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Biomedical subjects

M H Goldbaum

Publications and source records attributed to M H Goldbaum.

30 records · Page 2Linked to original sources
PubMed1978

The disc sign in sickling hemoglobinopathies.

The disc sign is the presence of dark red spots on the optic disc of patients with a sickling hemoglobinopathy. The dark spots appear to be plugs of deoxygenated erythrocytes in small surface disc vessels. The occlusions, which are transient and do not produce clinically detectable visual impairment, were seen most often in patients with homozygous sickle cell anemia and may be the result of clogging of small vessels by irreversibly sickled erythrocytes.

Adolescent↗
PubMed1978

Retinal depression sign indicating a small retinal infarct.

Retinal depression, a newly observed sign, has been observed as an abnormality in the reflection from the internal limiting lamina produced by depression of the inner surface of the retina after a small retinal infarct. These depressions were first observed in 16 patients with sickling hemoglobinopathies. Additionally, I examined a patient with systemic hypertension, a patient with retinal arteriolitis, and a patient with juvenile onset diabetes mellitus who also had retinal depression.

Adolescent↗
PubMed1977

The conjunctival sickling sign, hemoglobin S, and irreversibly sickled erythrocytes.

Sixty-five patients with hemoglobins AS, SC, and SS were investigated in a masked fashion. We observed a statistically significant positive correlation between the severity of conjunctival sickling signs and the counts of irreversibly sickled cells in each hemoglobinopathy group. We also observed a statistically significant positive correlation between the severity of the conjunctival vasculopathy and the percentage of sickle hemoglobin in the total group of patients with hemoglobins AS, SC, and SS.

Adolescent↗
PubMed1977

Evolution of neovascularization in sickle cell retinopathy. A prospective fluorescein angiographic study.

With prospective observations we have documented by fluorescein angiography the development of retinal neovascularization in the eyes of patients with sickle cell-hemoglobin C disease (hemoglobin SC). In each patient, arteriolarvenular (AV) anastomoses occurred before the development of neovascular sea fans. To our knowledge, this report constitutes the first such documentation in the literature. New sea fans from AV anastomoses appeared throughout an average interval of 18 months (range, 8 to 36 months) in approximately 21% of young adults with hemoglobin SC. Each year approximately 14% of young patients with hemoglobin SC may develop retinal neovascularization.

Adolescent↗
PubMed1976

Acute choroidal ischemia as a complication of photocoagulation.

Acute choroidal vascular insufficiency as a complication of photocoagulation has been little noticed. In 17 eyes of 16 patients photocoagulated with either xenon or argon sources for proliferative sickle cell retinopathy, gray lesions of the fundus developed peripheral to the photocoagulation sites. Histologic examination of similar gray lesions produced in monkeys showed necrosis and atrophy of the outer half of the retina. Intense photocoagulation of the human fundus, even with smaller spot sizes, may occlude a choroidal artery, producing separate gray lesions of distinctive shape. The lesions in both the patients and the monkeys progressed to granular hyperpigmentation by two to three weeks after photocoagulation.

Adolescent↗
PubMed1976

Vitrectomy in sickling retinopathy: report of five cases.

The unique problems encountered in sickle patients include the need to remove peripheral vitreous if perfusing sea fans-which can bleed after vitrectomy-are present at the time of surgery. However, peripheral vitrectomy is riskier than central vitrectomy alone. If visualization of the sea fans is sufficient, it is safer to close the sea fans prior to vitrectomy in order to obviate the need for peripheral vitrectomy; then, only central vitrectomy is performed. When sea fans cannot be closed prior to vitrectomy, peripheral vitreous is removed to allow early photocoagulation of the sea fans before they bleed again. Four case presentations illustrate these principles. Vitrectomy relieved severe vitreous traction that complicated retinal detachment in the fifth patient, thereby eliminating the need for a tight encircling structure, which can be poorly tolerated in patients with SC hemoglobin.

Adult↗
PubMed1975

Geometric analysis of radial buckling.

Tension analysis along the retinal surface demonstrates the advantage of meridional buckles over limbal-parallel buckles. A cylindrical sponge generates tensional forces in the retina along the long axis of the buckle and perpendicular to it. The tension perpendicular to the sponge is positive, and the retina and retinal pigment epithelium stretch in that direction. The tension along the long axis is positive (stretching) when the buckle is less than 90 degrees arc length; and negative (compression), greater than 90 degrees for a 5-mm sponge. Consequently, retinal compression folds on the buckles occur for buckles of arc length greater than 90 degrees. These tension forces at right angles to each other explain the development of (1) concave retinal detachment or retinal folds off short limbal-parallel buckles, (2) retinal folds on long limbal-parallel buckles, and (3) fishmouthing of horseshoe tears overlying a limbal-parallel buckle. The buckle increases retinal surface area overlying the buckle. The significance of this is not clear, but it may explain the lessening or disappearance of compression folds on the buckle in time.

Choroid↗
PubMed1975

Cryotherapy of proliferative sickle retinopathy. Part I. Single freeze-thaw cycle.

Transconjunctival cryocoagulation was used to treat proliferative sickle retinopathy in 6 patients. Ten eyes were treated with a single freeze-thaw cycle and were observed for 3 to 18 months. Nine of 13 (70%) neovascular lesions were completely closed without occluding major vascular trunks, while the remaining 4 (30%) showed marked attenuation.

Adolescent↗
PubMedDate not supplied

Peripheral proliferative retinopathies.

Peripheral retinal neovascularization (i.e., new vessel growth peripheral to the major vascular arcades) may be secondary to a wide variety of ocular and systemic diseases. Vascular and inflammatory diseases in particular may cause peripheral neovascularization. Following a brief review of ocular angiogenesis, the various clinical entities that can cause peripheral retinal neovascularization are described. The diagnostic workup of a patient with peripheral proliferative retinopathy is outlined and techniques of treatment of the neovascularization (including feeder vessel technique, cryopexy, and panretinal photocoagulation) are discussed.

Adult↗
PubMedDate not supplied

Peripheral proliferative retinopathies: an update on angiogenesis, etiologies and management.

Many clinical entities may be associated with the development of peripheral retinal neovascularization. In this paper, we review the mechanisms of normal and abnormal angiogenesis in the retina. Specific disease entities associated with peripheral proliferative retinopathies are discussed. These include vascular disease with ischemia, inflammatory diseases with possible ischemia and a variety of miscellaneous causes, including hereditary diseases and tumors. Basic principles for the clinical evaluation of patients with retinal neovascularization are described. Finally, the treatments for retinal neovascularization, including cryopexy and local and panretinal photocoagulation are reviewed, and techniques and possible mechanisms of the beneficial results of treatment are described.

Humans↗
PubMedDate not supplied

Retinal detachment following radial and astigmatic keratotomy.

Serious complications of radial keratotomy are infrequent, but include: iridocyclitis, microbial keratitis, endophthalmitis, corneal perforation, and traumatic wound rupture. We report a case of retinal detachment following microperforation during radial keratotomy.

Adult↗