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Biomedical subjects

H Desatnik

Publications and source records attributed to H Desatnik.

At least 19 recordsLinked to original sources
PubMed2001

Management of persistent loculated subretinal fluid after pneumatic retinopexy.

AIM: To report on the incidence and management of a unique and troublesome complication of pneumatic retinopexy-localised, delayed subretinal fluid absorption (DSRFA). METHODS: A retrospective chart review was done for all patients who underwent pneumatic retinopexy for retinal detachment over a 5 year period to identify the patients with DSRFA. RESULTS: Seven phakic patients (five females, two males, age range 26-87 years) were identified with the phenomenon of delayed resolution of subretinal fluid after pneumatic retinopexy and cryotherapy. In four patients the subretinal fluid involved the macula. Time taken to complete absorption of the subretinal fluid ranged from 10 to 26 months. In one patient there was still residual fluid inferiorly at 18 months of follow up. During the follow up period additional procedures were performed--scleral buckling (five eyes), pars plana vitrectomy (one eye), and mild laser scatter to extramacular areas of shallow subretinal fluid (four eyes). None of these procedures appeared to influence the rate of fluid absorption. CONCLUSIONS: Loculated subretinal fluid following pneumatic retinopexy may persist for very long periods, extending up to more than 2 years. Additional surgical procedures or laser photocoagulation do not affect the rate of subretinal fluid absorption. Spontaneous reattachment eventually occurs in most eyes, and conservative management is indicated.

Adult↗
PubMed2000

Reduced rate of retinal detachment following silicone oil removal.

PURPOSE: To investigate the rate of retinal redetachment and other complications after silicone oil removal over a 4-year period. METHODS: Retrospective analysis of charts of patients who underwent vitrectomy and silicone oil injection between January 1994 and June 1998 followed by oil removal. RESULTS: Sixty-eight eyes of 67 patients were included. The average follow-up time after oil removal was 15 months. Significant retinal redetachment developed in 6 eyes (8.8%). The redetachment rate was slightly higher in the 32 eyes with proliferative vitreoretinopathy (9.3%) than in the 36 eyes with other pathologies (8.3%). The average time to redetachment was 4.2 months. These eyes were reoperated and reattached, and at the end of the follow-up, three retained silicone oil. Two other eyes without redetachment were hypotonus after oil removal. Cataract extraction and intraocular lens implantation were performed at the time of oil removal in 18 eyes; 2 (11%) developed redetachment. Visual acuity improved significantly after oil removal (P < 0.001). CONCLUSION: The rate of retinal redetachment after removal of silicone oil in recent years is low compared with previous series. The authors attribute this reduction to the improved surgical management of complicated retinal detachments; particularly, the introduction of perfluorocarbon liquids and wide-field viewing systems and the widespread use of endolaser.

Adolescent↗
PubMed2000

ICGA-guided laser photocoagulation of feeder vessels of choroidal neovascular membranes in age-related macular degeneration. Indocyanine green angiography.

PURPOSE: To report the ability of indocyanine green angiography (ICGA) with a confocal scanning laser ophthalmoscope (SLO) to identify feeder vessels of choroidal neovascular membranes (CNVM) secondary to age-related macular degeneration (ARMD) and to show the feasibility of inducing complete closure of the CNVM by photocoagulation targeted exclusively to the feeder vessels. METHODS: Five consecutive patients with exudative ARMD in whom ICGA with the confocal SLO showed extrafoveal feeder vessels supplying choroidal neovascular nets had laser photocoagulation done only to the feeder vessels. In two patients, two separate membranes were seen. RESULTS: Laser photocoagulation resulted in closure of the feeder vessels and the CNVM in four patients. Complete closure was achieved with one treatment in one patient and with two treatments in three patients. In one patient, two treatments failed to close the feeder vessel and the CNVM, but a third, more intense laser treatment resulted in temporary closure of the feeder vessel and CNVM, which recanalized 2 to 4 weeks later with development of a large rip in the retinal pigment epithelium. In one patient, two separate CNVMs grew from the edge of the laser scars, but they were not directly related to the original CNVM and its feeder vessel, and were treated successfully. The same eye later developed subfoveal occult CNVM with gradual deterioration of visual acuity. In the other four patients, visual acuity improved in two and was unchanged in two. CONCLUSIONS: Indocyanine green angiography with the confocal SLO can identify choroidal feeder vessels supplying CNVM secondary to ARMD. Laser treatment to such extrafoveal feeder vessels, particularly in membranes that are large or subfoveal, may be effective in closing the feeder vessel and CNVM with preservation of the fovea and central vision. More than one treatment may be required, however, and failures and complications may be expected with this treatment modality.

