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Biomedical subjects

M A Mosier

Publications and source records attributed to M A Mosier.

18 recordsLinked to original sources

Retinal sensitivity in acute hypoglycemia.

We measured retinal threshold sensitivity via automated computerized static perimetry in predetermined meridians in euglycemic diabetic subjects and in the same subjects during insulin-induced hypoglycemia. During periods of reduced blood glucose levels, decreased retinal sensitivity, most marked in temporal meridians, was observed.

Acute Disease

Ageing parameters of the ocular lens by scanning fluorophotometry.

A Beer-Lambert analysis of fluorophotometric scans of ocular lenses has been carried out. It is shown that an assumption of a single flourophor allows us to calculate the distribution of this fluorophor along the central lens axis. For the great majority of lenses in our study, covering a wide range of ages, our results are in essential agreement with published results on excised lenses. For a small subset of lenses in the study the assumption of a single fluorophor is found to be unsatisfactory. In these cases a reasonable symmetry assumption allows us to estimate the distribution of an additional agent which removes light from the entering or exiting beams without contributing to the fluorescence. The fact that this agent is restricted to the lens nucleus and that it occurs in lenses in which nuclear changes are clinically evident suggests that it is an expression of nuclear cataract.

Adult

Fluorophotometric measurement of human tear turnover rate.

Measurement of tear turnover rate using an automated scanning fluorophotometer (FluorotronR) was compared to Schirmer test results without anesthesia in young adults with no known ocular disorder. After the instillation of fluorescein, tear film fluorescence, expressed as fluorescein concentration equivalent, decreased exponentially in a linear fashion with time. The mean tear turnover rate was 30% per minute. Contact lens wearers had higher mean tear turnover rates when compared with non-contact lens wearers, but differences were not statistically significant. Half of tested eyes demonstrated total wetting of Schirmer Tear Test StripsR. Higher mean tear turnover rates were associated with complete wetting of the Schirmer test strips. There was no significant correlation between Schirmer paper wetting of less than 30 mm and fluorescein turnover rate.

Adult

Delayed retinal effects of the frequency-doubled YAG laser (532 nm).

In order to compare the retinal effects of the frequency-doubled YAG laser (532 nm) with those of argon laser, rabbit eyes were exposed to green YAG laser irradiation and processed for light and electron microscopic study at 24 hr, 2 weeks and 4 weeks. Detailed analysis was conducted on tissue exposed to 7.3 and 7.6 millijoules (mj). Response of the photoreceptors and retinal pigmented epithelium to green YAG was very similar to that described for argon laser over the same time period. By 2 weeks post-exposure, there was histologic evidence of partial recovery with absence of damaged, pycnotic photoreceptor nuclei, increased numbers of typical photoreceptor outer segment lamellae and repair of retinal pigmented epithelium. Four weeks after irradiation, normal-appearing photoreceptor nuclei were present although inner photoreceptor segments still showed mitochondrial damage. Outer segments at 4 weeks showed regular lamellar structures. We conclude that the frequency-doubled YAG laser is equivalent to the argon laser with respect to the production of thermal lesions in the retina. Its additional advantages include increased efficiency, portability, reliability and lack of absorption by macular xanthophyll pigment.

Animals

Autofluorescence of the crystalline lens in diabetes.

Lenticular autofluorescence in a diabetic population was quantitated by scanning ocular fluorophotometry. Measurements were made through the lens along the optical axis. The profile of the scan from front to rear was characterized by anterior and posterior juxtacortical peaks and a central plateau. Maximum fluorescence values were compared with those of nondiabetic control subjects. Fluorescence increased linearly with age in both populations, but was significantly higher in the diabetic population of all ages. Posterior to anterior fluorescence peak ratios decreased as a parabolic function of age in both populations, but peak ratios were lower in the diabetic population. We conclude that in vivo measurements of lens autofluorescence correlate with premature lenticular senescence in diabetes.

Adolescent

Autofluorescence and light transmission in the aging crystalline lens.

