Biomedical subjects

F Meier-Gibbons

Publications and source records attributed to F Meier-Gibbons.

9 recordsLinked to original sources

PubMed1996

[Principles of effectiveness control in therapy of glaucoma].

There are two levels at which the efficacy of glaucoma therapy can be determined: first, the therapeutic trial and second, the experience gained when treating individual patients in the daily practice. At each level, various difficulties arise. At either level, however, the main problem is that there is no way to check on patient compliance. A trial on the efficacy of glaucoma therapy needs to be thoroughly planned and performed, correct statistical methods must be used, and the therapy must be critically evaluated a review of studies on glaucoma therapy for the years 1988 and 1993 showed the difficulties in planning and enforcing a correct study design. Most studies suffer from lack of adaptation to the characteristic features of primary open-angle glaucoma, the most important of all being its chronic course with minimal changes over many years once pressure is regulated. Thus, long-term studies are mandatory with simultaneous assessment of intraocular pressure (IOP), the visual field and the morphology of the optic nerve head (ONH). Measurement of the IOP is the parameter that can be most reliably checked on. Increased IOP represents the main cause for glaucoma damage-not the damage itself. For the early detection of glaucoma, morphometry of the ONH is the most reliable method, but it is still quite rough. The use of perimetry for early detection and follow-up of glaucoma is overestimated. Given the above-mentioned characteristic features of the disease, sufficient damage with corresponding perimetric and morphometric changes does not occur in the short time periods chosen for therapeutic trials. The future will show whether the blood supply of the ONH will be of primary interest in glaucoma detection and control of treatment efficacy. New and promising methods for measurement of the blood supply of the ONH are emerging. Last but not least, control of efficacy in glaucoma treatment should include cost-effect analyses. Such studies are almost nonexistent at present.

Clinical Trials as Topic↗

PubMed1995

[Normal pressure glaucoma: a diagnostic challenge].

PURPOSE: Normal-tension glaucoma (NTG) is a frequently discussed optic neuropathy. The purpose of this retrospective study was to evaluate the final diagnosis of patients with presumed NTG and to select the best distinguishing examination methods. PATIENTS: All patients with presumed NTG hospitalized for diurnal IOP curves from 1987-1992 were studied. We evaluated retrospectively which diagnostic tests contributed most to the final diagnosis. RESULTS: In 26 out of 50 patients with presumed NTG the final diagnosis had to be changed, mainly because the diurnal IOP curve showed a dysregulation; often only the early-morning IOP in supine position was elevated. CONCLUSIONS: We suggest that early-morning IOP spikes are one of the important pathogenetic factors in patients with glaucomatous changes without other pathology. Early morning IOP measurement in supine position before rising should therefore be a mandatory part of diurnal IOP curves in patients with presumed NTG.

Blood Pressure↗

PubMed1995

Optic disc size and optic nerve damage in normal pressure glaucoma.

BACKGROUND: Recent reports indicate that eyes with normal pressure glaucoma have larger optic discs than eyes with primary open angle glaucoma or normal eyes. This study was performed to find whether, in normal pressure glaucoma, a large disc is associated with more optic nerve damage than a small disc. METHODS: Colour optic disc photographs of 74 patients with normal pressure glaucoma were assessed morphometrically. RESULTS: Taking the study group as a whole, the optic disc size decreased significantly (p = 0.04) with increasing visual field defect. In an intraindividual bilateral comparison, the side differences in the disc area of the right minus the left eye of the same individual were not significantly correlated with the side differences in the mean visual field defect. CONCLUSIONS: The results indicate that the eye with the larger optic disc, when compared with the contralateral eye with the smaller optic nerve head, showed neither a significantly more marked nor less pronounced glaucomatous optic nerve damage. It suggests that for a given patient the degree of glaucomatous optic nerve atrophy was not markedly associated with the optic disc size. The finding that patients with large visual field defects had smaller discs than patients with moderate perimetric loss may indicate that the results of previous cross sectional studies reporting on an unusually large disc size in normal pressure glaucoma may be due partially to selection.

Female↗

PubMed1995

Phototherapeutic keratectomy for bullous keratopathy.

AIMS: This study was designed to investigate the therapeutic potential of excimer laser for recurrent painful erosions in patients not suited to treatment with penetrating keratoplasty. METHODS: Phototherapeutic keratectomy (PTK) with the excimer laser was performed prospectively on a series of 13 eyes of 12 patients with recurrent corneal erosions in connection with bullous keratopathy of varied aetiology. The main complaint of the patients before the treatment was frequent attacks of pain. The patients selected either refused corneal grafting or could not for a variety of reasons expect to profit visually from an operation. The treatment was performed with the MEL 60 Aesculap Meditec excimer laser using either a spot mode (five cases), a scanning mode (three cases), or a combination of both (five cases). RESULTS: All patients responded well to the treatment, and the pain subsided after a couple of weeks. In five cases (38.5%) a second treatment was necessary because of persistent pain, which was, however, much less than before the initial treatment. In four of these five patients small corneal bullae persisted. The visual performance of the seven patients with visual acuity better than 20/200 ameliorated in two cases and remained unchanged in four cases. One patient lost two Snellen lines after the laser treatment for terminal glaucoma. The mean follow up was 14.1 months (range 1-28 months). No complications were seen so far. CONCLUSION: It was concluded that PTK is a very promising and effective outpatient treatment for patients with bullous keratopathy. This therapeutic approach is not thought to have been described before.

