatidosis  

PubMed Central

Background Hydatid cyst disease is still a problem in many countries. Surgical removal is currently the generally accepted choice of treatment for lung hydatidosis. However, operating on bilateral widespread lung hydatidosis is still controversial. The aim of this retrospective study was to evaluate the results of surgical treatment in bilateral multiple hydatid disease of the lung. Methods In this study, we reviewed our experience in the surgical treatment of 17 (3.7%) patients with bilateral, and at least three, lung hydatid cysts. These 17 patients (8 male, 9 female), with an average age of 34.6 years (range 12–58 years), underwent bilateral staged thoracotomy. Results In total 105 lung cysts were removed from 17 patients who underwent staged thoracotomies. The mean count of cysts was 6.7 (range 3–20 cysts). Most of the cysts (38.2%) were located in the right lower lobe. The mean interval between thoracotomies was 4.2 (range 3–5) days. Two patients (11.7%) had cysts associated with hepatic hydatidosis and one (5.8%) had cysts associated with the spleen; they were treated via phrenotomy during thoracotomies. All cysts were removed without lung resection. We observed some complications such as prolonged air leaks (n?=?2), atelectasis (n?=?3) and empyema (n?=?2). No further surgery was required for management of complications. The mean hospital stay was 9.3 days. (range 7–23 days). Oral albendazole was started on the 2nd post operative day after the first thoracotomy in the dose of 10–20 mg/kg and was continued for 3 months with a gap of 1 week after each 21 days. No recurrences or deaths occured during the follow-up period. Conclusions Although staged thoracotomy applied in 3–5 days after the initial thoracotomy increases the total hospital stay, it decreases the chance of possible complications can occur in cysts in the other lung when long intervals are preferred between the first and the second thoracotomy. In our experience, bilateral staged thoracotomy is an appropriate surgical option because morbidity rates are minimal and the hospital stay is acceptable for the treatment of bilateral widespread lung hydatidosis, even in patients who had a total of 20 hydatid cysts.

2013-01-01

375

Bilateral internal carotid artery occlusion: natural history and surgical alternatives  

Microsoft Academic Search

Purpose and background: Bilateral internal carotid artery occlusion is an extremely rare entity, therefore, studies of the natural history of this disease are lacking in the English literature. The purpose of this study is to analyze the natural history and surgical alternatives for patients with bilateral internal carotid artery occlusion. Patient population and methods: Twenty-one patients with bilateral internal carotid

A. F AbuRahma; S. E Copeland

1998-01-01

376

Real exchange rates and China's bilateral exports towards industrialized countries  

Microsoft Academic Search

A bilateral export demand function is used to estimate the effects on the Chinese bilateral exports of three real exchange rates: (1) bilateral real exchange rate capturing the price-competitiveness of the Chinese products in the market of the considered import country (traditional effect); (2) real effective exchange rate capturing the price-competitiveness of the goods of Chinese competitors in the same

Ping Hua

2008-01-01

377

Vestibular Evoked Myogenic Potentials in Patients with Idiopathic Bilateral Vestibulopathy  

Microsoft Academic Search

Idiopathic bilateral vestibulopathy (IBV) is an acquired bilateral peripheral vestibular disorder of unknown cause. Three patients diagnosed as IBV by neuro-otological examination were reported. They underwent vestibular evoked myogenic potential (VEMP) testing which reflects the functionality of the sacculo-collic pathway. As a result, 2 of the 3 patients showed bilateral absence of VEMPs and one showed unilateral absence. The VEMPs

Masaki Matsuzaki; Toshihisa Murofushi

2001-01-01

378

Bilateral vertebral artery dissecting aneurysm with subarachnoid hemorrhage treated with staged bilateral vertebral artery coil occlusion: a case report  

Microsoft Academic Search

BackgroundVertebral artery dissecting aneurysm is now increasingly recognized as a cause of posterior circulation stroke in young adults. Here, we report a case of bilateral VADA with SAH, treated by bilateral coil occlusion using GDCs.

Akihiro Inoue; Kanehisa Kohno; Akihiko Takechi; Keiji Kohno; Toshinori Matsushige; Tetsuji Takeda

2008-01-01

379

Foveal Sensitivity and Morphology in Major and Macular Branch Retinal Vein Occlusion  

PubMed Central

Purpose: To determine whether foveal thickness, foveal volume, visual acuity, and foveal sensitivity after intravitreal injection of triamcinolone acetonide (IVTA) are influenced by the extent of occlusion (major versus macular branch retinal vein occlusion (BRVO)). Materials and Methodology: In this interventional case series, 22 eyes of 22 BRVO patients with macular oedema were treated by IVTA. Patients were divided into 2 groups according to the site of occlusion, with the Major group having occlusion of a major retinal vein and the Macular group having occlusion of a macular venule. Foveal sensitivity was measured by microperimetry before IVTA and 3 and 6 months after IVTA. Visual acuity was converted to logarithm of the minimal angle of resolution (logMAR) values. Foveal thickness and macular volume were measured by optical coherence tomography before IVTA and 3 and 6 months after IVTA. Results: Foveal thickness and foveal volume showed significant improvement from before to 3 and 6 months after IVTA in both groups (all P<0.001). Visual acuity also showed significant improvement from before to 3 and 6 months after IVTA in both groups (P=0.001 and P=0.022, respectively). Moreover, foveal sensitivity was significantly improved from before to 3 and 6 months after IVTA in the Major group (P<0.001). Foveal sensitivity also increased from before to 3 and 6 months after IVTA in the Macular group, but not significantly. There were no significant differences in the trend profiles of foveal thickness, foveal volume, visual acuity, and foveal sensitivity between the Major and Macular groups. Conclusions: These results suggest that IVTA may be effective for improving foveal morphology, visual acuity, and foveal sensitivity in BRVO patients regardless of the site of occlusion.

Noma, Hidetaka; Shimada, Katsunori; Mimura, Tatsuya

2012-01-01

380

Bilateral Cataract in a Cynomolgus Monkey  

PubMed Central

Severe bilateral cataract was found in a 7 year-old naďve female cynomolgus monkey (Macaca fascicularis) 3 months before necropsy. During macroscopic examination, severe opacity and thinning of the lens were observed in both eyes. Histopathology revealed that the lens nuclei and majority of cortex lens fibers had disappeared and become excavated, while the lens fibers in the subcapsular area were swollen and distorted. Other observations included atrophy and vacuolation in the lens epithelial cells and proliferation of spindle cells and collagen fiber beneath the anterior capsule of the right eye. Immunohistochemical staining of these spindle cells revealed the presence of vimentin, cytokeratin and ?-smooth muscle actin (?-SMA), which were considered to be derived from lens epithelial cells. This is a rare case of spontaneous, bilateral, hypermature cataract in a cynomolgus monkey.

Sasaki, Yuji; Kodama, Rinya; Iwashige, Shuichiro; Fujishima, Junko; Yoshikawa, Tsuyoshi; Kamimura, Yasuhiro; Maeda, Hiroshi

2011-01-01

381

Bilateral pulmonary sequestration in the elderly adult  

PubMed Central

Pulmonary sequestration (PS) is a rare malformation consisting of aberrant lung tissue which is not affiliated with the normal bronchial system and is fed by an aberrant artery that derives from systemic arteries. However, PS is usually seen unilaterally but, only rarely, it is bilateral. Most patients with PS are diagnosed because of symptoms due to pulmonary infection or cardiac disease, while a small portion of patients are asymptomatic and diagnosed incidentally. In this report, we present an extremely rare case of asymptomatic bilateral PS which was diagnosed at advanced age. To our knowledge, this case represents the oldest patient in the literature, and the second case that was diagnosed in a patient over the age of 50.

2012-01-01

382

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.

Sartorius, Gideon; Kalf, Katrin; Heinzelmann, Viola

2013-01-01

383

Bilateral breast masses with a rare etiology.  

