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Biomedical subjects

C Tello

Publications and source records attributed to C Tello.

At least 19 recordsLinked to original sources
PubMed2006

Axial length and optic disc size in normal eyes.

AIM: To investigate the relationship between optic disc area and axial length in normal eyes of white and black people. METHODS: Consecutive eligible normal subjects were enrolled. Ocular biometry was obtained using A-scan ultrasonography, and reliable images of the optic disc were obtained using a confocal scanning laser ophthalmoscope. The relationship between optic disc area and axial length was assessed using univariate and multivariate models. RESULTS: 281 eyes of 281 subjects were enrolled. Black subjects (n = 157) had significantly larger discs (mean (SD) disc area, 2.12 (0.5) mm(2)) than white subjects (n = 124; 1.97 (0.6) mm(2); t test, p = 0.02). Optic disc area increased with axial length (Pearson's correlation coefficient, r = 0.13, p<0.035) for the entire study population. Multivariate regression models including race, disc area and axial length showed that a significant but weak linear relationship exists between axial length and disc area (partial correlation coefficient 0.14; p<0.024), and with race and disc area (partial correlation coefficient 0.19; p<0.017) when adjusted for the effects of other terms in the model. CONCLUSION: Increased disc area is associated with longer axial length measurements and African ancestry. This may have implications for pathophysiology and risk assessment of glaucoma.

Adolescent↗
PubMed2006

Urrets-Zavalia syndrome as a complication of argon laser peripheral iridoplasty.

OBJECTIVE: To report on 8 patients who developed prolonged mydriasis after argon laser peripheral iridoplasty (ALPI). DESIGN: Retrospective case series. METHODS: A review of the charts of 8 patients with persistent occludable angles after laser iridotomy who developed mydriasis after undergoing ALPI. RESULTS: 12 eyes of 8 patients (mean age 50.2, standard deviation 6.9, range 40-61 years) developed persistent dilatation. 7 of 8 patients had plateau iris syndrome. Only one patient had a decrease in visual acuity. Intraocular pressure increased only in 1 eye and remained stable or decreased in the others. Of the 8 patients, 7 had blurred vision, 2 had photophobia, 4 had glare and 1 had discomfort. The pupillary response to pilocarpine instillation was minimal or absent. Mydriasis eventually resolved in all eyes without treatment. CONCLUSION: ALPI can be complicated by mydriasis unresponsive to pilocarpine. Mydriasis and accompanying symptoms resolved spontaneously within 1 year in most patients.

Adult↗
PubMed2006

Detection of glaucoma using operator-dependent versus operator-independent classification in the Heidelberg retinal tomograph-III.

OBJECTIVE: To compare the abilities of a new Glaucoma Probability Scoring (GPS) system and Moorfields regression analysis (MRA) to differentiate between glaucomatous and normal eyes using Heidelberg retinal tomograph (HRT)-III software and race-specific databases. METHODS: In this prospective study, one eye (refractive error < or =5 D) each of consecutive normal patients and those with glaucoma was enrolled. All patients underwent a full eye examination, standard achromatic perimetry (Swedish Interactive Threshold Algorithm-standard automated perimetry (SITA-SAP), program 24-2) and confocal scanning laser ophthalmoscopy (HRT-II) within 1 month. Normal patients had two normal visual fields in both eyes (pattern standard deviation (PSD) >5% and Glaucoma Hemifield Test within 97% normal limits) and a normal clinical examination. Glaucoma was defined on the basis of SITA-SAP visual field loss (PSD<5% or Glaucoma Hemifield Test outside normal limits) on two consecutive visual fields. HRT-II examinations were exported to the HRT-III software (V.3.0), which uses an enlarged race-specific database, consisting of 733 eyes of white people and 215 eyes of black people. Race-adjusted MRA for the most abnormal sector (operator-dependent contour line placement) was compared with the global race-adjusted GPS (operator independent). MRA sectors outside the 99.9% confidence interval limits (outside normal limits) and GPS > or =0.64 were considered abnormal. RESULTS: 136 normal patients (72 black and 64 white patients) and 84 patients with glaucoma (52 black and 32 white patients) were enrolled (mean age 50.4 (SD 14.4) years). The average visual field mean deviation was (-)0.4 (SD 1.1) db for the normal group and (-)7.3 (SD 6.7) db for the glaucoma group (p<0.001). Mean GPS values were 0.21 (SD 0.23) and 0.73 (SD 0.27) for normal and glaucomatous eyes, respectively (p<0.001). Sensitivity and specificity values were 77.1% and 90.3% for GPS, and 71.4% and 91.9% for MRA, respectively. CONCLUSIONS: In this cohort, GPS software sensitivity and specificity values are similar to those of MRA, which requires placement of an operator-dependent contour line. The development of software to detect glaucoma without a contour line is critical to improving the potential use of HRT as a tool for glaucoma detection and screening.

