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Biomedical subjects

C L Trempe

Publications and source records attributed to C L Trempe.

126 records · Page 7Linked to original sources
PubMed1982

Nanophthalmos: a perspective on identification and therapy.

Nanophthalmos is a rare and blinding disease. Diagnostic features include a small eye, small cornea, shallow anterior chamber, narrow angle, high lens/eye volume ratio, and uveal effusion. Intraocular surgery has a high rate of disastrous complications and blindness. The 32 eyes (16 patients) presented are in three categories based on angle closure and intraocular pressure levels. Treatment methods included medication, laser iridotomy and gonioplasty, peripheral iridectomy, filtration surgery, and cataract extraction. Glaucoma medication was effective, although miotics sometimes increased pupillary block. Laser iridotomy was successful in 83% of six eyes; laser gonioplasty in 91.6% of 12 eyes. Peripheral iridectomy succeeded in two of seven eyes, and filtering operations provided tension control in two of five eyes. Thirteen of 15 eyes undergoing filtration surgery suffered severe postoperative visual loss. Cataract extraction improved vision in only three of six eyes. The authors' experience confirms that surgery in nanophthalmic eyes has an extremely high complication rate with disastrous results. Medication and laser therapy are the procedures of choice for angle-closure glaucoma in nanophthalmos.

Adult↗
PubMed1981

Vitreoretinal relationship in diabetic retinopathy. A biomicroscopic evaluation.

The vitreoretinal relationships of 312 eyes with diabetic retinopathy were analyzed statistically, based on the results of biomicroscopic observation and photography of the vitreous. Vitreous detachment usually occurs outside the temporal vascular arcades, and the macula subsequently becomes involved in the midstage of the proliferative process. The incidence of no vitreous detachment and complete vitreous detachment are significantly lower in proliferative retinopathy as compared with nonproliferative than in nonproliferative retinopathy. The relatively high incidence of proliferation with no vitreous detachment indicates that vitreous detachment is not the sole triggering factor in the development of proliferative changes. However, partial vitreous detachment was shown, retrospectively, to stimulate a rapid exacerbation of the proliferative process as compared with eyes having no vitreous detachment or complete vitreous detachment.

Adolescent↗
PubMed1981

Microhemorrhagic maculopathy.

Twenty subjects, 12 males and eight females aged 14 to 58 years, had a small monocular macular hemorrhage that was punctate, round, or bilobed and seemed to originate from the perifoveal capillary plexus. Although clinical study results failed to establish a common causal denominator, three of the 20 patients had a history of preceding increased venous pressure (Valsalva stress), three of nine subjects tested showed impaired blood platelet aggregation, and an additional four of 20 were taking medications known to impair platelet function both in vitro and in vivo. Macular microhemorrhages resolve spontaneously, and available data suggest that the syndrome is benign.

Adolescent↗
PubMed1981

Biomicroscopic evaluation and photography of liquefied vitreous in some vitreoretinal disorders.

The vitreous condition in retinitis pigmentosa, high myopia, peripheral uveitis, and Wagner's disease and in normal eyes was evaluated biomicroscopically and documented photographically using a present lens (El Bayadi-Kajiura) in 205 eyes. Compared with the control group, the incidence of partial or complete vitreous detachment was significantly higher in all four clinical entities and partial vitreous detachment was more frequently found in Wagner's disease, high myopia, and peripheral uveitis, but not in retinitis pigmentosa. A higher incidence of cottonball-like opacities and/or spindle-shaped condensations in the posterior vitreous near the retina was found in retinitis pigmentosa and high myopia than in peripheral uveitis or Wagner's disease. This finding suggests that the vitreous changes seen in retinitis pigmentosa and high myopia are secondary to chorioretinal degeneration.

Adolescent↗
PubMed1981

Fellow eyes of eyes with macular holes.

We studied the fellow eyes of eyes with macular holes by fundus photography, fluorescein angiography, and central visual field testing. Eight of 37 fellow eyes (22%) observed for a minimum of 36 months developed macular holes. Fellow eyes initially classified as normal developed fewer macular holes than fellow eyes with initial pigment epithelial defects or cystic formation.

Female↗
PubMed1981

Vitreous changes in retinal branch vein occlusion.

The vitreous was studied in 50 eyes with retinal branch vein occlusion (RBVO) and compared to an age-matched control group. The incidence of partial vitreous detachment was significantly higher (22%) in the RBVO group than in the control group (2.2%) (P less than 0.01). The incidence of preretinal neovascularization in the RBVO group was 22%. No new vessels formed in eyes with complete posterior vitreous detachment (P less than 0.05). The risk of vitreous hemorrhage was greatest in patients with partial vitreous detachment (64%). There was no significant correlation between the status of the vitreoretinal relationship and the development of macular edema, which occurred in 56% of the patients. In two patients, intermittent vitreous traction on the fovea may have influenced the evolution of chronic macular edema and lamellar hole formation. Vascular occlusive disease of the retina produces significant changes in the overlying vitreous. These vitreous changes in turn influence the development of complications following retinal vascular occlusions.

