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Biomedical subjects

E Gramer

Publications and source records attributed to E Gramer.

49 records · Page 3Linked to original sources
PubMed1982

[Specificity of suprathreshold computer perimetry].

The problems encountered in linear suprathreshold computer perimetry are discussed in the light of results with the Fieldmaster 200 automatic perimeter utilizing different test conditions. A linear supraluminosity of the test points, especially in the central visual field, results in poor specificity of the periphery of the tested area if no substantial loss of sensitivity is acceptable. Taking the three-dimensional distribution of retinal thresholds into account, the supraluminosity of the perimetric stimuli should be adapted to the eccentricity of testing.

Computers↗
PubMed1981

[The Fieldmaster-200 computer perimeter: a comparative, controlled clinical study of its sensitivity and specificity in glaucomatous field defects (author's transl)].

The central visual fields of 119 glaucomatous eyes (78 patients) were evaluated under controlled conditions using the Goldmann kinetic perimeter and the Fieldmaster-200 automatic supra-threshold computer perimeter. Where there were qualitative differences between the two instruments, the high-resolution program 61 of the Octopus computer perimeter was used as a reference system. Central visual fields of 101 eyes were also studied using the Octopus 31 program. The Fieldmaster-200 was found to be more sensitive than manual kinetic perimetry in identifying early glaucomatous visual field defects. However, the specificity of the Fieldmaster instrument was significantly lower than that of the Goldmann perimeter. Taking into account the perimetry of the total central visual field using the Octopus program 31, the Octopus itself was found to be the most sensitive of the three methods of detecting early visual field loss. Problems related to the specificity and supra-threshold perimetry that is not adapted to the eccentricity of the test stimulus, as the case with the Fieldmaster-200, are discussed.

Clinical Trials as Topic↗
PubMed1981

[Follow-up of retrobulbar neuritis with the octopus computer perimeter (author's transl)].

Methodological possibilities of quantifying the visual field course in retrobulbar neuritis were studied. In nine patients suffering from this condition the visual field had been examined repeatedly using the Octopus computer perimeter (program 31, stimulus size 3). Total loss of sensitivity and the number of test points with pathologic results had been chosen to correlate to recovery of visual function. These parameters, as well as visual acuity, were compared with the cumulative steroid dose. It is concluded that rapid recovery of visual function with initial steroid therapy may have a starter effect for spontaneous further improvement of sensitivity in the central visual field. However, a prospective, controlled clinical trial would be required to provide definite proof of the usefulness of steroid therapy in retrobulbar neuritis.

Follow-Up Studies↗
PubMed1981

[Computer perimetry of glaucomatous visual field defects at different stimulus sizes (author's transl)].

The influence of stimulus size in computer perimetry of central visual field defects was investigated in 30 glaucomatous eyes of 30 patients. 12 eyes had been studied utilizing stimulus size 1 and 3, 18 eyes with stimulus size 3 and 5 at the computer perimeter Octopus (program 31). Using large test targets small scotomata can be overlooked and identified field defects appear smaller and less deep. To evaluate this well-known phenomenon quantitatively by computerized perimetry was the aim of the present study. The mean threshold values in the diseased areas of the glaucomatous fields were about 6--10 db higher with stimulus size 3 than 1 and again 6--10 dB higher with stimulus 5 in comparison to 3. The clinical significance of these findings is discussed for different types of perimetry.

Computers↗
PubMed1980

[Reproducibility of central visual field testing using kinetic or computerized static perimetry (author's transl)].

Under controlled conditions the differences between duplicated examinations with the Goldmann kinetic perimeter and the Krakau/Heijl static computerized perimeter were evaluated. Kinetic visual fields were obtained independently by two well trained examiners and duplicate examinations were performed by computer perimetry. The differences between the two examinations were statistically evaluated using quantitative criteria. The agreement between first and second examination--based on normal and pathologic findings--was 72% for the Goldmann and 88% for the computer perimeter. The greater reproducibility of central visual field testing with the computer perimeter is most probably due to the subjectivity of the observer in the kinetic manual technique. The computer obviously represents a standardized observer using a constant strategy with a fixed time course. The computerized perimeter was easy to operate and did not require a specially trained technician. All the patients in whom kinetic visual field testing was possible were able to undergo computerized perimetry.

Adolescent↗
PubMed1980

The ocular responses of oral administration of penbutolol in the glaucomatous patient.

A single oral dose of 20 mg or 40 mg Penbutolol was given to two groups of ten untreated glaucoma patients. The drug significantly decreased intraocular pressure and was dose-related. The IOP response was paralleled with a decrease in pulse rate without significant effect on blood pressure. In another group 27 glaucoma patients, which were under sufficient IOP control following topical treatment with different antiglaucomatous agents, the daily peroral treatment with 40 mg Penbutolol did not result in a further decrease of IOP. However, a significant drop in pulse rate could be noted over the four weeks period of treatment in this series of patients. Blood pressure was, similar to the single does study, not significantly affected. Penbutolol treatment did not significantly change pupillary diameter, quantitative tear flow or corneal sensitivity. The potential usefulness of the drug in glaucomas with systemic hypertension or as additive treatment when topical treatment is insufficient is outlined.