PubMed

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

Thieringer, Friederike; Sartorius, Gideon; Kalf, Katrin; Heinzelmann, Viola; Vetter, Marcus

2013-08-28

384

Bilateral Asymmetrical Traumatic Sternoclavicular Joint Dislocations  

PubMed Central

Unilateral and bilateral sternoclavicular joint (SCJ) dislocations are rare injuries. The difficulty in assessing this condition often leads to delay in diagnosis and treatment. We report a rare case of bilateral asymmetrical traumatic SCJ dislocations in a 45-year-old male. The right anterior SCJ dislocation was reduced in the emergency room (ER) and resulted in residual instability. The left posterior SCJ dislocation was asymptomatic and unnoticed for six months. It is important for ER physicians and orthopaedic surgeons to be able identify and treat this condition. All suspected SCJ dislocations should be evaluated by computed tomography (CT) scan for confirmation of the diagnosis and evaluation of both SCJs. Posterior SCJ dislocation is a potentially fatal injury and should not be overlooked due to the presence of other injuries. Surgical intervention is often necessary in acute and old cases.

Albarrag, Mohammed K.

2012-01-01

385

Bilateral idiopathic optic neuritis in pregnancy.  

PubMed

A 33-year-old primiparous woman at 31 weeks gestation with no prior history of ocular disease, autoimmune disease, or recent viral infection presented with rapidly decreasing visual acuity to 20/400 OD and counting fingers OS over 11 days. MRI demonstrated mild bilateral optic nerve enhancement. Humphrey 30-2 visual field testing showed bilateral seco-central scotomas. MR venogram, visual evoked potentials, preeclampsia workup, and serum blood tests for folate, B6, B12, Toxoplasmosis, Bartonella, Lyme disease, ACE levels, RPR, and LFTs were all within normal limits. After one-time treatment of IV 125?mg methylprednisolone and spinal tap, visual acuity improved to 20/20 OD and 20/20 OS. PMID:23305442

Liu, Tiffany S; Crow, Robert W

2013-01-01

386

Bilateral breast cancer after cured Hodgkin's disease  

SciTech Connect

Three patients developed bilateral breast cancer at 10 to 24 years after mantle irradiation for locally or systemically advanced Hodgkin's disease (HD). Four of the six cancers in the three patients were detected only by mammography. Pathologically, five of the cancers were intraductal carcinomas (four with an invasive component) with one being a lobular carcinoma. Five of the six lesions were Stage I pathologically without evidence of axillary nodal involvement. It is recommended that female patients with Hodgkin's disease who have received mantle irradiation as part of the therapy for their Hodgkin's disease and who are observed for 10 or more years after completion of mantle irradiation be considered at risk for the development of breast cancer. Such patients should be monitored appropriately by routine bilateral mammograms to increase the early detection of early stage lesions.

Anderson, N.; Lokich, J. (New England Baptist Hospital, Boston, MA (USA))

1990-01-15

387

Single-incision bilateral laparoscopic oophorectomy  

PubMed Central

Although single-incision laparoscopic surgery made an appearance on the surgical scene only recently, it is being increasingly applied in the treatment of a variety of disorders. We report single-incision bilateral laparoscopic oophorectomy and salpingooophorectomy performed in two patients who had previously undergone breast conservation surgery for early breast cancer. Each procedure was undertaken using two 5-mm and one 3-mm ports inserted through a 2-cm transverse supraumbilical incision and standard laparoscopic instruments. The operative time was 50 and 65 min respectively and the blood loss negligible. The patients were discharged 36 and 24 h after surgery, required minimal postoperative analgesia and remain well at a follow up of 19 and 17 months, respectively. With the benefit of improved cosmesis, the single-incision approach holds the potential to replace the traditional bilateral laparoscopic oophorectomy.

Bhandarkar, Deepraj; Katara, Avinash; Deshmane, Vinay; Mittal, Gaurav; Udwadia, Tehemton E

2011-01-01

388

Long-Term Follow-Up of Oral Administration of Flavonoids, Centella asiatica and Melilotus, for Diabetic Cystoid Macular Edema Without Macular Thickening.  

PubMed

Abstract Purpose: To evaluate long-term follow-up of the orally administered combination of flavonoids with Centella asiatica and Melilotus for treatment of diabetic cystoid macular edema (CME) without macular thickening. Methods: Seventy consecutive patients with type 2 diabetes and CME without macular thickening at optical coherence tomography (OCT) were prospectively and randomly enrolled in two groups of 35 subjects each (treatment and control groups). Patients in the treatment group were treated with an oral combination of diosmin (300?mg/day), with C. asiatica (15?mg/day) and Melilotus (160?mg/day). All patients underwent a complete ophthalmologic examination, OCT (Spectralis HRA-OCT), and central microperimetry (SD-SLO/OCT) at baseline, month 3, month 6, month 12, month 24, and month 36. Results: No differences in HbAc1 percentage, blood pressure, microalbuminuria, visual acuity, mean central retinal thickness, and stability of fixation were present between the two groups during follow up (p>0.05). Retinal sensitivity reduced in the control group only from month 6 until month 36 (p<0.001). In the treatment group, a greater retinal sensitivity was present at month 12, month 24, and month 36 (p=0.001). No side effects of treatment were observed. Conclusion: Oral administration of flavonoids, C. asiatica and Melilotus, in patients with CME without macular thickening provided preservation of retinal sensitivity during 36 months of follow up when compared with untreated patients. PMID:23844756

Forte, Raimondo; Cennamo, Gilda; Bonavolontŕ, Paola; Pascotto, Arduino; de Crecchio, Giuseppe; Cennamo, Giovanni

2013-07-11

389

Hard metal pneumoconiosis with spontaneous bilateral pneumothorax.  

PubMed

Hard metal pneumoconiosis, first described in 1964, is a diffuse disease caused by the inhalation of cobalt particles. The disease can manifest as occupational asthma, interstitial disease or allergic alveolitis. We report the case of a young male, working as a tool sharpener, who presented with dry cough and progressive dyspnea for one year, as well as with spontaneous bilateral pneumothorax at admission. The diagnosis was confirmed by open lung biopsy. PMID:20209319

Moreira, Maria Auxiliadora Carmo; Cardoso, Amanda da Rocha Oliveira; Silva, Daniela Graner Schuwartz Tannus; Queiroz, Maria Conceiçăo de Castro Antonelli Monteiro de; Oliveira, Albino Alegro; Noleto, Tiago Marinho Almeida

390

Progressive bilateral thinning of the parietal bones  

Microsoft Academic Search

Observation of a case of progressive bilateral parietal thinning within a period of 14 years induced us to study skull films of 3,636 consecutive patients. Parietal thinning was found in 86 patients (2.37%). It was more common in women, with a sex ratio of 1:1.9. The mean age of the females was 72 years, and that of the males 63

C.-G. Cederlund; L. Andrén; H. Olivecrona

1982-01-01

391

Laparoscopic repair of congenital bilateral Morgagni hernia  

Microsoft Academic Search

Morgagni hernia is a rare type of congenital diaphragmatic hernia found in the anterior aspect of the diaphragm. It typically\\u000a presents in the pediatric population and rarely is diagnosed in adults. Only 3% of diaphragmatic hernias are the Morgagni\\u000a type, and only 4% of these are found to present bilaterally. Surgical repair of Morgagni hernia has been performed through\\u000a various

Saurabh Khandelwal; Brant K. Oelschlager

2011-01-01

392

Bilateral Nongranulomatous Uveitis with Infective Endocarditis  

PubMed Central

A 32-year-old male who had infective endocarditis complained of photophobia and blurred vision in both eyes. Biomicroscopic examination and fundus examination revealed anterior chamber reaction, vitritis, optic disc swelling, and Roth spots. He was diagnosed with bilateral nongranulomatous uveitis and treated with topical steroid eye drops and posterior sub-Tenon injection of triamcinolone. His visual symptoms were resolved within 1 week, and inflammation resolved within 4 weeks after treatment.

Ha, Sang Won; Shin, Jae Pil; Kim, Si Yeol

2013-01-01

393

Bilateral mandibular regional odontodysplasia with vascular nevus.  

PubMed

Odontodysplasia is a rare clinicopathologic condition that has a variety of expressions, including a range of tooth coloration, formation of hypoplastic enamel affecting one or multiple teeth, bizarre radiographic appearance, and delayed eruption of teeth. An unusual case is presented of bilateral regional odontodysplasia associated with a vascular nevus of the face and neck. A review of the etiology with emphasis on the "local circulatory disease" theory is presented. PMID:1667684

Steiman, H R; Cullen, C L; Geist, J R

394

Bilateral limbic system destruction in man.  

PubMed

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

395

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

396

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.

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

2010-01-01

397

Bilateral cochlear implants in children: binaural unmasking.  