Aged↗
PubMed1999

Spontaneous separation of an idiopathic macular pucker in a young girl.

PURPOSE: To report a young girl with spontaneous separation of an idiopathic epiretinal membrane and notable visual recovery. METHOD: Case report. RESULT: A 12-year-old girl had spontaneous improvement in visual acuity of the left eye from 20/100 to 20/40 attributable to spontaneous peeling of an idiopathic epiretinal membrane more than 2 years after it was diagnosed. CONCLUSION: Conservative treatment can be considered in young patients with epiretinal membrane because spontaneous separation may occur and result in good vision.

Child↗
PubMed1998

A review of the role of visual problems in reading disabilities.

In this review we discuss the etiology of reading disturbances in children and adults. The majority of reading problems in children are either due to primary causes (dyslexia) or secondary to a variety of nonophthalmologic disorders or diseases. In adults the nature of reading difficulties is different to that in children and is defined as asthenopia. Asthenopia can develop as a result of uncorrected refractive errors or due to an imbalance of extraocular muscle action. The therapeutic approach to reading problems is reviewed and it will be seen to be different in children and in adults.

Adult↗
PubMed1998

Anterior chamber hemorrhage during cataract surgery in Lowe syndrome.

This article reports a spontaneous intracameral bleeding at the end of cataract surgery in both eyes of two patients with Lowe syndrome. Extracapsular cataract extraction with anterior vitrectomy and posterior capsulotomy, using the anterior chamber maintainer (ACM), was performed in both eyes of two patients. At the conclusion of the surgery, when the ACM was removed, spontaneous bleeding occurred into the anterior chamber and spread into the vitreous cavity. The hemorrhage resolved spontaneously over varying periods of time. We propose that bleeding occurred from damage to iris vessels in the abnormal angle in our patients with Lowe syndrome when the ACM was removed with a concomitant decrease in intraocular pressure.

Anterior Chamber↗
PubMed1996

Epileptic blindness in children: a localizing sign of various epileptic disorders.

UNLABELLED: The ictal manifestations, EEG, CT, and MRI correlates, as well as the management and outcome of 11 children with epileptic blindness are presented. Seven males and four females, aged 3 months to 12 years, experienced single or recurrent episodes of acute visual obscuration. Ictal blindness was the solitary epileptic phenomenon in only two children. The rest had other focal or generalized motor epileptic manifestations. Six children had either focal motor phenomena and/or unilateral EEG disturbances, with a normal head CT. The drug of choice in this group was carbamazepine and all became asymptomatic. Two patients had structural abnormalities of the brain, of which one had a low-grade occipital astrocytoma which was resected. His blindness abated shortly following initiation of carbamazepine, even prior to surgery. Status epilepticus amauroticus and focal motor seizures, secondary to focal cortical dysplasia, was detected in another 3-month-old infant. These required cortical resection and she regained full vision. Three patients had generalized epileptiform discharges on EEG, of which two were photic-induced. Blindness was accompanied with motor seizures and myoclonic jerks. Full seizure control could be achieved in only one child. CONCLUSION: our data suggest a relatively benign nature and a favorable outcome in most children with ictal blindness. Resection of a secondary temporo-parietal focus, as occurred in an infant with status epilepticus amauroticus which originated in the occipital region, may result in complete cessation of seizures and visual recovery.

Blindness↗
PubMed1996

Early postoperative intraocular pressure pattern in glaucomatous and nonglaucomatous patients.

