PubMed Health⌕ Search

Biomedical subjects

N E Byer

Publications and source records attributed to N E Byer.

At least 19 recordsLinked to original sources
PubMed2002

Perspectives on the management of the complications of senile retinoschisis.

PURPOSE: To evaluate various published views regarding the management of complications of senile retinoschisis. METHODS: To analyze and compare various reports of studies of natural history and prognosis, and comparative risks of non-intervention vs prophylactic surgery. RESULTS: Although a number of recent techniques for treatment or prevention of complications of senile retinoschisis have been reported with generally satisfactory results, the numbers of cases have been small and no consensus can be said to have been achieved as to superiority of method. When compared to the extremely low likelihood of the natural occurrence of complications such as posterior progression to involve the macula, or of the development of progressive clinical retinal detachment, as well as the occurrence of risks of treatment, it appears preferable to postpone treatment until these complications actually make their appearance. CONCLUSIONS: It is recommended that in cases of retinoschisis either without or with breaks, or retinoschisis with localized 'schisis-detachment', that prophylactic treatment be withheld except in a very few exceptional cases. In all cases of progressive, symptomatic rhegmatogenous retinal detachment however, prompt surgical treatment should be carried out.

Adult↗
PubMed2001

Spontaneous regression and disappearance of subclinical rhegmatogenous retinal detachment.

PURPOSE: To report spontaneous regression and disappearance of subclinical rhegmatogenous retinal detachment. METHODS: Case reports. RESULTS: Three separate areas of subclinical retinal detachment in two eyes of two patients were followed without treatment for 35 years (Case 1) and 28 years (Case 2). The three areas of subclinical retinal detachment spontaneously regressed and disappeared. There has been no recurrence of subclinical retinal detachment in Case 1 for 12 years and 14 years, and in Case 2 for 12 years. CONCLUSION: Subclinical retinal detachment can show spontaneous regression and disappearance as its natural outcome when observed without intervention.

Adult↗
PubMed2001

Subclinical retinal detachment resulting from asymptomatic retinal breaks: prognosis for progression and regression.

PURPOSE: To give a more accurate epidemiologic description of subclinical retinal detachments and to learn their prognosis. DESIGN: Prospective, natural history cohort study. PARTICIPANTS: Seventeen patients, with 19 eyes involved with 22 separate areas of subclinical retinal detachment (SCRD). Ages at initial diagnosis ranged between 14 and 67 years. METHODS: Periodic retinal examinations over follow-up periods of between 8 months and >33 years, using indirect ophthalmoscopy and scleral indentation, and sometimes slit-lamp vitreous examinations with Goldmann lens. MAIN OUTCOME MEASURES: Documentation with written descriptions and drawings of lesions and estimation of size and dimensions. RESULTS: The rate of progression to clinical retinal detachment (CRD), which involved 11% of eyes (2 of 18), was found to be exactly equal to the likelihood of spontaneous regression and disappearance, also found in 11% (2 of 18), without any treatment. The calculated incidence rate of progression to CRD was 0.008 (<1% per year). Also, myopic females were found to have a 4.7-times greater risk of subclinical retinal detachment developing than were males, P = 0.036. All of these findings are reported for the first time in the ophthalmic literature. CONCLUSIONS: Compared with symptomatic clinical retinal detachment, SCRD is much less threatening to the vision and the health of the eye. Therefore, SCRD does not require or justify routine treatment but should be reexamined at regular annual intervals or more frequently if changes are observed. If it definitely progresses to CRD, surgical treatment is justified.

Adolescent↗
PubMed1998

What happens to untreated asymptomatic retinal breaks, and are they affected by posterior vitreous detachment?