PubMed

Bilateral cochlear implants (CIs) may offer deaf children a range of advantages compared to unilateral CIs. However, speech perception in noise is mainly facilitated by better-ear effects and much less by interaural comparisons or true 'binaural' hearing. Little is known about the development of the binaural auditory system with CIs provided at a young age. It is possible that, as with adults, binaural sensitivity exists but is not accessed due to technical limitations in electrical stimulation methods. In this paper, we present results on binaural hearing in children with bilateral CIs. Binaural masking level differences (BMLDs) were measured for a 180-degree phase shift in a 125-Hz sinusoid, presented in a 50-Hz-wide noise band and modulating a 1000-pps carrier pulse train. Stimuli were presented to a single electrode in the middle of the electrode array at both ears. Eight children between 6 and 15 years of age participated in this study. Six children had a significantly better detection threshold when the signal was out of phase (dichotic) between two ears than when it was in phase (diotic), with a mean difference (BMLD) of 6.4 dB. The present results show that children with bilateral CIs are sensitive to binaural cues in electrical stimuli, similar to adults, even when implants are provided at a later age and with a longer delay between implantations. PMID:19141992

Van Deun, Lieselot; van Wieringen, Astrid; Francart, Tom; Scherf, Fanny; Dhooge, Ingeborg J; Deggouj, Naďma; Desloovere, Christian; Van de Heyning, Paul H; Offeciers, F Erwin; De Raeve, Leo; Wouters, Jan

2009-01-13

398

Cystoid Macular Edema Associated with Oral Antineoplastic Agent S-1 in a Patient with Diabetic Retinopathy  

PubMed Central

A 60-year-old man with neovascular glaucoma due to diabetic retinopathy received an intravitreal injection of 1.25 mg bevacizumab (IVB) followed by extensive panretinal photocoagulation in the right eye. The anterior segment neovascularization regressed within 10 days after IVB. One and a half months later, the patient underwent gastrectomy for stage IIIb gastric cancer. Two months later, he was started on S-1 orally (100 mg/day for 48, 26, and 32 consecutive days in the first, second, and third treatment cycle, respectively). The interval between the first and second treatment cycle was 20 days and between the second and third cycle it was 24 days. The patient developed anemia and diarrhea. At the end of the second S-1 cycle, cystoid macular edema developed in the right eye, although diabetic retinopathy and neovascular glaucoma were stable. Macular edema persisted for 5 months despite another IVB, and disappeared 3 months after termination of S-1 therapy. The time course of the magnitude of macular edema correlated well with the severity of anemia. The macular edema was possibly associated with anemia, which is a major side effect of S-1. Further studies are warranted to investigate the relationship between anemia and macular edema in patients with diabetic retinopathy.

Higashide, Tomomi; Murotani, Eiji; Sugiyama, Kazuhisa

2012-01-01

399

Peripheral Vasodilators in the Treatment of Macular Degenerative Changes in the Eye  

PubMed Central

Four peripheral vasodilators — tolazoline HCl (Priscoline), nicotinic acid, nicotinyl alcohol (Roniacol), and nylidrin HCl (Arlidin)—were studied in 203 patients over a 13-year period as treatment for macular degenerative changes in the eye. Visual acuity was improved or maintained in 87%. Excellent results were obtained in the treatment of macular edema following cataract surgery and in older patients with diabetic retinopathy. In 126 out of 145 patients with senile macular degeneration, improvement or stabilization was obtained. For all the types of macular degeneration, nylidrin HCl was the most effective of the drugs studied and had the fewest side effects. A recent report based upon animal experiments advises against the use of peripheral vasodilators in degenerative arterial diseases of the eye; however, the assumption made therein that blood volume is a measure of blood flow cannot be accepted. Peripheral vasodilator therapy, which long-term clinical study has shown to be valuable in the treatment of macular degeneration, should not therefore be denied to these patients.

Laws, H. Wyatt

1964-01-01

400

Correlation of Macular Thickness With Visual Fields in Glaucoma Patients and Suspects.  

PubMed

PURPOSE:: To provide a quantitative comparison of the retinal thickness in the macula, with Humphrey visual field (HVF) parameters and circumpapillary retinal nerve fiber layer (RNFL) defects, in glaucoma patients and suspects. PATIENTS AND METHODS:: Retrospective statistical analysis of spectral domain optical coherence tomography (SD-OCT) compared with HVF mean deviation (MD) and pattern standard deviation (PSD) in 73 subjects who met the study criteria. Bivariate statistical analysis was performed. RESULTS:: Macular thickness correlates with HVF deficits, with much worse MD (-6.8) and PSD (5.8) scores in subjects with average macular thickness <270 ?m, compared with those >300 ?m, (MD +0.4, PSD 1.7). Both the MD (P=0.0001) and PSD (P<0.0001) correlated with average macular thickness. In subjects with a difference of 3 or greater in the MD between the 2 eyes, there was a difference of 11 to 13 ?m in average macular thickness. Asymmetry within the same eye, between the superior macula and inferior macula, correlated with a larger PSD in that eye. There was a strong correlation between RNFL defects and retinal thinning in the macula. CONCLUSIONS:: SD-OCT measurements of retinal thickness in the macula correlate with HVF parameters and RNFL parameters in glaucoma patients and suspects. This correlation between visual field defects and macular thickness can help in confirming the existence and extent of the visual field defect. PMID:23661046

Mathers, Keith; Rosdahl, Jullia A; Asrani, Sanjay

2013-05-01

401

Comparison of macular and retinal nerve fiber layer thickness in untreated and treated binocular amblyopia.  

PubMed

Abstract Purposes: To identify morphological retinal relationships to visual acuity (VA), refraction and axial length in binocular hyperopic amblyopia. Materials and methods: Children (n?=?118), ages 5-12 years, were divided into three groups: those with current amblyopia (n?=?53), those with fully corrected previous amblyopia (n?=?26) and those with emmetropia and normal VA (n?=?39). Macular thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were measured by optical coherence tomography (OCT) and compared among the three groups. Results: The outer macular ring and RNFL of the current amblyopia group were significantly (independent t-test) thicker than those of the emmetropia group. However, significance of this difference disappeared after adjustment for axial length and refractive error. There was no significant difference in foveal or inner macular ring thickness among the three groups, either before or after adjustment for age, gender, axial length, and refractive error. When controlled for age, gender and VA, outer macular ring and RNFL thicknesses correlated with axial length (r?=?-0.350 and -0.334, respectively; p?Macular and RNFL thicknesses appear to be more extensively associated with differences in axial length and refraction than with amblyopic development, based on the fact that these thicknesses remained unchanged after amblyopic treatment. PMID:24073963

Chen, Wuhe; Chen, Jie; Huang, Jinhai; Xu, Jinling; Zhang, Fang; Lu, Fan

2013-09-27

402

Pars Plana Vitrectomy and Internal Limiting Membrane Peeling for Macular Oedema Secondary to Retinal Vein Occlusion: a Pilot Study  

Microsoft Academic Search

Introduction: Macular oedema is the main cause of visual impairment following retinal vein occlusion. The purpose of this study was to evaluate the anatomical and functional outcome of pars plana vitrectomy and internal limited membrane (ILM) peeling for macular oedema secondary to retinal vein occlusion. Clinical Picture: This pilot study is a prospective non- randomised series of 11 eyes of

Xiao-Ling Liang; Hao-Yu Chen; Yong-Sheng Huang; Kah-Guan Au Eong; Shan-Shan Yu; Xing Liu

403

Posterior Subtenon Triamcinolone, Intravitreal Triamcinolone and Grid Laser Photocoagulation for the Treatment of Macular Edema in Branch Retinal Vein Occlusion  

Microsoft Academic Search

Purpose: To evaluate the efficacy of posterior subtenon triamcinolone (PSTT), intravitreal triamcinolone (IVT) injections and grid laser photocoagulation (GLP) in eyes with macular edema secondary to branch retinal vein occlusion (BRVO). Material and Methods: Patients with macular edema due to BRVO treated with PSTT, IVT injections or GLP were evaluated retrospectively. Complete ophthalmic examination with fluorescein angiography and optic coherence

Sengul Ozdek; Yudum Tiftikcioglu Deren; Gokhan Gurelik; Berati Hasanreisoglu

2008-01-01

404

Visual acuity and foveal thickness after vitrectomy for macular edema associated with branch retinal vein occlusion: a case series  

