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Biomedical subjects

D T Weidenthal

Publications and source records attributed to D T Weidenthal.

17 recordsLinked to original sources
PubMed1998

Foveal outer retinal function in eyes with unexplained visual symptoms or acuity loss.

OBJECTIVE: To determine whether foveal outer retinal dysfunction is common in eyes with unexplained visual symptoms or acuity loss. DESIGN: Prospective study. PARTICIPANTS: Seventy-three eyes of 44 consecutive patients with unexplained visual symptoms or acuity loss, 39 eyes of 39 control subjects, and 12 eyes of 7 patients with known maculopathy. INTERVENTION: Foveal cone electroretinography (ERG) and letter recognition perimetry. MAIN OUTCOME MEASURES: Foveal cone ERG data. RESULTS: Abnormal foveal cone ERG data were recorded in 35 (48%) of 73 eyes (23 [52%] of 44 patients). Among these 35 eyes, amplitude was lower than in normal controls (P<.001) and was correlated with visual acuity and the number of letter recognition perimetry errors (P<.05 for both). The latter was higher in eyes with abnormal retinal responses than in symptomatic eyes with normal responses (P<.01). However, initial symptoms, visual acuity, and macular appearance did not differentiate between these 2 groups. Foveal cone ERG test vs retest data showed consistent results. CONCLUSION: Foveal outer retinal dysfunction is a common underlying mechanism of previously unexplained visual symptoms or acuity loss. Foveal cone ERG testing should be considered early in the evaluation of eyes with this presentation.

Adolescent↗
PubMed1998

Foveal dysfunction and central visual field loss in glaucoma.

OBJECTIVE: To determine whether foveal function distal to the ganglion cell layer is an independent predictor of central visual field function in glaucoma. SETTING: University affiliated hospital and private practice. PARTICIPANTS: Twenty-seven eyes (27 patients) with normal-pressure glaucoma, 10 eyes (10 patients) with primary open-angle glaucoma, and 47 eyes of 47 matched normal volunteers. INTERVENTION AND MAIN OUTCOME MEASURES: Foveal cone electroretinogram (ERG) amplitude, relative optic cup to disc area and their relations to Humphrey full-threshold 30-2 visual field central 4-point mean total deviation (C4MTD) and pattern deviation (C4MPD). RESULTS: Foveal cone ERG amplitude was subnormal in 14 (37.8%) of the 37 glaucomatous eyes and lower in the glaucoma group compared with normal eyes (P<.01). The C4MTD and C4MPD were lower in glaucomatous eyes with subnormal amplitudes compared with those with normal amplitudes (P<.01 and P<.05, respectively). Amplitude was directly correlated with C4MTD (P<.01) and C4MPD (P<.01). Relative optic cup to disc area was inversely correlated with C4MTD (P<.001) and C4MPD (P<.001). Partial correlation analysis revealed that amplitude and relative optic cup to disc area were independent predictors of C4MTD and C4MPD. CONCLUSION: Foveal function distal to the ganglion cell layer and optic disc cupping independently predict central visual field function in glaucoma.

Adult↗
PubMed1998

Intraocular mass simulating a retained foreign body.

PURPOSE: To present an unusual case of a preretinal mass that simulated a retained metallic foreign body. METHOD: Case report. RESULTS: A 30-year-old man presented with unilateral iridocyclitis and an ipsilateral preretinal mass with ultrasonographic and computed tomographic characteristics of a metallic foreign body. Histologic examination of the mass disclosed a central concentration of iron-containing hemoglobin breakdown products surrounded by a cocoon of fibrous tissue. CONCLUSION: Blood breakdown products surrounded by a fibrous capsule can present with the characteristics of an intraocular metallic foreign body.

Adult↗
PubMed1997

Histologic study of a shielded macula.

PURPOSE: To illustrate the histologic changes at the macula of an eye shielded from focused light for 76 years. Age-related macular degeneration with a central, subretinal, fibrous scar was present in the fellow eye. METHODS: Autopsy examination of both eyes of a 91-year-old man was performed. The superior half of the macular area of the shielded eye was studied by light microscopy, and the inferior half was studied by electron microscopy. Serial sections through the macular area of the fellow eye were prepared and studied. RESULTS: The shielded eye contained basal laminar deposits up to 6.0 microns in thickness and basal linear deposits up to 1.0 micron in thickness in the macular area. The photoreceptor outer and inner segments of the outer nuclear layer were intact. The macular area of the fellow eye contained a two-component, vascularized, disciform scar that measured up to 250 microns in one area, with retinal pigment epithelial tears at the nasal and temporal margins. Extensive photoreceptor layer atrophy was present. CONCLUSIONS: Such marked asymmetry of macular degeneration in this case may be further evidence of the role of light exposure in the development of age related macular degeneration.

