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Biomedical subjects

L M Jampol

Publications and source records attributed to L M Jampol.

At least 127 records · Page 7Linked to original sources
PubMed1983

A randomized clinical trial of feeder vessel photocoagulation of proliferative sickle cell retinopathy. I. Preliminary results.

A randomized prospective clinical trial of feeder vessel photocoagulation for proliferative sickle cell retinopathy was performed. In Chicago there were 34 argon laser-treated eyes and 30 control eyes. In Kingston there were 53 xenon arc treated eyes and 50 control eyes. Prolonged loss of visual acuity was rare in both photocoagulated and control eyes. Argon laser and xenon arc feeder vessel photocoagulation reduced the incidence of vitreous hemorrhage and visual loss from vitreous hemorrhage. However, photocoagulation was associated with an increased risk of choroidal neovascularization (xenon arc greater than argon laser) and retinal detachment (argon laser), although visual loss from these complications has not been seen in these patients so far.

Adult↗
PubMed1983

Arteriolar occlusive diseases of the macula.

Occlusion of retinal precapillary arterioles may be related to vascular endothelial damage, embolization, vasculitis, and other factors. Following acute retinal precapillary arteriolar occlusion in the macular area, inhibition of axoplasmic transport results in the formation of cotton-wool patches. A variable loss of retinal function occurs. During the subacute phase, reperfusion of the vascular bed is usually seen with a gradual fading of the cotton-wool patch. In the chronic phase, the only sign of the infarction may be a loss of inner retinal substance with an irregularity of the light reflex from the internal limiting membrane, the retinal depression sign. The characteristics of retinal precapillary arteriolar occlusions are reviewed and specific features of hypertensive retinopathy, talc retinopathy, and sickle cell retinopathy are discussed.

Anemia, Sickle Cell↗
PubMed1983

Disseminated herpes simplex infection with retinitis in a renal allograft recipient.

An immunosuppressed recipient of a renal allograft developed bilateral necrotizing retinitis. Disseminated herpes simplex infection was documented by clinical findings and serologic and viral culture studies. Cultures and serologic tests for cytomegalovirus were negative. The evidence strongly favored the diagnosis of herpes simplex retinitis. Tapering of immunosuppressive drugs and administration of adenine arabinoside appeared to halt temporarily the progression of the disease in one eye and resulted in healing of the retinitis in the other eye. Subsequent progression of the more severely involved right eye resulted in an exudative retinal detachment and loss of vision prior to the patient's death from meningoencephalitis. Herpes simplex retinitis must be considered in the differential diagnosis of necrotizing retinitis in an immunosuppressed patient.

Adult↗
PubMed1983

Spontaneous peripheral chorioretinal neovascularisation in association with sickle cell anaemia.

Chorioretinal neovascularisation was noted in the midperipheral fundus of a young black girl with sickle cell anaemia. Rapid-sequence fluorescein angiography showed choroidally fed neovascularisation in the centre of a large black sunburst (chorioretinal scar). We suspect that a massive midperipheral retinal haemorrhage from the sickle cell disease caused the sunburst and altered Bruch's membrane, thus allowing the ingrowth of choroidally fed vessels.

Adolescent↗
PubMed1982

An update on vitrectomy surgery and retinal detachment repair in sickle cell disease.

Eighteen patients (19 eyes) with sickling hemoglobinopathies underwent vitrectomy or scleral buckling operations. The indications for surgery were tractional or rhegmatogenous retinal detachment or vitreous hemorrhage. The retina was reattached in all four patients with rhegmatogenous detachments requiring scleral buckling surgery but no vitrectomy. All had excellent visual acuity postoperatively. Four of the five patients with vitreous hemorrhage requiring vitrectomy without buckling had substantial improvement in visual acuity. In ten patients with vitreous hemorrhage with either preexisting or iatrogenic retinal breaks, rhegmatogenous detachment, or tractional detachment, the rate of improvement in visual acuity was only 50%. Problems associated with vitreous or retinal surgery in patients with sickling hemoglobinopathies include iatrogenic retinal breaks, intraocular bleeding and secondary glaucoma, anterior segment ischemia, and systemic sickling.