We quantitated blue-green light transmission and autofluorescence of the human crystalline lens in vivo, using an automated scanning fluorophotometer (Fluorotron) coupled with a lens system designed for high resolution of the ocular anterior segment. Lenses were scanned through the dilated pupil along the optical axis, generating a fluorescence profile consisting of anterior and posterior juxtacortical peaks and a central plateau. Fluorescence increased linearly with increasing age. We calculated percent transmission of excitation (410-500 nm) and emission (510-670 nm) as the ratio of posterior to anterior juxtacortical peaks. Light transmission decreased as a parabolic function of age and was correlated with both fluorescence increase and observed lens brunescence.

Adolescent

Increased synthesis of glycosaminoglycans of the cornea during fasting and refeeding in rats.

The effect of a 48 hour fast on sulfate incorporation of corneal mucopolysaccharides was investigated in the rat. After fasting for 24 hours, experimental and control rats were injected intraperitoneally with 35S-sulfate. After fasting an additional 24 hours, the rats were sacrificed and incorporation of the label into the acid mucopolysaccharide fraction of the cornea was determined. Incorporation of the label into the acid mucopolysaccharide fraction was significantly increased in the fasted rat cornea. Increased synthesis of corneal sulfated mucopolysaccharides during fasting in the rat contrasts with the well known decreased synthesis in cartilage under the same conditions. These findings suggest that corneal acid mucopolysaccharide synthesis is selectively preserved and/or increased during fasting.

Animals

Anterior retinal cryotherapy in diabetic vitreous hemorrhage.

Recurrent vitreous hemorrhage associated with proliferative retinopathy can occur in eyes that do not satisfactorily respond to argon laser pantretinal photocoagulation. To evaluate the effect of relatively low-risk surgical intervention, we performed peripheral retinal cryopexy on 24 eyes of 23 diabetic patients with proliferative diabetic retinopathy and vitreous hemorrhage. In most cases, cryopexy followed complete or nearly complete panretinal photocoagulation which did not prevent subsequent vitreous hemorrhage. Existing vitreous hemorrhage cleared postoperatively in 23 of 24 eyes. The best corrected visual acuity improved in 15 eyes, remained unchanged in five, and worsened in four. Four postoperative anterior segment complications resolved completely within a short time. One patient, a 68-year-old woman who had had diabetes for 18 years, postoperatively had a macular hole in one eye and macular edema with tractional retinal detachment in the other.

Adult

Retinal effects of the frequency-doubled (532 nm) YAG laser: histopathological comparison with argon laser.

Retinal lesions produced in Dutch Cross rabbits with a frequency-doubled (532 nm) YAG laser in single pulse mode (30-100 microJ) and in train of uniform pulses (2.6 and 7.5 mJ) underwent histopathological examination by light and electron microscopy. The results were compared to argon laser lesions (11 and 15 mJ) in the same animals. Low-energy single-pulse YAG lesions produced separation of the neural retina from the retinal pigmented epithelium (RPE), while higher energies caused severe disruption of retinal structures with moderate damage to the RPE. A striking and consistent finding of all the single-pulse lesions was the presence of red blood cells between the RPE and neural layers. The findings appear to support a process of mechanical disruption. In contrast, the lesions produced by a uniform train of pulses showed well-defined damage to RPE and photoreceptors with no red blood cells between these two layers, no choroidal damage, and relatively little disruption of the inner retina. The typical argon lesion evidenced cellular damage from the RPE through all retinal layers. Leukocytes in the choroid contained "holes" or vacuoles not seen in YAG lesions. Both the uniformly pulsed YAG laser burst and argon laser produced effects consistent with a thermal process. Some differences between argon and YAG burst were observed. The results suggest that there may be a clinical potential for the 532-nm burst YAG in treating retinopathies.

Animals

Factors affecting vitreous fluorescence.

