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Avinoam Ophir

Publications and source records attributed to Avinoam Ophir.

10 recordsLinked to original sources
PubMed2005

[Lamellar macular hole and continuous vitreofoveal adherence].

PURPOSE: To demonstrate a sub-type of idiopathic inner lamellar macular hole (ILH) that may merit surgical consideration. METHODS: The study was conducted on patients examined with optical coherence tomography (OCT) between August 2001 and December 2003 and included 22 patients each with ILH in one eye. Eyes with persistent vitreofoveal adherence at the ILH site were included in the study. Eyes that had previously undergone posterior vitrectomy and removal of the posterior hyaloid were excluded. RESULTS: Out of the 22 cases, persistent vitreous adherence to the edge of the ILH was detected in 3 eyes (3 patients; 13.6%). The ILH occurred spontaneously in 2 eyes and was detected after extraction of an intraocular foreign body in one eye. The vitreous adherence at the ILH, related to the incompletely detached posterior hyaloid in each, was asymmetric: in 2 eyes it was detached only nasal to the ILHs; in the third eye the posterior hyaloid was detached for 360 degrees around the adherence site, but appeared much thicker at a specific site than elsewhere. CONCLUSIONS: The findings indicate that persistent vitreofoveal adherence might be present in eyes with ILH. Further studies should signify whether such ILHs have a potential of progression, cases in which surgical intervention should be considered.

Adult↗
PubMed2004

Retinal nerve fiber layer thinning in Parkinson disease.

Retinal dopamine loss in Parkinson disease (PD) is reflected by visual neurophysiological dysfunction. We measured the thickness of the circumpapillary retinal nerve fiber layer (RNFL) in PD patients using optical coherence tomography. The thickness in the inferior quadrant of PD patients (147 +/- 20 microns) was significantly thinner than that of controls (173 +/- 12 microns; p=0.002), while the inferotemporal area was the thinnest (146 +/- 24 vs. 191 +/- 21 microns; p=0.0003). The results show significant loss of RNFL thickness in PD at specific sites.

Adult↗
PubMed2003

Optic disc traction syndrome associated with central retinal vein occlusion.

OBJECTIVE: To describe the association between ischemic central retinal vein occlusion (CRVO) and the development of optic disc (vitreopapillary) traction, as verified by optical coherence tomography (OCT). METHODS: In a prospective, noncomparative, observational patient series, 3 women aged 51 to 64 years developed an ischemic type of CRVO. One patient underwent cannulation of the central retinal vein with injection of a tissue plasminogen activator. In each eye, the contour of the optic nerve head could not be accurately detected because of overlying fibrous tissue. Each patient underwent OCT examination 6 to 10 months (average, 8.3 months) after the occlusive event. RESULTS: Optic disc traction was found by OCT in the 3 patients. In each, the disc was elevated, associated with either incomplete posterior vitreous detachment (2 eyes) or vitreopapillary fibrous membrane (1 eye). Secondary peripapillary retinal traction and macular or retinal detachment developed ("optic disc traction syndrome"). These findings were less marked, or not evident, on both clinical examination and ocular ultrasonography. CONCLUSIONS: Optic disc traction and secondary localized retinal detachment can develop after ischemic CRVO and may contribute to the poor visual acuity. This syndrome should merit special attention before surgery for CRVO is planned. The use of OCT was helpful to diagnose this syndrome.

Diagnostic Imaging↗
PubMed2002

Detachment of subfoveal choroidal neovascularization in age-related macular degeneration.

PURPOSE: To report the entity of partial detachment and folding of subfoveal choroidal neovascularization (CNV) in age-related macular degeneration (ARMD). DESIGN: Interventional case reports. METHODS: Review of the features of CNV detachment in two patients with CNV due to ARMD by contact lens slit-lamp biomicroscopy, fluorescein angiography, optical coherence tomography, and three-dimensional confocal scanning laser indocyanine green (ICG) angiography. RESULTS: One patient out of approximately 300 (0.5%) ARMD patients treated by photodynamic therapy (PDT) developed partial CNV detachment and folding 6 weeks after the second PDT treatment. Another patient out of approximately 100 (1.0%) ARMD patients treated by transpupillary thermotherapy (TTT) developed partial CNV detachment and folding 6 weeks after the second TTT treatment. The CNVs were large (2,500 microm to 4,500 microm) and located between the retina and the retinal pigment epithelium. In each, these findings were clearly visualized by slit-lamp biomicroscopy. Fluorescein angiography demonstrated an associated retinal pigment epithelium tear in one patient. Optical coherence tomography showed distinctive features and confocal scanning laser ICG further delineated the detached folded CNV. The best-corrected visual acuity improved in one patient from 20/80 to 20/40 and in the other from counting fingers at 6 feet to 20/200 after the CNV detachment. CONCLUSIONS: Partial CNV detachment and folding represent a unique, not previously reported, and possibly favorable outcome of PDT and TTT. The low energy and selectivity of these treatments may explain this phenomenon.