Microsoft Academic Search

BACKGROUND: The mechanism by which vitrectomy improves macular edema in patients with branch retinal vein occlusion remains unclear, although intraocular levels of vascular endothelial growth factor have been suggested to influence the visual prognosis and macular edema. METHODS: A series of 54 consecutive patients (54 eyes) with branch retinal vein occlusion was studied prospectively. All patients underwent pars plana vitrectomy

Hidetaka Noma; Hideharu Funatsu; Tatsuya Mimura; Shuichiro Eguchi; Katsunori Shimada

2010-01-01

405

Evaluation of a new quantitative technique to assess the number and extent of preferred retinal loci in macular disease  

Microsoft Academic Search

Patients with scotomas due to macular disease may use more than one preferred retinal locus (PRL) for fixation. We have developed and evaluated an objective, quantitative technique to determine the number of PRLs used during an episode of fixation and the extent of each locus. In five of eight adults with macular disease our techniques consistently indicated the presence of

M. D. Crossland; M. Sims; R. F. Galbraith; G. S. Rubin

2004-01-01

406

Evaluation of Time Domain and Spectral Domain Optical Coherence Tomography in the Measurement of Diabetic Macular Edema  

Microsoft Academic Search

PURPOSE. To evaluate macular thickness and volume measure- ments and their intrasession repeatability in two optical coher- ence tomography (OCT) systems: the Stratus OCT, a time domain system, and the Cirrus HD-OCT, a spectral domain system (both by Carl Zeiss Meditec, Inc., Dublin, CA), in the context of diabetic macular edema (DME). METHODS. Thirty-three eyes of 33 diabetic patients with

Farzin Forooghian; Catherine Cukras; Catherine B. Meyerle; Emily Y. Chew; Wai T. Wong

2008-01-01

407

Macular hole formation, progression, and surgical repair: case series of serial optical coherence tomography and time lapse morphing video study  

Microsoft Academic Search

BACKGROUND: To use a new medium to dynamically visualize serial optical coherence tomography (OCT) scans in order to illustrate and elucidate the pathogenesis of idiopathic macular hole formation, progression, and surgical closure. CASE PRESENTATIONS: Two patients at the onset of symptoms with early stage macular holes and one patient following repair were followed with serial OCTs. Images centered at the

Ronald C Gentile; Gennady Landa; Mauricio E Pons; Dean Eliott; Richard B Rosen

2010-01-01

408

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.

Yoshimura, Nagahisa

2013-01-01

409

Radiation therapy for neovascular age-related macular degeneration  

PubMed Central

Antivascular endothelial growth factor (anti-VEGF) therapies represent the standard of care for most patients presenting with neovascular (wet) age-related macular degeneration (neovascular AMD). Anti-VEGF drugs require repeated injections and impose a considerable burden of care, and not all patients respond. Radiation targets the proliferating cells that cause neovascular AMD, including fibroblastic, inflammatory, and endothelial cells. Two new neovascular AMD radiation treatments are being investigated: epimacular brachytherapy and stereotactic radiosurgery. Epimacular brachytherapy uses beta radiation, delivered to the lesion via a pars plana vitrectomy. Stereotactic radiosurgery uses low voltage X-rays in overlapping beams, directed onto the lesion. Feasibility data for epimacular brachytherapy show a greatly reduced need for anti-VEGF therapy, with a mean vision gain of 8.9 ETDRS letters at 12 months. Pivotal trials are underway (MERLOT, CABERNET). Preliminary stereotactic radiosurgery data suggest a mean vision gain of 8 to 10 ETDRS letters at 12 months. A large randomized sham controlled stereotactic radiosurgery feasibility study is underway (CLH002), with pivotal trials to follow. While it is too early to conclude on the safety and efficacy of epimacular brachytherapy and stereotactic radiosurgery, preliminary results are positive, and these suggest that radiation offers a more durable therapeutic effect than intraocular injections.

Petrarca, Robert; Jackson, Timothy L

2011-01-01

410

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.

2013-01-01

411

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 (mu) 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

412

Seven new loci associated with age-related macular degeneration.  

PubMed

Age-related macular degeneration (AMD) is a common cause of blindness in older individuals. To accelerate the understanding of AMD biology and help design new therapies, we executed a collaborative genome-wide association study, including >17,100 advanced AMD cases and >60,000 controls of European and Asian ancestry. We identified 19 loci associated at P < 5 × 10(-8). These loci show enrichment for genes involved in the regulation of complement activity, lipid metabolism, extracellular matrix remodeling and angiogenesis. Our results include seven loci with associations reaching P < 5 × 10(-8) for the first time, near the genes COL8A1-FILIP1L, IER3-DDR1, SLC16A8, TGFBR1, RAD51B, ADAMTS9 and B3GALTL. A genetic risk score combining SNP genotypes from all loci showed similar 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

Fritsche, Lars G; Chen, Wei; Schu, Matthew; Yaspan, Brian L; Yu, Yi; Thorleifsson, Gudmar; Zack, Donald J; Arakawa, Satoshi; Cipriani, Valentina; Ripke, Stephan; Igo, Robert P; Buitendijk, Gabriëlle H S; Sim, Xueling; Weeks, Daniel E; Guymer, Robyn H; Merriam, Joanna E; Francis, Peter J; Hannum, Gregory; Agarwal, Anita; Armbrecht, Ana Maria; Audo, Isabelle; Aung, Tin; Barile, Gaetano R; Benchaboune, Mustapha; Bird, Alan C; Bishop, Paul N; Branham, Kari E; Brooks, Matthew; Brucker, Alexander J; Cade, William H; Cain, Melinda S; Campochiaro, Peter A; Chan, Chi-Chao; Cheng, Ching-Yu; Chew, Emily Y; Chin, Kimberly A; Chowers, Itay; Clayton, David G; Cojocaru, Radu; Conley, Yvette P; Cornes, Belinda K; Daly, Mark J; Dhillon, Baljean; Edwards, Albert O; Evangelou, Evangelos; Fagerness, Jesen; Ferreyra, Henry A; Friedman, James S; Geirsdottir, Asbjorg; George, Ronnie J; Gieger, Christian; Gupta, Neel; Hagstrom, Stephanie A; Harding, Simon P; Haritoglou, Christos; Heckenlively, John R; Holz, Frank G; Hughes, Guy; Ioannidis, John P A; Ishibashi, Tatsuro; Joseph, Peronne; Jun, Gyungah; Kamatani, Yoichiro; Katsanis, Nicholas; N Keilhauer, Claudia; Khan, Jane C; Kim, Ivana K; Kiyohara, Yutaka; Klein, Barbara E K; Klein, Ronald; Kovach, Jaclyn L; Kozak, Igor; Lee, Clara J; Lee, Kristine E; Lichtner, Peter; Lotery, Andrew J; Meitinger, Thomas; Mitchell, Paul; Mohand-Saďd, Saddek; Moore, Anthony T; Morgan, Denise J; Morrison, Margaux A; Myers, Chelsea E; Naj, Adam C; Nakamura, Yusuke; Okada, Yukinori; Orlin, Anton; Ortube, M Carolina; Othman, Mohammad I; Pappas, Chris; Park, Kyu Hyung; Pauer, Gayle J T; Peachey, Neal S; Poch, Olivier; Priya, Rinki Ratna; Reynolds, Robyn; Richardson, Andrea J; Ripp, Raymond; Rudolph, Guenther; Ryu, Euijung; Sahel, José-Alain; Schaumberg, Debra A; Scholl, Hendrik P N; Schwartz, Stephen G; Scott, William K; Shahid, Humma; Sigurdsson, Haraldur; Silvestri, Giuliana; Sivakumaran, Theru A; Smith, R Theodore; Sobrin, Lucia; Souied, Eric H; Stambolian, Dwight E; Stefansson, Hreinn; Sturgill-Short, Gwen M; Takahashi, Atsushi; Tosakulwong, Nirubol; Truitt, Barbara J; Tsironi, Evangelia E; Uitterlinden, André G; van Duijn, Cornelia M; Vijaya, Lingam; Vingerling, Johannes R; Vithana, Eranga N; Webster, Andrew R; Wichmann, H-Erich; Winkler, Thomas W; Wong, Tien Y; Wright, Alan F; Zelenika, Diana; Zhang, Ming; Zhao, Ling; Zhang, Kang; Klein, Michael L; Hageman, Gregory S; Lathrop, G Mark; Stefansson, Kari; Allikmets, Rando; Baird, Paul N; Gorin, Michael B; Wang, Jie Jin; Klaver, Caroline C W; Seddon, Johanna M; Pericak-Vance, Margaret A; Iyengar, Sudha K; Yates, John R W; Swaroop, Anand; Weber, Bernhard H F; Kubo, Michiaki; Deangelis, Margaret M; Léveillard, Thierry; Thorsteinsdottir, Unnur; Haines, Jonathan L; Farrer, Lindsay A; Heid, Iris M; Abecasis, Gonçalo R