OBJECTIVE: The purpose of the study was to ascertain the natural consequences of asymptomatic retinal breaks and to learn what effects, if any, the occurrence of posterior vitreous detachment (PVD) has on such breaks. DESIGN: This was a cohort study of consecutive asymptomatic phakic patients, all of whom had asymptomatic retinal breaks, observed without treatment over periods of 1 to 33 years (average, 11 years). PARTICIPANTS: There were 196 patients with 235 involved eyes. INTERVENTION: Periodic clinical examinations, including binocular indirect ophthalmoscopy with scleral indentation on all eyes and posterior vitreous examination on 50 eyes, were performed. RESULTS: In the total study period, one small peripheral retinal detachment developed, without symptoms, from a previous subclinical detachment over a period of 14 years. Nineteen eyes (8%) originally had or developed 22 areas of subclinical detachment, 2 of which were treated because of moderate extension, even though remaining subclinical and without symptoms. Ten eyes encountered acute PVDs, which caused symptomatic retinal tears in three eyes, one of which also had a clinical retinal detachment. Of the 50 asymptomatic eyes examined with Goldmann lens and slit lamp, 12 (24%) were found to have an existing PVD, which had not led to any complication of the previous retinal breaks in any eye. CONCLUSIONS: Asymptomatic retinal breaks discovered in phakic primary eyes do not show any significant tendency toward clinical retinal detachment, with the exception of a few of those cases that progress to subclinical retinal detachment. It is only some of these, comprising 1% to 2% of the total group, that may justify treatment. Posterior vitreous detachment coexists safely with asymptomatic retinal breaks in phakic primary eyes and shows no tendency to provoke complications to pre-existing breaks at the time of its occurrence.

Adolescent↗
PubMed1994

Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment.

PURPOSE: This study was designed to elucidate various aspects of the natural history of posterior vitreous detachment (PVD), in particular the relation between symptomatology and prognosis as it relates to management of patients with the earliest symptoms of PVD. METHODS: A prospective study of 350 consecutive patients with PVD was performed, excluding all patients referred from an ophthalmologist, those with symptoms of more than 3 months in duration, and those with a history of ocular trauma, except for cataract surgery. Aphakia was present in 21 eyes, and 50 patients were bilaterally involved. RESULTS: Of 163 patients who had one to two floaters as their presenting symptom, with or without light flashes, a retinal tear developed in 12 (7.3%). Of 31 phakic eyes with secondary retinal tears on initial examination, 9 (29%) had one to two floaters and light flashes as the only symptoms. Of eight phakic eyes that initially, or eventually, had a retinal detachment, three (37%) had an interval of 2 1/2 to 3 weeks before visual field loss, during which they noticed only one to three visual floaters plus light flashes as their only symptoms. This early stage in which symptoms are detectable is crucial in terms of providing an opportunity for early treatment that might prevent retinal detachments. CONCLUSIONS: The prompt and conscientious vitreoretinal examination of each patient older than 45 years of age who experiences vitreous floaters, even though limited to one or two, should be undertaken without delay. This practice, combined with expeditious treatment of any secondary retinal tears, provides the most effective known means of preventing rhegmatogenous retinal detachment, and currently it appears to be neglected. A national public educational effort should be pursued to publicize the importance of these symptoms.

Adult↗
PubMed1989

Long-term natural history of lattice degeneration of the retina.

An initial series of patients with lattice degeneration was reported to the Academy in 1964 and a follow-up report given in 1973. A continuing prospective study of 276 consecutive untreated patients (423 eyes) is now reported with follow-up from 1 to 25 years (average, 10.8 years). Clinical retinal detachments (RDs) occurred in 3 (1.08%) of 276 patients and 0.7% of eyes. Tractional retinal tears were seen in eight (2.9%) patients and 1.9% of eyes; one of these led to a clinical RD. Clinical or progressive subclinical RD occurred in 3 (2%) of eyes with atrophic holes. Subclinical RD was seen in 10 (6.7%) of 150 eyes with atrophic holes, involving 9 (7.5%) of 120 patients, and had a much less serious prognosis than clinical detachment. Prophylactic treatment of lattice with or without holes in phakic, nonfellow eyes should be discontinued.

Adolescent↗
PubMed1986

Long-term natural history study of senile retinoschisis with implications for management.

