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Biomedical subjects

J H Zeiter

Publications and source records attributed to J H Zeiter.

18 recordsLinked to original sources

Relationship between optic disc cupping change and intraocular pressure control in adult glaucoma patients.

BACKGROUND: Until recently, there has been a paucity of quantitative evidence for intraocular pressure (IOP)-dependent optic disc cupping change in adult glaucoma patients. Therefore, we investigated the relationship between optic disc cupping change and IOP control. METHODS: The study involved 78 eyes of 78 randomly selected adult patients with early to moderate chronic open-angle glaucoma (CO-AG), treated on various therapeutic regimens, who had had two consecutive successful optic disc analyses with the Rodenstock Optic Nerve Head Analyzer 15.8 +/- 14.8 weeks apart. RESULTS: The mean initial IOP of 27 eyes (34%) with cupping reversal did not differ from that of 17 eyes (22%) demonstrating progressive deterioration (29.2 +/- 8.8 vs 26.2 +/- 6.1 mmHg, P > 0.5), but the reversal group did have a significantly greater mean IOP decrease than the progression group (-10.8 +/- 7.9 vs-1.0 +/- 7.7 mmHg, P < 0.001) and significantly lower mean final IOP (18.3 +/- 6.1 vs 25.2 +/- 7.9 mmHg, P < 0.003). CONCLUSION: A decrease of optic disc cupping is more likely with a greater IOP reduction and a lower final IOP, and an increase of cupping is more likely with less or no IOP reduction and a higher final IOP.

Adult↗

Diabetes in primary open-angle glaucoma patients with inferior visual field defects.

We reviewed the charts of 144 randomly selected patients with primary open-angle glaucoma who had Aulhorn's stage 1, 2, or 3 visual field defects to investigate whether primary open-angle glaucoma patients with predominantly inferior visual field defects had a higher prevalence of diabetes mellitus than primary open-angle glaucoma patients without such visual field defects. Of the 59 patients with mainly inferior visual field defects in one or both eyes, 19 (32%) had diabetes mellitus, while 11 of 85 (13%) patients without such defects had diabetes mellitus. This difference was statistically significant (P = 0.0096). These results suggest that primary open-angle glaucoma patients with predominantly inferior visual field defects in one or both eyes are more likely to have diabetes and that such patients with no known history of diabetes may benefit from glucose tolerance testing to detect occult impaired glucose tolerance or diabetes mellitus.

Adult↗

A closed chamber technique for repair of iridodialysis.

We have developed a surgical technique for repair of traumatic iridodialysis, in which a 25-gauge hypodermic needle is used to place a 10-0 polypropylene suture in sewing-machine fashion through a closed anterior chamber. The technique also can be modified to secure a posterior capsule with a partial zonular dialysis, such as may occur during phacoemulsification or cortical clean-up.

Aged↗

Visual field defects in patients with normal-tension glaucoma and patients with high-tension glaucoma.

We compared the automated visual field test results of 24 patients with normal-tension glaucoma and 24 patients with high-tension glaucoma who were closely matched for the amount of visual field loss to determine any differences in the characteristics of visual field defects between the two groups. Patients were matched with a maximum allowable difference in mean deviation of 0.3 dB. Although the normal-tension group had a greater amount of focal visual field loss (pattern standard deviation), the difference was not statistically significant (P = .628). Additionally, there was no statistically significant difference in the amount of diffuse or focal visual field damage in the superior hemifields between the two groups; however, the patients with normal-tension glaucoma had a significantly greater amount of localized visual field loss in the inferior hemifield than the patients with high-tension glaucoma (P = .015). Our data support the hypothesis that a vascular mechanism may have a greater role in the pathogenesis of optic nerve damage and visual field loss in patients with normal-tension glaucoma than in patients with high-tension glaucoma.

Aged↗

Intraocular pressure-related pattern of optic disc cupping in adult glaucoma patients.