Black People↗
PubMed2003

Effect of a tight necktie on intraocular pressure.

AIM: To evaluate the effect of a tight necktie on intraocular pressure (IOP) measurement using Goldmann applanation tonometry. METHODS: 40 eyes of 20 normal subjects and 20 open angle glaucoma patients (all male) were enrolled. IOP was measured with an open shirt collar, 3 minutes after placing a tight necktie, and 3 minutes after loosening it. All measurements were made by the same examiner. RESULTS: Mean IOP in normal subjects increased by 2.6 (SD 3.9) mm Hg (p=0.008, paired t test; range -3 to +14 mm Hg) and in glaucoma patients by 1.0 (1.8) mm Hg (p=0.02, paired t test; range -2 to +4.5 mm Hg). In normal subjects, IOP in 12 eyes was increased by >/=2 mm Hg and in seven eyes by >/=4 mm Hg. In glaucoma patients, IOP in six eyes was increased by >/=2 mm Hg and in two eyes by >/=4 mm Hg. CONCLUSION: A tight necktie increases IOP in both normal subjects and glaucoma patients and could affect the diagnosis and management of glaucoma.

Adult↗
PubMed2001

Ultrasound biomicroscopy before and after goniosynechialysis.

PURPOSE: To report the ultrasound biomicroscopic appearance of the anterior chamber angle before and after successful goniosynechialysis. METHODS: Interventional case report. Ultrasound biomicroscopy using a 50-MHz transducer was performed in the supine position preoperatively and postoperatively in a 76-year-old woman with angle-closure glaucoma. RESULTS: Ultrasound biomicroscopy of the anterior chamber angle demonstrated restoration of an open anterior chamber angle after goniosynechialysis. CONCLUSION: High-resolution imaging of the anterior segment to evaluate preoperative and postoperative anatomy may be useful in eyes undergoing goniosynechialysis.

Aged↗
PubMed1999

Aqueous misdirection after glaucoma drainage device implantation.

OBJECTIVE: To describe the clinical presentation, outcome, and possible underlying mechanism of aqueous misdirection after glaucoma drainage device implantation. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Ten eyes (five primary open-angle glaucoma, four chronic angle-closure glaucoma, one nanophthalmos) of nine patients with a mean age of 68.5+/-12.0 years (range, 43-83 years). INTERVENTION: The authors reviewed the medical records of all patients with a clinical diagnosis of aqueous misdirection after Baerveldt glaucoma drainage device implantation at two tertiary care referral centers from October 1992 to October 1997. Surgery was performed in a standardized fashion; all drainage tubes were inserted in the anterior chamber and occluded with an external 7-0 polyglactin ligature. All eyes were treated with topical corticosteroids, cycloplegia, and aqueous suppressants. Eyes with persistent aqueous misdirection received neodymium:YAG (Nd:YAG) hyaloidotomy or pars plana vitrectomy. MAIN OUTCOME MEASURES: Visual acuity, intraocular pressure, biomicroscopic anterior chamber depth, and antiglaucomatous medication. RESULTS: All eyes had axial shallowing of the anterior chamber, one or more patent iridotomies, and no ophthalmoscopic or B-scan ultrasonographic evidence of serous or hemorrhagic ciliochoroidal detachment. Median time to the development of angle-closure glaucoma was 33.5 days (range, 1-343 days) and mean intraocular pressure at diagnosis was 27.7+/-18.7 mm Hg (range, 10-62 mm Hg). Normalization of anterior segment anatomy was achieved with aqueous suppression and cycloplegia (one eye); Nd:YAG capsulotomy (four eyes); pars plana vitrectomy alone (two eyes) or with lensectomy (one eye), and pars plana vitrectomy with intraocular lens explanation (two eyes). Mean final intraocular pressure was 14.1+/-6.0 mmHg at a mean follow-up of 9.1+/-7.8 months after the development of aqueous misdirection (range, 1-23 months). CONCLUSIONS: Aqueous misdirection may develop days to months after glaucoma drainage device implantation. In this series, there was a poor response to medical therapy, and normalization in anterior chamber depth required aggressive laser and surgical therapy.

