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Biomedical subjects

M A Bloome

Publications and source records attributed to M A Bloome.

12 recordsLinked to original sources

Pneumatic retinopexy versus scleral buckle. Preferences of Vitreous Society members, 1990.

A survey was conducted among the 1990 members of the Vitreous Society in order to measure their acceptance of pneumatic retinopexy. They were asked which treatment they would prefer should they suffer a hypothetical detachment. The choices were limited to pneumatic retinopexy or scleral buckling (encircling or segmental). The majority of respondents selected a scleral buckling procedure for a phakic retinal detachment with two adjacent superior temporal quadrant tears. Surgeons who had been in practice for 10 years or less (median for entire group = 10 years) were significantly more likely to select a pneumatic retinopexy procedure. As the details of the hypothetical detachment became more complicated with myopia, additional tears, vitreous hemorrhage, or lattice degeneration with a positive family history, the respondents selected a scleral buckling procedure with greater frequency, and the differences between the choices of the surgeons became nonsignificant. This survey shows that many surgeons feel pneumatic retinopexy is an acceptable alternative to buckling surgery in select cases. There were no trends by geographic location.

Humans

Acute retinal necrosis.

Three cases of acute retinal necrosis are presented. Acute retinal necrosis is an unusual syndrome which is the result of severe contusion to the globe. It is characterized by large irregular retinal holes with pieces of necrotic retina in the adjacent vitreous, retinal edema and hemorrhage surrounding the holes, underlying choroidal disruption, and vitreous hemorrhage. The incidence of acute retinal necrosis is difficult to determine but it does not appear to be common entity. Although acute retinal necrosis may be associated with a retinal detachment, other retinal breaks are usually responsible for the detachment. The necrosis results from the direct force of the injury striking the globe although a contrecoup mechanism may explain cases of nasal necrosis. Treatment is necessary for associated retinal detachments and acute lesions but may not be necessary if adequate fibrosis is present when the lesion is first seen.

Acute Disease

Massive spontaneous subretinal hemorrhage.

We studied eight cases of massive, spontaneous subretinal hemorrhage which was characterized by the sudden appearance of one or more large, dark, elevated hematomas under the retina. The initial location of the hemorrhage may have been in the choroid or under the pigment epithelium, or both, but further extravasation of the blood anteriorly frequently resulted in hemorrhage under the neurosensory retina and in the vitreous. Although the lesion can initially be mistaken for a melanoma, the diagnosis is confirmed by the formation of a typical, elevated scar in the involved area. Frequent fundus examinations are essential, and ultrasound, radioactive phosphorus uptake testing, and bilateral patching are helpful in establishing the diagnosis. The hemorrhage is usually the result of a ruptured vessel from a subretinal neovascular network or arterioclerotic degeneration and may be precipitated by the use of anticoagulants.

Adult

Transient angle-closure glaucoma in central retinal vein occlusion.

Two cases are presented in which unilateral transient angle-closure glaucoma accompanied occlusion of the central retinal vein. In both cases, the uninvolved eye had a wide-open angle and the involved eye demonstrated a marked anterior displacement of the lens-iris diaphragm. Short-term treatment with cycloplegics and carbonic anhydrase inhibitors resulted in a rapid and permanent deepening of both angles. The similarity of this picture to malignant glaucoma as well as possible causative factors is discussed.

Acetazolamide