2013-03-03

413

Development of polypoidal lesions in age-related macular degeneration  

PubMed Central

Purpose To investigate the development of polypoidal lesions using indocyanine green angiography (IA) in eyes with typical age-related macular degeneration (AMD). Methods We retrospectively reviewed the medical records of 47 consecutive patients (47 eyes) with typical AMD who had been followed up with IA for at least 2 years. Results At the initial visit, although all eyes showed classic and/or occult choroidal neovascularization (CNV) associated with AMD, no eyes showed polypoidal lesions by IA. However, during follow-up, 13 (27.7%) of the 47 eyes did show polypoidal lesions. All polypoidal lesions developed at the edge of persistent CNV or, more often, at the terminus of recently progressed CNV. Of 12 eyes with a final lesion area >8 disc area, 7 (58.3%) showed newly developed polypoidal lesions. In the eyes with these newly developed polypoidal lesions, the mean area of the vascular lesion had extended significantly from 10.50±7.88?mm2 to 20.87±10.21?mm2 during follow-up (P=0.0018). Conclusion The current observation suggests that IA of active AMD sometimes reveals polypoidal lesions if there is progression of the CNV in the subretinal pigment epithelium space.

Tsujikawa, A; Ojima, Y; Yamashiro, K; Ooto, S; Tamura, H; Nakata, I; Yoshimura, N

2011-01-01

414

Automatic age-related macular degeneration detection and staging  

NASA Astrophysics Data System (ADS)

Age-related macular degeneration (AMD) is a degenerative disorder of the central part of the retina, which mainly affects older people and leads to permanent loss of vision in advanced stages of the disease. AMD grading of non-advanced AMD patients allows risk assessment for the development of advanced AMD and enables timely treatment of patients, to prevent vision loss. AMD grading is currently performed manually on color fundus images, which is time consuming and expensive. In this paper, we propose a supervised classification method to distinguish patients at high risk to develop advanced AMD from low risk patients and provide an exact AMD stage determination. The method is based on the analysis of the number and size of drusen on color fundus images, as drusen are the early characteristics of AMD. An automatic drusen detection algorithm is used to detect all drusen. A weighted histogram of the detected drusen is constructed to summarize the drusen extension and size and fed into a random forest classifier in order to separate low risk from high risk patients and to allow exact AMD stage determination. Experiments showed that the proposed method achieved similar performance as human observers in distinguishing low risk from high risk AMD patients, obtaining areas under the Receiver Operating Characteristic curve of 0.929 and 0.934. A weighted kappa agreement of 0.641 and 0.622 versus two observers were obtained for AMD stage evaluation. Our method allows for quick and reliable AMD staging at low costs.

van Grinsven, Mark J. J. P.; Lechanteur, Yara T. E.; van de Ven, Johannes P. H.; van Ginneken, Bram; Theelen, Thomas; Sánchez, Clara I.

2013-03-01

415

Treatment of age-related macular degeneration: focus on ranibizumab  

PubMed Central

Ranibizumab, a humanized antigen-binding fragment (Fab) that binds all isoforms of VEGF-A, significantly slows down loss of vision and causes significant visual improvement in many patients with choroidal neovascularization (CNV) due to exudative age-related macular degeneration (AMD). These benefits of intravitreal ranibizumab apply to all angiographic subtypes of neovascular AMD and across all lesion sizes when the drug is injected at monthly intervals as shown in two pivotal phase III trials (ANCHOR and MARINA). The results from the PrONTO study suggest that less frequent treatment with ranibizumab through a variable dosing regimen dependent on optical coherence tomography (OCT) findings is a treatment option that results in comparably favorable visual outcomes. Currently, it is unclear whether combination therapy of ranibizumab with photodynamic therapy (PDT) provides any significant advantage over ranibizumab monotherapy (FOCUS trial); however, the combination of PDT and ranibizumab may decrease the need for frequent retreatment. This question will be addressed in the SUMMIT trial. Therapy with ranibizumab is generally very well tolerated with a low rate of seriously adverse ocular events or systemic side-effects. The advent of vascular endothelial growth factor (VEGF) inhibitors has revolutionized the therapy of neovascular AMD. Ranibizumab at the moment appears to be the most effective approved treatment for neovascular AMD.

Spitzer, Martin S; Ziemssen, Focke; Bartz-Schmidt, Karl U; Gelisken, Faik; Szurman, Peter

2008-01-01

416

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

PubMed

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; Woo, Se Joon; Park, Kyu Hyung; Chung, Hum

2013-09-10

417

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.

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

2013-01-01

418

Clinical applications of the sustained-release dexamethasone implant for treatment of macular edema  

PubMed Central

Macular edema is one of the leading causes of vision loss among patients with retinal vein occlusion, diabetic retinopathy, and posterior chamber inflammatory disease. However, the treatment of macular edema is considerably limited by the difficulty in delivering effective doses of therapeutic agents into the vitreous cavity. In recent years, the development of a sustained-release dexamethasone intravitreal implant (Ozurdex®) has enabled more controlled drug release at a stable rate over a long period of time, with a potentially lower rate of adverse events. Clinical studies indicate that this dexamethasone implant is a promising new treatment option for patients with persistent macular edema resulting from retinal vein occlusion, diabetic retinopathy, and uveitis or Irvine-Gass syndrome.

Herrero-Vanrell, Rocio; Cardillo, Jose Augusto; Kuppermann, Baruch D

2011-01-01

419

Accidental Nd:YAG Laser-Induced Macular Hole in a Pediatric Patient.  

PubMed

After being exposed to an industrial Nd:YAG laser, an 11-year-old boy developed a full-thickness macular hole in the right eye with resultant visual acuity of 20/100. Five months after the initial injury, the vision was stable and the hole was still present. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, and gas tamponade with prone positioning. Three months postoperatively, visual acuity improved to 20/25 with closure of the macular hole; however, there was a focal photoreceptor deficit. A review of the English-language literature identified 15 eyes with similar macular hole injuries after Nd:YAG exposure. Three eyes were surgically managed. While all holes were successfully closed, only two experienced visual improvement. [Ophthalmic Surg Lasers Imaging Retina. 2013;44:e7-e10.]. PMID:24094528

Fernandez, Maria Paula; Modi, Yasha S; John, Vishak J; Berrocal, Audina M

2013-10-09

420

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

2010-06-03

421

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

422

Laser Photocoagulation Combined with Intravitreal Triamcinolone Acetonide Injection in Proliferative Diabetic Retinopathy with Macular Edema  

PubMed Central

Purpose To evaluate therapeutic effects and usefulness of a combination treatment of intravitreal injection of triamcinolone acetonide (IVTA) and panretinal photocoagulation (PRP) in patients with clinically significant macular edema secondary to proliferative diabetic retinopathy (PDR). Methods Visual acuity test, fundoscopy, fluorescein angiography, and optical coherence tomography (OCT) were taken in 20 patients (20 eyes) of macular edema and PDR. A combination of intravitreal injection of triamcinolone acetonide and PRP was performed in 10 patients (10 eyes) and a combination of focal or grid laser photocoaqulation and PRP in the remaining 10 eyes. The postoperative outcomes were compared between the two combination treatments by best corrected visual acuity (BCVA), tonometry, fluorescein angiography, and OCT at 2 weeks, 1, 2, and 3 months. Results Average BCVA (log MAR) significantly improved from preoperative 0.56±0.20 to 0.43±0.08 at 1 month (P=0.042) and it was maintained until 3 months after a combination of IVTA and PRP in 10 eyes (P=0.007). The thickness of fovea decreased from average 433.3±114.9 µm to average 279.5±34.1 µm at 2 weeks after combined treatment of IVTA and PRP (P=0.005), which was significantly maintained until 3 months, but there was a transient visual disturbance and no significant difference in thickness of the fovea before and after treatment in the groups with PRP and focal or grid laser photocoagulation. Conclusions A combination of IVTA and PRP might be an effective treatment modality in the treatment of macular edema and PDR and prevent the subsequent PRP-induced macular edema result in visual dysfunction. In combination with PRP, IVTA might be more effective than focal or grid laser photocoagulation and PRP for reducing diabetic macular edema and preventing aggravation of macular edema without transient visual disturbance in patients requiring immediate PRP.