Adult↗

PubMed1994

Sebaceous gland adenoma of the palpebral conjunctiva in a patient with Muir-Torre-syndrome: a case report.

BACKGROUND: Muir-Torre syndrome (MTS) is a hereditary genodermatosis associated with internal malignancies. METHODS: We report the histological case of an atypical sebaceous gland adenoma of the palpebral conjunctiva in a 42-year-old female patient. RESULTS: The combination of this adenoma with atypical adenomatous hyperplasia of the endometrium and a strong family history of gastrointestinal and urogenital cancers led to the diagnosis of MTS. CONCLUSION: We present a case where the diagnosis of an atypical solitary sebaceous gland adenoma of the palpebral conjunctiva combined with a conspicuous personal and family history led to the diagnosis of MTS.

Adenoma↗

PubMed1994

The diagnosis of normal-tension glaucoma.

The diagnosis of normal-tension glaucoma includes optic nerve head and retinal nerve-fiber layer assessment, standard static computerized visual field testing, gonioscopy, and a diurnal (24-hour) intraocular pressure curve. In addition to a careful history to exclude previous phases of increased intraocular pressure, an internal medicine checkup including 24-hour ambulatory blood pressure measurements and neurological assessment are required. Additionally, carotid artery Doppler sonography, nailfold capillary microscopy, and a computed tomography scan of the brain may be performed.

Glaucoma↗

PubMed1992

[Vitrectomy in Terson syndrome. Report of 18 cases].

A vitrectomy was performed in 18 eyes (15 patients) with vitreous hemorrhages due to Terson's syndrome. The average age of the patients was 46.5 +/- 14.4 years. The mean interval between the acute event of an intracranial hemorrhage and the vitrectomy was 6.8 +/- 4.9 months. The vitreous hemorrhage was associated with epiretinal membranes in 3, PVR in 2, and retinal breaks and/or rhegmatogenous retinal detachment in 3 eyes. The vitrectomy had to be combined with membrane peeling in 2, encircling procedures or exoplants in 4, cryotherapy in 5, endolaser in 1, and air/SF6 gas filling in 3 eyes. A missing or incomplete posterior vitreous detachment in 8 eyes was associated with a higher risk of PVR and retinal detachment. Two eyes with this condition needed 3 secondary operations. The mean follow-up duration was 32 (1 to 126) months. Two patients died 4 and 11 months after the operation. The visual acuity improved significantly following vitrectomy in all 18 eyes. The final visual acuity was better than 20/40 in 73% and 20/25 to 20/20 in 56%. The initial postoperative visual acuity decreased later on due to nuclear cataract in 7 of 10 eyes of patients over 45 years of age. A complicated cataract developed in only 1 of 8 eyes of younger patients who maintained a mean visual acuity of 20/25. Vitrectomy for Terson's syndrome is recommended in bilateral cases without spontaneous clearing of the vitreous within 3 months, as well as in cases with PVR and imminent retinal detachment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

[Value of the RPM safety index in retinopathy of prematurity].

The safety-index (S-index): S = log birth weight (kg) + gestational age (weeks)/oxygen therapy (days) combines the three main risk factors for a development of ROP. Only in very immature children which had a long time oxygen therapy (and therefore a low S-index) one finds severe stages of ROP. In our study, we correlated retrospectively ROP stages versus S-index in 261 children. The results confirm that children with S-index greater than 1 never had a severe ROP (that means, stage 3 and more, which need treatment). Therefore, the 2/3 of all newborn infants at risk with an S-index greater than 1 need only minimal ophthalmological controls.

Birth Weight↗

PubMed1990

[Immunohistochemical differentiation of periretinal membranes].

The etiology of periretinal membranes, a complication of various ocular diseases, trauma, and ocular surgery, is still unknown. In the study reported here, 134 surgically removed periretinal membranes were semiquantitatively analyzed by immunohistochemical and morphological method (antigens S 100, GFAP, leukocyte antigens, factor 8; fibrosis). It was found that the cell population of the membranes varied both morphologically and immunohistochemically according to the disease. However, the RPE cell count did not correlate with the number of retinal tears recorded in the patients' histories.

Diabetic Retinopathy↗