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Biomedical subjects

A Scheider

Publications and source records attributed to A Scheider.

34 records · Page 2Linked to original sources
PubMed1994

[An unusual eye defect in Highland cattle: diverging unilateral strabismus].

In the course of an investigation on breeding, management, health and economic problems in seven Highland Cattle farms, two castrated (male) full sibs were detected showing divergent unilateral strabismus (DUS). The reason being found for this eye-defect was a displacement of the M. rectus lateralis by 40 degrees to ventral. Besides DUS, both full sibs were affected by crop ears. It seems probable that DUS is an inborn defect, but the pedigree was not so informative that conclusions on the inheritance of DUS could be drawn.

Animals↗
PubMed1993

Fluorescein and indocyanine green angiographies of central serous choroidopathy by scanning laser ophthalmoscopy.

We examined 19 patients (41 +/- 7.5 years old) with central serous chorioretinopathy and symptoms that ranged from one day to 24 months. Fluorescein and indocyanine green angiographies were performed with a scanning laser ophthalmoscope. Focal exudation was found in all patients with fluorescein and in 15 patients (79%) with indocyanine green. We found a more widespread exudation of indocyanine green into the choroid around the focal hyperfluorescent spot in seven patients (37%). Perfusion with fluorescein was delayed in the area of focal exudation in two patients (11%) and with indocyanine green in 12 patients (63%). Exudation of both dyes stopped with clinical improvement, whereas the perfusion deficits remained unchanged. These results further indicate that central serous chorioretinopathy is primarily a choroidal disease.

Adult↗
PubMed1993

[Does combined pancreas-kidney transplantation modify diabetic retinopathy in type-1 diabetic patients?].

The study group consisted of 30 patients with a functioning pancreas graft of at least 12 months. Fifty-seven eyes were examined; 26 eyes from 15 patients with a non-functioning pancreas graft made up the control group. Three patients were in both groups because their graft was rejected after a 12-month period. The mean age in the study group was 37 years, the mean observation time 38 months. The mean duration of diabetes before transplantation was 24 years and all patients were on kidney dialysis. Retinal coagulation for diabetic retinopathy had previously been performed in 80.7% of the patients. The mean age (38 years), observation time (36 months), duration of diabetes before transplantation (24 years), and incidence of retinal coagulation (84.6%) were comparable in the control group. All patients had regular ophthalmological examinations every 6 to 12 months. This included best-corrected visual acuity, applanation tonometry, slit-lamp examination and dilated binocular funduscopy. Seven 30 degrees fundus pictures of the posterior pole were taken: The images were graded by comparing them with the ETDRS (Early Treatment Diabetic Retinopathy Study) Group standard photographs. The original Airlie House grading scale was changed because we did not take stereoscopic pictures. Evaluation and grading were done independently by two examiners. The retinopathy score was graded from 0 (no retinopathy) to 11 (no evaluation possible due to opaque media). Visual acuity remained stable in both the study and control groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Multifocal inner choroiditis.

Young, moderately myopic women presenting with typical signs of ocular histoplasmosis (OHS) but negative serology or skin tests were delimited in 1984 as a new entity of "punctate inner choroidopathy". On the basis of observations in 17 patients combined with similar cases reported in the literature, the following hypothesis is proposed herein. Myopia, young age and female sex are general high-risk factors for the development of focal choroidopathy. A hypothesis is presented to explain this accumulation. Women have a significantly higher risk of developing bacteremia before the age of 50 years than do men. The attenuated choroidal vessels in myopia might elevate the risk for infectious thrombosis in the choriocapillary layer. When combined, these risk factors could significantly lower the infectious threshold, leading to infections outside areas endemic for particularly virulent agents. The more general term multifocal inner choroiditis, proposed by Krill in 1968, should be maintained to emphasise the multifactorial genesis of this disease. Patients go to an ophthalmologist when secondary complications such as subretinal neovascular membranes have developed; this makes the search for causes of the primary infection difficult, if not impossible. Further studies carried out in collaboration with gynaecologists and other subspecialists are necessary to challenge this hypothesis and to evaluate the possibilities of preventing multifocal inner choroiditis.

Adolescent↗
PubMed1992

Detection of subretinal neovascular membranes with indocyanine green and an infrared scanning laser ophthalmoscope.

We studied 80 patients with subretinal neovascular membranes to demonstrate the features and limitations of indocyanine green angiography. Indocyanine green increased the detection of ill-defined membranes or those in larger exudative maculopathies. Each membrane had a characteristic small dark rim that demarcated it from surrounding choroidal tissue. Nevertheless, the complex vascular structures of the choroid and retina, which are displayed at one time, can sometimes render the separation of new vessels difficult when displayed at the same time. The results of our study indicate that indocyanine green angiography may be suggested as an additional diagnostic tool in cases of ill-defined or exudative subretinal neovascular membranes.

