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Jonathan L Prenner

Publications and source records attributed to Jonathan L Prenner.

9 recordsLinked to original sources

Congenital X-linked retinoschisis classification system.

PURPOSE: To establish a classification system for congenital X-linked retinoschisis (CXLRS) using clinical examination and optical coherence tomography (OCT). METHODS: Thirty-eight eyes of 19 patients who carried a clinical diagnosis of CXLRS were examined with OCT and clinical examination. Eyes were classified into one of four types based on a combination of clinical examination and OCT. RESULTS: All patients had bilateral OCT scanning performed at an average age of 8.64 years (range 2.24-17.4 years). Review of OCT scans revealed that 37 of 38 eyes had foveal schisis (97%) while 31 of 38 (82%) eyes had macular schisis deeper than the nerve fiber layer in areas of ophthalmoscopically normal macular retina. The authors termed this flat schisis phenomenon lamellar schisis. Thirty of 38 (79%) had peripheral bullous schisis cavities present. CONCLUSIONS: OCT examinations of patients with CXLRS reveal lamellar schisis in areas of ophthalmoscopically normal macular retina in 82% of eyes with the clinical diagnosis of CXLRS. Using both clinical examination and OCT, the authors were able to identify foveal, lamellar, and peripheral schisis, lamellar schisis only identifiable by OCT. These findings allow the authors to propose a classification system. The authors hope this classification system will allow a better understanding of the natural history of CXLRS disease and allow testing of therapeutic options.

Adolescent↗

Longer-term outcomes of transconjunctival sutureless 25-gauge vitrectomy.

PURPOSE: To report longer-term outcomes in eyes undergoing 25-gauge transconjunctival sutureless vitrectomy. DESIGN: Retrospective, noncomparative, case series. METHODS: Chart review of the initial 45 consecutive patients (45 eyes) that underwent TSV by one surgeon (T.S.H.) for idiopathic epiretinal membrane (n = 15), refractory diabetic macular edema (n = 11), idiopathic macular hole (n = 10), and nonclearing vitreous hemorrhage (n = 9). All patients had at least 6-month follow-up. Main outcome measures included visual acuity (VA), intraocular pressure, intraoperative complications, and postoperative complications. RESULTS: Mean follow-up was 13 months (range 6 to 25 months). Mean overall preoperative VA vs last postoperative VA was 20/229 and 20/65, respectively (P < .0001). Statistically significant VA improvement was seen for each patient subgroup. Mean preoperative intraocular pressure was 16.9 mm Hg (range 10-26 mm Hg). On postoperative day 1, week 1, and week 4, median intraocular pressure was 14.6 mm Hg (range 8-17 mm Hg), 17.6 mm Hg (range 8-38 mm Hg), and 17.7 mm Hg (range 9-33 mm Hg), respectively. No intraoperative complications occurred. Postoperative complications were 1 inferior retinal detachment (2.2%) 4 weeks after macular hole repair, 1 macular hole (2.2%) 6 months after epiretinal membrane peel, and 23 worsening cataracts in 29 phakic eyes (79.3%). CONCLUSIONS: Less surgically complex vitreoretinal pathology may be successfully repaired with TSV. After a mean follow-up of more than 1 year, minimal complications were seen, and none was specifically related to the sutureless nature of the procedure.

Aged↗

Visual outcomes after lens-sparing vitrectomy for stage 4A retinopathy of prematurity.

PURPOSE: To assess the visual outcomes of patients with stage 4A retinal detachments (RDs) from retinopathy of prematurity (ROP). DESIGN: Retrospective review of a consecutive case series of children referred to the pediatric retina service of Associated Retinal Consultants, Royal Oak, Michigan. PARTICIPANTS: Forty-five eyes of 39 children. METHODS: The stage of RD for each patient was determined during an examination under anesthesia. All patients underwent a lens-sparing pars plana vitrectomy (PPV) with membrane peeling. Postoperative anatomic status was determined by ophthalmoscopy either during an office examination or during an examination under anesthesia. Visual outcomes were ascertained by consulting pediatric ophthalmologists using either Teller or Allen acuities. MAIN OUTCOME MEASURES: Anatomic and visual outcomes. RESULTS: Formalized visual acuity (VA) measurement was performed in 23 eyes of 20 children, and was not performed in 22 eyes of 19 children. All 23 eyes that were formally tested had successful retinal reattachment. The macula appeared to be normal and without distortion in 19 of 23 eyes (83%) during the follow-up period. Average logarithm of the minimum angle of resolution VA was 20/58. Three eyes had acuities of 20/200, and 4 had acuities of 20/100. All other eyes were 20/80 or better. Average age at time of VA was 3.51 years. CONCLUSIONS: Patients with ROP and stage 4A RDs can be treated successfully with respect to anatomic and visual outcome utilizing lens-sparing PPV.

Gestational Age↗

Risk factors for choroidal neovascularization and vision loss in the fellow eye study of CNVPT.

PURPOSE: To identify risk factors for the development of choroidal neovascularization (CNV) and vision loss in the Fellow Eye Study of the Choroidal Neovascularization Prevention Trial. METHODS: Retrospective review of 121 patients enrolled in a multicentered, randomized, controlled trial. Patients had neovascular age-related macular degeneration in one eye and more than 10 large drusen in the other eye. Records of patients randomly assigned to laser treatment or observation were reviewed through 4 years of follow-up. Three candidate risk factors for the development of CNV and vision loss were evaluated. RESULTS: Eyes with hyperfluorescent drusen on fluorescein angiography at 3 minutes appeared to have a decreased risk of CNV. Patchy choroidal filling was seen in 14% of patients. Eyes with patchy choroidal perfusion showed a higher risk of developing CNV that was not statistically significant, and the increased risk was present only in treated eyes. Reticular pseudodrusen were present in only three eyes. CONCLUSIONS: Reticular pseudodrusen were rare. Late drusen fluorescence may protect against the development of CNV.

Aged↗

Foveal spot: a report of thirteen patients.

PURPOSE: To describe the natural history of a series of patients with a small foveal or juxtafoveal red lesion. METHODS: Retrospective chart review of 13 patients with a small foveal or juxtafoveal red spot. Long-term follow-up examination was obtained in seven patients. RESULTS: Thirteen patients with a mean age of 34.6 years are reported. Initial visual complaints ranged from no complaints to mild blurring and central distortion of vision. None of the patients had a history of sun gazing or known macular disease. Eleven of the 13 patients had best-corrected visual acuities in the involved eye that were better than 20/30. The lesions were bilateral in five patients and unilateral in eight. When performed, optical coherence tomography and fluorescein angiography were unremarkable. Follow-up was obtained in seven patients (mean, 58 months), and visual acuity remained stable in all affected eyes. In all patients, the lesions remained stable without expansion or alteration of the foveal appearance over the course of follow-up. CONCLUSIONS: This report identifies a foveal or juxtafoveal, irregular, apparently intraretinal, red lesion of unclear cause. Long-term follow-up of these patients has demonstrated stable visual acuity and lesion appearance.

Adolescent↗

Prolonged premonitory optic disc signs in anterior ischemic optic neuropathy.

A patient displayed a pink mass on the right optic disc and normal visual function that was diagnosed as a capillary hemangioma. Seven months later, he developed typical features of nonarteritic anterior ischemic optic neuropathy (NAION) in that eye. Such a long latency between "preeruptive" and "eruptive" disc edema has not been well documented in NAION.

Diagnosis, Differential↗