Adult↗
PubMed1981

Vitreous cinematography in the study of vitreoretinal diseases.

A new technique of vitreous cinematography involves scanning of the vitreous cavity using optical sections to provide objective, reproducible information on the dynamics of the posterior vitreous and vitreoretinal relationships. Using a newly developed preset lens (El Bayadi-Kajiura lens), this technique makes it possible to document an entire optical section of the posterior vitreous. This is done by mechanically displacing the vitreous so that maximum reflectivity can be obtained from the vitreous gel. This article describes the technique and presents clinical examples documenting complete and incomplete vitreous detachment in normal eyes, Cloquet's canal associated with an optic disc pit, vitreous traction associated with a lamellar hole in an area of preretinal macular fibrosis, and vitreous traction at the anterior flap of a retinal break.

Aged↗
PubMed1980

Biomicroscopic evaluation and photography of posterior vitreous detachment.

This is a preliminary effort to demonstrate conditions of the posterior vitreous more objectively by slit-lamp photography. For this purpose, a + 58.6-diopter, aspherical, preset lens (El Bayadi-Kajiura lens [Nikon]) and a photoslit (Zeiss Jena) were used. The most fundamental aspect in our technique of observation and photography of the posterior vitreous is that of catching the appropriate moment during the vitreous movement that follows horizontal and/or vertical displacement of the patient's eye. Posterior vitreous photographs by this method in normal eyes, retinitis pigmentosa, Wagner's disease, and preretinal macular fibrosis associated with macular edema in phakic eyes are presented, and biomicroscopic characteristics in each of these diseases are discussed. Our observations clearly demonstrate a new technique for detailed examination and photography of the posterior vitreous.

Adult↗
PubMed1980

Hypertrophy of the retinal pigment epithelium associated with Gardner's syndrome.

Congenital hypertrophy of the retinal pigment epithelium was seen in three affected members of a kindred with Gardner's syndrome. The latter consists of a triad of many intestinal polyps, hard-tissue abnormalities, and soft-tissue abnormalities. Although the appearance of the individual lesions in our patients was typical of hypertrophy of the retinal pigment epithelium, the following atypical features were present: multiple lesions per eye; bilateral occurrence; familial transmission; and association with systemic disease. Ophthalmoscopic examination can help identify children who are at risk of developing polyposis and carcinoma of the colon. In some instances, Gardner's syndrome may be diagnosed in a patient and his family as a result of observing the fundus lesions.

Adult↗
PubMed1978

Choroidal folds.

We documented the presence of choroidal folds in a series of 59 eyes. Fifteen separate conditions were established as causes of the choroidal folds. Hyperopia was the most common cuase, although no definite etiology could be established in ten cases.

Adolescent↗
PubMed1976

Chorioretinal anastomoses after argon laser photocoagulation.

Communication between the retinal and the choroidal circulation occurred in one case of proliferative diabetic retinopathy and one case of Leber's disease (multiple miliary aneurysms) after argon laser photocoagulation treatment to eliminate abnormal retinal vasculature. In both instances rapid-sequence fluorescein angiography documented the choroidal origin of the anastomoses. Such anastomoses developed in areas where an excessively dense laser beam aimed at occluding retinal vessels presumably destroyed the underlying Bruch's membrane and permitted invasion of the retina by fibrovascular growth from the choriod. The occurrence of such growths is a potential complication of argon laser photocoagulation directly related to the power density used.

Adult↗
PubMed1976

Fluorescein angiography of degenerative lesions of the peripheral fundus and rhegmatogenous retinal detachment.

Since the number of cases for each of the conditions in our study was small, only preliminary conclusions can be made; in order to establish the fluorescein pattern of each of these peripheral retinal lesions, additional studies will be required. The following summarizes our preliminary observations. 1. Areas of retinal white-with-pressure or without and peripheral retinal cystoid degeneration did not reveal remarkable fluorescein angiographic findings. One exception was in an area of pigment epithelial disturbance characterized by atrophy and proliferation, which showed a "window and masking" effect of choroidal fluorescence. 2. Fluorescein angiography of areas of the fundus with lattice retinal degeneration showed little or no findings in early or mild cases. In severe or advanced cases, the affected retina revealed poor or absent perfusion caused by vascular occlusion. The retinal and choroidal circulation was devoid of fluorescein leakage. Advanced lesions displayed choroidal hypofluorescence in areas of pigment proliferation and hyperfluorescence in areas of pigment atrophy. 3. In advanced cases, occlusive vascular changes over areas of acquired retinoschisis were observed. There was intraretinal leakage of the dye from deep capillaries and pooling of the dye in cystic cavities near the margin of the retinoschisis. 4. There was no perfusion of the choroid and retina in the area of the hole and in the retina surrounding it. This finding suggests choroidal and retinal ischemia in the pathogenesis of a retinal hole. 5. Fluorescein angiography of retinal tears revealed fluorescein leakage along the edge of the tear and absent perfusion of the retinal flap. The retinal and choroidal circulation-around the tear was otherwise unremarkable. The choroidal fluorescein underlying the retinal flap was not visible, perhaps because it was masked by the retinal flap. 6. Our fluorescein angiographic findings in cases of rhegmatogenous retinal detachment confirmed those of others [7, 8, 10]. Transit of fluorescein through the retinal circulation was sluggish. The retinal capillaries were dilated. 7. In cases of rhegmatogenous retinal detachment which had become reattached surgically, areas treated with diathermy or cryoapplications showed absent or diminished choroidal and retinal perfusion. Leakage of the fluorescein from capillaries in the optic disc and retina in the posterior pole was sometimes persistent several months postoperatively.

