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H C Fledelius

Publications and source records attributed to H C Fledelius.

82 records · Page 5Linked to original sources
PubMed1982

Ophthalmic changes from age of 10 to 18 years. A longitudinal study of sequels to low birth weight. III. Ultrasound oculometry and keratometry of anterior eye segment.

Anterior eye segment features were investigated longitudinally by ultrasound and keratometry in 70 low-birth-weight subjects (LBW less than 2000 g) and 67 full-term controls, at the ages of 10 and 18 years. Concerning the changes during adolescence, a slight significant deepening of anterior chamber and lens position is found (about 0.1 mm), while lens thickness, corneal curvature radius and corneal astigmatism have remained stable. Differences between BW-groups indicate a permanent influence of LBW on ocular development, as evident from a presumed early environmental (LBW) arrest of corneal growth, given by a significantly lower value of corneal curvature radius, just as zonular slackness due to a smaller suspension ring may explain a thicker lens. Further a LBW disturbance of correlation between refraction and anterior eye segment parameters is suggested. Besides the documented occasional posterior eye segment damage of LBW (retinopathy of prematurity), the present study indicates a more general restraining influence also on anterior eye segment development.

Adolescent↗
PubMed1982

Ophthalmic changes from age of 10 to 18 years. A longitudinal study of sequels to low birth weight. IV. Ultrasound oculometry of vitreous and axial length.

The present report on vitreous and axial length completes an analysis of changes in eye size during adolescence. The sample is divided into 70 with low birth weight (less than 2000 g) and 67 full-term controls (FT). 1) Contrary to classical statements regarding early arrest of eye growth, a basic 'pubertal' axial growth of about 0.4-0.5 mm is found in refractively static eyes. Eyes with progressive myopia elongate even more, due mainly to vitreous elongation. 2) The previously reported 10-year LBW ocular size deficit remains an adult feature, even in seemingly normal eyes. There is a parallel permanent lack of catching-up also regarding height, head circumference, and some other anthropometric parameters. 3) Two classical rules of thumb are discussed: a) 1 mm axial length change coincides with 3 D refractive change, and b) that of 24 mm as the emmetropic eye length. Although tenacious, bot statements have to be modified--according to biological variation and the weak correlation between most refractive parameters.

Adolescent↗
PubMed1981

Ophthalmic changes from age of 10 to 18 years. A longitudinal study of sequels to low birth weight. II. Visual acuity.

Re-examination of corrected visual acuity was done in 137 18-year-old Danes, who were originally examined at the age of 10 years, as part of a study of sequels to low birth weight (LBW) (Fledelius 1976). Median values indicate that most adolescents are able visually to discriminate considerably above the customary 6/6 limit. As compared with low-birth-weighters (n=70), full-terms (n=67) show a significantly higher cumulated visual acuity score. Similarly, binocular median visual acuities are 1.2 (LBW) and 1.4 (in FT). The difference is neither explained by the ex-prematures' higher frequency of heterotropia, nor by their (minor) share of eyes with subnormal vision. The latter occurred especially in the subgroup of 'myopia of prematurity'. The exceptional cases with RLF-blindness were discarded from follow-up. Concerning visual acuity, the previously reported lagging behind of ex-prematures in childhood has proven to be not only a temporary delay, but a permanent (adult) feature.

Adolescent↗
PubMed1980

Ophthalmic changes from age of 10 to 18 years. A longitudinal study of sequels to low birth weight. I. Refraction.

A report is given on refractive changes (delta R) from age of 10 to 18 years. The 1979 follow-up comprises 137 persons who had earlier (around 1970) participated in a larger investigation into ophthalmic sequels to a low birth weight (n = 539). In general (127 out of 137), there is a shift towards lower dioptric values (increase in refraction). Seven remained static while three showed a slight decrease in refraction (0.25-0.5 D). Adult emme- and hypermetropia show a median delta R about 0.7 D (increase) during adolescence, against median values of 1.7 and 2.5 D in juvenile myopia, of ex-prematures and full-terms respectively. With a median delta R of 1.2 D, 'myopia of prematurity' occupies an intermediate position (21 eyes of 13 subjects). Except for this subgroups, there is no evidence that low birth weight has influenced refractive distribution. With a (planned) skewing towards myopia, the 1979-sample cannot be considered epidemiologically representative, as was the original 1970-material. Concerning the latter, the 18-year incidence of myopia is given as 17.6% for ex-prematures and 13.1% for fullterms (minimum figures, based on school medical records).

