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Biomedical subjects

M Neudorfer

Publications and source records attributed to M Neudorfer.

At least 19 recordsLinked to original sources
PubMed2006

Decreased prevalence of asymptomatic choroidal metastasis in disseminated breast and lung cancer: argument against screening.

AIM: To determine the frequency of visually asymptomatic choroidal metastases in patients with disseminated breast and lung carcinomas in order to establish optimal patient management policies. METHODS: All patients with confirmed metastatic disease treated in our institution between January 2002 and December 2003 were invited to undergo a funduscopic examination and a B-scan ultrasound evaluation. RESULTS: Of the 169 study participants, 77 had breast cancer (64 with metastases in one organ and 13 with multiple-organ involvement) and 92 had lung cancer (85 with metastases in one organ and 7 with multiple-organ involvement). No patient with metastatic breast cancer and two patients with metastatic lung disease (each with multiple-organ involvement) were found to have choroidal metastases. The choroidal metastases were detected by both the funduscopic and ultrasound examinations. CONCLUSIONS: The 2.17% incidence of choroidal metastasis in disseminated lung cancer and the 0% incidence in disseminated breast cancer speaks against the practicality of screening for early detection of choroidal metastasis among these patients, even though it would lead to early implementation of appropriate, often vision saving, therapeutic management. Its low incidence probably testifies to progress achieved by enhanced systemic oncological treatment policies that have been introduced into routine patient management over the past few years.

Adult↗
PubMed2006

Minocycline-induced cutaneous hyperpigmentation: confocal laser scanning microscope analysis.

BACKGROUND: Minocycline has a characteristic yellow-green fluorescent emission. This fluorescence has been previously demonstrated only in type 1 minocycline-induced skin hyperpigmentation. OBJECTIVE: To investigate whether the fluorescence can be detected in other types of minocycline-induced cutaneous hyperpigmentation, and to study the possible mechanisms. METHODS: Biopsies of pigmented and nonpigmented skin from 3 patients with different types of skin hyperpigmentation induced by minocycline were analysed by light microscopy and Confocal Laser Scanning Microscope (CLSM). RESULTS: A yellow-green fluorescence was observed in the hyperpigmented skin of two patients with type 2, and one patient with type 4 minocycline-induced cutaneous hyperpigmentation. No fluorescence was detected in the non-pigmented skin. CONCLUSION: Minocycline can possibly serve as a fluorescent probe in the diagnosis of all types of minocycline-induced cutaneous hyperpigmentation.

Adolescent↗
PubMed2002

Massive choroidal hemorrhage associated with low molecular weight heparin therapy.

An 84-year-old woman with unstable angina pectoris was treated with subcutaneous enoxaparine (Clexane) for several days before presenting with severe pain and decreased vision in her left eye. The intraocular pressure was 70 mmHg, and fundus examination showed a pigmented choroidal lesion and associated choroidal and retinal detachment. Ultrasonography was consistent with choroidal hemorrhage, and she was diagnosed as having acute glaucoma secondary to massive subchoroidal hemorrhage. Medical control of the intraocular pressure resulted in a significant clinical improvement. Intraocular hemorrhage and angle-closure glaucoma are rare and previously unreported complications in patients treated with low molecular weight heparin. It is important to be aware of this ocular complication as these drugs are so often used.

Acetazolamide↗
PubMed2000

Clonidine provides an allergy-free alternative in glaucoma patients with proven allergy to apraclonidine.

PURPOSE: The aim of this study was to determine allergic responses to clonidine hydrochloride 0.25% in glaucoma patients with proven allergic reaction to apraclonidine 0.5%. METHODS: Fifteen consecutive glaucoma patients with allergic reaction to apraclonidine were prospectively challenged with clonidine hydrochloride 0.25% and evaluated for recurrence of allergic reactions and efficacy of treatment. Intraocular pressure (IOP), conjunctival hyperemia, blood pressure and resting pulse rate were determined at baseline and after 1, 3, 6 and 12 months. RESULTS: None of the patients developed ocular allergic reaction during 12 months on clonidine therapy. Blood pressure and pulse rate did not change significantly with clonidine treatment. Clonidine caused a significant reduction of IOP from baseline. In one patient, topical clonidine caused fatigue, dizziness and dry mouth. CONCLUSION: Clonidine did not cause allergic reaction in patients with proven allergy to apraclonidine, indicating that there is no cross-reactivity with apraclonidine. Due to the small series, however, we cannot assume that allergy will not occur with clonidine 0.25% given time and a larger number of patients.

Adolescent↗
PubMed1999

Pulsatile ocular blood flow in diabetic retinopathy.