PURPOSE: To evaluate intraocular pressure (IOP) changes in the 24 hours following cataract extraction in glaucomatous and nonglaucomatous patients. SETTING: General Eye Service and Glaucoma Service of the Goldschleger Eye Institute, Tel Hashomer, Israel. METHODS: Twenty-six nonglaucomatous patients and 13 glaucomatous patients scheduled for routine cataract extraction and intraocular lens implantation were evaluated. In each patient, IOP was measured before cataract surgery and every 4 hours for 24 hours postoperatively. Thirteen of the nonglaucomatous patients were randomly treated with one drop of timolol maleate at the end of surgery (NG-T group). The other 13 nonglaucomatous patients (NG group) and all glaucoma patients (G group) were not treated. RESULTS: In the NG group, mean preoperative IOP was 13.9 mm Hg. Following surgery, IOP rose steadily to 22.2 mm Hg at 12 hours; it returned to almost presurgical levels at 24 hours. The IOP exceeded 35 mm Hg in only one patient. In the NG-T group, mean preoperative IOP was 16.5 mm Hg and increased to 21.2 mm Hg at 12 hours. The IOP returned to almost presurgical levels at 24 hours. In the G group, mean IOP was 18.8 mm Hg preoperatively and rose to 29.9 mm Hg at 8 hours after surgery. In seven eyes the IOP exceeded 35 mm Hg. COMMENTS: Our findings of elevated IOP emphasize the need for prophylactic treatment (medical or combined cataract and glaucoma surgery) to prevent IOP spikes in high-risk patients.

Acetazolamide↗
PubMed1996

Glaucoma and visual outcome in central retinal vein occlusion.

Glaucoma is a recognized risk factor for central retinal vein occlusion. The authors retrospectively reviewed charts of fifty patients with central vein occlusion examined over a 5-year period. The visual outcome and clinical characteristics of eyes with and without glaucoma were compared. There were 32 eyes without glaucoma and 18 eyes with glaucoma. Final visual acuity of 20/100 or better was obtained in 22% of eyes with glaucoma, compared with 34% of eyes without glaucoma, and final visual acuity of finger counting and less was found in 56% and 22%, respectively (p = 0.02). The rate of ischemic occlusion was higher in the glaucoma group, 44% and 28% respectively, but the difference did not reach statistical significance. There was no difference in the rate of neovascular complications and macular edema between the two groups. The results suggest that glaucoma has an adverse effect on the visual outcome of eyes with central vein occlusion.

Aged↗
PubMed1996

Study of central retinal ganglion cell loss in experimental glaucoma in monkey eyes.

PURPOSE: The objective of this research was to compare the loss of retinal ganglion cells subserving the fovea to that of the ganglion cells in the surrounding perifoveal region in eyes with experimental glaucoma. METHODS: Ganglion cell nucleoli were counted using light microscopy from vertically oriented retinal, strips and the cell density was calculated using the modified Abercombie formula. Percent ganglion cell loss in glaucomatous eyes from five monkeys was determined for each of up to five contiguous areas within the central 12 degrees of the retina by comparison to normal fellow eyes. RESULTS: Loss of central ganglion cells was present even in eyes with mild glaucomatous damage. The percent ganglion cell loss in glaucomatous eyes at five adjacent areas within the central 12 degrees of the retina did not differ significantly (ANOVA, p = 0.77, n = 8). Cell loss in areas nearest to the fovea was indistinguishable from that in more peripheral perifoveal areas. CONCLUSIONS: Foveal ganglion cells appear to be susceptible to experimental glaucoma injury. Psychophysical testing of foveal functions may deserve renewed attention in glaucoma diagnosis and follow-up.

Analysis of Variance↗
PubMed1995

Comparison of ganglion cell loss and cone loss in experimental glaucoma.