Adult↗
PubMed1998

High-resolution ultrasound biomicroscopy of the pars plana and peripheral retina.

OBJECTIVE: This study aimed to evaluate the ability and role of ultrasound biomicroscopy in imaging the peripheral retina, pars plana, and anterior choroid. DESIGN: The study design was a case series. PARTICIPANTS: Seventeen eyes of 17 patients with a variety of clinical diagnoses involving the anterior portion of the posterior segment were studied. INTERVENTION: High-frequency (50 MHz), high-resolution (50 microns) ultrasound biomicroscopy was performed. RESULTS: Ultrasound biomicroscopy was capable of imaging the peripheral retina, pars plana, and anterior choroid. Images had features consistent with known histopathology. Retinoschisis consisted of one thin hyper-reflective echo and could be differentiated from a retinal detachment, which was thicker and formed a bilayered echo. A choroidal effusion could be identified as an echolucent space within the suprachoroidea, whereas a choroidal hemorrhage was moderately echodense. Inflammatory diseases, such as a sarcoid granuloma, pars planitis, and Harada's disease, were characterized by different forms of uveal thickening. A ciliochoroidal nevus was internally hyporeflective and could be measured accurately and localized. CONCLUSIONS: Imaging of the peripheral retina, pars plana, and anterior choroid is possible with ultrasound biomicroscopy and may aid in the diagnosis and management of pathology involving this region.

Adolescent↗
PubMed1997

Ultrasound biomicroscopy in anterior ocular trauma.

BACKGROUND AND OBJECTIVE: The authors investigated the role of ultrasound biomicroscopy after ocular trauma. PATIENTS AND METHODS: Ultrasound biomicroscopy was performed in six eyes of six patients at the New York Eye and Ear Infirmary after a variety of traumatic ocular injuries. RESULTS: Eyes with angle recession, iridodialysis, cyclodialysis, hyphema, an intraocular foreign body, scleral laceration, and subluxed crystalline lens were imaged without complication. Ultrasound biomicroscopy aided in the diagnosis when visualization was limited by media opacities or distorted anterior segment anatomy. CONCLUSION: Ultrasound biomicroscopy is a safe and effective adjunctive tool for the clinical assessment and management of ocular trauma, especially when visualization is limited and multiple traumatic injuries are involved.

Adult↗
PubMed1997

[Alkaline encrusted cystitis secondary to Proteus mirabilis infection in a HIV infected patient].

We described for the first time an alkaline encrusting cystitis in a patient with the acquired immune deficiency. This is an entity characterized by severe dysuria and long standing urinary frequency, alkaline urine and radiographically visible calcification of the urinary bladder. It has been observed in patients with permanent Foley catheter, persistent infections due to microorganisms with urolytic activity, urinary bilharziosis or tuberculosis, or malignant bladder tumors. None of these entities were described and the patient had all conditions for this syndrome.

Adult↗
PubMed1996

Personal computer-based 3-dimensional ultrasound biomicroscopy of the anterior segment.