Administration, Oral↗
PubMed1980

Patient information before cataract surgery.

Patients have to be informed before cataract surgery about possible complications, about chances and risks. This should be done in a written manner with additional verbal explanations. We documented all details of 4,300 cataract operations on computer-readable forms and obtained statistics on type and frequency of complications as well as visual acuity 1 week after the operation. With these data we have a reliable base for the presurgical information of our patients. Detailed information about possible risks and chances of cataract extraction were given to each patient by means of a written form which was read to the patient and explained in details to him. Immediately afterwards we tested the reaction of the patient upon the full information. It was found that the reactions were surprisingly positive. Not one of the patients felt less inclined to undergo surgery and not one patient had less confidence toward the hospital. The vast majority (approximately 90%) of the patients said in contrary that their confidence was much increased after the information. A similar type of information can be recommended, therefore, for moral and legal reasons.

Aged↗
PubMed1979

Infantile glaucoma in unilateral uveal ectropion.

Two case reports are presented where a unilateral uveal ectropion was associated with congenital and late infantile glaucoma. Ipsilateral to the anterior segment anomaly a dysgenetic angle was found to be the basis of the glaucomatous process. The clinical implication that when such an iris malformation is found in a young child the possibility of glaucoma must be considered is discussed in detail.

Child↗
PubMed1979

[The perimetry of the blind spot. A comparison of kinetic and static, computerized stratgies].

The reproducibility of perimetric results on the blind spot has been investigated under controllnt well-trained perimetrists on 178 eyes of 107 patients; the same eyes and patients were examined twice with the computer perimeter as well. Perimetric results obtained from 158 eyes were considered for statistics. There was qualitative agreement based on the alternative 'normal' or 'pathological' in kinetic perimetry in 74% of the double examinations and in 89% in computer perimetry. Identical size of the blind spot in repeated examinations was found in 34% with the Goldmann perimeter and in 78% with the computer perimeter. Observer variability of the static computer perimetry of the blind spot was compared with the variability of the results on the rest of the central visual field.

Computers↗
PubMed1979

[First experiences with a written consent form for patients prior to cataract surgery (author's transl)].

The first experiences with a written consent form signed by patients prior to cataract surgery are presented. Details of possible surgical complications were discussed with the patient. The average time for this type of discussion was 15,6 min (7--30 min). The positive outcome of this study appeared to be that the confidence of the patient towards the surgeon or the hospital did not suffer nor did any patient change his decision to undergo surgery. This was tasted in a questionnaire showed to the patients after the discussion on possible complications. Some patients stated that they preferred enlightment on the day before surgery, whereas others would have preferred to have the written consent form sent home some days before surgery to have chance to discuss the problems with their relatives.

Cataract Extraction↗
PubMed1978

The response of ophthalmic arterial pressure to topically applied clonidine.

The effect of topically applied clonidine on aphthalmic arterial pressure was tested in three groups of open-angle glaucoma patients. In this test, 0.125% clonidine eye drops did not cause a statistically significant change in ophthalmic arterial pressure, but 0.25% and 0.5% clonidine caused a statistically significant, dose-dependent decrease in the diastolic and the systolic arterial pressure in the orbit. The clinical relevance of the results is discussed.

Blood Pressure↗
PubMedDate not supplied

Time of diagnosis, reoperations and long-term results of goniotomy in the treatment of primary congenital glaucoma: a clinical study.

PURPOSE: The aim of our study was to get information about the development of visual acuity, visual field and cup-disc ratio of patients with primary congenital glaucoma after IOP-regulating goniotomy by means of a katamnestic inquiry. The preoperative conditions of IOP, corneal diameter and corneal opacity were related to postoperative findings of visual acuity, visual field and cup-disc ratio reported by the treating ophthalmologists. METHODS: 196 patients were contacted, who had a goniotomy in the period from 1965 to 1983 at the University Eye Hospital Würzburg. Out of the 92 returned replies, the address of the treating ophthalmologists could be ascertained from 77 patients. Sixty of the 77 patients fulfilled the inclusion criteria: (1) primary congenital glaucoma and (2) IOP-regulating goniotomy as last surgery. RESULTS: I. In 76% of 106 eyes childhood glaucoma was diagnosed during the first year of life. II. In 72% of 60 eyes/patients with primary congenital glaucoma one goniotomy was sufficient to reach a normal IOP. In 18% a second and in 10% a third goniotomy was necessary, but without influence on the visual outcome. III. Even in the groups of eyes with a preoperative IOP of more than 40 mmHg, preoperative corneal diameter of more than 13 mm and preoperative severe corneal opacity more than 50% reached a visual acuity of 0.4-1.2 and more than 80% had a normal visual field. Only 9% of the eyes showed a cup-disc ratio of 0.6 or more. CONCLUSIONS: In primary congenital glaucoma even eyes with high preoperative IOP, large corneal diameters and severe corneal edemas had a good prognosis of visual outcome after goniotomy.

Adolescent↗