Biomedical subjects

A B Litwak

Publications and source records attributed to A B Litwak.

5 recordsLinked to original sources

PubMed2000

Optic nerve evaluation among optometrists.

PURPOSE: To determine agreement among optometrists regarding assessment of optic nerve C/D ratios and perceived glaucomatous damage and to separately analyze these results on the basis of residency training, practice setting, and glaucoma patient experience. METHODS: Fifty-six optometrists from various modes of professional practice evaluated 33 stereoscopic optic nerve photographs. Observers were asked to estimate the vertical cup-to-disk (C/D) ratio and determine the glaucomatous status of the optic nerve. The mean vertical C/D ratio, percentage perceived as glaucomatous, and levels of interobserver and intraobserver agreement (kappa) are reported. RESULTS: Estimated C/D ratios differ significantly on the basis of training (p = 0.02) practice setting (p = 0.001), glaucoma patient experience (p = 0.001). Glaucomatous damage interpretation was significantly different (p = 0.006) based upon an optometrist's practice setting. Interobserver agreement regarding C/D ratios is significantly higher among optometrists who have completed a residency (kappaw = 0.59) and practice in clinical settings (optometry school/medical center/hospital) (kappaw = 0.59) compared with non-residency-trained optometrists (kappaw = 0.52) and those practicing in commercial settings (kappaw = 0.54). Interobserver agreement of glaucomatous damage is significantly higher among optometrists who have completed a residency (kappa = 0.50) compared with non-residency-trained optometrists (kappa = 0.42). CONCLUSIONS: Intraobserver agreement is higher than interobserver agreement among optometrists when C/D ratios are estimated and the glaucomatous status of the optic nerve is assessed. Optic nerve evaluation among optometrists is significantly influenced by residency training, practice setting, and glaucoma patient encounters.

Clinical Competence↗

PubMed1995

Non-CMV infectious chorioretinopathies in AIDS.

Cytomegalovirus (CMV) retinitis is the most common posterior segment opportunistic infection and the leading cause of blindness in acquired immunodeficiency syndrome (AIDS) patients. CMV is not the sole agent that can infect the fundus of an immunocompromised patient. Disseminated herpes zoster (HZ), herpes simplex, toxoplasmosis, and Candidiasis are possible. Syphilis, Pneumocystis carinii, cryptococcosis, tuberculosis, and a host of other viruses, protozoa, bacteria, or neoplasms may invade the retina or choroid. The eye care practitioner must not only differentiate noninfectious retinopathy (AIDS retinopathy) from CMV retinitis, but also distinguish CMV retinitis from other posterior segment infections because the treatment modalities are different. This paper will review the clinical features of non-CMV infectious retinopathies and choroidopathies that occur in AIDS patients.

AIDS-Related Opportunistic Infections↗

PubMed1990

Evaluation of the retinal nerve fiber layer in glaucoma.

The health of the optic nerve in glaucoma can be evaluated by examination of the retinal nerve fiber layer with red free illumination. Retinal nerve fiber layer defects have been shown in some studies to precede enlargement of optic cupping and visual field defects in glaucoma patients. Detection of glaucomatous damage at an earlier stage in the disease may prevent subsequent visual field loss. Retinal nerve fiber layer evaluation may give important information in the management and treatment of glaucoma patients.

Fundus Oculi↗

PubMed1989

Juxtapapillary choroidal neovascular membrane in a patient with Paget's disease and lattice corneal dystrophy.

Paget's disease (osteitis deformans) is a relatively common metabolic bone disease characterized by the gradual development of bony deformities. These deformities lead to cranial and peripheral neuropathies from nerve and blood vessel impingement. Angioid streaks are associated with Paget's disease and are the result of linear breaks in Bruch's membrane caused by the calcification and degeneration of this elastic tissue layer. A case report of a patient with Paget's disease with angioid streaks and a secondary choroidal neovascular membrane is presented. The membrane was treated with argon laser photocoagulation. The patient also had an incidental finding of lattice corneal dystrophy which required penetrating keratoplasty.

Aged↗

PubMed1989

Posterior scleritis with secondary ciliochoroidal effusion.

Posterior scleritis is a granulomatous inflammation occurring either within the scleral tissue or in the vascular networks adjacent to it. This inflammatory process can cause leakage of fluid from the choroid into the suprachoroidal space leading to ciliochoroidal effusion and an exudative retinal detachment. The following is a case report of a 64 year old white male, who presented with an acute angle closure attack and myopic shift in one eye, and later developed an exudative choroidal and retinal detachment. Posterior scleritis was diagnosed based on ultrasonography and the orbital CT scan findings. The acute angle closure attack, myopic shift and exudative detachments completely resolved with the use of oral steroids and cycloplegics.

Choroid↗