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Biomedical subjects

H Freyler

Publications and source records attributed to H Freyler.

At least 19 recordsLinked to original sources
PubMed1991

[Differences in the pathogen spectrum of the conjunctival sac before and after irrigation of the lacrimal apparatus].

The microbial flora in the conjunctival sac of 30 patients was investigated. Qualitative and quantitative differences before and after irrigation of the lacrimal system were found. In some cases a quantitative increase was registered. In 12 cases conjunctival samples before and after irrigation changed. Negative results before and bacterial growth of coagulase-negative staphylococci after irrigation were found in 4 cases. In 3 cases unfavourable changes were seen. Pseudomonas, Klebsiella and beta-hemolytic streptococci were isolated after irrigation in these cases. In the other cases differences were insignificant. The sense of preoperative irrigation of the lacrimal system is discussed and questioned.

Aged↗
PubMed1990

[Laser therapy of diabetic maculopathy. A comparative study of the argon green laser and dye red laser].

One hundred eyes with (pre)-proliferative diabetic retinopathy underwent central laser treatment for macular involvement. Fifty eyes were treated with the dye red 630 nm, the other 50 with the argon green 514 nm laser. Eighty of the eyes had previously undergone panretinal photocoagulation; in the other 20 this was performed 1.5-3 months after treating the macula because the central retinal changes were predominant. In accordance with the clinical angiographic classification of diabetic maculopathy, into an exudative, an edematous, and an ischemic type, three photocoagulation techniques were employed as appropriate, i.e., focal coagulation, (modified) grid coagulation, and extensive centripetal panretinal coagulation. Neither postoperative visual acuity, nor the fluorescein angiogram, nor fundus color photography revealed any significant difference in the results obtained with the two laser wavelengths.

Diabetic Retinopathy↗
PubMed1988

[Comparison of the effectiveness and safety of levobunolol and timolol in ocular hypertension and chronic open-angle glaucoma].

Twenty-six patients with open-angle glaucoma or ocular hypertension were studied in a concomitant double-masked clinical trial lasting three months, in which the ocular hypotensive efficacy and safety of levobunolol (0.5%) and timolol (0.5%), topically administered twice daily, were compared. At all follow-up examinations there was a significant decrease in mean intraocular pressure from baseline in both treatment groups, with no significant difference between them in this regard. Few changes were seen in either treatment group in cup/disk ratio, visual fields, visual acuity, biomicroscopy, or ophthalmoscopy. In both groups slight decreases in mean blood pressure were observed. Levobunolol and timolol were similarly effective and safe in reducing intraocular pressure in patients with chronic open-angle glaucoma and those with ocular hypertension.

Adult↗
PubMed1988

Coagulation factors of contact phase of haemostasis are normal in well-controlled type-I diabetic patients despite presence of diabetic retinopathy.

Alterations of plasma coagulation factors have been reported in diabetic patients with severe microangiopathy and metabolic derangement. No information is available, however, for well-controlled type-I diabetic patients. Thus, we studied coagulation factors of the contact phase and inhibitors in 80 fairly well-controlled diabetics (42 female, 38 male, age 28 +/- 11 SD years). Mean HbA1c in these patients was 6.6 +/- 1.0 SD, duration of diabetes ranged from 6 months to 30 years, and 36% had retinopathy shown by fluorescein angiography. The well-controlled diabetic patients did not differ from controls in terms of the activity of prekallikrein, factor XII, high molecular weight kininogen, kallikrein inhibitor, C-1-esterase inhibitor and antithrombin III. Only alpha-2-macroglobulin, an inhibitor of the contact phase of blood coagulation, was elevated significantly in these patients (p less than 0.05). Diabetics with retinopathy had similar activities of prekallikrein, factor XII, high molecular weight kininogen, kallikrein inhibitor, c-1-esterase inhibitor and antithrombin III when compared with patients without retinopathy and controls respectively. alpha-2-macroglobulin did not differ in patients with and without diabetic retinopathy but were significantly elevated in both groups compared with controls. Correlation analysis showed significant positive correlation between HbA1c and the activity of high molecular weight kininogen, kallikrein inhibitor and alpha-2-macroglobulin. In patients with poor metabolic control (n = 11; 6 female, 5 male; age 25 +/- 5 SD years; HbA1C 10.7 +/- 0.9) prekallikrein (p less than 0.05), kallikrein inhibitor (p less than 0.005) and alpha-2-macroglobulin (p less than 0.005) were significantly elevated compared to the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

No evidence for increased growth hormone responses to growth hormone-releasing hormone in patients with diabetic retinopathy.

