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Biomedical subjects

C L Trempe

Publications and source records attributed to C L Trempe.

At least 73 records · Page 4Linked to original sources

Photocoagulation of chorioretinal anastomoses in far-advanced age-related macular degeneration.

In age-related macular degeneration, communication between the retinal and choroidal circulations occurs spontaneously or following unsuccessful laser photocoagulation of subretinal new vessels. The resulting chorioretinal anastomotic complex, which includes the subretinal new vessels and their feeder retinal vessels, usually shows marked exudation and produces an extensive serous detachment of the neurosensory retina in the posterior pole, often associated with hard exudates. Eleven eyes with chorioretinal anastomotic complexes were treated using the monochromatic green argon laser. Adequate closure of the chorioretinal anastomotic complexes by photocoagulation resulted in retinal flattening in the posterior pole with resolution of the hard exudates and improvement of vision in eight of the 11 treated eyes.

Aged↗

Biomicroscopic evaluation and photography of ocular toxoplasmosis.

The vitreous of 39 eyes with ocular toxoplasmosis was studied and photographed using an El Bayadi-Kajiura preset lens. In active cases of toxoplasmosis, the vitreous showed inflammatory opacities and gel shrinkage. In inactive cases, the vitreous was often liquefied. Compared with 39 normal eyes of age- and sex-matched controls, the prevalence of partial posterior vitreous detachment was significantly higher in toxoplasmosis (P less than .001). A higher prevalence of posterior vitreous detachment was found in eyes with the major chorioretinal lesion outside the temporal vascular arcade than in those with lesions inside the temporal vascular arcade (P less than .05). Our results indicated that various vitreous changes may cause posterior vitreous detachment and that location of the inflammatory focus may influence the vitreous condition.

Adolescent↗

Risk factors associated with branch vs. central retinal vein occlusion.

Records of 145 consecutive central and 214 branch retinal vein occlusion (CRVO and BRVO) patients were reviewed retrospectively to determine the differences in risk factors associated with these two diseases. Mean ages and sex ratios of both groups did not differ significantly. Hypertension and hyperopia were significantly more prevalent in BRVO than in CRVO, and elevated intraocular pressure, elevated erythrocyte sedimentation rate (ESR), and a positive tuberculin skin test were significantly more prevalent in CRVO. We conclude that the causes of the ESR elevation are more significant risk factors for CRVO, and systemic hypertension and hyperopia continue to be the main risk factors for BRVO.

Age Factors↗

Macular edema in branch retinal vein occlusion: types and treatment.

In this study of branch retinal vein occlusion, we distinguished between cystoid macular edema caused by increased capillary pressure and noncystoid edema due to hard exudates in the macula caused by chronic leakage from vascular abnormalities in the posterior pole or midperiphery. We performed laser photocoagulation in 51 eyes with cystoid macular edema to achieve focal narrowing of the retinal arterioles perfusing the macular area affected by the cystoid edema; good anatomic and functional results were achieved in 40 of these eyes (78%). In 25 of the five eyes, the treated segment of the retinal arteriole was outside the area of macular edema; results were successful in 19 of these eyes (76%). In 14 eyes with noncystoid exudative macular edema, we performed laser photocoagulation to the vascular abnormalities; good anatomic and functional results were obtained in 12 of these (86%).

Aged↗

Visual results with low-vision aids in age-related macular degeneration.

We reviewed the records of 61 patients with age-related macular degeneration who had an exudative or a dry macular scar and who had received low-vision rehabilitation. Exudative scars resulted from the natural course of sub-retinal new vessels, and dry scars from successful photocoagulation to the new vessels. Low-vision aids consisted of high-power positive lenses. Eyes were divided into three groups according to their distance visual acuity before using low-vision aids: Group 1, 20/100; Group 2, 20/200 to 20/300; and Group 3, 20/400 or poorer. The print size resolution on the Rosenbaum pocket vision screener and power of the low-vision aid in each group were compared for the eyes having exudative scars and those with dry photocoagulation scars. In Groups 2 and 3, eyes with dry macular scars reached a similar resolution of print size but with significantly (P less than .01) lower-power visual aids than eyes with exudative macular scars. In Group 1, eyes with dry macular scars achieved a better print size resolution using significantly (P less than .01) lower-power visual aids than eyes with exudative scars.

Aging↗

Unusual central chorioretinitis as the first manifestation of early secondary syphilis.

Three young, otherwise healthy patients had a similar picture of unilateral central chorioretinitis associated with severe visual loss. Fluorescein angiography disclosed diffuse leakage under the neurosensory retina in the posterior pole, associated with multifocal areas of staining along the retinal vessels. Systemic examination showed a positive fluorescent treponemal antibody absorption test and a sharp increase in VDRL titers, indicative of active secondary syphilis. The patients responded dramatically to penicillin treatment, with visual recovery and resolution of the fundus lesions.