PURPOSE: To compare the loss of ganglion cells to cone loss in the macular area of monkey eyes with experimental glaucoma. METHODS: Experimental glaucoma was induced in eyes of three cynomolgus monkeys by argon laser applications to the trabecular meshwork. The average duration +/- S.D. of glaucoma in the experimental animals was 3.8 +/- 0.5 months. Glaucomatous damage was estimated, before the animals were killed, by evaluating stereoscopic photographs of the optic disk and red-free photographs of the nerve fiber layer. Ganglion cell nucleoli and cone pedicles were counted by using light microscopy from slides containing strips of retinal tissue. Cell density was then calculated by using the modified Abercrombie formula. Percent loss of ganglion cells and cones was determined from three eyes of three monkeys in 300-micron segments that were 900 to 1,200 microns superior and inferior to the foveal center. RESULTS: Cone loss was not found at 4.5 to 6 degrees eccentricity above and below the fovea, whether damage was mild or severe. The average loss +/- S.D. of ganglion cells was 81.1% +/- 10.7%, whereas the average cone loss was only 3.5% +/- 6.4%. CONCLUSIONS: Marked parafoveal cone loss was not found in experimental glaucoma in which extensive damage to ganglion cells occurred.

Animals↗
PubMed1995

Angiogenic activity of vitreous extract obtained from rabbit eyes with endotoxin-induced uveitis.

The effect of rabbit vitreous with endotoxin-induced uveitis was investigated for its role in the modulation of rat corneal neovascularization (NV). Elvax pellets implanted into at cornea contained either uveitic vitreous, intact vitreous or Elvax alone. The latter two kinds of pellets did not elicit NV. Uveitic vitreous pellets caused, in 100% of eyes, a persistent NV with maximal growth on the 10th day post implantation. Prostaglandin E2 and leukotriene B4 levels in the uveitic rabbit vitreous at 36 h postendotoxin injection were 7- and 5-fold higher than baseline, respectively. Histopathologically, the neovascularized cornea showed a significant inflammatory reaction attributable to the uveitic vitreous extract.

Animals↗
PubMed1994

[Secondary glaucoma after congenital cataract surgery].

In a retrospective study, the incidence of secondary glaucoma after congenital cataract extraction was evaluated. Causes of this type of secondary glaucoma include peripheral anterior adhesions which obstruct the anterior chamber angle and prevent normal outflow of aqueous humor, pupillary block, intraocular hemorrhage, and chronic uveitis, among others. During the past 12 years 41 children (57 eyes) were operated for congenital cataract. Secondary glaucoma was found in a 1-month-old boy and a 1-month-old girl (5.3%; 3 eyes). Follow-up in most patients was less than 5 years. A similar incidence of secondary glaucoma has been reported by others. In spite of the low incidence of this complication, secondary glaucoma should be excluded during routine follow-up of these children.

Cataract↗
PubMed1992

Silicone oil-induced corneal hydrops?

A 27-year-old man with a personality disorder, who did not have keratoconus previously, recently presented with a clinical picture resembling acute corneal hydrops OS three years after silicone oil injection for a complicated retinal detachment. Although self-induced trauma could not be excluded completely, this case might represent a newly described late corneal complication of intracameral silicone oil.

Adult↗
PubMed1992

Secondary cataract in infants after extracapsular cataract extraction and anterior vitrectomy.

Two infants developed secondary cataract after undergoing extracapsular cataract extraction (ECCE), posterior chamber intraocular lens (IOL) implantation, posterior capsulectomy, and anterior vitrectomy. A similar complication developed in a third child, who had undergone ECCE and posterior capsulotomy. The secondary cataracts developed in these patients from 3 to 12 weeks after the primary operation. In infants, unlike adults, posterior capsulectomy and anterior vitrectomy after ECCE do not seem always to prevent secondary cataracts. In infants, the complication may be related to IOL implantation.

Anterior Eye Segment↗
PubMed1992

Retinitis pigmentosa and discoid lupus erythematosus.

A 41 year old male is presented who suffers from both advanced retinitis pigmentosa and active discoid lupus erthematosus. A possible association between the two pigmenting disorders is discussed as well as the treatment of the discoid lupus with potentially retinotoxic hydroxychloroquine.

Adult↗