A variety of mechanical (intensity of the light source, the width and the angle of the exciting source) and physiological factors (retinal pigmentation, vitreous fluorescence) and many systemic factors affect the results of vitreous fluorophotometry. These factors are discussed with respect to identifying those that are inconsequential and those that are significant. Methods to compensate for the important factors are described.

Eye

Optimized protocol for Fluorotron Master.

The technical aspects of fluorophotometry equipment are presented. The sources of artifact are described and a protocol to optimize the use of the "Coherent Fluorotron Master" system is presented. The results of fluorophotometry studies on ten patients indicate that more accurate data evaluation can be achieved using this approach.

Adult

Identification of the pre-proliferative diabetic eye.

The rationale for early identification of the stage of diabetic retinopathy immediately preceding development of fibrovascular proliferation is that early diagnosis affords the opportunity to treat by photocoagulation or other methods at the appropriate stage of retinal disease. Aids to identification include: venous abnormalities, intraretinal microvascular abnormalities, "cotton-wool" spots and fluorescein angiographic evidence of capillary non-perfusion. Although no one of these fundus changes is specific for the pre-proliferative stage of diabetic retinopathy, the presence of more than one of these findings increases the risk of subsequent fibrovascular proliferation. The development of frank proliferation frequently occurs within two years of first appearance of the preproliferative stage.

Capillaries

Retinal cryopexy in the management of proliferative diabetic retinopathy.

Peripheral retinal cryopexy resulted in stabilization of progressive retinopathy and vitreous hemorrhage in 13 eyes of 13 diabetics. In most cases, cryopexy followed complete or nearly complete pan-retinal photocoagulation which did not prevent subsequent vitreous hemorrhage. No eyes in our series hemorrhaged following cryopexy during the period of postoperative observation. Existing vitreous opacities generally cleared sufficiently to permit further photocoagulation. Visual acuity did not decrease on the basis of hemorrhage after cryotherapy, but rather improved in most cases. Peripheral retinal cryopexy is recommended as an alternative to vitrectomy for the initial treatment of recurrent and persistent diabetic vitreous hemorrhage.

Adult

Hypoplasia of the optic nerve.

Premorbid ophthalmoscopic and histopathologic findings were correlated in a case of bilateral optic nerve hypoplasia in a 9-month-old infant with bilateral hydranencephaly. The double-ring sign was due to an extension of retina and retinal pigment epithelium (RPE) over the outer portion of the lamina cribrosa. The outer ring was the junction between sclera and lamina cribrosa, and the inner ring was the termination of the RPE. The center of the inner ring was the hypoplastic nerve head, which appeared whitish because of fibroglial tissue surrounding the central retinal vessels where they entered the optic nerve head. We speculate that an in utero vascular insult, after the third month of development, led to cystic cavitation of the anterior cerebral hemispheres, with subsequent retrograde degeneration of developing retinal ganglion cells.

Abnormalities, Multiple

Four common ocular complications of diabetes--and how to treat them.

To minimize the risk of visual loss in diabetic patients, recognition of early signs of oculopathy is essential. Diabetes-associated third-nerve palsy is manifested by unilateral ptosis and exotropia. Symptoms of closed-angle glaucoma are intense pain, halos around lights, and blurred vision. Open-angle glaucoma does not necessarily produce symptoms and is treated medically. A gradual decrease in visual acuity, sometimes associated with photophobia and difficulty in night driving, and monocular diplopia, are manifestations of cataract. The patient with "background" retinopathy usually complains of blurred or distorted central vision. Once the macula is involved, vision progressively decreases. Although the relationship of metabolic control to retinopathy has not been settled, evidence indicates that good medical control of the disease may delay onset of vascular complications.

Age Factors

Fungal endophthalmitis following intraocular lens implantation.

Endophthalmitis developed in a 61-year-pld man after an intraocular lens implantation. A whitish opacity developed, visual acuity decreased to light perception, and we enucleated the eye. Paecilomyces lilacinus (Thom) Samson, a saphrophyte that has contaminated laboratory solutions, was cultured.

Cataract Extraction