The pattern of glaucomatous optic disc cupping was investigated in 67 eyes of 67 primary open-angle glaucoma patients with early-to-moderate visual field loss and a wide range of intraocular pressure. We determined the position of the deepest point of the optic disc cup using the Rodenstock Analyzer. This position correlated significantly with intraocular pressure: the deepest point tended to be located below the center of the optic disc at high intraocular pressure and above the center at low intraocular pressure. There was no significant correlation between the position of the deepest cup point along the horizontal axis and intraocular pressure. The position of the deepest point of the cup also correlated significantly with the severity of glaucoma, albeit less strongly than with intraocular pressure: it tended to be in the inferior portion of the disc at an early stage of glaucoma and in the superior portion of the disc at a more advanced stage of glaucoma. Therefore, the inferior portion of the optic nerve head appears to be most yielding to changes of intraocular pressure. These findings are consistent with histologic evidence of the least connective tissue support in the inferoperipheral region of the lamina cribrosa and with greater prevalence of inferior rim loss and corresponding superior visual field defects in early to moderately advanced primary open-angle glaucoma patients.

Aged↗

Visual field defects in diabetic patients with primary open-angle glaucoma.

We reviewed the automated visual field tests of 110 nondiabetic and 87 diabetic patients with primary open-angle glaucoma randomly selected from a large glaucoma practice to investigate a possible qualitative difference in the pattern of visual field defects between nondiabetic and diabetic patients with primary open-angle glaucoma. A single reviewer analyzed, in masked fashion, the visual field tests of each patient and decided whether or not visual field defects were present mainly in the inferior half of the visual field. Of the 110 nondiabetic patients, 40 (36.4%) had visual field defects located mainly in the inferior half of the visual field in one or both eyes, whereas 56 of the 87 (64.4%) diabetic patients had such defects. This difference was statistically significant (P = .0001). We believe that a vascular factor, such as that attributable to diabetes mellitus, may influence glaucomatous optic nerve damage, thus causing a difference in the pattern of visual field loss in patients with primary open-angle glaucoma.

Adult↗

Visual field global indices in patients with reversal of glaucomatous cupping after intraocular pressure reduction.

The authors investigated visual field changes in 28 eyes of 28 adult patients with early-to-moderate chronic open-angle glaucoma (COAG) in whom reversal of glaucomatous disc cupping was documented by computerized image analysis (Rodenstock Optic Nerve Head Analyzer) after intraocular pressure (IOP) reduction from 29.3 (+/- 5.9) to 19.4 (+/- 4.3) mmHg over 34.8 (+/- 24.8) weeks. Humphrey Statpac global indices (mean deviation and pattern standard deviation) improved in direct proportion to the magnitude of IOP reduction even after controlling for the possible influences of learning effect, short-term fluctuation, reliability, duration of IOP reduction, age, and pupil size. The mean visual field global indices (mean deviation and pattern standard deviation) improved in patients with IOP reduction of 40% or greater, in statistically significant contrast to no improvement of mean global indices with IOP reduction less than 35%. The beneficial effect of IOP reduction is apparent in COAG patients with topographical evidence of reversal of cupping.

Adult↗

Endogenous endophthalmitis with lenticular abscess caused by Enterobacter agglomerans (Erwinia species).

We report for the first time a case of metastatic endophthalmitis caused by the gram-negative organism Enterobacter agglomerans (Erwinia species). One day following internal hemorrhoidal ligation, the patient developed anterior uveitis that progressed to panophthalmitis with a lenticular abscess and a necrotic retina. Despite aggressive surgery and appropriate antibiotic therapy, the affected eye lost useful vision.

Abscess↗

The effect of scleral cautery on corneal astigmatism in cadaver eyes.

We studied the effect of scleral cautery on corneal astigmatism in 20 cadaver eyes using the Zeiss wetfield bipolar cautery either at or 2 mm posterior to the corneoscleral limbus. The chord of cauterized area was set at either 5.5 or 11 mm. Cautery induced net corneal steepening along the meridian of the cauterized area, and induced the greatest astigmatism when applied at the limbus. At each location the 11-mm cautery application induced less astigmatism. The majority of the astigmatic change occurred within the first 5 to 10 seconds of application. We found that scleral cautery at or 2 mm posterior to the limbus can induce extensive corneal astigmatism.

Astigmatism↗

Ophthalmologic findings associated with arthrogryposis multiplex congenita: case report and review of the literature.

Arthrogryposis multiplex congenita is a birth defect characterized by multiple joint deformities and sometimes associated with various other congenital anomalies. There have been several reported cases of miscellaneous ocular abnormalities in conjunction with this syndrome. We report the first case of congenital ophthalmoplegia as well as juvenile onset glaucoma associated with arthrogryposis multiplex congenita. This case represented a unique therapeutic dilemma in that it was extremely difficult to surgically treat the patient's glaucoma because of her severe restrictions of ocular motility.

Adult↗