Chung, JK; Lim, Sang Hyun

2007-01-01

423

The Heritability of Macular Response to Supplemental Lutein and Zeaxanthin: A Classic Twin Study  

PubMed Central

Purpose. Antioxidant supplements may reduce age-related macular degeneration (AMD) progression. The macular carotenoids are of particular interest because of their biochemical, optical, and anatomic properties. This classic twin study was designed to determine the heritability of macular pigment (MP) augmentation in response to supplemental lutein (L) and zeaxanthin (Z). Methods. A total of 322 healthy female twin volunteers, aged 16–50 years (mean 40 ± 8.7) was enrolled in a prospective, nonrandomized supplement study. Macular pigment optical density (MPOD) measurements using two techniques (2-wavelength fundus autofluorescence [AF] and heterochromatic flicker photometry [HFP]), and serum concentrations of L and Z, were recorded at baseline, and at 3 and 6 months following daily supplementation with 18 mg L and 2.4 mg Z for a study period of 6 months. Results. At baseline, mean MPOD was 0.44 density units (SD 0.21, range 0.04–1.25) using HFP, and 0.41 density units (SD 0.15) using AF. Serum L and Z levels were raised significantly from baseline following 3 months' supplementation (mean increase 223% and 633%, respectively, P < 0.0001 for both), with no MPOD increase. After 6 months' supplementation, a small increase in MPOD was seen (mean increase 0.025 ± 0.16, P = 0.02, using HFP). Subdivision of baseline MPOD into quartiles revealed that baseline levels made no difference to the treatment effect. Genetic factors explained 27% (95% confidence interval [CI] 7–45) of the variation in MPOD response. Distribution profiles of macular pigment did not change in response to supplementation. Conclusions. MPOD response to supplemental L and Z for a period of 6 months was small (an increase over baseline of 5.7% and 3.7%, measured using HFP and AF, respectively), and was moderately heritable. Further study is indicated to investigate the functional and clinical impact of supplementation with the macular carotenoids.

Hammond, Christopher J.; Liew, S. H. Melissa; Van Kuijk, Frederik J.; Beatty, Stephen; Nolan, John M.; Spector, Tim D.; Gilbert, Clare E.

2012-01-01

424

Proteomic analysis of aqueous humor from patients with branch retinal vein occlusion-induced macular edema.  

PubMed

The mechanisms responsible for macular edema with branch retinal vein occlusion (BRVO) remain to be elucidated. It is known that the expression profile of certain proteins in the aqueous humor (AH) changes in some diseases. Accordingly, determining the expression of these AH proteins may aid in the understanding of their potential role in this pathogenesis. The aim of this study was to identify the possible mechanisms involved in the development of BRVO-induced macular edema. A proteomic analysis of the AH composition in the eyes of patients with BRVO was performed and compared with that in the eyes of patients with cataract (non-BRVO; controls). AH from 6 patients with macular edema due to BRVO and 6 patients with cataract (non-BRVO) was collected. A proteomic approach which included 2?dimensional electrophoresis (2?DE) coupled with mass spectrometry (MS) and bioinformatics analysis were used to identify AH proteins with altered expression in patients with macular edema due to BRVO compared with the controls. An enzyme?linked immunosorbent assay was used to validate the proteomic results. The total protein concentration in the AH of patients with BRVO-induced macular edema was significantly greater than that of the controls. In the patients with BRVO, a total of 56 protein spots were significantly altered on the 2D gels. A total of 49 protein spots were identified by MS; many of these proteins have been implicated in angiogenesis, oxidative stress and collagen synthesis. In conclusion, the protein composition in AH differed significantly between the patients with BRVO and the controls. The identified proteins may be potential biomarkers for the development of macular edema due to BRVO and may play a role in the mechanisms responsible for it. PMID:24068204

Yao, Jiaqi; Chen, Zhijun; Yang, Qin; Liu, Xiaoyi; Chen, Xi; Zhuang, Min; Liu, Qinghuai

2013-09-25

425

Bilateral emphysematous pyelitis: a rare encounter in urology.  

PubMed

Gas-forming infection of the kidneys can affect either the parenchyma or the collecting system. They are known as emphysematous pyelonephritis (EPN) and emphysematous pyelitis (EP) respectively. Bilateral EPN is a fairly established entity and numerous articles about this condition have been published. However, much less is known about bilateral EP. We report a rare case of bilateral EP and a literature review of this disease. A 66-year-old woman with long-standing bilateral staghorn calculi presented with bilateral EP and severe sepsis. She was treated with antibiotics and bilateral double-J stents to drain the upper urinary tracts. She recovered after 1 month of intensive care and medical therapy. Percutaneous nephrolithotomy (PCNL) had been scheduled to treat her staghorn calculi. A literature search on MEDLINE and Google Scholar with the terms "bilateral emphysematous pyelitis" only found 1 case report in English and another 2 reports in the Korean language that discussed bilateral EP. The collective experience of these few cases, including the present case, suggests that bilateral EP runs a more benign course than bilateral EPN. It should be diagnosed as soon as possible with computed tomography (CT) scans of the renal system. Current evidence shows that can be treated successfully with timely antibiotics. Drainage of the collecting system either percutaneously or with placement of double-J stents might facilitate recovery. PMID:24045515

Tan C C K Ho, G H; Bahadzor, B; Praveen, S; Goh, E H; Syahril, A S; Zulkifli, M Z

426

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.

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

2010-01-01

427

La posesión como hecho punible  

Microsoft Academic Search

Este trabajo estudia el delito de posesión, el cual se extiende semánticamente hasta términos como custodia, mantener disponible, almacenar, etc., y como conminada con la pena se halla la posesión de explosivos, de armas de fuego, de drogas, de pornografía infantil, etc. En este mismo trabajo se analizan, bajo la óptica del Código Penal alemán, cómo las acciones graves o

Friedrich Christian Schroeder

428

Lake Como 1991 Reservoir Survey.  

National Technical Information Service (NTIS)

This report presents the results of the first extensive survey of Lake Como by Reclamation since construction of Como Dam. The primary objective of the 1991 survey was to gather necessary data for computing the current total and active capacities of Lake ...

R. L. Ferrari

1992-01-01

429

Bilateral simultaneous rupture of the quadriceps tendons.  

PubMed

Bilateral simultaneous rupture of the quadriceps tendons is very rare and occurred in an 82-year-old man. This may be the fifth case to have been reported in the English literature. Only minor stress on extensor mechanisms preceded the ruptures. Interrupted mattress sutures restored muscle continuity and function. A "pull-out" wire system was not used for protection of healing muscles because adequate amount of tissue mass was available for approximation. Excellent results require intensive postoperative physical therapy. Old age of the patient should not be a deterrent to surgical treatment in carefully selected individuals. PMID:657630

Siwek, K W; Rao, J P

430

Bilateral Endoprosthetic Replacements of the Proximal Femur  

PubMed Central

Patient. We report the case of a 20-year-old caucasian male with an Ewing's sarcoma in the left upper femur. After induction chemotherapy, he underwent resection of the left upper femur and insertion of a cemented proximal femoral replacement. Four years later, he presented with a solitary bone metastasis in the right upper femur. He underwent further chemotherapy followed by resection and endoprosthetic replacement of the other proximal femur. He remains disease free with excellent function almost a year after the second operation. Discussion. We believe this is the first reported case of bilateral proximal femoral endoprostheses.

Grimer, Robert J.

1998-01-01

431

Bilateral clubfoot in three homozygous preterm triplets.  