Adult↗
PubMed1982

Talc retinopathy in primates: a model of ischemic retinopathy. II. A histopathologic study.

Experiment talc retinopathy was produced in four adult rhesus monkeys by biweekly intravenous injections of talc for 31/2 to ten months and was studied by retinal vascular flat preparations and by light microscopy. Talc particles were lodged in the walls of the precapillary arterioles and capillaries, producing focal occlusion of retinal and choroidal capillaries. The pericyte-endothelial cell ratio was 1:0.77 in the posterior pole and 1:0.53 in the retinal periphery. The horseradish peroxidase study showed leakage of tracer from the retinal vasculature into the extracellular interstitial space, but the barrier of the retinal pigment epithelium was intact. Microinfarcts produced small cystoid spaces in the outer plexiform layer, inner nuclear layer, and ganglion cell layer of the macula. Cytoid bodies and macrophages were scattered in the retina. No retinal or vitreal neovascularization was observed.

Animals↗
PubMed1982

Talc retinopathy in primates: a model of ischemic retinopathy. III. An electron microscopic study.

Electron microscopic study of experimental talc retinopathy provides an opportunity to study the basic cytologic response of retinal and choroidal vessels to small, relatively inert emboli. Occlusion of the retinal and choroidal capillaries resulted primarily from the cellular reaction to, rather than directly from, the emboli. Mitotic figures in pericytes were observed. Even though we failed to produce retinal neovascularization (as is sometimes seen in human talc retinopathy) in this experimental model, our observations suggest that proliferation of pericytes may be an initial step in the process of retinal neovascularization.

Animals↗
PubMed1982

Central retinal artery occlusion without retrobulbar hemorrhage after retrobulbar anesthesia.

Four patients had central retinal artery occlusions after retrobulbar anesthesia with lidocaine HCl was administered before photocoagulation. One of these four had two separate episodes of closure. Only one had permanent visual loss, and none had evidence of retrobulbar hemorrhage. Each patient had a severe hematologic or vascular disorder. We think that direct trauma to the central retinal artery behind the globe, the pharmacologic or compressive effects of the injected solution, or both caused the occlusions in these patients.

Adult↗
PubMed1982

Scatter retinal photocoagulation for proliferative sickle cell retinopathy.

We treated sea-fan neovascularization in 19 patients (21 eyes) who had proliferative sickle cell retinopathy with localized scatter photocoagulation. We placed burns of light to moderate intensity adjacent to 45 sea fans in a scatter fashion. In general, treatment extended from 1.5 mm posterior to 1.5 mm anterior to the sea fan and one clock hour to each side of each lesion. Flat sea fans responded dramatically to treatment, with complete regression in 24 of 28 lesions. Elevated sea fans (especially large ones) responded less rapidly, with complete regression in only four of 17 lesions. Localized scatter photocoagulation is valuable in treating patients with early proliferative sickle cell retinopathy.

Adolescent↗
PubMed1982

Pathophysiology of hypertensive retinopathy.

The effects of systemic hypertension on the posterior segment of the eye are discussed under the headings of hypertensive choroidopathy, hypertensive retinopathy, and hypertensive optic disc edema. The sympathetic nervous control and autoregulatory mechanisms of the retinal and choroidal vasculatures are briefly reviewed. In hypertensive choroidopathy focal occlusion of choriocapillaris leads to necrosis of retinal pigment epithelium (Elschnig spots). Hypertensive retinopathy is described in vasoconstrictive, exudative, and sclerotic phases, followed by complications of the sclerotic phase. Hypertensive optic disc edema is influenced by the blood supply and extracellular tissue fluid pressure of the optic nervehead. In baboons with hypertensive disc edema, accumulation of axoplasmic components is observed in the optic nervehead.

