Biomedical subjects

J F Vander

Publications and source records attributed to J F Vander.

26 records · Page 2Linked to original sources

PubMed1991

Surgical removal of massive subretinal hemorrhage associated with age-related macular degeneration.

The authors report on 11 patients with age-related macular degeneration associated with massive subretinal hemorrhage, who were treated with surgical removal of the hemorrhage and associated fibrosis. Preoperative visual acuity ranged from 20/400 to hand motions. Postoperative visual acuity ranged from 20/200 to light perception with a minimum of 3 months of follow-up. Complications included partial or total retinal detachment in four patients (36%) and cataract in four patients (36%). Four of 11 patients showed some improvement in vision (36%). All four of these patients had surgery within 1 week of the onset of severe visual loss. Although surgical removal of large subretinal hemorrhages is technically feasible, visual recovery is limited, even in uncomplicated cases, by macular degenerative changes.

Aged↗

PubMed1991

Retinal tolerance of an implantable light source for use during vitrectomy surgery.

To assess for the possible development of a phototoxic lesion, we exposed five Dutch belted rabbit retinas to constant illumination with an implantable "chandelier" light source at maximal intensity for 1 hour. No clinically apparent lesion developed in any of the experimentally treated eyes by 48 to 72 hours posttreatment. Light and electron microscopic examination failed to reveal any of the characteristic changes of retinal phototoxicity. A control eye treated with a 20-minute exposure to a standard endoiluminator probe at maximal intensity held 2 mm from the retinal surface demonstrated typical light and electron microscopic phototoxic abnormalities, whereas a retina similarly treated with a 5-minute exposure was normal. We have confirmed that a standard endoilluminator probe can create a phototoxic lesion in the experimental setting. Furthermore, no phototoxicity from the sustained retinal exposure to a fixed, implantable light source for a clinically relevant duration could be demonstrated.

Animals↗

PubMed1990

Iris neovascularization after central retinal artery obstruction despite previous panretinal photocoagulation for diabetic retinopathy.

Five consecutive patients with proliferative diabetic retinopathy who were treated successfully with panretinal photocoagulation subsequently developed a central retinal artery obstruction. Iris neovascularization developed in the affected eye within one to three months after the obstruction in four of the five patients despite the previous laser treatment. Additional retinal ischemia, as occurs in central retinal artery obstruction, appears to promote marked iris neovascularization in a large percentage of patients, even when successful photocoagulation for proliferative retinopathy has been previously administered.

Adult↗

PubMed1990

The ocular effects of intracarotid bromodeoxyuridine and radiation therapy in the treatment of malignant glioma.

Since July 1985, 23 patients have been entered into a phase I/II clinical trial using intraarterial 5-bromodeoxyuridine (BUdR) (400-600 mg/m2 daily for 8.5 weeks) and focal external beam radiotherapy (59.4 Gy at 1.8 Gy daily in 6.5 weeks) in the treatment of malignant gliomas (Kernohan grades 3 and 4). The side effects in all patients have included varying degrees of anorexia, fatigue, ipsilateral forehead dermatitis, blepharitis, and conjunctivitis. Mucopurulent conjunctivitis and exposure keratitis developed in several patients and spontaneous corneal perforation developed in one. Eyes from two individuals examined at autopsy showed significant changes. Animal studies that predated clinical trials using rhesus monkeys did not predict the ophthalmologic complications seen in human subjects.

Adult↗

PubMed1989

Flurbiprofen sodium to prevent intraoperative miosis during vitreoretinal surgery.

To assess the efficacy of flurbiprofen sodium 0.03% at maintaining pupillary dilation during vitreoretinal surgery, we performed a randomized, double-masked, controlled trial of 139 consecutive patients. The mean decrease in pupil size during surgery in patients who received flurbiprofen was 0.9 mm; for patients who did not receive the drug it was 0.8 mm. The type of surgery performed (vitrectomy or scleral buckle), gender, age, lens status, and a history of diabetes or previous intraocular surgery were assessed and the addition of flurbiprofen to routine preoperative dilation did not significantly affect the mean change in pupil size for any of these subgroups. Of the nine patients who developed at least 3 mm of miosis, five received flurbiprofen and four did not. Use of flurbiprofen did not appear to reduce intraoperative miosis during vitreoretinal surgery in a clinically meaningful manner.

Adolescent↗

PubMed1989

Growth rate of subretinal neovascularization in age-related macular degeneration.

To determine the growth rate of subretinal neovascularization (SRNV) in age-related macular degeneration (ARMD), 35 pairs of serial fluorescein angiograms from 30 consecutive patients with SRNV who had not been treated with laser photocoagulation were analyzed. The daily growth rate of SRNV measured on consecutive fluorescein angiograms less than 120 days apart ranged from 0 to 74 microns (mean, 18 microns daily). The daily estimated growth rate of SRNV in any one direction ranged from 0 to 37 microns (mean, 9 microns daily). Documented initial slow growth of SRNV in one eye did not preclude a greater subsequent growth rate in the fellow eye. It was not possible to predict reliably the growth rate of SRNV. This reinforces the necessity of prompt evaluation of all subretinal neovascular membranes initially for the purpose of possible laser treatment.

Aged↗

PubMed1988

Penetrating orbital injury with cavernous sinus involvement.

Penetrating orbital injuries may involve intracranial structures as well. We report an unusual case of permanent visual loss, temporary complete ophthalmoplegia, and penetration of the internal carotid artery following penetrating nail injury. CT scanning and arteriography are important diagnostic tests to consider prior to removal of an orbital foreign body. This case also demonstrates the importance of delaying repair of traumatic ptosis and ophthalmoplegia.

Adult↗

PubMedDate not supplied

Retinopathy of prematurity: diagnosis and management [continuing education credit].

1. Despite advancements in neonatal and ophthalmic care, over 500 infants per year are blinded by retinopathy of prematurity (ROP). 2. Cryotherapy and laser photocoagulation have greatly improved the prognosis for infants with ROP. 3. Despite timely intervention, some infants with ROP will develop retinal detachment.

Cryotherapy↗