PubMed

The etiology of congenital idiopathic talipes equinovarus deformity is unclear. Studies on populations, families, and twins have suggested a genetic component. However, the mode of inheritance does not fit classic patterns. The intrauterine posture and environmental and developmental causative factors have also been associated with the deformity. Neurologic, muscular, bony, connective tissue, and vascular structures can be affected. We present the case of monochorionic triplets with bilateral congenital idiopathic talipes equinovarus deformities. To the best of our knowledge, such a presentation has not been previously described and supports a genetic etiology of congenital idiopathic talipes equinovarus deformity. PMID:21616690

Pagnotta, Gaetano; Boccanera, Francesca; Rizzo, Giuseppe; Agostino, Rocco; Gougoulias, Nikolaos; Maffulli, Nicola

2011-05-26

432

Progressive bilateral thinning of the parietal bones  

SciTech Connect

Observation of a case of progressive bilateral parietal thinning within a period of 14 years induced us to study skull films of 3 636 consecutive patients. Parietal thinning was found in 86 patients (2.37%). It was more common in women, with a sex ratio of 1:1.9. The mean age of the females was 72 years, and that of the males 63 years. Previous skull films of 25 of these patients were available and showed progression in 10. It is concluded that parietal thinning is a slowly progressive disease of middle-aged and old patients and is not an anatomical variant or congenital dysplasia of the dipole.

Cederlund, C.G.; Andren, L.; Olivecrona, H.

1982-03-01

433

Metallization thickness in bilateral and unilateral Finlines  

NASA Astrophysics Data System (ADS)

The theory and numerical results are presented to the effective dielectric constant and characteristic impedance of bilateral and unilateral finlines with metallization thickness. The full wave analysis of the transverse transmission line — TTL method is used to determine the electromagnetic fields of the structure in Fourier transform domain — FTD. Applying the suitable boundary conditions and the moment method, a homogeneous matrix system is obtained and the effective dielectric constant is extracted. The characteristic impedance is obtained using the relation between the voltage in slot and the transmitted power. Computational programs are developed to obtain numerical results to the effective dielectric constant and characteristic impedance.

Fernandes, Humberto César Chaves; Martins de Souza, Eduardo Amorim; de Souza Queiroz Júnior, Idalmir

1994-06-01

434

Bilateral retroesophageal course of the carotid arteries.  

PubMed

Many variations in the anatomy of the carotid artery are described in the literature. There are few case reports of hypoplasia or the retropharyngeal course of the internal carotid artery. We describe the unique case of a 72-year-old woman with bilateral complete retroesophageal common carotid arteries and concomitant hypoplasia of the right carotid system. Anatomical detection of such a variation is critical because the misidentification of a retroesophageal carotid artery carries the risk of potential injury during orotracheal intubation and oropharyngeal procedures. PMID:23601592

Virvilis, Dimitrios; Koullias, George; Labropoulos, Nicos

2013-05-01

435

Safety and Efficacy of Ranibizumab in Macular Edema following Retinal Vein Occlusion  

PubMed Central

Macular edema is the leading cause of visual impairment in patients with retinal vein occlusion. Limited improvements may be obtained with laser photocoagulation or intravitreal triamcinolone. However, according to the data provided by randomized clinical trials, intravitreal injections of ranibizumab (Lucentis; Genentech, South San Francisco, CA) constitute a new effective and safe option for the management of these vision-threatening diseases. The aim of the present review is to summarize the clinical evidence of ranibizumab for macular edema due to retinal vein occlusions.

Gallego-Pinazo, Roberto; Dolz-Marco, Rosa; Marin-Lambies, Cristina; Diaz-Llopis, Manuel

2012-01-01

436

Intravitreal triamcinolone acetonide versus bevacizumab therapy for macular edema associated with branch retinal vein occlusion  

Microsoft Academic Search

Purpose  To compare visual outcomes after intravitreal triamcinolone acetonide (IVTA) injection and intravitreal bevacizumab (IVB)\\u000a administration for treatment of macular edema associated with branch retinal vein occlusion (BRVO).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A retrospective comparative case series of 134 consecutive patients that were treated with either IVTA or IVB for macular\\u000a edema caused by BRVO. Visual acuity at baseline and 1, 3, 6, 9, and

Yeo Jue Byun; Mi In Roh; Sung Chul Lee; Hyoung Jun Koh

2010-01-01

437

Meta-analysis and review on the effect of bevacizumab in diabetic macular edema  

Microsoft Academic Search

Background  Systematic review and meta-analysis to evaluate the effect of bevacizumab (Avastin) in diabetic macular edema (DME)\\u000a \\u000a \\u000a \\u000a Methods  Pertinent publications were identified through systematic searches of PUBMED and Cochrane Central Register of Controlled Trials.\\u000a Change in central subfield macular thickness (CSMT) in ?m and best-corrected visual acuity (BCVA) in log MAR equivalents were\\u000a extracted at 6, 12 and 24 weeks, and results compared

Sunali Goyal; Michael LaValley; Manju L. Subramanian

2011-01-01

438

Retinoschisis and macular detachment associated with acquired enlarged optic disc cup  

PubMed Central

We describe a case of maculopathy consisting of macular retinoschisis and serous macular detachment occurring in a patient with an acquired enlarged optic disc cup, similar to the maculopathy observed in congenital optic nerve abnormalities, mainly optic nerve pits and colobomas, without vitreomacular traction nor angiographic leak. Pars plana vitrectomy with argon laser endophotocoagulation and gas tamponade was found to be useful. Traction from membranes covering deep optic disc cups may create small retinal dehiscences, as described in congenital optic nerve abnormalities, which will enable the liquefied vitreous to pass, leading to retinoschisis with or without associated neurosensory detachment. Vitrectomy, photocoagulation, and gas tamponade may be a useful therapy for this entity.

Moreno-Lopez, Maria; Gonzalez-Lopez, Julio Jose; Jarrin, Elena; Bertrand, Josefina

2012-01-01

439

Visual acuity and perimetry as measures of visual function in diabetic macular oedema  

Microsoft Academic Search

Aims\\/hypothesis  We examined to what extent visual acuity and perimetric sensitivity as measures of central and paracentral visual function\\u000a would be useful for evaluating the presence and severity of diabetic macular oedema.\\u000a \\u000a \\u000a \\u000a Materials and methods  We evaluated 59 eyes of 59 diabetic patients by identifying the presence (n=20) or absence (n=39) of macular oedema on stereo fundus photographs. The area of oedema

E. Agardh; H. Stjernquist; A. Heijl; B. Bengtsson

2006-01-01

440

Aphakic cystoid macular edema and the operating microscope: is there a connection?  

PubMed Central

The literature documenting the phototoxic effect of relatively low intensity light on the retina and the suggestions by several authors that this might influence the development of cystoid macular edema in the aphakic and pseudophakic patient is reviewed. In particular, the possibility that the operating microscope may be a factor has been emphasized. A study is presented, designed to investigate the possibility that the operating microscope is a factor important in the development of cystoid macular edema. No correlation was found. The need for further investigation into other phototoxic effects from the light of the operating microscope is stressed.

Iliff, W J

1985-01-01

441

Intravitreal bevacizumab (Avastin) for occult choroidal neovascularization in age-related macular degeneration  

Microsoft Academic Search

Background  The purpose of the study is to report data on short-term safety of intravitreal bevacizumab treatment and its effect on visual\\u000a function, central retinal thickness, and angiographical changes of occult choroidal neovascularization due to age-related\\u000a macular degeneration.\\u000a \\u000a \\u000a \\u000a Methods  A consecutive interventional case series of 30 patients with active subfoveal occult choroidal neovascularization secondary\\u000a to age-related macular degeneration was followed after one

S. Aisenbrey; F. Ziemssen; M. Völker; F. Gelisken; P. Szurman; G. Jaissle; S. Grisanti; K. U. Bartz-Schmidt

2006-01-01

442

Methods of processing biomedical image of retinal macular region of the eye  

NASA Astrophysics Data System (ADS)

In this paper we report a new method for determination of macular area of the retina obtained by optical coherent tomography (OCT). A novel program of image processing was developed for this purpose. The improved efficiency of proposed tools and it accuracy in the determination of the parameters in the macular area was checked by comparison of results with the standard procedure of processing of the biomedical images of this class. All calculation were obtained from the retina tomograms by using coherent optical topographic scanner STRATUS OCT 3000

Pavlov, S. V.; Vassilenko, V. B.; Vovkotrub, D. V.; Poplavskaya, A. A.; Hotra, O.

2013-01-01

443

Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125  

PubMed Central

Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs' syndrome. Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department. Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835?UI/mL) in a pronounced general alteration condition. Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs' syndrome. Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices.

Loue, Vedi Andre Serges; Gbary, Eleonore; Koui, Sylvanus; Akpa, Bedi; Kouassi, Adelaide

2013-01-01

444

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.

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

2012-01-01

445

Outer retinal structure in best vitelliform macular dystrophy.  

