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Biomedical subjects

L A Yannuzzi

Publications and source records attributed to L A Yannuzzi.

At least 91 records · Page 5Linked to original sources
PubMed1991

Choroidal vasculitis in acute posterior multifocal placoid pigment epitheliopathy.

A 24-year-old Caucasian female presented with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and associated infiltration round some of the larger choroidal blood vessels. This infiltration dissipated as the patient's clinical condition improved and did not induce any permanent alteration of the overlying retinal pigment epithelium. We suggest that the infiltration round the choroidal vessels was due to a choroidal vasculitis. The finding of choroidal inflammation in this case lends support to the hypothesis that choroidal vasculitis is an underlying pathological process in APMPPE.

Adult↗
PubMed1990

Lack of the HLA-DR2 specificity in multifocal choroiditis and panuveitis.

The prevalence of the HLA-B7 and HLA-DR2 specificities in 17 unrelated patients with multifocal choroiditis and panuveitis, 11 with and six without subretinal neovascularisation, was evaluated and compared with those of two different groups. The first group was 17 patients with subretinal neovascularisation associated with presumed ocular histoplasmosis syndrome, and the second was a group of 105 eye patients with no retinal disease. HLA-DR2 was not found in any patient with multifocal choroiditis and panuveitis, but it was found in 13 patients with presumed ocular histoplasmosis syndrome (p = 6.72 x 10(-5), comparison of the groups with subretinal neovascularisation). The lack of HLA-DR2 was also significant in comparison with the control group of eye patients (p = 0.041). This study suggests that patients with multifocal choroiditis and panuveitis and presumed ocular histoplasmosis syndrome have differing genetic predispositions, though the fundus pictures in these entities have many similarities.

Adult↗
PubMed1990

Idiopathic polypoidal choroidal vasculopathy (IPCV).

Eleven patients, 40 to 71 years old, had a choroidal vasculopathy that led to hemorrhagic and exudative macular degeneration. The patients had peculiar polypoidal, subretinal, vascular lesions associated with serious and hemorrhagic detachments of the retinal pigment epithelium. This macular disorder, which we have named idiopathic polypoidal choroidal vasculopathy (IPCV), appears to represent a distinct entity that differs clinically and demographically from age-related macular degeneration (AMD) and other macular diseases associated with subretinal neovascularization. Recognition of this condition is important because it may have specific risk factors, natural course, and management considerations that differ from those of age-related macular degeneration.

Adult↗
PubMed1990

A slitlamp comparator system for macular photocoagulation.

A slitlamp comparator device has been developed to project the image of a 35mm angiogram frame into the field of view of a standard slitlamp during macular photocoagulation. The image may be varied in brightness, magnification, and position, and viewed either on a black background or superimposed on a slitlamp fundus image. The comparator is a useful alternative to conventional angiogram projection systems and suggests the utility of more sophisticated "heads-up" display devices.

Fluorescein Angiography↗
PubMed1989

[Retinal pigment epithelial detachment].

The vast majority of cases of AMD involve widespread disease with visible neovascularization, "occult" neovascularization, and serous as well as hemorrhagic detachments of the RPE. Accurate interpretation of the clinical and fluorescein angiographic findings in PEDs is difficult. The most noteworthy problem is the recognition of the presence and extent of associated neovascularization. Definitive guidelines for laser photocoagulation treatment of these PEDs have not yet been established. Large-scale, sophisticated clinical trials are needed to assess the efficacy and safety of laser treatment for this important manifestation of exudative AMD. Until these investigations are completed, certain cases of PEDs may be selected for laser treatment by one of three treatment techniques. A grid pattern photocoagulation to a serous PED may be carried out when there is no demonstrable or suspected underlying SRN and there is persistence and progression of the detachment with associated visual decline. Total photocoagulation of the PED which is suspected of having neovascularization can also be carried out if the fovea can be spared. Finally, photocoagulation of extrafoveal neovascularization beneath or at the margin of a PED can be performed in an attempt to obliterate the neovascularization, resolve the exudative manifestations, and stabilize or improve the vision. Only experienced retinal specialists who are well trained in the recognition of the complex clinical and fluorescein angiographic features of PEDs should attempt to treat these unusual and complicated cases.

Aging↗
PubMed1989

Solar retinopathy. A photobiologic and geophysical analysis.

A series of young adult patients developed solar retinopathy during sun exposure over a two-day period in a particular region of the United States during March of 1986. Evaluation of the photobiological and geophysical parameters involved in solar retinitis are presented. A multifactorial pathogenesis is proposed. Of interest, a possible increase in terrestrial ultraviolet B radiation secondary to a localized relatively low ozone column during the days involved may have contributed to the retinal damage. Recommendations for protection from solar retinitis are noted.

Adolescent↗
PubMed1988

Acute frosted retinal periphlebitis.

