Biomedical subjects
N W Hindle
Publications and source records attributed to N W Hindle.
Is a 'favorable' outcome acceptable?
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Macular pigment epitheliopathy in retinopathy of prematurity.
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Controversies in the management of retinopathy of prematurity.
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Cryotherapy in infants with retinopathy of prematurity.
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Cryotherapy for retinopathy of prematurity: none, one, or both eyes.
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Critical mass retinopathy of prematurity: what is it and what can you do about it?
This paper presents a summary of my experience with treatment of 41 patients with retinopathy of prematurity. From November, 1976, to June, 1988, 76 eyes with Stage 3b, 3c, and Stage 4 ROP had treatment to the ridge-EFP complex, the avascular retina, or both locations. Cryotherapy was used in all eyes, with two having Argon laser photocoagulation as well. These studies have shown that: 7.9% of all treated eyes had Grade III to V RLF; the optimal timing of intervention is recommended during progression of Stage 3b+ ROP; the optimal location of treatment appears to be the avascular retina with the ridge-EFP perhaps as effective but the treatment of both areas simultaneously is to be avoided due to an increased occurrence of grade II RLF and macular pigment epitheliopathy in those eyes so treated. A comparison of results of four major studies indicate that the U.S. Cryo-ROP Study has three times the rate of Grade III to V RLF, probably because of intervention after the accumulation of excessive quantities of Stage 3b and/or 3c ROP.
Home oxygen therapy. Outcome of infants discharged from NICU on continuous treatment.
Forty-four oxygen-dependent infants were discharged home in oxygen from an NICU during an 8-year period. Survivors were followed for 3 years. The infants' discharge diagnoses were bronchopulmonary dysplasia (BPD) (39), sleep apnea (2), and congenital cardiac defects (3). The five infants who had diagnoses other than BPD all died, but 34 of 39 infants with BPD survived. Supplemental oxygen was discontinued at a mean age of 13.4 months. The infants with BPD experienced health, growth, nutritional, neurodevelopmental and sensory problems that necessitated frequent rehospitalizations and utilization of a variety of medical and support services.
Cryotherapy for retinopathy of prematurity: timing of intervention.
This is a retrospective study of the results of cryotherapy for retinopathy of prematurity in 30 eyes of 17 patients from November 1976 to March 1983. The report is in the language of the international classification of retinopathy of prematurity. Ten eyes were treated at stage 4 disease, seven eyes at severe or late stage 3 'plus' disease, and 13 eyes at moderate or mid-stage 3 'plus' disease. All eyes had the cryotherapy applied to the ridge and the extraretinal fibrovascular proliferation contiguous with the ridge, some with additional treatment of the avascular retina. The results show that this method of treatment must be applied before severe stage 3 'plus' disease is established in order to prevent visual disability and minimise retrolental fibroplasia. The treatment of the selected cases of progressive moderate stage 3 'plus' disease accomplished those objectives.
Cryotherapy for retinopathy of prematurity to prevent retrolental fibroplasia.
This report analyses the results of cryotherapy in 22 eyes with severe retinopathy of prematurity (acute retrolental fibroplasia) and compares the results with data from other sources on untreated eyes. The evolution of the indications for and methods of treatment, the results of treatment, and related features are discussed. The need for a common terminology and classification of the disease is emphasized.
International classification of retrolental fibroplasia: a proposal.
There is evidence that, owing to the increased rate of salvage of premature infants weighing less than 1500 g at birth, the incidence of both retinopathy of prematurity (acute retrolental fibroplasia) and cicatricial retrolental fibroplasia is increasing. Treatment of the acute process to prevent blindness is controversial. In order that adequate studies be conducted to settle this issue, an international classification of retrolental fibroplasia is proposed.
The Calgary Code: a numerical and alphabetical nosography of retrolental fibroplasia.
With the Calgary Code, clinical observation in retrolental fibroplasia can be translated into numerical and alphabetical symbols. This paper outlines the prerequisites for use of the code, the method of use and the potential applications.
Prevention of cicatricial retrolental fibroplasia by cryotherapy.
A premature infant who was developing cicatricial retrolental fibroplasia, was given cryotherapy to both eyes. This stopped the progress of the disease in almost all areas of the retina. The infant died three months later of complications related to prematurity. A comparison between the inadequately treated areas and those adequately treated during the clinical follow-up prior to death and in the pathology of the eyes confirms the value of cryotherapy in preventing cicatricial retrolental fibroplasia and indicates where it should be applied.
Dislocation of the lens in Marfan's syndrome. Its effect and treatment.
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Cryotherapy for retinopathy of prematurity.
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Results of cryotherapy at different locations for retinopathy of prematurity.
Fifty eyes with stage 3 plus retinopathy of prematurity (ROP) were treated with cryotherapy. The avascular retina (AR) only was treated in 15 eyes with a mean extent of 8.3 hours of stage 3 ROP; the ridge extraretinal fibrovascular proliferation complex (REFP) was treated in 17 eyes with a mean extent of 7.5 hours; and both locations (BL) were treated in 18 eyes with a mean extent of 7.7 hours. Ninety-three percent to 94% of eyes in each group had less than grade III retrolental fibroplasia (RLF-Reese). However, 87% of the AR treated eyes, 59% of the REFP treated eyes, and 44% of the BL treated eyes had less than grade II RLF. Whether more than or less than 8 hours of stage 3 ROP was treated, significantly better results occurred in the AR group than the BL group (.02 < P < .05) and a statistical trend suggests that treating the AR is more effective than treating the REFP (.1 < P < .2).