Adult↗

Role of the vitreous in branch retinal vein occlusion.

We analyzed the vitreous findings in 62 patients (62 eyes) with major branch retinal vein occlusion to determine whether vitreous examination was useful in predicting the development of retinal or disk neovascularization, or both. In 18 eyes with no or partial posterior vitreous detachment and large areas of capillary nonperfusion (5 disk diameters or more), ten eyes (55.6%) eventually developed neovascularization. Only three of the remaining 44 eyes (6.8%) developed neovascularization. The probability of this development was greater in eyes with no partial posterior vitreous detachment at the initial vitreous examination (P = .0177, Cox's regression analysis), and in those with large areas of nonperfusion (P = .0097, Cox's regression analysis).

Aged↗

A new solid-state, frequency-doubled neodymium-YAG photocoagulation system.

We have developed a solid-state laser system that produces a continuous green monochromatic laser beam of 532 nm by doubling the frequency of a neodymium-YAG laser wavelength of 1064 nm with a potassium-titamyl-phosphate crystal. Photocoagulation burns of equal size and intensity were placed in two rabbit eyes with the solid-state laser system and the regular green argon laser system, respectively, using the same slit-lamp mode of delivery. Histologic findings of lesion sections revealed no important differences between the two systems. In theory, the longer wavelength of the solid-state laser offers the advantages of less scattering in ocular media, higher absorption by oxyhemoglobin, and less absorption by macular xanthophyll than the 514-nm wavelength of the regular green argon laser. The solid-state laser has impressive technical advantages: it contains no argon-ion gas tube that wears out and is expensive to replace; it is much more power efficient, and thus considerably smaller and compact; it is sturdier and easily movable; it does not require external cooling; it uses a 220-V monophasic alternating current; and it requires little maintenance.

Aluminum↗

The role of the vitreous in diabetic macular edema.

The authors assessed retrospectively clinical records of 76 patients (125 eyes) 60 years of age or older with diabetic retinopathy who had undergone a vitreous examination. The groups consisted of 105 eyes (63 patients) with macular edema and 20 eyes (13 patients) without macular edema. Vitreous studies were done using the El Bayadi-Kajiura lens to determine whether or not the posterior vitreous was attached to the retina in the macula. Twenty-one of 105 eyes (20.0%) in the edema group and 11 of 20 eyes (55.0%) in the no-edema group had a detached posterior vitreous. This difference was found to be statistically significant, indicating that diabetic cases without macular edema have a significantly higher rate of posterior vitreous detachment than those with macular edema. This study demonstrates that the vitreous may play a role in diabetic macular edema.

Aged↗

Treatment of small choroidal melanomas with photocoagulation.

Seventeen eyes with small choroidal melanomas presumed to be malignant were photocoagulated. The melanomas measured 7 to 15 mm at the tumor base and 2 t0 5 mm thick. First, photocoagulation using the green argon laser was aimed at closing the choroidal vascular supply of the tumor. In a second stage, tumor tissue was destroyed using the red krypton laser for confluent burns of long duration. Such treatment was supplemented by cryotherapy in peripherally located tumors or whenever photocoagulation alone did not result in tumor regression. Photocoagulation alone was used in ten eyes and combined wih cryotherapy in seven. After an average follow-up of 42 months, marked tumor regression was achieved in 12 eyes and some tumor regression in two. Tow eyes ultimately required proton beam irradiation, and one eye was enucleated. No metastasis occurred during follow-up.

Aged↗

Long-term follow-up of photocoagulated choroidal neovascular membranes in age-related macular degeneration.

Eighty-nine consecutive eyes with age-related macular degeneration and choroidal neovascularization treated with green argon laser were followed for an average of 54 months after photocoagulation. Good anatomical and functional results were obtained in 36 of 52 eyes (69%) with foveal new vessels, in 12 of 20 eyes (60%) with juxtafoveal new vessels, and in 13 of 17 eyes (76%) with perifoveal new vessels. Thirty-four of the 89 eyes (38%) had at least one recurrence of new vessels, which most often affected the edge of the previously treated area (30 eyes, 34%). In 18 eyes (20%), these recurrences involved the edge of the scar closer to the fovea.

Aged↗

Choroidal neovascularization in degenerative myopia: role of laser photocoagulation.

Laser photocoagulation of extrafoveal choroidal new vessels was performed in 19 eyes with degenerative myopia. Sixteen eyes required only one treatment. Three eyes required more than one because of incomplete closure of the new vessels after the first treatment. Choroidal new vessel formation did not recur during the post-treatment follow-up period (average 29.2 months), and a dry, atrophic photocoagulation scar was achieved in all eyes. Visual acuity improved in only two eyes (11%), stabilized in four eyes (21%), and deteriorated in 13 eyes (68%). All except two eyes showed spontaneous progressive enlargement of the atrophic photocoagulation scar, which worsened visual acuity in 13 eyes (68%).

Adult↗