Fluorescein Angiography↗
PubMedDate not supplied

Diffuse choroidal thickening detected by ultrasonography in various ocular disorders.

Diffusely thickened choroid was detected ultrasonically in 207 eyes in various conditions, including: following intraocular surgery (108 eyes), trauma (8 eyes), phthisis bulbi (52 eyes), endophthalmitis (12 eyes), and nanophthalmos (27 eyes). Diffusely thickened choroid was seen by A-scan as a widening of the echo pattern originating from the posterior coats of the eye and by B-scan as a curvilinear echo giving a double contour to the globe. Although B-scan characteristics of thickened choroid consisted of a smooth curvilinear echo in 196 eyes, this echo was irregular with multiple angulations in 11 eyes that had phthisis bulbi. The mechanisms suspected of choroidal thickening were ocular hypotony (sudden or chronic, 154 eyes), impaired drainage in the vortex system (41 eyes), and severe intraocular inflammation (12 eyes).

Adolescent↗
PubMedDate not supplied

Prevalence of posterior vitreous detachment in retinitis pigmentosa.

To investigate the prevalene of posterior vitreous detachment (PVD) and PVD with collapse in relation to age in eyes with retinitis pigmentosa (RP), we retrospectively studied the vitreous condition in 218 eyes of 109 patients with RP. Two hundred thirty healthy eyes of 115 subjects served as controls. The prevalence of both PVD and PVD with collapse, respectively, in the first through the sixth decades of life, and the second through the seventh decades was significantly higher in the RP eyes than in the controls (P < .01). Our findings demonstrated the early onset and progression of PVD with age in the eyes with RP as compared with the control eyes.

Adolescent↗
PubMedDate not supplied

Comparison of the prevalence of posterior vitreous detachment in whites and Japanese.

The vitreous condition of healthy white (n = 551) and Japanese (n = 528) eyes were reviewed and compared with respect to the prevalence of posterior vitreous detachment (PVD) in the two groups. No white or Japanese patient 39 years of age or younger had PVD; the prevalence among those older than 39 increased with age in the fifth through the ninth decades, i.e., respectively, to 4%, 24%, 37% 59%, and 87% in the whites, and to 5%, 21%, 43%, 72%, and 82% in the Japanese. In none of these decades was there any significant difference between the prevalence of complete or partial PVD in the whites and the Japanese. This finding is significant because the vitreoretinal relationship influences the development and prognoses of the various vitreoretinal disorders.

Adolescent↗
PubMedDate not supplied

Retinal breaks in diabetic retinopathy: vitreoretinal relationships.

We retrospectively reviewed the eyes of 143 patients with tractional retinal detachment caused by diabetes that had been studied biomicroscopically, and, after some exclusions, divided them into two groups: those with retinal breaks (group 1) (16 patients, 16 eyes), and those without retinal breaks (group 2) (127 patients, 161 eyes). The group 1 eyes were further divided into three subgroups: those with retinal tears from limited anteroposterior vitreous traction (subgroup A), those with macular holes in an area without posterior vitreous detachment (subgroup B), and those with oval retinal holes anterior to the anteroposterior vitreous traction (subgroup C). Subgroup C comprised most of the eyes in group 1 (10 eyes) and was the only subgroup that we compared with group 2. Significant differences between subgroup C and group 2 were found in terms of the extent of tractional retinal detachment (P = .002) and the degree of preretinal fibrosis (P = .009). These data suggest that large tractional retinal detachments and extensive preretinal fibrosis are significant risk factors for the development of retinal breaks in proliferative diabetic retinopathy.

Diabetic Retinopathy↗
PubMedDate not supplied

Diabetic maculopathy.

The incidence, pathogenesis, and treatment of diabetic maculopathy are discussed. A plea is made for earlier, more discrete treatment that may improve the chances of prolonging sharp central vision.

Blindness↗