PURPOSE: To assess circulatory properties of eyes with progressive stages of diabetic retinopathy. METHODS: The intraocular pressure, pulse amplitude (PA) and pulsatile ocular blood flow (POBF) were measured with a pneumatonometer (OBF Labs UK Ltd). The eyes were grouped: (a) normal control, n = 26, (b) diabetes with no observable diabetic retinopathy (NDR), n = 18, (c) mild to moderate non-proliferative diabetic retinopathy (NPDR), n = 20, and (d) very severe pre-proliferative and proliferative diabetic retinopathy (PPDR/PDR), n = 12. RESULTS: The PA and POBF values were lower than normal values in the earliest stage (NDR). The POBF increased but was still below normal levels at the NPDR stage, and then increased to an above normal level in the PPDR/PDR stage of diabetic retinopathy. The PA was at normal levels in these later two stages. CONCLUSION: An initial decrease in pulsatile ocular blood flow is present with the onset of diabetes where no diabetic retinopathy has yet occurred. Subsequently, the pulsatile ocular blood flow increases with the severity of the retinopathy.

Aged↗
PubMed1998

Iris retraction syndrome associated with nonrhegmatogenous retinal detachment.

PURPOSE: To present the first documentation of iris retraction syndrome in eyes with nonrhegmatogenous retinal detachment. PATIENTS AND METHODS: One patient with age-related macular degeneration and another with panuveitis developed exudative retinal detachment with iris retraction configuration. Ultrasound biomicroscopy was performed to investigate the anatomic relationship of structures in the anterior segment of the eye. RESULTS: Ultrasound biomicroscopy demonstrated a severe backward bowing of the peripheral iris with irido-ciliary body and irido-zonular contact as well as broad iris lens touch. The iris retraction syndrome resolved after pupil dilation and disruption of the pupillary adhesions in both cases. The retinal detachment resolved several months later, without surgery. CONCLUSION: Iris retraction syndrome appears not to be exclusive to rhegmatogenous retinal detachment but can present in eyes with exudative - nonrhegmatogenous retinal detachment. Thus, when the configuration of the iris shows bowing in patients with retinal detachment, iris retraction syndrome should be considered and prompt pupil dilation should be carried out.

Aged↗
PubMed1998

Reproducibility of topographic measures of the glaucomatous optic nerve head.

AIMS/BACKGROUND: Laser scanning tomography provides an assessment of three dimensional optic disc topography. For the clinical purpose of follow up of glaucoma patients, the repeatability of the various measured variables is essential. In the present study, the reproducibility of morphometric variables calculated by the topographic scanning system, TopSS (Laser Diagnostic Technology, San Diego, CA) was investigated. METHODS: Two independent measurements (30 minutes apart) each consisting of three complete images of the optic disc were performed on 16 eyes of 16 glaucoma patients using a TopSS. The instrument calculates 14 morphometric variables for the characterisation of the optic disc. RESULTS: From the two tailed paired tests, all variables were seen to have good reproducibility. However, correlation and regression analyses showed that only the three variables, volume below, half depth area, and average cup depth, are acceptably reproducible. CONCLUSION: The TopSS provides three variables which describe the physiological shape of the optic disc that have high reproducibility. These three variables might be useful for following the progression of optic disc changes in glaucoma patients.

Aged↗
PubMed1997

The mechanism of intraocular pressure rise during cyclocryotherapy.

PURPOSE: Intraocular pressure (IOP) spikes that occur during cyclocryotherapy for advanced glaucoma may further injure the already damaged glaucomatous optic nerve and be responsible for visual impairment that may occur after this treatment. The authors investigated the mechanism of pressure rise to see whether it can be avoided and thus prevent further optic nerve injury. The authors postulated that intraocular ice forms during the cryo procedure and causes the pressure changes. METHODS: Intraocular pressure was monitored using a pneumatonometer during 15 cryocycles of four patients with advanced glaucoma and 21 cryocycles of five normal rabbits. A simple thermal model was developed to analyze the relation between volume expansion and pressure rise in the eye. The physical effect of freezing rabbit eye structures was investigated in vitro. RESULTS: The largest pressure spikes observed during the cryocycles in this work were increases of 32 mm Hg for humans and 25 mm Hg for rabbits. The mean value of the IOP immediately before and after the cryo freezing stage was 53 +/- 1 and 68 +/- 2 mm Hg, respectively, for humans and 22 +/- 1 and 32 +/- 1 mm Hg for rabbits. The parameters of the thermal model were determined from the observed IOP spikes. Calculated thaw times were consistent with measured times for return to precryo IOPs. In vitro cryoapplication (rabbit eye) showed the formation of an ice ball internal to the eye. CONCLUSIONS: Volumetric increase of the intraocular content related to the formation of an ice ball in the eye, is the mechanism of pressure spikes during cyclocryotherapy. Because this complication is unavoidable, other cyclodestuctive methods may be more prudent, particularly in patients with advanced glaucoma.

