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Biomedical subjects

R C Kleiner

Publications and source records attributed to R C Kleiner.

13 recordsLinked to original sources
PubMed1990

The posterior uveal bleeding syndrome.

Eight patients were observed who suffered varying degrees of visual loss secondary to multiple recurrent hemorrhages or serous fluid beneath the retinal pigment epithelium and neurosensory retina in the posterior fundus. Vitreous hemorrhage occurred in two patients. In all patients, hemorrhages or exudates were associated with orange subretinal lesions of which the clinical and fluorescein angiographic appearances were not previously familiar to the authors. Six of the eight patients were female, and all but one was black. Ages ranged from 40 to 79 years (median, 57 years). Final visual acuities ranged from 20/40 to hand motions. The term "posterior uveal bleeding syndrome" is proposed to describe these findings.

Adult↗
PubMed1989

Vaso-occlusive retinopathy associated with antiphospholipid antibodies (lupus anticoagulant retinopathy).

The authors observed three cases (6 eyes) of vaso-occlusive retinopathy associated with the lupus anticoagulant and the related antiphospholipid antibody anticardiolipin. The disease occurred in patients who had no definable autoimmune disease such as systemic lupus erythematosus (SLE) and was characterized by severe bilateral retinal vascular occlusion. There was profound visual loss from intraretinal ischemia as well as vitreous hemorrhage from preretinal neovascularization. Results of laboratory testing showed a prolonged partial thromboplastin time (PTT) in two patients, and the presence of the lupus anticoagulant in all. Treatment with panretinal photocoagulation appeared to stabilize the neovascularization. The role of systemic anticoagulation and immunosuppressive therapy is uncertain.

Adult↗
PubMed1988

Transient severe visual loss after panretinal photocoagulation.

Seven diabetic patients experienced severe but transient visual loss after panretinal photocoagulation for proliferative diabetic retinopathy. In all patients, visual acuity decreased shortly after treatment to levels ranging from 5/200 to no light perception. In five of the patients, no observable ocular disease or surgical complications could explain the degree of visual loss. The other two patients developed exudative macular detachments, although it was not clear that this change accounted for their severe visual loss. Vision improved in all patients over a period ranging from nine days to nine months. In five patients, visual acuity returned to within two Snellen lines of the pretreatment level.

Adult↗
PubMed1988

Acute frosted retinal periphlebitis.

We examined three previously healthy young patients who suffered acute visual loss associated with diffuse bilateral retinal periphlebitis. Each patient developed thick, inflammatory infiltrates surrounding all of the retinal veins, creating the appearance of frosted tree branches. Initial visual acuities ranged from 20/20 to hand motions (median, counting fingers). All patients showed rapid improvement after starting oral corticosteroid therapy, and all but one of the six affected eyes regained a visual acuity of 20/20. The clinical appearance and course of these patients matched those of a condition previously described in Japan and labeled frosted branch angiitis. The term "acute frosted retinal periphlebitis" seems to describe more accurately the clinical findings.

Acute Disease↗
PubMed1988

Contrast sensitivity in age-related macular degeneration.

Low-contrast charts were used to investigate the possibility that patients with drusen have visual deficits not detected by standard Snellen charts. We compared performance on Regan letter charts between 52 eyes with drusen and Snellen acuity of 20/20 and 27 control eyes. The drusen group read fewer letters than the control group on all of the charts tested. This difference increased as the contrast of the charts decreased. The loss of performance on all of the Regan charts correlated with drusen severity. Twenty-one eyes with drusen and normal Snellen acuity also were tested with a Ginsburg contrast sensitivity chart and compared with age-matched normal controls. The results showed a loss of contrast sensitivity at high spatial frequencies and a loss of peak contrast sensitivity with increasing drusen severity. These results suggest that in patients with drusen, low-contrast charts may be useful for measuring visual loss not detected by standard Snellen charts.

Adult↗
PubMed1988

A new device for performing fluid-gas exchanges.

A new device was developed for performing outpatient fluid-gas exchanges in vitrectomized eyes. This device allows the operator to hold his needle in position steadily with less effort and fatigue. It is particularly useful for fluid-gas exchanges in phakic eyes where precise needle positioning is required.

Equipment Design↗
PubMed1988

Acute multifocal hemorrhagic retinal vasculitis.

The authors present a series of seven patients with acute visual loss associated with mild anterior uveitis, multifocal retinal vasculitis, retinal capillary nonperfusion, retinal hemorrhage, disc swelling, and vitreitis. Oral prednisone was of some benefit in these patients and oral acyclovir was generally ineffective. Neovascular complications including retinal, disc, choroidal, and iris new vessels were common, requiring photocoagulation in five patients. Horseshoe tears developed in two patients in zones of uninvolved retina but retinal detachment did not occur. The etiology remains unknown, although it may represent either a localized ocular form of Behçet's disease or other systemic syndrome, infection with a herpes group virus other than zoster varicella virus, or a manifestation of an undefined infectious agent.

Acute Disease↗
PubMed1988

Subfoveal neovascularization in the ocular histoplasmosis syndrome. A natural history study.

The visual outcome of 74 eyes with the ocular histoplasmosis syndrome and active subfoveal subretinal neovascular membranes was studied retrospectively. Follow-up time ranged from 12 to 109 months (median, 36.5 months). Ten eyes (14%) retained visual acuity of 20/40 or better. Fifty-seven eyes (77%) suffered visual loss of 20/100 or worse and 36 eyes (49%) suffered visual loss of 20/400 or worse. Factors significantly associated with retaining vision of 20/40 or better were: age less than 30 years (P = 0.008); smaller membrane size (P = 0.0002); and absence of visual loss secondary to ocular histoplasmosis in the fellow eye (P = 0.053). Factors significantly associated with vision decreasing by four or more lines were: older patient age (P = 0.006); better initial visual acuity (P = 0.090); and more than 50% involvement of the foveal avascular zone (P = 0.059). These results were confirmed by multiple logistic regression. Final vision of 20/40 or better was associated with better initial visual acuity using univariate analysis, but this result was not confirmed by multiple logistic regression.

Adult↗
PubMed1984

Scleritis, pericarditis, and aortic insufficiency in a patient with rheumatoid arthritis.

A 55-year-old black man developed anterior nodular scleritis in his left eye in November 1981. He had no symptoms of systemic disease, and initial laboratory tests revealed only a positive rheumatoid factor. Fourteen months later he presented with pericarditis and aortic insufficiency requiring aortic valve replacement. Examination of excised valvular and pericardial tissue showed changes compatible with rheumatoid disease. Shortly after the surgery he developed florid rheumatoid arthritis. The clinical course of this patient illustrates how scleritis can be the initial sign of severe systemic disease.

Aortic Valve↗