PubMed

IMPORTANCE Demonstrating the utility of adaptive optics scanning light ophthalmoscopy (AOSLO) to assess outer retinal structure in Best vitelliform macular dystrophy (BVMD). OBJECTIVE To characterize outer retinal structure in BVMD using spectral-domain optical coherence tomography (SD-OCT) and AOSLO. DESIGN, SETTING, AND PARTICIPANTS Prospective, observational case series. Four symptomatic members of a family with BVMD with known BEST1 mutation were recruited at the Advanced Ocular Imaging Program research lab at the Medical College of Wisconsin Eye Institute, Milwaukee. INTERVENTION Thickness of 2 outer retinal layers corresponding to photoreceptor inner and outer segments was measured using SD-OCT. Photoreceptor mosaic AOSLO images within and around visible lesions were obtained, and cone density was assessed in 2 subjects. MAIN OUTCOME AND MEASURE Photoreceptor structure. 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 were consistent with Henle fibers. CONCLUSIONS AND RELEVANCE The AOSLO findings indicate that 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. 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

2013-09-01

446

The ERCC6 Gene and Age-Related Macular Degeneration  

PubMed Central

Background Age-related macular degeneration (AMD) is the leading cause of irreversible visual loss in the developed countries and is caused by both environmental and genetic factors. A recent study (Tuo et al., PNAS) reported an association between AMD and a single nucleotide polymorphism (SNP) (rs3793784) in the ERCC6 (NM_000124) gene. The risk allele also increased ERCC6 expression. ERCC6 is involved in DNA repair and mutations in ERCC6 cause Cockayne syndrome (CS). Amongst others, photosensitivity and pigmentary retinopathy are hallmarks of CS. Methodology/Principal Findings Separate and combined data from three large AMD case-control studies and a prospective population-based study (The Rotterdam Study) were used to analyse the genetic association between ERCC6 and AMD (2682 AMD cases and 3152 controls). We also measured ERCC6 mRNA levels in retinal pigment epithelium (RPE) cells of healthy and early AMD affected human donor eyes. Rs3793784 conferred a small increase in risk for late AMD in the Dutch population (The Rotterdam and AMRO-NL study), but this was not replicated in two non-European studies (AREDS, Columbia University). In addition, the AMRO-NL study revealed no significant association for 9 other variants spanning ERCC6. Finally, we determined that ERCC6 expression in the human RPE did not depend on rs3793784 genotype, but, interestingly, on AMD status: Early AMD-affected donor eyes had a 50% lower ERCC6 expression than healthy donor eyes (P?=?0.018). Conclusions/Significance Our meta-analysis of four Caucasian cohorts does not replicate the reported association between SNPs in ERCC6 and AMD. Nevertheless, our findings on ERCC6 expression in the RPE suggest that ERCC6 may be functionally involved in AMD. Combining our data with those of the literature, we hypothesize that the AMD-related reduced transcriptional activity of ERCC6 may be caused by diverse, small and heterogeneous genetic and/or environmental determinants.

Bergeron-Sawitzke, Julie; Uitterlinden, Andre G.; Hofman, Albert; van Duijn, Cornelia M.; Merriam, Joanna E.; Smith, R. Theodore; Barile, Gaetano R.; ten Brink, Jacoline B.; Vingerling, Johannes R.; Klaver, Caroline C. W.; Allikmets, Rando; Dean, Michael; Bergen, Arthur A. B.

2010-01-01

447

Macular degeneration affects eye movement behavior during visual search.  

PubMed

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

2013-09-03

448

Bilateral Comparison in Chemosensory-Mediated Foraging  

NASA Astrophysics Data System (ADS)

Motivation is drawn from the need to determine the sensory cues that animals such as blue crabs and lobsters use to track chemical odor plumes to locate food or mates. Major steps forward with this difficult problem can only be achieved through an appreciation of the spatial and temporal variation of concentration fields and the information content available to a forager in the plume. Here we discuss the usefulness of bilateral comparison to an animal tracking a turbulent plume. Instantaneous concentration fields of a chemical plume diffusing in a fully-developed turbulent open channel flow are measured using planar laser-induced fluorescence (PLIF). The plume is released iso-kinetically 25 mm above the smooth bed (z+ = 90), thus transport is mainly due to advection and ambient turbulence. A spatial correlation function in the spanwise direction is a dramatic indicator of the relative position of the centerline and distance from the source. The relative direction of the plume centerline can be estimated from an instantaneous bilateral comparison provided the sensors are separated by a distance that is relatively large compared to the spanwise integral length scale based on the spatial correlation function.

Webster, D. R.; Rahman, S.; Dasi, L. P.

2000-11-01

449

Bilateral Progressive Idiopathic Annular Lipid Keratopathy  

PubMed Central

Purpose. To report two unusual cases of idiopathic lipid keratopathy with symmetrical bilateral annular corneal lipid infiltration and describe confocal microscopy findings. Methods. Case reports. Results. We report two patients with bilateral peripheral deep stromal lipid deposits beginning in an arcuate pattern and progressing to a complete annular shape. Cholesterol crystals were observed in the paracentral area in both cases with characteristic crystalline-like structures in the confocal microscopy. Deep thin corneal blood vessels were observed in one patient, but no cause for then was established, despite decades of followup. This patient had an idiopathic limbitis as well, occurring in episodes. No previous ocular trauma, systemic disease or family history was reported for both cases. Conclusion. These two cases of idiopathic annular lipid keratopathy were observed for more than a decade with documented slow and insidious progression of the infiltrates, in spite of the use of topical steroids in one case. In the majority of other reported cases, a penetrating keratoplasty was made necessary. Differently, we showed that the visual acuity can remain quite good for years with very slow deterioration.

Ghanem, Ramon C.; Ghanem, Vinicius C.; Victor, Gustavo; Alves, Milton Ruiz

2012-01-01

450

Bilateral retinoblastoma: clinical presentation, management and treatment.  

PubMed

Management of retinoblastoma (Rb), the most common intraocular malignant tumor in childhood, is tailored to each individual case and based on the overall situation. We present a case of bilateral Rbs in a 4-month-old girl, referred to our center for bilateral leukocoria. In the right eye, the optic disc was partially visible, and three large foci of retinoblastoma were noted adjective in the vitreous cavity with satellite retinal detachment. The macula was obscured by the tumors. The tumor was therefore classified as group D (International classification of retinoblastoma), and thus underwent intravenous chemotherapy with the standard three-agent protocol of ifosfamide, carboplatin and etoposide (ICE protocol) delivered monthly for six cycles, regressing with a type I calcified pattern. The left eye presented three multifocal yellow-white retinal masses, with a total retinal detachment, and secondary glaucoma. The lesions were classified as group E and, therefore, taking the results obtained by Shields et al. in group E tumors into consideration, underwent enucleation. This case clearly shows that this cancer is curable if detected at a stage in which it is still contained within the retina, subretinal space or vitreous, and that the management of Rb relies on an experienced team of ocular oncologists, pediatricians and pediatric ophthalmologists working together for the single goal of saving the child's life. PMID:23277210

Pichi, Francesco; Lembo, Andrea; De Luca, Mariacarla; Hadjistilianou, Theodora; Nucci, Paolo

2013-01-01

451

[Disseminated erythematous lupus with bilateral diaphragmatic involvement].  

PubMed

The diaphragm is an unusual localization for disseminated erythematous lupus and is generally not recognized. We present the case of a 34-year-old woman who developed bilateral pain in the base of the thorax 15 days before hospitalization without any bronchial signs and NYHA stage II dyspnea. The patient's general health status remained satisfactory and the physical examination was normal except for diffuse inflammatory joint pain and cutaneous photosensitivization. The chest x-ray disclosed ascension of both hemidiaphragms with retracted lungs associated with bilateral basal atalectasia. The diagnosis of lupus with diaphragmatic involvement was retained due to the clinical presentation with diffuse joint pain, photosensitization with facial erythema, pericardial effusion and elevated antinuclear antibody and lymphopenia (1 100/mm3). Lung function tests revealed a restrictive syndrome. Oral corticosteroids 1 mg/kg/d enabled clinical and functional improvement. In light of this observation we discuss the pathogenic mechanisms of this uncommon localization of lupus and the difficulty of establishing a sure diagnosis. PMID:16840998

El Bied, B; Afif, H; Safieddine, S; Hassani, L; Aichane, A; Trombati, N; Bouayad, Z

2006-06-01