Animals↗
PubMed1996

Effect of oral nifedipine on ocular blood flow in patients with low tension glaucoma.

AIM: To investigate the effect of oral nifedipine on ocular blood flow in patients with low tension glaucoma (LTG). METHODS: In this prospective study we examined the effects of 3 weeks of treatment with oral nifedipine 30 mg/day in 11 patients with LTG, by using colour Doppler ultrasound imaging to measure haemodynamic variables in the central retinal (CRA), short posterior ciliary (SPCA), and ophthalmic (OA) arteries. Intraocular pressure (IOP) and blood pressures were also evaluated. RESULTS: Nifedipine failed to alter IOP nor did it change peak systolic velocity, end diastolic velocity,or the resistance index in any of the three ocular vessels studied (p > 0.05). However systolic and diastolic systemic arterial blood pressure measurements varied significantly after nifedipine treatment compared with baseline (p < 0.05). CONCLUSION: Our study failed to demonstrate a significant effect of nifedipine on retrobulbar circulation of patients with LTG.

Administration, Oral↗
PubMed1995

The additive miotic effects of dapiprazole and pilocarpine.

BACKGROUND: Since dapiprazole on alpha-adrenergic agent, produces miosis by paralyzing the dilator muscle, and pilocarpine, a parasympathetic drug, causes miosis by affecting the sphincter, we speculated that the two drugs might have additive effects. METHODS: The additive miotic actions of pilocarpine 2% and dapiprazole 0.5% were evaluated by comparing the effects of two drugs given together and alone on the reversal of mydriasis induced by tropicamide (0.5%) and phenylephrine (10%) in one eye each of 60 healthy volunteers. RESULTS: Dapiprazole and pilocarpine together induced miosis significantly faster than each drug alone, showing additive effects. CONCLUSION: Co-administration of dapiprazole and pilocarpine at the end of the eye examination will induce fast pupillary constriction, which might be useful in preventing the development of an acute attack of angle-closure glaucoma in patients with anatomically narrow angles.

Adolescent↗
PubMed1995

Panuveal malignant mesenchymoma.

Intraocular malignant mesenchymal tumors are very rare, and only a few case reports of such primary and metastatic tumors have been reported. We report a case of a malignant mesenchymoma involving the entire uveal tract. A 21-year-old woman presented with a tumor on the whole iris of the right eye, which caused intractable glaucoma. Upon enucleation of the eye, a very anaplastic tumor was found to occupy the whole uveal tract; its features were compatible with a tumor of mesenchymal origin, including rhabdomyosarcomatous and liposarcomatous characteristics. Choroidal osteoma was a coincidental finding. The histologic findings of the tumor were of two types of malignant mesenchymal tumors, and therefore the diagnosis of malignant mesenchymoma was made. This is to our knowledge the first tumor of its kind to be reported intraocularly.

Adult↗
PubMed1994

Opening by the Nd:YAG laser of the anterior portion of the capsular bag in the treatment of delayed onset pseudophakic endophthalmitis.

We report on a pseudophakic patient with delayed onset endophthalmitis. The patient was treated twice topically and systemically with antibiotic and steroids with temporary response to treatment. The inflammation recurred twice upon withdrawal of treatment. Upon the third relapse of endophthalmitis the anterior portion of the capsular bag was opened by Nd:YAG laser. A third course of systemic and topical antibiotic and steroid treatment was followed by permanent resolution of inflammation. No relapse occurred during 18 months of follow-up.

Aged↗
PubMed1993

Sphenoid and cavernous sinuses involvement as first site of metastasis from a fallopian tube carcinoma. Case report.

The occurrence of central nervous system metastases in ovarian cancer patients ranges from 0.88 to 4.5%. Centra nervous system involvement in a fallopian tube carcinoma is extremely rare. A 77-year-old woman with an invasive tubal carcinoma was admitted because of ophthalmoplegia, sparing the lateral rectus muscle of the left eye, a decreased left corneal reflex and hypoesthesia along the distribution of the ophthalmic and maxillary branches of the left trigeminal nerve. CT scan showed a space occupying lesion in the left sphenoid sinus invading the left cavernous sinus and the submucosa of the left lateral wall of the nasopharynx, proven histologically to be a metastasis from her primary cancer. Attention should be paid to the possibility of distant and unusual metastases associated with tubal cancer in order to treat the patients promptly.

Aged↗