OBJECTIVE: To develop a practical, inexpensive system for 3-dimensional ultrasound biomicroscopic imaging of the anterior segment with a commercially available high-frequency ultrasound imager and a personal computer. METHODS: Sequential, high-frequency, ultrasound biomicroscopic images of the anterior segment were obtained with a motorized scanning control arm designed in our imaging laboratory. Images were acquired by a personal computer-based video capture device. Ultrasound slice data were then reconstructed as 3-dimensional volumetric images by a personal computer and commercially available software. RESULTS: Four 3-dimensional visualization formats were developed to enhance the clinical utility of high-frequency ultrasound. Rotational animation sequences were created that detailed the extent and anatomy of a filtering bleb, intraocular lens subluxation, focal angle closure from an iridociliary cyst, intraocular foreign bodies, and an iris tumor. CONCLUSIONS: Three-dimensional, high-frequency ultrasound of the anterior segment enhances our ability to visualize spatial relationships between adjacent anatomic structures. The low cost and ease of use of this system make widespread clinical application practical.

Adult↗
PubMed1996

Reduced trabecular meshwork height in juvenile primary open-angle glaucoma.

OBJECTIVE: To compare trabecular meshwork height in a series of patients with juvenile primary open-angle glaucoma (JPOAG) with that in normal control patients. METHODS: Ultrasound biomicroscopy and A-scan biometry were performed on 16 eyes with JPOAG and 24 normal eyes. A radial, perpendicular image in the horizontal temporal meridian detailing the line of Schwalbe, scleral spur, and angle anatomy was obtained for each eye by a single examiner. Trabecular meshwork height was defined as the distance from the scleral spur to the Schwalbe line. RESULTS: Mean patient age (P = .85, t test), refractive error (P = .68), sex distribution (P = .26, Fisher exact test) and axial length (P = .39) were similar between the groups. Mean +/- SE trabecular meshwork heights were 0.36 +/- 0.03 mm (range, 0.19-0.53 mm) for JPOAG and 0.58 +/- 0.02 mm (range, 0.40-0.80 mm) for controls (P < .001). Eyes with greater axial length tended to have larger trabecular meshworks in both groups (P = .012, multivariate regression). A trabecular meshwork height-axial length ratio of 0.021 or less was associated with a significantly increased risk for JPOAG being present (odds ratio, 57; 95% confidence interval, 6.0-541). CONCLUSIONS: The trabecular meshwork is smaller in eyes with JPOAG compared with that in normal eyes. This finding suggests a structural abnormality that may underlie the reduced outflow.

Adolescent↗
PubMed1996

Repair of Descemet's membrane detachment with the assistance of intraoperative ultrasound biomicroscopy.

PURPOSE: To evaluate the ability of ultrasound biomicroscopy to monitor the repair of large Descemet's membrane detachments. METHODS: Intraoperative ultrasound biomicroscopy was performed in two patients who had undergone previous unsuccessful surgical repair of large Descemet's membrane detachments. RESULTS: Ultrasound biomicroscopy visualized and located Descemet's membrane detachment and verified proper suture placement and membrane repositioning. CONCLUSIONS: Ultrasound biomicroscopy is a useful tool to guide surgical repair of Descemet's membrane detachments, particularly when hazy media prevent satisfactory visualization.

Aged↗
PubMed1996

Risk factors for ciliochoroidal effusion after panretinal photocoagulation.

PURPOSE: To determine the incidence, duration, and risk factors for ciliochoroidal effusion after panretinal photocoagulation. METHODS: Thirty-nine consecutive patients with diabetic retinopathy underwent ultrasound biomicroscopy of both eyes to image the ciliochoroidal space immediately before and 1 day after unilateral argon-green panretinal photocoagulation. Imaging was repeated on days 3, 7, and 14 in patients in whom ciliochoroidal effusion developed. RESULTS: Low-lying ciliochoroidal effusions were imaged in 23 (59%) of 39 eyes. Of 23 eyes, effusions resolved in 6 (26%), 12 (52%), and 5 (22%) eyes by 3, 7, and 14 days respectively. The number of laser applications (P = 0.02), shorter axial length (P = 0.01), and percentage of retinal surface area treated (P = 0.02) were associated with systemic hypertension, location of treatment, previous panretinal photocoagulation of cataract surgery, retinal surface area treated, and mean blood pressure before photocoagulation were not associated with effusion. All fellow, untreated eyes remained effusion-free. CONCLUSION: Ciliochoroidal effusion develops commonly after panretinal photocoagulation. Limiting the number of laser applications and the percentage of retinal surface area treated reduces the likelihood of this complication. Eyes with shorter axial lengths are at higher risk

Adult↗
PubMed1996

Ciliary body enlargement and cyst formation in uveitis.

