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Biomedical subjects

L M Jampol

Publications and source records attributed to L M Jampol.

At least 19 recordsLinked to original sources
PubMed1992

Choroidal neovascularization associated with choroidal hemangiomas.

Two patients with choroidal hemangiomas developed choroidal neovascularization. One patient with Sturge-Weber syndrome, a unilateral diffuse choroidal hemangioma, and a serous detachment of the macula was treated with yellow dye laser photocoagulation in a grid pattern to the tumor before glaucoma filtration surgery. Four years after successful laser treatment, the patient developed subfoveal choroidal neovascularization in an area of treatment. A second patient with a circumscribed choroidal hemangioma developed spontaneous subfoveal choroidal neovascularization 12 years after initial diagnosis of the hemangioma. The development of choroidal neovascularization associated with choroidal hemangiomas represents a potential cause of poor visual outcome in these patients.

Adolescent↗
PubMed1992

Primary malignant melanoma of the optic nerve simulating a melanocytoma.

Primary malignant melanoma of the optic nerve head is an extremely rare tumor. We describe a patient with a pigmented optic nerve lesion that simulated a growing melanocytoma. The pigmented tumor slowly infiltrated the optic nerve causing disc edema, retinal venous congestion, progressive visual field loss, and eventually, loss of central acuity. Following enucleation of the eye, and later resections of the optic nerve to the chiasm, histopathologic examination of the optic nerve, disc, and peripapillary region demonstrated a primary malignant melanoma of the optic nerve without choroidal involvement. Involvement of the optic nerve extended 26 mm beyond the lamina cribrosa. Malignant melanoma of the optic nerve is a real entity and may clinically simulate a melanocytoma.

Cranial Nerve Neoplasms↗
PubMed1992

Complications of glaucoma surgery. Ocular decompression retinopathy.

In seven eyes of four patients, retinal hemorrhages were observed following trabeculectomy under both local and general anesthesia. The hemorrhages were diffuse, both deep and superficial, and many had white centers when first observed. Two patients were young healthy male myopes undergoing primary trabeculectomy. The third patient was a young man with chronic uveitis. The fourth patient was an elderly man with primary open angle glaucoma who had an acute rise in intraocular pressure following cataract extraction. Intraocular pressure and visual results appeared unaffected by the hemorrhages. Retinal hemorrhages associated with ocular decompression appear to be relatively benign.

Adolescent↗
PubMed1992

Retinal periphlebitis in patients with acquired immunodeficiency syndrome with cytomegalovirus retinitis mimics acute frosted retinal periphlebitis.

Acute frosted retinal periphlebitis is an inflammatory condition of unknown origin characterized by marked perivenular infiltration in otherwise healthy patients. We encountered seven patients with acquired immunodeficiency syndrome who exhibited visual loss associated with an unusual diffuse retinal periphlebitis very similar in appearance to acute frosted retinal periphlebitis. Each patient developed a thick inflammatory infiltrate surrounding the retinal venules, creating a frosted appearance. Two cases were bilateral. All patients had areas of more typical cytomegalovirus retinitis in their involved eye(s). Five of six patients treated with ganciclovir sodium showed improvement not only of the cytomegalovirus retinitis but also of the periphlebitis. Although we do not have histopathologic evidence that cytomegalovirus was the cause of these cases of periphlebitis, we believe that periphlebitis may be a previously unrecognized finding of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome. So far, there is no evidence implicating cytomegalovirus as the cause of acute frosted retinal periphlebitis in healthy patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Improvement in visual acuity in chronic aphakic and pseudophakic cystoid macular edema after treatment with topical 0.5% ketorolac tromethamine.