Aged↗
PubMed1992

Fluorescence characteristics of indocyanine green in the normal choroid and in subretinal neovascular membranes.

Indocyanine green angiography with scanning laser ophthalmoscopy is a new supplementary method studying subretinal neovascular membranes. However, it is still controversial as to whether of not exudation of this dye occurs from regular choroidal vessels or such membranes. Fluorescence of the macula area, a parapapillary retinal vein, and of venous blood and plasma was therefore measured with a picture analysis system in five healthy young volunteers. Furthermore, the angiograms of 150 subretinal neovascular membranes were reviewed. Membrane fluorescence was measured in ten exemplary cases and compared with the background fluorescence. The results show that macula fluorescence is detectable much longer than the fluorescence of retinal vessels. However, a comparison with the fluorescence of blood and plasma samples revealed that this late fluorescence must be caused by retinal and choroidal capillaries with a significantly reduced hematocrit. It is not caused by apposition or exudation of indocyanine green. The same was true for the majority of subretinal neovascular membranes. Exudation was rarely detected in membranes that were regularly surrounded by exudates but could be induced by laser coagulation. These observations indicate that exudation occurs only after massive destruction of the endothelial barrier. The results are important for the interpretation of indocyanine green angiograms and for possible photodynamic therapy with this dye.

Adult↗
PubMed1992

Fluorescence characteristics of drusen during indocyanine-green angiography and their possible correlation with choroidal perfusion.

The fluorescence of drusen and their correlation with choroidal perfusion was investigated using indocyanine-green videoangiography in 37 patients (mean age, 66 +/- 16 years) with juvenile and senile drusen. Most senile drusen (89%) blocked choroidal indocyanine-green fluorescence, and only three patients had small, weakly hyperfluorescent drusen at the vascular arcade. In contrast, all juvenile drusen (patients aged 31-52 years) demonstrated strong hyperfluorescence. Impaired choroidal perfusion was not detected. In 33% of the patients, all of them older than 60 years, moderate choroidal hypofluorescence could be explained by the presence of confluent drusen and/or a thickening of the pigment epithelium-Bruch's membrane complex. The results of the present study demonstrate that indocyanine-green angiography enables the differentiation of juvenile drusen from senile drusen, which could be an indication of a differing pathogenesis for the two diseases. Indocyanine-green hyperfluorescence of drusen must be caused by the transmission of choroidal fluoresence. This jeopardizes the hypothesis that the fluorescein fluorescence of drusen is invariably caused by storage of the dye. Our results contradict previous fluorescein studies that have demonstrated impaired choroidal perfusion in patients with age-related macular degeneration.

Adult↗
PubMed1992

[Indocyanine green angiography with an infrared scanning laser ophthalmoscope. Initial clinical experiences].

This report summarizes our first clinical results with indocyanine green angiography using an infrared scanning laser ophthalmoscope (IR-SLO) is equipped with an infrared laser diode of 780 nm and a barrier filter of 830 nm. Angiographies are recorded on videotape and images simultaneously digitized and saved on the disk. For each examination, 25 mg of Indocyanine Green (ICG), dissolved in 5 ml aqueous solvent, is injected into a cubital vein. We came to the following conclusions: First, the detection of subretinal neovascular membranes is certainly improved, especially for ill-defined membranes when the exact demarcation cannot be seen either because of diffuse exudation of fluorescein or because of the pigment epithelium. Second, we were able to demonstrate the lobular structure of the choriocapillary layer and prove that the acute form of posterior multifocal placoid pigment epitheliopathy is derived from a defect in this layer. Third, examination of the meaning sites of retinal and choroidal vessels revealed the additive fluorescence of ICG, which had not previously been known and which is bound to complicate tremendously the analysis of quantitative measurements. Our results prove that this new method is a useful diagnostic procedure for both the clinical routine and research. The different properties of fluorescein and indocyanine green prevent competition of these dyes. ICG represents a true completion.

Adult↗
PubMed1991

Diabetic retinopathy and pancreas transplantation: a 3-year follow-up.

The effect of simultaneous pancreas and kidney transplantation on diabetic retinopathy was studied in a prospective study with 30 patients (57 eyes) and 15 control subjects (26 eyes), patients who lost the pancreas, but preserved kidney function. There was no significant difference between the groups after a mean observation time of more than 35 months (a range of 12 to 96 months). Both populations had a stable retinopathy during follow-up. This seems to be a consequence of the far advanced retinopathy (mean duration of type 1 diabetes was 22 years) and the high percentage of coagulated eyes (81% and 85%, respectively), but is not related to the organ transplantation. A closer look at the few patients who did not receive laser coagulation (14 patient and 6 control eyes), produced a different result. Four control eyes experienced a significant deterioration of the retinopathy which had been stable before rejection. It is the most important and so far never mentioned aspect of this study, that periods of destabilisation are a definite threat for the retinopathy. Nevertheless, it seems questionable whether we will ever be able to make a definite statement on the pancreas-eye relation, as long as the transplantation must be restricted to carefully selected late-stage diabetic subjects.