Aged↗
PubMed1997

Foveal cone function in nonproliferative diabetic retinopathy and macular edema.

PURPOSE: To study results of foveal cone electroretinography (ERG) in patients with nonproliferative diabetic retinopathy (NPDR), with and without clinically significant macular edema (CSME). METHODS: Electroretinograms of foveal cones were elicited, with a dual-beam stimulator-ophthalmoscope, from 18 consecutive patients with bilateral NPDR and unilateral CSME. RESULTS: Analysis of resulting data revealed that mean amplitude was significantly lower in eyes with CSME and in eyes without CSME., compared with that in normal eyes. Mean implicit time was significantly longer in eyes with CSME compared with that in normal eyes, but in eyes of diabetic patients without CSME., mean implicit time was the same as that in normal eyes. Amplitudes were directly correlated and implicit times were inversely correlated with best-corrected Snellen visual acuity in eyes with and without CSME. Eyes with CSME had significantly lower amplitudes and longer implicit times than their fellow eyes without CSME. In addition, eyes with NPDR, with or without CSME, did not exhibit the normal rise in amplitude with increasing duration of light exposure. CONCLUSIONS: Electroretinographic findings showed abnormalities in foveal cone responses in eyes with NPDR, particularly in the presence of CSME. These results may support a functional role for outer retinal dysfunction in patients with diabetic retinopathy and loss of central vision.

Adult↗
PubMed1995

Cardiopulmonary arrest after retrobulbar anesthesia in a patient with an orbital roof defect.

PURPOSE: Cardiopulmonary arrest developed after injection of bupivacaine hydrochloride, lidocaine, and hyaluronidase in a 78-year-old woman who had previously undergone ipsilateral transcranial orbital surgery with removal of the bone of the orbital roof. METHODS: The patient required immediate cardiopulmonary resuscitation and intubation. Mechanical ventilation was necessary for 18 hours before spontaneous respirations resumed. RESULTS: The patient improved and was discharged on the fifth postanesthetic day. CONCLUSIONS: There were several possible mechanisms by which the local anesthetic could have entered the central nervous system. In patients with orbital roof defects, we recommend that retrobulbar anesthetic agents be used with caution.

Aged↗
PubMed1988

[Uveal effusion syndrome and scleral thickening].

The uveal effusion syndrome associates bullous no rhegmatognous retinal detachment with shifting subretinal fluid, choroidal detachment and elevated spinal fluid protein. This syndrome could result of nonophthalmos, scleral thickening and/or vortex vein attenuation. The author describes a case of uveal effusion syndrome with isolated scleral thickening. Theoretical explanations of this syndrome are emphasized on the basis of literature and clinical and surgical guidelines are given.

Choroid↗
PubMed1987

Skin necrosis following fluorescein extravasation. A survey of the Macula Society.

Three patients developed cellulitis and skin necrosis following fluorescein dye extravasation. This experience prompted a survey of the Macula Society membership to determine whether this complication of fluorescein angiography is as rare as the paucity of cases in the literature suggests. In addition, the manufacturer was asked to reexamine the dye lot to determine whether an impurity had been introduced unintentionally during the manufacturing process. No impurity was found in the dye lots tested. The survey disclosed only nine additional cases of skin necrosis, leading to the conclusion that skin necrosis probably represents a rare, idiosyncratic reaction. Although fluorescein angiography remains a safe procedure, efforts should be directed toward prevention of dye extravasation. When extravasation does occur, prompt and proper medical attention with close follow-up study may minimize the likelihood of skin necrosis.

Aged↗
PubMed1983

Subretinal neovascularization as a complication of drainage of subretinal fluid.

Four cases of subretinal choroidal neovascularization that developed at the sight of breaks in Bruch's membrane were made for the drainage of subretinal fluid during retinal reattachment surgery. This neovascularization can occur in both young and older patients. All drainage sights were posterior to the equator, which may indicate a higher risk of the development of this complication from posterior drainage sights. Unless the fovea is threatened, there is no urgency to treat this choroidal neovascularization. It is unclear why this complication is so rare, considering the frequency of surgical perforation of the choroid and Bruch's membrane during drainage of subretinal fluid in retinal reattachment surgery.

Adolescent↗
PubMed1976

Retinal detachment in a battered infant.

A 12-week-old battered infant boy had bilateral retinal detachments. The retina in the left eye was considered inoperable, but retinal detachment surgery was performed in the right eye. This retina was reattached and limited vision was restored. The history, the location of the retinal pathology, and the absence of a lens coloboma helped differentiate this result of physical abuse from a congenital retinal detachment.

Battered Child Syndrome↗