Aged↗
PubMed2002

Acetazolamide for central serous retinopathy.

OBJECTIVE: To find out whether acetazolamide has a beneficial effect in the treatment of central serous retinopathy (CSR). DESIGN: Prospective, nonrandomized, comparative trial. PARTICIPANTS: Fifteen acetazolamide-treated and 7 untreated (control) CSR patients who completed at least 24 months of follow-up. METHODS: Patients in the treatment group were given systemic acetazolamide according to a standard protocol. Main outcome measures were compared between treatment and control groups using Student's t test and the Mann-Whitney U test for statistical analysis. MAIN OUTCOME MEASURES: Time until subjective visual improvement, time until full clinical resolution, and rate of recurrences. RESULTS: Mean times to both subjective visual improvement and clinical resolution of the attack were shorter in the study group than in the control group. Recurrence rate did not differ between the study and control groups. CONCLUSIONS: Acetazolamide treatment for CSR shortens the time for subjective and objective clinical resolution, but has no effect on either final visual acuity or recurrence rate of the disease.

Acetazolamide↗
PubMedDate not supplied

5-Fluorouracil-needling and paracentesis through the failing filtering bleb.

BACKGROUND AND OBJECTIVE: Standard needle revision of the filtering bleb after glaucoma filtration surgery has many disadvantages. This study reports the technique and outcome of a modified needling of the failing bleb. PATIENTS AND METHODS: Consecutive patients who presented with increased intraocular pressure (lOP) and open internal ostium were included in this prospective study. When their IOP rose to levels >20 mm Hg despite various therapeutic regimens and visibility of the sclerostomy site was unclear, the modified needling technique was conducted. In each needling, a total dose of 1 mg (0.1 mL) of 5-fluorouracil (FU) was administered subconjunctivally, adjacent and into the bleb. The needle was then passed via the bleb, anterior to the sclera, through the anterior limbus to penetrate intracamerally. Standard treatment to inhibit bleb scarring followed. RESULTS: Twelve 5-FU-needle revisions were performed on 8 eyes. The first needle revision was performed 51.1+/-36.2 days (range, 5-117) postoperatively. IOP decreased from 31.0+/-5.7 (range, 25-43) mm Hg with 0.6+/-0.9 (range, 0-2) hypotensive medications to 15.5+/-2.6 mm Hg (range, 12-19) with 0.9+/-1.1 medications (range, 0-3), 11.3+/-4.9 months (range, 8-23) after the only or second (last) needling (P=0.012). In all eyes, the filtering bleb became diffused; in 7 eyes, it remained diffusely elevated or shallow-diffused. CONCLUSION: Relatively few needle revisions of the filtering bleb by a modified approach that bypassed the activated scarring tissue contributed to the restoration of IOP control. It is possible that the 5-FU-needle revision may offer advantages over the standard approach. A larger sample and a controlled study are required to validate these considerations.

Aged↗
PubMedDate not supplied

Potential applications of optical coherence tomography in posterior segment trauma.

BACKGROUND AND OBJECTIVE: To describe potential clinical applications of optical coherence tomography (OCT) in diagnosis and surgical timing in eyes with posterior segment trauma. PATIENTS AND METHODS: In a noncomparative study, 7 consecutive patients who had open-globe or closed-globe injury and were found to have posterior abnormality that could also be detected by OCT are described. RESULTS: All patients had documented OCT abnormalities in the posterior segment. In one patient with a penetrating injury, two metal foreign bodies were located in the posterior segment, one in the vitreous compartment coupled with inflammatory reaction and localized posterior vitreous detachment and the other embedded in the retina. In a second patient with a penetrating injury, OCT revealed the appearance of posterior vitreous detachment 5 days after injury. A closed-globe injury in one patient resulted in anterior optic neuropathy, manifested as disc edema and thickening of the circumpapillary retinal nerve fiber layer. The other patients had received blunt trauma and were found to have either full-thickness macular holes (2 patients), retinal pigment epithelium detachment at the papillomacular bundle site (1 patient), or macular edema (1 patient). CONCLUSIONS: OCT may serve as an important adjunct imaging device in evaluation of injuries to the posterior segment, qualitatively and quantitatively. It has potential in diagnosing subtle key abnormalities and in follow-up of these injuries.

Adult↗