Adult↗
PubMed1991

[Determination of arteriovenous transit time of the choroid with indocyanine green].

We present a very sensitive, yet light-weight videosystem for infrared angiography with Indocyanine green. This system was used to quantify for the first time the choroidal arteriovenous passage time (chAVP) in eight healthy volunteers and eight patients with retinal detachment pre- and postoperatively. The mean normal value of the chAVP was measured to be 3,46 + 0,59 sec. Patients with retinal detachment could be divided into two groups. The chAVP did not change significantly (p = 0,298) from 3,37 + 0,55 sec. to 3,48 + 0,54 sec. in six patients (mean age 49,7 + 5,4 years), who had a simple scleral buckling procedure. In two further patients (63 and 70 years), who had been operated with an encircling band, a postoperative chAVP-delay of 0,72 and 1,48 sec. was detected. This verification of the clinically expected obstruction of choroidal venous outflow after encircling bands emphasizes the validity of the method. Nevertheless, since the procedure is time consuming and detects only marked disturbances, it must be taken as one basic step in the search for the quantification of the choroidal circulation.

Adult↗
PubMed1991

[Serous retinal detachment in O2 therapy of primary pulmonary hypertension].

Primary pulmonary hypertension (PPH) is a rare disease, which almost inevitably leads to right-sided heart failure and death. This is to our knowledge the first report of ophthalmological complications. A 43-year-old woman in the late stage of PPH who had been continuously treated with oxygen developed an uveal effusion syndrome, which manifested as bilateral central serous retinal detachment and ciliochoroidal swelling. The serous detachment improved promptly after interruption of the oxygen therapy and again worsened when it was resumed because of massive dyspnea. Systemic blood pressure was 115/95. Right-sided cardiac catheterization revealed a systolic pulmonary arterial pressure of 110 mmHg. Pulmonary function tests showed a normal PO2 with oxygen and a light hypoxia without therapy. We came to the following conclusions: First, the central serous retinal detachment and peripheral choroidal swelling were induced by the striking increase in pulmonary arterial pressure, which almost equaled the systemic arterial pressure. Although the same ophthalmological findings have been reported in experimental animals after exposure to pure oxygen, pulmonary function tests disproved high oxygen concentration as the causative agent in our patient. Second, the improvement of pigment epithelial function after the interruption of oxygen therapy could be explained by the following hypotheses. Hypoxia induced a dilation of the choroidal arteries, followed by an improved supply of nutritive material for the pigment epithelium. There is experimental evidence that glucose might be the limiting metabolite of pigment epithelial function.

Adult↗
PubMed1990

[Pancreas transplantation in Type I diabetic patients].

Successful pancreas transplantation can result in the longterm normalization of glucose metabolism. Since most pancreas recipients already have severe diabetic complications, and the observation period after transplantation is rather short, an assessment of the effect of complete glucose normalization on these diabetic changes is problematic. It has, however, been shown that the development of diabetic nephropathy can be prevented, peripheral microcirculation improved, and autonomic and peripheral neuropathy and retinopathy stabilized. These positive effects are, possibly, in part due to the elimination of uremia, since most patients receive both a pancreas and a kidney. The aim must be to perform pancreas transplantation in an early stage of diabetes, even though remarkable improvements have also been reported in terminal stages of the disease, and the quality of life of these patients has been significantly improved.

Blood Glucose↗
PubMed1989

Metabolic control and effect on secondary complications of diabetes mellitus by pancreatic transplantation.

After successful pancreatic transplantation blood glucose can be normalized without exogenous insulin, although oral and intravenous glucose tolerance remains impaired in 10-45% of the patients. There is no significant deterioration of glucose control with time in most patients. Since most recipients of pancreatic grafts have far advanced secondary diabetic lesions and the observation time after grafting is rather short, the effects of pancreatic transplantation on these complications are difficult to interpret. However, the development of diabetic nephropathy can be prevented, skin microcirculation improves significantly, while autonomic and peripheral neuropathy and diabetic retinopathy remain stable or improve slightly in most patients. But these ameliorations may be in part due to elimination of uraemia, since in almost all patients combined pancreas/kidney transplantations were performed. It is concluded that pancreas grafting probably has to be performed much earlier in the course of diabetes, although the improvement in the quality of life is striking even in the end-stage diabetics studied so far.

Blood Glucose↗