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Biomedical subjects

E E Kritzinger

Publications and source records attributed to E E Kritzinger.

30 records · Page 2Linked to original sources
PubMed1985

Underlying medical conditions in young patients and ethnic differences in retinal vein occlusion.

Eighty-seven patients with retinal vein occlusion were investigated for the prevalence of associated conditions, and divided in two groups, young (less than 50 years, n = 40) and an older group (greater than 50 years, n = 47). Young patients had a highly significant decreased prevalence of hypertension compared to the older group (27 per cent versus 62 per cent: P less than 0.001), with hyperlipidaemia being the predominant underlying condition (35 per cent). Four young female patients presenting with retinal vein occlusion were on the contraceptive pill. In the majority of young patients (60 per cent) an underlying medical condition could be identified. Striking ethnic differences in the occurrence of retinal vein occlusion have also been observed in a total of 214 patients referred without prior selection in two major ophthalmological centres over a four year period. Only 3 per cent of patients with retinal vein occlusion were Asian and 2 per cent of West Indian origin. In particular, no West Indian patient has been seen with the central form of venous occlusion. We conclude that hyperlipidaemia, and not hypertension, is the predominant associated medical condition in young patients and that other aetiological factors including the contraceptive pill may be found. Marked ethnic differences have also been observed which may give further insight into the exact aetiology of retinal vein occlusion.

Adult↗
PubMed1983

Should diabetes be a contraindication for an intraocular lens?

Twenty-five patients with Binkhorst 4-loop intraocular lenses were studied to assess the ease of visualization of their fundi, and the feasibility of treating diabetic retinopathy. All patients had fulfilled several pre-operative selection criteria. Visualization with the direct ophthalmoscope and posterior pole contact lens was good in most cases through undilated pupils. Documentation of fundus abnormalities by fundus photography and fluorescein angiography was possible only if the pupils were dilated. Retinal photocoagulation with argon laser could be carried out through the intraocular lenses in all patients requiring treatment. Iris clip lenses should not be regarded as contraindicated in selected diabetic patients.

Adult↗
PubMed1982

Permeability of blood-retinal barriers in urethane-induced rat retinopathy: a fluorescein angiographic, vitreous fluorophotometric, and fluorescence microscopic study.

Urethane-induced rat retinopathy, characterised by permeability abnormalities of the blood-retinal barriers (BRB), was studied during the developmental phases by fluorescein fundus angiography (FFA), vitreous fluorophotometry (VF), and fluorescence microscopy (FM). A distinction based on VF values could be made at the p less than 0.02 confidence level between the retinopathic rats as a group and the control rats. Fluorescence microscopy provided a basis, however, for subdividing the test group into those rats with evidence of intraretinal leakage of NaFl and those without. Statistical analysis of the VF values of the control (A), nonleaky retinopathic (B), and leaky retinopathic (C) rats showed no significance between groups A and B, but highly significant differences between groups A and C (p less than 0.001) and between groups B and C (p less than 0.01). Fluorescence microscopy also showed that leakage of NaFl from retinal vessels occurred only after the retinopathy has progressed to the point where retinal vessels had become incorporated into the pigment epithelium. We conclude from this fluorescent marker clinicopathological study that breakdown of the blood-retinal barriers is a result of an interaction between the retinal pigment epithelium (RPE) and the retinal vessels after the vessels become incorporated into the RPE.

Animals↗
PubMed1971

Plasma-renin assay.

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Biological Assay↗
PubMedDate not supplied

Does type II diabetes predispose to retinal vein occlusion?

Retinal vein occlusion (RVO) not infrequently occurs in diabetic patients. Although the aetiology is unclear, it could relate to the other microvascular complications of diabetes. In the non-diabetic, both the central (CRVO) and branch (BRVO) forms are commonly associated with hypertension and hyperlipidaemia. We have therefore studied fifty type II diabetic patients with RVO compared to a carefully matched diabetic control group (n = 50) to elucidate underlying medical conditions and hence the aetiology of RVO in diabetic patients. The two groups were well matched. Diabetics with RVO showed a strikingly high prevalence of hypertension compared to the controls (72% versus 32%: p < 0.001) and a trend to increased hyperlipidaemia (54% versus 36%). Diabetic microvascular complications were more common in the control group (diabetic retinopathy and proteinuria). No significant differences were observed in mean HbA1 or weight, but current smoking habits and blood pressure levels were increased in the diabetics with RVO. 80% of diabetic patients with the BRVO form, were hypertensive. We conclude that the main underlying medical conditions for RVO in diabetics are hypertension and hyperlipidaemia, and these may be important in the aetiology as in the non-diabetic. RVO is more common in type II rather than type I diabetes, and does not associate with the presence of diabetic microvascular complications. Clinical assessment for hypertension and hyperlipidaemia is therefore important in diabetic patients with RVO, especially if recurrence of the condition and further visual loss is to be prevented.

Adult↗
PubMedDate not supplied

Management of retinal vein occlusion.

Retinal vein occlusion is a common cause of visual loss. The clinical features, pathogenesis, aetiology and management of this condition are presented and discussed. It is an advantage to involve both the physician and the ophthalmologist in the management of the condition.

Comorbidity↗
PubMedDate not supplied

A 'fail-safe' screening programme for diabetic retinopathy.

OBJECTIVE: To improve screening for diabetic retinopathy in a hospital diabetic clinic through the use of the audit process. DESIGN: Comparison of an existing system of screening for diabetic retinopathy (a specialist optometrist using ophthalmoscopy alone) with a new system in which a specialist optometrist examined retinal Polaroid photographs taken through pharmacologically dilated pupils and combined this with ophthalmoscopy in all cases except when the photographs were perfect and definitely showed no retinopathy. In this new system, the optometrist could discuss cases of uncertainty with a diabetes physician while the patient was still in the clinic with eyes dilated. SETTING: Inner city hospital diabetes clinic. SUBJECTS: 289 hospital diabetic clinic patients not already attending an ophthalmologist; a consecutive series of 144 such patients for the first audit, 145 for the repeat audit. MAIN OUTCOME MEASURES: Assessment of each screening system against a gold standard. For the first audit this was agreement by two of four diabetes physicians, who combined examination of the photographs with the findings from dilated ophthalmoscopy, on the classification of the retinae of each patient, guided by standard European criteria. For the second audit, the gold standard was enhanced by discussing the photographs and findings of all patients with an independent ophthalmologist. For patients requiring referral, a second ophthalmologist also commented on the case. RESULTS: The addition of retinal photography to universal pupil dilatation, and the availability of diabetes physician backup to discuss cases of uncertainty, greatly increased the optometrists' detection rate. Sensitivities for the first (ophthalmoscopy only) and second (ophthalmoscopy plus photography plus diabetologist back-up) audits were, respectively, 71.4% vs 100% for sight-threatening retinopathy, 33% vs 100% for retinopathy requiring six-month review, and 40.3% vs 97.2% for any retinopathy (p = 0.002). CONCLUSIONS: Optometrists specialising in diabetic retinopathy using Polaroid retinal photography and ophthalmoscopy, both through dilated pupils, backed up by experienced diabetologists to discuss cases of uncertainty, could form the basis of a retinopathy screening service that accurately identifies and categorises retinopathy and does not miss sight-threatening cases.

Diabetic Retinopathy↗