Ketorolac tromethamine 0.5% ophthalmic solution treatment was compared to placebo treatment in 120 patients with chronic aphakic or pseudophakic cystoid macular edema (six-month or more duration of distance visual acuity of 20/40 or less and angiographic evidence of cystoid changes) during a four- to five-month double-masked, multicenter study in which patients were randomly assigned. A statistically significant improvement in distance visual acuity (two lines or more) was observed in the ketorolac-treated group as compared to the placebo-treated group after 30 days (P = .038), 60 days (P = .017), and 90 days (P = .008) of treatment. This improvement in visual acuity remained statistically significant one month after cessation of treatment (P = .001). Nine ketorolac-treated patients and two placebo-treated patients demonstrated a decrease in visual acuity one month after treatment was discontinued. Seven of the nine ketorolac-treated patients experienced an improvement in visual acuity after retreatment as compared to none of the placebo-treated patients. This study offers evidence for a more optimistic outlook in the medical treatment of chronic aphakic and pseudophakic cystoid macular edema.

Administration, Topical↗
PubMed1991

Unilateral frosted branch angiitis.

We examined two patients with monocular frosted branch angiitis. The patients were young and healthy; they rapidly developed severe visual loss with thick, white sheathing of the retinal veins and responded promptly to systemic corticosteroids. The fluorescein angiograms showed late leakage from the retinal veins, without evidence of stasis or occlusion. Frosted branch angiitis can be either a unilateral or a bilateral condition. We believe the potential for visual loss and the prompt response to systemic corticosteroids make early, accurate diagnosis and institution of therapy desirable.

Administration, Oral↗
PubMed1991

A randomized clinical trial of scatter photocoagulation of proliferative sickle cell retinopathy.

A randomized prospective clinical trial of argon laser scatter photocoagulation therapy for proliferative sickle cell retinopathy was performed on 116 patients (174 eyes) in Kingston, Jamaica. Ninety-nine eyes were treated with scatter photocoagulation and 75 eyes served as controls. The average length of follow-up was 42 months for the control eyes and 47 months for the treated eyes. Prolonged loss of visual acuity was statistically significantly reduced in the treated eyes. The incidence of vitreous hemorrhage was also significantly reduced in the treated eyes after controlling for the previously defined risk factors of vitreous hemorrhage and extent of proliferative sickle cell retinopathy at entry into the study. There were no complications associated with argon laser scatter photocoagulation. Scatter photocoagulation of proliferative sickle cell retinopathy is currently the most effective and safe way to treat patients with sea fan neovascularization.

Adult↗
PubMed1991

Blind spot enlargement as a manifestation of multifocal choroiditis.

Enlargement of the blind spot without optic disc edema has been reported in patients with no other ocular findings (acute idiopathic blind spot enlargement) and in patients with multiple evanescent white dot syndrome. We describe three patients with multifocal choroiditis who developed acute symptomatic enlargement of the blind spot. All three patients were young women in excellent health. During the course of the blind spot enlargement, the appearance of the optic nerve remained normal. We demonstrate that acute enlargement of the blind spot without disc edema occurs in patients with multifocal choroiditis. This enlargement is likely due to peripapillary retinal dysfunction. We speculate on the association of multifocal choroiditis with acute idiopathic blind spot enlargement and multiple evanescent white dot syndrome.

Adrenal Cortex Hormones↗
PubMed1991

Unilateral acute idiopathic maculopathy.

This is a report of nine patients who experienced sudden, severe, unilateral central vision loss following a flulike illness. Each patient had an exudative detachment of the macula. All patients experienced a spontaneous resolution of the acute macular manifestations with near-complete recovery of vision. A characteristic "bull's-eye" appearance in the macula persisted. The acute manifestations of the disorder did not recur in any of the patients during the period of follow-up. The constellation of findings was suggestive of an inflammatory disease of the retinal pigment epithelium, but a specific causative agent could not be identified. The acute clinical and angiographic features, the natural course, and the residual pigment epithelial derangement were not consistent with any previously described disorder.

Acute Disease↗
PubMed1991

Idiopathic sclerochoroidal calcification.

Idiopathic sclerochoroidal calcification is a disorder that is often overlooked, occurring at the level of the posterior sclera and choroid in older patients. Clinically, it may be confused with choroidal osteoma, choroidal metastasis, amelanotic choroidal nevus, or choroiditis. The authors present seven cases of this unusual entity. The patients ranged in age from 58 to 80 years. In all cases, the yellow lesions were clinically estimated to be at the level of the choroid and sclera, and they were usually located superior to the superotemporal retinal vascular arcade. Systemic investigation of calcium and phosphate metabolism was normal in all patients. The classic clinical manifestations and differentiation of this unusual entity from other similar fundus lesions is discussed.