Animals↗
PubMed1982

Pharmacologic therapy of aphakic cystoid macular edema. A review.

Pharmacologic therapy of aphakic cystoid macular edema (ACME) in the past has included the use of topical, periocular, and systemic corticosteroids as well as inhibitors of prostaglandin synthesis. Preliminary studies have suggested a beneficial effect of systemic corticosteroids on ACME, although it has been said that this effect is temporary and that recurrences are common. To date, no adequate therapeutic or prophylactic trial of topical, periocular, or systemic corticosteroids for ACME has been performed. Several elegant clinical trials have been done to study the effects of indomethacin, a prostaglandin (PG) synthesis inhibitor, on the incidence of ACME. It seems likely that topical, and perhaps systemic, indomethacin is effective in reducing the incidence of angiographically proved ACME. To date, however, no trial has demonstrated a sustained effect of topical or systemic PG synthesis inhibitors on ACME or visual acuity. Further studies of the role of PG synthesis inhibitors (especially topical agents) in the therapy of ACME are necessary. In addition, further efforts should be made to determine the efficacy of the use of PG synthesis inhibitors in combination with corticosteroids.

Administration, Topical↗
PubMed1982

Prophylaxis of pseudophakic cystoid macular edema with topical indomethacin.

A prospective double-masked study of 500 patients was performed to assess the effect of topical indomethacin on the angiographic incidence of cystoid macular edema (CME) in patients undergoing intraocular lens implant surgery. All patients received either topical indomethacin or placebo before surgery and for nine months after surgery. All patients underwent planned extracapsular extraction (PEC) or posterior chamber phacoemulsification (PC-KPE). Implantation of a posterior chamber lens and a primary capsulotomy were performed in all cases. All cases received postoperative topical corticosteroids. Of the 500 cases, 390 (78%) underwent fluorescein angiography; most were performed between 2 1/2 and 5 months after surgery. The incidence of angiographically confirmed CME was significantly higher in the placebo-treated patients as compared to those treated with indomethacin (18.5% vs 9.6%; P = 0.04). Patients 60 years of age or older had a significantly higher incidence of CME than younger individuals (15% vs. 3.4%; P = 0.03). When corrected for the effects of drug regimen and age, by means of multiple logistic regression, there was no significant correlation between procedure (PEC vs. PC-KPE) and CME rate (P = 0.62). There was no significant difference in postoperative visual acuity between the indomethacin- and placebo-treated patients (P = 0.65).

Adrenal Cortex Hormones↗
PubMed1982

Exudative retinal detachment in hemoglobin SC disease.

A 21-year-old black man with hemoglobin SC disease had a unilateral exudative retinal detachment. A large area of sea fan neovascularization was identified in this eye at the superotemporal border of the detachment; no retinal holes were present. Following closure of the neovascularization by argon laser photocoagulation using feeder vessel technique, the retina flattened and the exudation cleared. However, multiple holes developed in thin ischemic retina at foci of vitreoretinal traction. Although many retinal vascular diseases may cause exudative detachments, to the authors' knowledge, this is the first definite case of exudative retinal detachment in a patient with a sickling hemoglobinopathy.

Adult↗
PubMed1982

Computed tomography in the management of orbital infections associated with dental disease.

Two patients developed orbital infection secondary to dental infections. In one patient the infection spread from maxillary premolar and molar teeth to the infratemporal and pterygopalatine fossa and then through the inferior orbital fissure to the subperiosteal space. A subperiosteal abscess in the posterior orbital wall developed, which subsequently spread within the muscle cone. In the second patient infection of an anterior maxillary tooth caused a pansinusitis and unilateral orbital cellulitis. In both patients computed tomographic scanning of the orbit proved valuable in localising the infection and, in one case, planning a surgical approach to the orbit. The infection in both patients responded to treatment, with no permanent visual impairment. Appropriate antibiotics and prompt identification and surgical drainage of orbital abscesses are essential for the preservation of vision in cases of orbital infection.

Abscess↗