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Biomedical subjects

A L Maberley

Publications and source records attributed to A L Maberley.

At least 19 recordsLinked to original sources
PubMed2001

Vitrectomy for pars planitis complicated by vitreous hemorrhage: visual outcome and long-term follow-up.

PURPOSE: To characterize the visual results of vitrectomy for nonclearing vitreous hemorrhage in pars planitis. METHODS: Case series. RESULTS: All six eyes (100%) had a visual acuity of 20/200 or less preoperatively. Postoperatively, five eyes (83%) improved to a final visual acuity of better than 20/30, and one eye improved to 20/100. The poorer vision of the latter patient was attributed to cystoid macular edema. Postoperative follow-up range was from 1.3 to 9 years (mean, 4.2 years). CONCLUSION: A substantial long-term benefit is seen in patients with pars planitis treated with vitrectomy for nonclearing vitreous hemorrhage. A larger case series will be needed to confirm whether such excellent outcomes can be expected.

Adolescent↗
PubMed1999

Prophylactic scleral buckle for prevention of retinal detachment following vitrectomy for macular hole.

AIM: To review the rate of retinal detachment after macular hole surgery in patients who received vitrectomy and scleral buckle versus those who had vitrectomy alone. METHODS: All patient charts and hospital records were examined for patients who underwent vitrectomy surgery for macular hole between September 1993 and June 1997. A total of 326 patients were identified and all were followed for a minimum of 6 months. Clinical records were examined for details of the surgical procedure, visual acuity, hole closure status, adjuvant therapies used, and postoperative retinal attachment status. Relative risks (the ratio of the incidence rate in the exposed to that in the unexposed) with 95% confidence intervals and chi(2) tests were calculated to determine which variables were associated with retinal detachment. The primary outcome measure in this review was retinal attachment status. RESULTS: Of 326 eyes which underwent surgery for macular hole during the study period, scleral buckles were utilised in 152 (46.6%) patients. Analysis revealed a detachment rate of 13.2% in patients who did not receive a scleral buckle compared with 5.9% detachment rate in those who did. Analysis of these results indicated a 2.42 times greater risk of developing a retinal detachment in patients without a scleral buckle. Complications related to the use of scleral buckles occurred in two of 152 cases (1.3%) CONCLUSIONS: A reduction in the rate of retinal detachment was noted in patients receiving prophylactic scleral buckles. Those finding suggest a possible beneficial effect of this adjunctive procedure in preventing postoperative retinal detachments. The authors are currently preparing a multicentred, prospective, clinical trial to further study this hypothesis

Adolescent↗
PubMed1996

Closure of persistent macular holes with human recombinant transforming growth factor-beta 2.

OBJECTIVE: To evaluate the efficacy of human recombinant transforming growth factor-beta 2 (TGF-beta 2) in the closure of persistent macular holes. SETTING: Retina service at a university-affiliated hospital in Vancouver. PATIENTS: Seventeen patients with macular holes who had previously undergone vitrectomy, posterior cortical vitreous removal and prolonged gas tamponade, with failure to close the hole. INTERVENTIONS: Treatment with TGF-beta 2 followed by gas tamponade. OUTCOME MEASURE: Closure of macular hole (defined as complete absence of the surrounding neurosensory detachment). RESULTS: Of the 17 holes 16 (94%) were closed. The average improvement in Snellen acuity was 1.76 lines; nine patients (53%) had at least two lines of improvement. The patients who gained two or more lines of acuity following surgery with TGF-beta 2 had lost significantly more lines of acuity with the primary procedure (p = 0.008) and had worse Snellen acuity following the primary procedure (p = 0.0004) than the patients who gained one line or less of acuity following surgery with TGF-beta 2. Among the patients with a final visual acuity of 20/80 or better the average duration of the hole from the onset of symptoms to the second procedure was 22.2 months. CONCLUSIONS: Treatment with TGF-beta 2 is a potentially useful adjuvant in the closure of persistent macular holes following failed primary surgery.

Aged↗
PubMed1996

Effect of macular edema on surgical visual outcome in eyes with idiopathic epiretinal membrane.

OBJECTIVE: To determine whether macular edema affects the surgical outcome in eyes with idiopathic epiretinal membrane. DESIGN: Case series. SETTING: University-based referral practice in Vancouver. PATIENTS: Sixty-one patients (63 eyes) (37 women and 24 men ranging in age from 47 to 96 [mean 70] years) who underwent pars plana vitrectomy with membrane peeling for idiopathic epiretinal membrane. OUTCOME MEASURES: Degree of macular edema on preoperative fluorescein angiograms (none, mild or severe), as rated independently by two masked observers, and preoperative and postoperative Snellen visual acuity. RESULTS: Of the 63 eyes 32 had no macular edema, 21 had mild edema, and 10 had severe edema. Fifty-two eyes (83%) had an improvement in visual acuity. The mean number of lines of improvement in visual acuity for the three groups was 2.2, 3.7 and 2.6 respectively. Multiple regression analysis showed that the factor with the greatest adverse effect on visual outcome was intraoperative macular hole formation. The presence of macular edema preoperatively did not significantly affect visual outcome. CONCLUSIONS: Our results suggest that even eyes with significant macular edema secondary to idiopathic epiretinal membranes may benefit from vitrectomy with membrane peeling.

Aged↗
PubMed1995

Idiopathic retinal vasculitis, aneurysms, and neuro-retinitis. Retinal Vasculitis Study.