Aged↗
PubMed1991

A randomized clinical trial of feeder vessel photocoagulation of sickle cell retinopathy. A long-term follow-up.

Long-term follow-up of patients enrolled in a randomized prospective trial of feeder vessel photocoagulation for proliferative sickle retinopathy has been completed. Of the 44 patients enrolled in Chicago, nearly a decade follow-up has been achieved on 29 patients (45 eyes). There were 20 control untreated eyes and 25 argon laser-treated eyes. Prolonged loss of visual acuity was rare in both groups. Argon laser photocoagulation has had a sustained effect on reducing the incidence of vitreous hemorrhage and visual loss from vitreous hemorrhage. Nine (45%) of 20 control eyes had vitreous hemorrhage, and it was recurrent in six (66%) of these nine eyes. A single episode was the only hemorrhagic event in the treated eyes. The laser-induced complications of choroidal neovascularization or retinal detachment were not associated with long-term visual sequelae. New sea fan evolution in 47% of study eyes suggests that these patients require long-term surveillance.

Adolescent↗
PubMed1991

An update on techniques of photocoagulation treatment of proliferative sickle cell retinopathy.

Proliferative sickle cell retinopathy (PSR) can lead to visual loss from vitreous haemorrhage and traction or rhegmatogenous retinal detachment. We review two techniques of photocoagulation for PSR, feeder vessel photocoagulation and scatter photocoagulation. A prospective randomised trial of feeder vessel photocoagulation for PSR demonstrated that the incidence of vitreous haemorrhage and visual loss was diminished in eyes which were treated. Since this technique of treatment is difficult and can be associated with choroidal neovascularisation and retinal tears, scatter photocoagulation has also been tested. A prospective randomised trial of scatter photocoagulation for PSR demonstrated a decreased incidence of vitreous haemorrhage and visual loss in treated eyes compared to untreated eyes. No complications of scatter treatment were noted. We presently recommend local scatter photocoagulation to areas of PSR. In unreliable patients, we recommend 360 degrees of peripheral circumferential treatment as otherwise new seafans will develop. If scatter photocoagulation does not result in sufficient regression of the neovascularisation and vision threatening complications such as vitreous haemorrhage continue, feeder vessel treatment can be used to supplement the scatter treatment.

Anemia, Sickle Cell↗
PubMed1991

Diagnosis and treatment of cytomegalovirus retinitis.

Cytomegalovirus (CMV) retinitis is the most common ocular opportunistic infection in patients with the acquired immune deficiency syndrome (AIDS), in whom it may cause loss of vision. The early diagnosis of CMV retinitis depends on patient awareness of often subtle clinical symptoms; screening examinations may be of benefit. Aggressive treatment of the condition is imperative. Ganciclovir administered intravenously has been shown to be effective therapy, but treatment must be continued indefinitely and is associated with a risk of neutropenia. Careful monitoring during treatment is required. Investigational methods of treatment, including intravitreal injection of ganciclovir or use of foscarnet, another antiviral agent, may be of benefit if intravenous ganciclovir therapy must be discontinued.

Antiviral Agents↗
PubMed1990

Crohn's disease and retinal vascular disease.

Patients with Crohn's disease may manifest extraintestinal findings including ocular involvement. We treated two patients with Crohn's disease who manifested retinal vascular disease that may have been related to the immune nature of the underlying disease or possibly to changes in the vasculature or coagulation system. One patient had a central retinal vein occlusion and the other had retinal vasculitis involving retinal arteries and veins with an apparent branch retinal artery occlusion. Both patients were in excellent health except for Crohn's disease, which was confirmed by a biopsy specimen. In one patient, the diagnosis of retinal vasculitis preceded the clinical diagnosis of Crohn's disease, whereas for the second patient the symptomatology of the intestinal disease preceded the ocular manifestations. We suggest that inflammatory bowel disease should be considered in the differential diagnosis of retinal vascular occlusive disease, especially in a young patient.

Adult↗