Several studies report increased growth hormone (GH) responses to provocative stimuli in patients with diabetic retinopathy. We studied GH responses to 1 microgram/kg body wt human pancreatic GH-releasing hormone 1-44 (hpGHRH 1-44) in 33 patients with type I diabetes mellitus, 31 patients with type II diabetes mellitus, and 2 control groups (N = 11 and 8). Based on the results of fundoscopy and fluorescein angiography, the diabetic patients were subdivided into patients without diabetic retinopathy, patients with nonproliferative diabetic retinopathy, and patients with proliferative diabetic retinopathy. Growth hormone responses to hpGHRH 1-44 in diabetic patients with proliferative or nonproliferative retinopathy or without retinopathy were not significantly different regardless of the type of diabetes. Remarkably, GH responses to hpGHRH 1-44 in type I diabetic patients without retinopathy were significantly higher than the matched controls. Our data suggest that diabetic retinopathy in type I and in type II diabetes is not associated with increased GH responsiveness to hpGHRH 1-44, whereas in type I diabetes mellitus without diabetic retinopathy, a GH hyperresponsiveness to hpGHRH seems to occur.

Adult↗
PubMed1986

Combined vitrectomy and scleral resection in the therapy of massive epiretinal fibrous membranes due to diabetic retinopathy.

Between December 1981 and June 1984 scleral resection was performed in 35 patients suffering from end-stage proliferative diabetic retinopathy with traction retinal detachment involving the macula. In all cases, vitrectomy, membranectomy, segmentation, and delamination proved to be insufficient to mobilize the "shrunken" retina. In 22 cases (63%), retinal detachment was at least partially flattened in the area of the posterior pole of the eye. Visual acuity thus achieved ranged between 6/24 and 1/60, corresponding to an improvement of visual acuity compared with the preoperative situation in about one-third of the cases successfully treated (8 eyes).

Diabetic Retinopathy↗
PubMed1986

[Pseudophakic keratoplasty].

The author reports on 12 unselected consecutive penetrating keratoplasties performed for pseudophakic bullous keratopathy, in which the intraocular lens was retained. The visual results achieved were significantly better than those in aphakic eyes.

Corneal Diseases↗
PubMed1986

[Diabetic choroidopathy--a retrospective fluorescein angiography study. Preliminary report].

Both histologic studies and findings with Indocyanin green angiography furnish clear indications of the existence of diabetic choroidopathy. Out of 19,387 fluorescein angiograms made over the last 15 years at the First Ophthalmological Clinic of Vienna University, 902 were selected in which the choroidal vascular system is at least partially visible due to melanin hypopigmentation. The pathologic changes in the choroid observed in these angiograms can be allocated in two basic types of pathologic fluorescence: on the one hand hyperfluorescent lesions such as drusen in Bruch's membrane in suprisingly young diabetics, extremely hyperfluorescent lobules of the choriocapillaris, choroidal aneurysms, and neovascularizations; on the other hand, hypofluorescent lesions or structures were observed, such as delayed filling of the choriocapillaris and, in the late phase of angiography, varicose and tortuous choroidal vessels, drained and appearing dark in contrast to the diffuse background fluorescence.

Aneurysm↗
PubMed1986

[20 years' experience at a special department for diabetic retinopathy at the 1st University Eye Clinic in Vienna. A status determination].

This survey summarizes the results of almost 20 years of scientific research into diabetic retinopathy. On the basis of examinations and experience in the treatment of 5734 diabetics suffering from retinopathy, present knowledge with regard to the epidemiology, pathogenesis, prophylaxis, and treatment of diabetic retinopathy is communicated and discussed.

Austria↗
PubMed1986

[Retinal pseudothrombosis].

As opposed to florid diabetic retinopathy, pseudothrombosis in type I diabetics has a favorable prognosis and responds well to panretinal photocoagulation therapy. In the past decade eight cases of retinal pseudothrombosis were evaluated, treated and kept under observation at the department for diabetic eye complications of the 1st University Eye Clinic, Vienna. Photocoagulation therapy repeated at brief intervals halted progression in all cases and improved visual acuity. In the follow-up period (2-10 years) no further episodes of progression were seen.

Adolescent↗
PubMed1985

[Use of neodym-YAG-lasers in ophthalmology].

Structures within the eye bulb diminishing visual acuity can be cut by means of neodymium-YAG-laser without surgical opening of the globe. The First Eye Department has had the first instrument of this kind in Vienna at its disposal since the summer of 1984. Up to now it has been used for posterior capsulotomy, iridotomy, opening pupillary membranes and for cutting vitreous membranes in 84 operations altogether. The advantages of neodymium-YAG-laser are minimal psychological and physical stress for the patient and the possibility of out-patient surgery. A possible transient increase in the eye pressure and endothelial cell loss are disadvantages. Our experiences with the Lasertek Neodymium-YAG-laser model 135 are reported.

Cataract Extraction↗
PubMed1985

[Ultrastructural findings in secondary lipoidosis of the cornea].

A patient suffering from a progressive keratopathy which could not be identified clinically underwent penetrating keratoplasty. Light microscopy showed cholesterol deposits in deep stromal regions. Further ultrastructural investigations confirmed these findings and, in addition, fibrous long spacing collagen was found in that region; this represents a new factor in the possible pathogenesis of corneal lipid degenerations.

Cholesterol↗
PubMed1985

[Peripheral fluorescence angiography in diabetic retinopathy].

Using the CANON CG 6 60 Z wide-angle fundus camera, fluorescein angiographic examinations of the fundus periphery were performed on 90 diabetic patients presenting with exudative diabetic maculopathy. The peripheral angiogram demonstrates that perimacular hyperpermeability - the main cause of diabetic maculopathy - is preceded by extensive disturbances of capillary perfusion in the midperiphery.

