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Biomedical subjects

M Hickey-Dwyer

Publications and source records attributed to M Hickey-Dwyer.

11 recordsLinked to original sources
PubMed2000

Long-term follow-up of ischaemic retinopathy in the antiphospholipid syndrome with lupus-like disease.

PURPOSE: Antiphospholipid syndrome (APS), as an acquired prothrombotic disorder, is increasingly being recognised as an important cause of systemic venous and arterial thrombosis. The defining feature of the condition is the presence of raised levels of antibodies to negatively charged phospholipids in the serum. METHODS: We describe 2 cases of APS with ocular involvement and review the recent literature. Both patients experienced acute visual loss. It was the presenting symptom in one case--a finding that led to the diagnosis of the syndrome. RESULTS: Management with anticoagulation therapy, in which the International Normalised Ratio (INR) has been maintained at or above 3, resulted in reperfusion of the ischaemic retina and stabilisation of the retinopathy in one patient, whilst in the other case, where the INR was less than 3, irreversible visual loss occurred. CONCLUSION: Anticoagulation with warfarin appears to result in reperfusion of ischaemic retina with stabilisation of the neovascular process when the INR is greater than 3.

Adult↗
PubMed1994

Persistent binocular diplopia following cataract surgery: aetiology and management.

We studied all patients referred to the orthoptic department with binocular diplopia following cataract surgery between January 1991 and June 1993. Persistence of diplopia for a minimum of 3 months after cataract surgery was required for inclusion in the study. Eighty-one patients (2% of all patients who underwent cataract surgery during this time) satisfied the entry criteria. The patients fell into two groups: non-traumatic and traumatic cataracts. Horizontal deviations were seen in 24 patients. Vertical deviations were seen in 8 patients and a combined horizontal and vertical deviation was seen in 49 patients. Fresnel prisms were used to manage the diplopia in 58 patients. Of these, 48 patients in the non-traumatic group regained binocular single vision with this prism while 10 in the traumatic group benefited. Mechanical and sensory causes are discussed.

Adolescent↗
PubMed1993

The apparent role of blood transfusions in the development of retinopathy of prematurity.

During a 30-month-period, 184 very low birth weight infants from two Liverpool neonatal intensive care units were screened for evidence of retinopathy of prematurity (ROP). Seventeen clinical variables previously considered relevant to the development of ROP, blood gas and blood pressure data over the first 7 days, and the maximum stage of ROP reached in either eye were recorded, together with the need for cryotherapy and current visual status. Ninety-two infants developed any stage of ROP and 15 required cryotherapy or became blind. Logistic regression showed that only gestational age and frequency of blood transfusion were independently associated both with the risk of occurrence of ROP and its severity.

Female↗
PubMed1993

Double-masked three-period crossover investigation of timolol in control of raised intraocular pressure.

Forty patients with an intraocular pressure (IOP) between 30 and 49 mmHg in either eye (57 eyes) were recruited into a trial of timolol 0.25% versus timolol 0.5%. Patients were randomised to receive the two concentrations of drug in the order ABA or BAB. The study period was 12 weeks for each patient, with changes in drug concentration at 4 and 8 weeks. IOPs were measured at the same time every 2 weeks. Mean IOP of both eyes was used, excluding any eyes with initial IOPs of less than 30 mmHg. There was no difference between the 2-week and 4-week pressure readings, which were therefore combined. There was no statistically significant difference in the initial IOPs of the two groups (0.5%, 33.45 mmHg; 0.25%, 32.63 mmHg) nor in the initial fall in IOP with either concentration (0.5%, 12.03 mmHg; 0.25%, 11.31 mmHg). Furthermore, changing from one concentration to the other had no significant effect on IOP. Mean IOPs over the whole study period averaged 21.12 mmHg for timolol 0.25% and 20.75 mmHg for timolol 0.5%. Again these differences were not statistically significant. The statistical power of the study was estimated to exceed 85%. The authors suggest that there is no justification for use of the 0.5% strength, which is more expensive and has no advantages.

Dose-Response Relationship, Drug↗
PubMed1991

Doubled-masked three-period crossover investigation of metipranolol in control of raised intraocular pressure.

Metipranolol is a non-cardioselective beta adrenergic blocking drug used in the treatment of glaucoma. 56 patients with intraocular pressure between 30-49 mm hg were randomised to one of six treatment regimens for a 12 week period. Each patient received each concentration for 4 weeks and intraocular pressures were checked every two weeks. Using a worst and an average eye approach, mean initial intra-ocular pressures were 35.8 and 35.0 mm hg respectively. The mean fall in intra-ocular pressure after 4 weeks treatment ranged from 12.8 (0.1%) to 14.1 mm hg (0.6%) for average eyes (n = 56), and from 13.4 to 16.7 mm hg for worst eyes. These differences were not statistically significant (p greater than 0.05-p greater than 0.5). Increasing the concentration had no significant effect on pressure. Reducing the concentration had no effect except in patients who changed from 0.6% to 0.1%, when there was a mean rise of approximately 2 mm hg, p less than 0.02. The incidence of stinging varied from 19% of attendances on 0.1%, to 63% on 0.6%. We recommend the use of the 0.1% strength since all three significantly lower intra-ocular pressure but the higher concentrations are more expensive, cause more stinging, and are no better at lowering intra-ocular pressure.

Adult↗