Adolescent↗
PubMed1979

Orbital abscess in two neonates, deriving from conjunctival malformations.

A report is given of two infants who developed an orbital abscess within their first month of life. Generally they were unaffected, and malignancies were initially suspected. Ultrasonography showed partly cystic, partly solid lesions. The likely infectious foci were conjunctival malformations, a mucosal fistula in case No. 1, a conjunctival cyst in case NO. 2. There was rapid and complete recovery after surgery. The infections were caused by Staph. aureus and by diplococcus pneumoniae, respectively. Additional findings: Infant No. 1 had a fibroma of the tongue. Infant No. 2 had pes equino-varus.

Abnormalities, Multiple↗
PubMed1978

Ultrasonography and computer tomography in orbital diagnosis. With special reference to dysthyroid ophthalmopathy.

A report is given on a series of 162 patients referred for ultrasound examination (US, A-mode) due to orbital disease. 101 also had computerized tomography (CT, Emi scanner Mark I, 160 X 160 matrix, 8 mm sections), the results of which were emphasized in a recent publication (Gyldensted et al. 1977). The present approach is primarily clinical. With histopathological confirmation in only 40% of the cases, it is difficult to give exact values for diagnostic accuracy, but it appeared to be above 90% for CT, and close to this value for US (depending on, of course, how specified the diagnostic predictions were). Dysthyroid ophthalmopathy (DO, orbital Graves' disease, endocrine exophthalmos) was the most frequent cause of unilateral protrusion (24 cases). In some such cases "tumour-positive" CT scans represent a diagnostic pitfall, unless the examiner is familiar with the clinical features of DO. In the present series, for example, one of the DO cases had transcranial exploration of the orbit. The two--indeed valuable--non-invasive methods (CT and US) should be assessed in combination, and also combined with the classic clinical evaluation of the patient.

Adolescent↗
PubMedDate not supplied

Serial pattern evoked potential recording in a case of toxic optic neuropathy due to ethambutol.

Visual evoked potentials (VEPs) were studied in a patient who developed visual impairment during ethambutol treatment. The ERG and the flash VEP were normal at the time of maximal visual loss, whereas pattern reversal VEPs 2 and 5 months after onset revealed evidence of severe bilateral optic nerve involvement, especially affecting macular fibres. Seven months after onset paramacular PNP complexes with a late positivity (scotomatous response) were recorded after pattern reversal and half-field stimulation, suggesting involvement of fibres subserving central vision. At the time when visual acuity was normal there was still electrophysiological evidence of a mild involvement of the anterior visual pathway. The papillomacular bundle seems to be especially involved in ethambutol eye toxicity.

Aged↗
PubMedDate not supplied

Liposarcoma metastatic to the orbit.

PURPOSE: To describe a patient with liposarcoma metastatic to the left orbit. METHODS: A 72-year-old man was admitted with diplopia and proptosis of the left eye. Previously, a retroperitoneal liposarcoma had been surgically removed followed by postoperative radiation. Visual acuity was normal. There was proptosis of the left eye, increased retrobulbar resistance and reduced mobility. Trans-septal orbital biopsies showed liposarcoma. The patient was initially treated with prednisolone and later received radio- and chemotherapy. Despite treatment he lost vision of the left eye and died a few months later. RESULTS: Histological examination of the orbital tumor revealed a spindle-cell liposarcoma similar to the primary tumor of the retroperitoneum. CONCLUSIONS: Liposarcoma metastatic to the orbit is rare, but should be suspected in a patient with proptosis caused by a space-occupying lesion and a history of liposarcoma.

Aged↗
PubMedDate not supplied

Retinopathy of prematurity in Denmark. Epidemiological considerations and screening limits.

The epidemiology of retinopathy of prematurity (ROP) in Denmark is analysed based on two sources. Regional experience is presented from 12 years' prospective ophthalmic control of infants at risk, in a Danish county with population 342,000 and 44,805 liveborns over the period 1982-93. Out of 127 subjects with ROP 101 reached stage 1 or 2 only; 26 progressed to at least stage 3. Seven with blindness due to ROP amounted to 15.6/100,000 liveborns, a high frequency. The trend over the twelve years was towards less serious sequelae. Currently, the national screening limits for ROP have been adjusted under guidance from the compulsory registration of childhood visual impairment; with birth years 1974-94 there were 157 ROP-children in the register. Blindness due to ROP is now seen only in the very immature. It is suggested that gestational age 30 weeks will soon replace the present limits of less than 32 weeks/1750 g.

Adolescent↗