Adult↗
PubMed1985

[Use of the neodymium YAG laser following posterior chamber lens implantation].

The authors report on the neodymium-YAG laser used after extracapsular cataract extraction with the implantation of a posterior chamber lens in 1726 patients. The most common indication was capsular fibrosis necessitating posterior capsulotomy. The alternative to the YAG laser would be a bulbus-opening procedure via pars plana using a Sato knife. The advantage of the YAG laser in comparison with capsulotomy with a Sato knife is that there is no danger of intraocular infection or bleeding (which may result from tension on the fibers with the first method). A disadvantage of the YAG laser method is a possible transitory increase in intraocular pressure and an endothelial cell loss. In 1726 cases with posterior chamber lenses 45 capsulotomies using the YAG laser were necessary. A further indication for the YAG laser are posterior chamber lenses decentered by capsular fibrosis (3 cases). A third indication is chorepraxia after posterior chamber lens implantation. In three cases with posterior chamber lenses a flattening of the pupil occurred because remnants of the anterior capsule had shifted into the anterior chamber. In two cases a pupil became decentered for no apparent reason. In these cases YAG laser therapy is indicated. In at least three cases pupillary membranes were cut with the YAG laser. The authors treated their patients with the Lasertec model 135 YAG laser (Q-switched mode).

Humans↗
PubMed1984

[Vitrectomy in uveitis].

Between January 1976 and December 1983, at the First University Eye Clinic in Vienna, 568 vitrectomies and 287 lensectomies were carried out; in 69 of these interventions (20 lensectomies and 49 vitrectomies) the diagnosis was uveitis. In 24 cases the indication for vitrectomy was an intermediary uveitis, a post-traumatic uveitis in 4 and a sympathetic uveitis in 6 cases as well as suppurative endophthalmitis in 7 patients. Indications for surgical removal of pathological tissue from the anterior chamber by the use of vitrectomy instrumentation were, in 4 cases each, hypopioniritis and a hemorrhagic uveitis, and in 12 cases a phacogenic uveitis. In about two thirds of this very heterogeneous patient material, employing vitrectomy made it possible to achieve regression of uveitis. In the remaining third of the patients, at least a stationary state of the disease was achieved and a reduction of corticosteroid and immunosuppressive therapy were made possible. The best functional results were achieved in all surgical interventions in the anterior ocular segment and in vitrectomies for intermediary uveitis. In suppurative endophthalmitis, however, these results were unfavorable.

Humans↗
PubMed1984

Increased angiotensin-converting enzyme activities in diabetes mellitus: analysis of diabetes type, state of metabolic control and occurrence of diabetic vascular disease.

Serum angiotensin-converting enzyme activities were measured in 41 type 1 diabetics (16.4 +/- 4.0 U/ml), in 40 type 2 diabetics (15.0 +/- 5.2 U/ml) and in 52 controls (13.0 +/- 2.7 U/ml, mean +/- SD). Twenty six (32%) of 81 patients presented with serum angiotensin-converting enzyme activities above the normal range. No relation between serum angiotensin-converting enzyme activities and the presence or lack of diabetic vascular diseases in type 1 and type 2 diabetics could be detected. No significant differences in serum angiotensin-converting enzyme activities were found when comparing various types of diabetic vascular disease (retinopathy, neuropathy, renal failure, arterial vascular disease, diabetic vascular disease, coronary artery disease). However, mean serum angiotensin-converting enzyme activities were significantly increased in diabetics with retinopathy when compared with controls (p less than 0.0005). Correlation between metabolic long term control as determined by measuring glycohaemoglobin (HbA1) concentrations and serum angiotensin-converting enzyme activities could not be established. Serum angiotensin-converting enzyme activities did not show any correlations with duration of diabetes, age or sex of patients. A representative number of diabetics (32%) showed elevated serum angiotensin-converting enzyme activities, but a correlation with diabetic vascular disease, metabolic control or type of disease could not be established.

Adult↗
PubMed1983

[Continuous subcutaneous insulin infusion: long-term treatment in an unselected group of insulin-dependent diabetics].

Long-term ambulatory continuous subcutaneous insulin infusion was undertaken under serial blood-glucose control in nine insulin-dependent diabetics. Before this treatment was started, haemoglobin A1 was increased (more than 13%), diabetic lipoid necrosis was present in three, proliferative diabetic retinopathy in one, treatment-resistant Candida oesophagitis in one and Addison's disease in one. During the total of 630 weeks (range 6-135 weeks) of continuous subcutaneous insulin infusion it was found that (1) the metabolic state of the patients improved significantly, the previously non-responding oesophagitis healed and one of three patients with diabetic lipoid necrosis was markedly improved; (2) the risks of insulin treatment, hypoglycaemia (especially with Addison's disease) and keto-acidosis (for technical reasons) remained; and (3) in long-standing diabetes of type I even good control of blood glucose levels (mean 113 mg/dl) could neither prevent the occurrence of proliferative diabetic retinopathy nor loss of sight.

Adult↗