BACKGROUND: Acute anterior uveitis has diverse causes and systemic associations. Inflammation is predominantly localised to the iris and pars plicata. Little is known about the in vivo effects of uveitis on ciliary body anatomy. METHODS: Bilateral, high frequency, high resolution, ultrasound biomicroscopy was performed on consecutive patients with unilateral anterior uveitis to evaluate ciliary body anatomy. Imaging was repeated when possible during the clinical course. The cross sectional area of the anterior ciliary body was measured using image processing and analysis software. Measurements from the uveitic eyes were compared with the fellow eyes and the effect of treatment was evaluated. RESULTS: Fourteen patients were enrolled. Ultrasound biomicroscopy demonstrated a larger ciliary body cross sectional area in the uveitic eyes compared with the fellow, clinically uninvolved eyes (2.45 (SD 0.48) mm2 versus 1.55 (SD 0.15) mm2, (p = 0.0000; paired t test)). A ciliochoroidal effusion was present in one uveitic eye. Epithelial cysts were imaged bilaterally in four uveitic patients (29%) and unilaterally in unaffected eyes of two uveitic patients. Ciliary body cross sectional area decreased following steroid therapy (p = 0.0001; paired t test). New cysts were noted in three uveitic eyes during the follow up period and in none of the fellow, unaffected eyes. CONCLUSION: Ultrasound biomicroscopy offers a new approach to the evaluation of anterior uveitis. The response to treatment can be evaluated objectively and therapeutic efficacy can be more easily assessed. It has the potential to help elucidate the pathophysiology and anatomical changes of this heterogeneous group of disorders.

Adolescent↗
PubMed1996

In vivo increase of the human lens equatorial diameter during accommodation.

The movement of the human lens equator during accommodation was examined in vivo. High-resolution ultrasound images of the lens equator were obtained from young human subjects whose amplitude of accommodation was controlled with 1% tropicamide and 2% pilocarpine. To avoid errors that otherwise arise from eye rotation or other movement, the cornea and sclera were used as positional references in comparative studies of the video images obtained from the unaccommodated and accommodated states. During accommodation, the movement at the lens equator involved small displacement; i.e., < 100 microns, and the equator did not move anteriorly or posteriorly but peripherally toward the sclera. These results indicate that the lens equator is under increased zonular tension during accommodation, in contradiction to Helmholtz's widely accepted theory of accommodation.

Accommodation, Ocular↗
PubMed1996

Diagnosis of traumatic cyclodialysis by ultrasound biomicroscopy.

BACKGROUND AND OBJECTIVE: To evaluate the ability of high-frequency ultrasound biomicroscopy to diagnose traumatic cyclodialyses not evident on clinical examination. PATIENTS AND METHODS: Six eyes to six patients with posttraumatic hypotony and/or shallow anterior chamber and suspected cyclodialysis clefts were examined with slit-lamp biomicroscopy, gonioscopy, B-scan ultrasonography, and ultrasound biomicroscopy. Ultrasound biomicroscopy provided high resolution of cross-sectional images of the anterior chamber angle, posterior chamber, and anterior uveal tissue. RESULTS: Ultrasound biomicroscopy confirmed the disinsertion of the ciliary body from the scleral spur and associated ciliary body detachment in all eyes. Gonioscopy failed to demonstrate a cyclodialysis cleft in five eyes because of hyphema (two eyes) and abnormal iris architecture (related to trauma) precluding visualization of the angle recess (three eyes). Using information from ultrasound biomicroscopy imagining, one patient underwent a ciliary body reattachment procedure and repair of the cyclodialysis cleft. CONCLUSION: Ultrasound biomicroscopy is a noninvasive method that can accurately diagnose the presence of traumatic cyclodialyses and can aid in surgical management. It is particularly useful in the presence of hazy media, hypotony, and/or abnormal anterior segment anatomy.

Adolescent↗