We examined three previously healthy young patients who suffered acute visual loss associated with diffuse bilateral retinal periphlebitis. Each patient developed thick, inflammatory infiltrates surrounding all of the retinal veins, creating the appearance of frosted tree branches. Initial visual acuities ranged from 20/20 to hand motions (median, counting fingers). All patients showed rapid improvement after starting oral corticosteroid therapy, and all but one of the six affected eyes regained a visual acuity of 20/20. The clinical appearance and course of these patients matched those of a condition previously described in Japan and labeled frosted branch angiitis. The term "acute frosted retinal periphlebitis" seems to describe more accurately the clinical findings.

Acute Disease↗
PubMed1987

The ocular complications of boxing.

In cooperation with the New York State Athletic Commission, 74 boxers applying for a new or yearly renewal license were sequentially referred over a 2-year period for a complete dilated ocular examination at the Sports Vision Institute of the Manhattan Eye, Ear and Throat Hospital. At least one ocular injury was found in 66% of boxers. Vision-threatening injuries, defined as significant damage to the angle, lens, macula, or peripheral retina occurred in 58% of boxers. Nineteen percent of boxers had angle abnormalities. Nineteen percent of boxers had pathologic cataracts, over 70% of these were posterior subcapsular. Six boxers had macular lesions. A total of 24% of boxers had retinal tears. Standardized photographs were used to distinguish pathologic cataracts from congenital opacities and pathologic retinal tears from atrophic holes. Attempts were made to identify risk factors in boxing that might be predictive for ocular injury. Variables included age, weight division, left- or right-handedness, total number of losses, and total number of bouts. Significant correlations were found between the total number of bouts and the total number of losses, and the presence of retinal tears. College varsity athletes were selected as controls. Significant differences were found between boxers and controls for the total number of injuries, total vision-threatening injuries, and the number of retinal tears. A series of recommendations are proposed to aide in the early detection and prevention of serious ocular injuries.

Adolescent↗
PubMed1987

Type-A behavior and central serous chorioretinopathy.

A consecutive series of newly-diagnosed patients with central serous chorioretinopathy (CSC) was compared to two independent control groups chosen from the same patient population for the presence of a Type A behavioral pattern based on the Jenkins Activity Survey. The patients selected as matched controls had painless, reduced central vision and other chorioretinal diseases (Group I), or non-chorioretinal ocular conditions (Group II). The Type A behavior was significantly more frequent in study patients than in either Control Group I (X2 = 6.1 and P less than 0.025) or Control Group II patients (X2 = 17.7 and P less than 0.001). When both control groups were combined for comparison to the CSP patients, there was also a highly significant difference with regard to Type A behavior (X2 = 14.1 and P less than 0.001). A comparison of Control Group I with Control Group II revealed no significant difference in Type A behavior. Subfactor analysis of the Type A behavior pattern was also studied. The results of this clinical study were used in conjunction with experimental evidence linking catecholamines with CSP in developing a multifactorial etiologic hypothesis. The hypothesis suggests that the eyes as an organ system, and the macula as an ultimate target area, can be intermittently or continuously stimulated adversely by Type A behavior and its physiological consequences, most notably a sympathetic discharge. The multifactorial concept alludes to other potential risk factors such as age, race, sex, refractive state, or unknown tissue susceptabilities. The pathogenesis implies an inter-relationship between finely balanced components of a complex biopsychological system involving an individual's genetic endowment, his environment, and his behavioral pattern. The concept also offers new possible lines of investigation for the treatment of CSP, utilizing pharmacological regulators and for its prevention through early identification of CSP-prone individuals. A review of the pertinent cardiovasculature literature linking the Type A behavior with coronary artery disease and the significant papers in the ophthalmic literature on central serous pigment epitheliopathy are included in the discussion.

Adult↗
PubMed1987

Posterior segment manifestations of orbital trauma.

The posterior segment of the eye can be affected by blunt orbital trauma by either direct or indirect mechanisms or by equatorial expansion. Commotio retinae can occur either at the site of direct or indirect injury. Retinal detachments can be precipitated at the site of the direct injury by a necrotic tear, at the site of the indirect injury with a macular hole, or just posterior to the vitreous base if equatorial expansion plays a role. Contusion effects on the choroid can manifest as a localized hemorrhage, a hemorrhagic choroidal detachment, or a choroidal rupture. Chorioretinitis sclopetaria results from simultaneous laceration of both the retina and choroid due to the shock waves from a high-velocity missile passing adjacent to the globe in the orbit.

Choroid↗
PubMed1986

Fluorescein angiography complication survey.

This is a report on the results of a national survey designed to study the nature and frequency of moderate and severe complications of intravenous fluorescein angiography. In this survey, 2434 responding ophthalmologists reported on 221,781 fluorescein angiograms performed in the year 1984. Adverse reactions were classified as mild, moderate, severe, and death, depending on the duration of the effect, the necessity for medical intervention, the time required for its resolution, and the final outcome. The frequency rate for a moderate reaction was (1:63), for a severe reaction (1:1900), and for death (1:222,000). A review of previous studies on adverse reactions to the drug, a compilation of suggested methods for the amelioration and prevention of the complications, and a comparison of the responses of the general ophthalmic public to the members of The Macula Society are also reported.

Fluorescein↗