This is a long-term natural history study of 123 consecutive, nonselected patients (218 eyes) with senile retinoschisis examined periodically, while deliberately withholding all forms of treatment, for from 1 to 21 years (average, 9.1 years) so that the natural behavior and prognosis of this disease could be learned and reasonable recommendations for management could be formulated. The quadrant of maximal involvement was the inferior temporal and 74% of the lesions had posterior borders which were postequatorial. Senile retinoschisis was found to be primarily asymptomatic and nonprogressive. Current indications for treatment, treatment modalities, and complication rates published in recent literature are analysed. No case of symptomatic progressive retinal detachment occurred, but there were 14 cases of localized, nonprogressive and asymptomatic "schisis-detachment". Current indications for treatment of senile retinoschisis should be seriously reevaluated and reduced to one primary indication for treatment, namely symptomatic progressive retinal detachment.

Adult↗
PubMed1982

The natural history of asymptomatic retinal breaks.

A long-term prospective follow-up of 359 asymptomatic retinal breaks, involving 231 eyes of 196 patients, was carried out for from one to 18 years, without treatment. This group was drawn from a consecutive series of phakic eyes of patients who had not had retinal detachment. Fifty of the breaks were tractional tears with attached flaps. No case of clinical retinal detachment occurred. Eighteen separate small subclinical retinal detachments occurred, involving 17 eyes, but only three of these enlarged slightly. No case in the series was treated. The absence of clinical retinal detachment in this series argues strongly for the relative safety of asymptomatic retinal breaks in phakic, nonfellow eyes, even if they are tears with attached flap in superior locations. Prophylactic treatment is not justified for this type of break in this type of eye.

Adolescent↗
PubMed1981

Cystic retinal tufts and their relationship to retinal detachment.

Cystic retinal tuft, a lesion of the peripheral retina that has been described histologically, is herein described clinically and illustrated by fundus photographs. It is a congenital developmental vitreoretinal abnormality associated with firm vitreoretinal adhesions and can lead to acute tractional retinal tears at the time of an acute posterior vitreous detachment. It has been reported to be present in 5% of autopsy cases. In a consecutive series of 200 retinal detachment cases, 6.5% seemed to be causally related to cystic retinal tufts. The risk of a cystic retinal tuft leading to retinal detachment was computed to be less than 1% (range, 0.18% to 0.28%). Prophylactic treatment of cystic retinal tufts is therefore not advised.

Adult↗
PubMed1981

Relationship of cystic retinal tufts to retinal detachment.

The histologic and gross pathologic features of cystic retinal tufts are reviewed, and the clinical characteristics of this lesion described. A survey of 200 retinal detachments revealed that cystic retinal tuft was the precipitating lesion for the detachment in from 6.5 to 10% of cases. Since the prevalence of cystic retinal tuft is 5%, the risk of such a lesion leading to retinal detachment was computed to be from 0.18 to 0.28%, and for this reason prophylactic treatment of cystic retinal tufts is not advised.

Adult↗
PubMed1977

The natural history of senile retinoschisis.

The natural history of senile retinoschisis was studied in 193 eyes of 108 non-referred patients while refraining from the use of any prophylactic intervention, over follow-up periods ranging from 2 to 11 years. No case of clinical symptomatic retinal detachment occurred. 2 cases of small localized subclinical retinal detachment occurred, but these did not progress. 9 eyes showed new retinal holes. 11 showed increase in extent, and 7 showed spontaneous regression of lesions. An estimated risk of clinical detachment is calculated and four indications for treatment are given.

Adult↗
PubMed1975

A clinical definition of lattice degeneration of the retina and its variations.

Lattice degeneration has certain invariable histologic features but presents clinically in a variety of similar and dissimilar forms. Photographic documentation and statistical data on the evolution of round atrophic holes and of white lines are represented which tend to support the view that all of these clinical forms actuallysent one basic disease process.

Diagnosis, Differential↗