PURPOSE: The authors describe the clinical feature of ten patients with a new syndrome characterized by the presence of retinal vasculitis, multiple macroaneurysms, neuro-retinitis, and peripheral capillary nonperfusion. METHODS: The authors evaluated ten patients identified to have clinical features compatible with the syndrome of idiopathic retinal vasculitis, aneurysms and neuroretinits (IRVAN). Clinical examination findings, sequential funds photographs (when available), fluorescein angiograms, systemic investigations, response to therapy, and visual outcomes were reviewed. RESULTS: Seven eyes of four patients sustained a marked decrease in visual acuity of 20/200 or worse. Visual loss was due to a combination of an exudative maculopathy and sequelae of retinal ischemia. Capillary nonperfusion was seen in all ten patients and was severe enough to warrant panretinal laser photocoagulation in six patients. Systemic investigations were uniformly noncontributory. Oral prednisone appears to have little beneficial effects on patients with this disorder. CONCLUSIONS: Patients with IRVAN have characteristic retinal features that readily identify this syndrome. An increased awareness of this rare syndrome may help to identify sight-threatening complications at an earlier stage. The authors caution against extensive medical investigations.

Adult↗
PubMed1993

Complications of retinotomies for subretinal fluid drainage.

We reviewed 287 cases of pars plana vitrectomy performed between January 1985 and June 1990 in which retinotomies were created for drainage of subretinal fluid or blood. We found subretinal neovascularization associated with the retinotomy site in two cases (1%) and focal proliferative vitreoretinopathy associated with the retinotomy site in seven cases (2%). These complications were more likely to occur with retinotomies made within the superior macular region (p = 0.002).

Adult↗
PubMed1992

Central retinal vein occlusion in young adults (papillophlebitis).

We performed a retrospective study of 103 cases of central retinal vein occlusion (CRVO) in young, nondiabetic adults that were followed for at least six months. Of these patients, 64% were men and 36% were women. While visual acuity was usually good, 33 eyes (32%) had a final visual acuity of 20/200 or worse, including 6 eyes (6%) with a final visual acuity of no light perception. Ocular complications included chronic cystoid macular edema, macular pigmentary changes (37%), sheathing of retinal vessels (22%), venous collaterals of the disc (33%), macular hole formation (1%), neovascularization of the disc (1%), retina (1%), and iris (19%), neovascular glaucoma (8%), and vitreous hemorrhage (7%).

Adolescent↗
PubMed1991

Pars plana vitrectomy for macular degenerative disorders.

We describe nine patients (10 eyes) treated with pars plana vitrectomy for vitreous hemorrhage secondary to disciform macular degeneration. Nine of the eyes showed improved acuity at about 3 months and at the last follow-up visit (6 to 30 months). Two of the patients had ambulatory acuity (counting fingers or better) before surgery, compared with all the patients at the last follow-up visit. Vitrectomy may be beneficial in this subgroup of patients with macular degeneration.

Aged↗
PubMed1989

Subretinal neovascularization associated with retinochoroidal colobomas.

The development of subretinal neovascularization as a complication of retinochoroidal coloboma has been reported in only three cases, in only one of which was the patient treated with laser photocoagulation. We report an additional case of subretinal neovascularization associated with retinochoroidal coloboma in a 57-year-old man that was treated with laser photocoagulation. The patient's visual acuity has remained stable at 20/50.

Choroid↗
PubMed1989

The use of silicone oil in vitreoretinal surgery.

Silicone oil is used with increasing frequency to treat complex vitreoretinal disorders. We report our results in 48 consecutive cases (50 eyes) with at least 6 months' follow-up. Postoperatively the retina was completely attached in 76% of eyes. A final visual acuity of 5/200 or better was achieved in 66% of eyes. Complications seen with silicone oil injection include recurrent detachment, corneal decompensation, cataract formation and increased intraocular pressure. The use of sophisticated vitreoretinal surgical techniques in addition to silicone oil injection allowed successful management in eyes that would otherwise have had a poor prognosis.

Adolescent↗
PubMed1987

Ultrasonography of pathologically proved choroidal melanoma with a high-resolution small-parts scanner.

Between March 1983 and March 1985, 13 patients with choroidal melanoma underwent ultrasonography with a high-resolution small-parts scanner. The patients subsequently underwent enucleation, and the specimens were examined histopathologically. We reviewed the ultrasonograms for the presence of choroidal excavation, rupture through Bruch's membrane, retro-orbital fat shadowing, acoustic texture and retinal detachment. Comparison with the histopathological results showed that when conventional diagnostic criteria were used, most cases of rupture through Bruch's membrane were missed owing to the limits of resolution. No patients with homogeneous acoustic texture had pathological evidence of tumour necrosis or hemorrhage, while most of those with inhomogeneous texture did. The results suggest that high-resolution small-parts scanning may lead to reassessment of the conventional criteria for the diagnosis of intraocular melanomas.

Choroid Neoplasms↗
PubMed1977

The visual field in indirect traumatic rupture of the choroid.

Nine cases of indirect rupture of the choroid due to trauma were examined by indirect ophthalmoscopy, fluorescein angiography and static and kinetic perimetry. Our results indicate that the visual field defect cannot be correlated with the ophthalmoscopic picture as concerns shape, size, or location of the lesion. Seven of the 9 cases had a central scotoma and we demonstrated nerve involvement in 4 of the 9 cases. We do not know of other studies of the visual field in indirect traumatic rupture of the choroid.

Adult↗
PubMed1975

Three hundred and sixty degree scleral buckling.

A three hundred and sixty degree scleral buckling procedure is proposed for treating difficult and complicated cases of retinal detachment. This procedure has been used successfully in more than 242 cases with an anatomic re-attachment rate of greater than 90%. The overall re-operation rate was about 11%. Complications directly attributable to this procedure were minimal.

Adolescent↗