Biomedical subjects
P L Lou
Publications and source records attributed to P L Lou.
Complications of macular hole surgery.
Macular hole is a serious vision-threatening disease for which, until the early 1990s, no effective treatment was available. However, with advanced techniques in microsurgical vitrectomy surgery, effective and successful closure of macular holes now can be obtained. Many complications can occur after any ocular surgery. Some of the specific complications associated with macular hole surgery are RPE alterations, retinal detachments, CME, subretinal neovascular membrane, endophthalmitis, hypopyon, late re-opening of macular holes, increased intraocular pressure, visual field defects, and cataract formation. Because macular hole surgery is a relatively recent operation devised in the last 8 years, data on complications still are being compiled and studied to understand and minimize the rates of complications after such surgery. We hope that, in the future, the rate of complications after macular hole surgery will be no higher than that for any other ophthalmic procedure.
Surgical management of macular hole.
Explore the source record for details and available documents.
Acute retinal necrosis syndrome: findings, management, and differential diagnosis.
Explore the source record for details and available documents.
Resolution of an external layer macular hole associated with an optic nerve pit after laser photocoagulation.
Explore the source record for details and available documents.
Hydroxychloroquine toxicity despite normal dose therapy.
The risk of retinopathy associated with the use of hydroxychloroquine is said to be nullified if the dosage recommendations are followed strictly. In this case report, we describe an elderly patient with rheumatoid arthritis who had bilateral maculopathy, presumably secondary to hydroxychloroquine therapy, despite a dosing regimen within therapeutic guidelines. We believe special attention should be given to elderly patients who are being treated with hydroxychloroquine because their retinal pigment epithelium may be more susceptible to the toxic effects of this drug.
Role of diabetologist in evaluating diabetic retinopathy.
OBJECTIVE: To evaluate the ability of diabetologists to screen diabetic patients for diabetic retinopathy. RESEARCH DESIGN AND METHODS: Comparison of eye examination performed by diabetologists with direct ophthalmoscopy through an undilated pupil and by ophthalmologists through a dilated pupil with seven-field stereoscopic fundus photography (gold standard). The study consisted of 67 insulin-dependent and non-insulin-dependent diabetic outpatients attending a diabetes clinic. RESULTS: On the basis of fundus photography, patients were classified as having no or insignificant (30%), minimal (31%), moderate (24%), or severe (15%) retinopathy. The diabetologists and ophthalmologists performed similarly in their ability to classify severity of diabetic retinopathy accurately. When no or insignificant retinopathy (isolated microaneurysms only) was detected by examination, clinically significant retinopathy detected by fundus photography was highly unlikely (less than 5%). On the other hand, if more than isolated microaneurysms were seen on examination, all examiners missed more severe lesions detected by fundus photography. Patients with corrected visual acuity worse than 20/30 had a high likelihood (100%) of moderate or severe retinopathy. CONCLUSIONS: Motivated well-trained diabetologists can screen for diabetic retinopathy. The absence of detectable lesions by direct ophthalmoscopy indicates that automatic referral to an ophthalmologist is not necessary. However, if any level of retinopathy is detected or corrected acuity is worse than 20/30, referral to an ophthalmologist is required. In this setting, fundus photography is advised because it is the most sensitive means of detecting clinically significant retinopathy. If other nonophthalmologists can be trained to achieve similar results, current recommendations for ophthalmologic referral that require annual ophthalmologic examinations for most diabetic patients may need to be reconsidered.
Digoxin in the subretinal spaces of humans with rhegmatogenous retinal detachments.
Explore the source record for details and available documents.
Bioartificial thyroid. The in vitro culture of microencapsulated rabbit thyroid tissue.
A new technique of encapsulating thyroid tissue with an artificial membrane for protection against immune attack is reported. The membrane was made of calcium alginate and a poly-L-lysin coating. The membrane prevents the diffusion of large molecules such as hemoglobin but freely permits the passage of smaller molecules such as T4 and culture medium 1640. Because larger molecules are barred, the contents of the microcapsules are safe from immune system rejection. In vitro cultured, microencapsulated rabbit thyroid tissue secreted T3 and T4, achieving a concentration of 8.68 +/- 2.93 nmol/L and 245.23 +/- 124.87 nmol/L, after 3 days; this level remained steady for 6 to 9 days of incubation. These microcapsules show promise as a treatment modality and as a possible solution to the problem of immuno-isolation.