PubMed Health⌕ Search

Biomedical subjects

R T Wendel

Publications and source records attributed to R T Wendel.

14 recordsLinked to original sources
PubMed1999

Bartonella henselae infection associated with peripapillary angioma, branch retinal artery occlusion, and severe vision loss.

PURPOSE: To report atypical clinical features of Bartonella henselae neuroretinitis treated with combination antibiotics. METHOD: Case report. RESULTS: A 20-year-old man with a positive B. henselae titer developed a unilateral neuroretinitis, a large peripapillary angiomatous lesion, branch artery occlusion with ischemic maculopathy, and vision loss that failed to improve with clindamycin. Treatment with doxycycline and rifampin led to rapid clinical improvement. The severe vision loss in this case is atypical. CONCLUSIONS: Ocular findings associated with B. henselae infection may include retinal angiomatous lesion and branch retinal artery occlusion. Doxycycline and rifampin were successful in treating the infection.

Adult↗
PubMed1999

Surgical repair of cytomegalovirus-related retinal detachment without silicone oil in patients with AIDS.

PURPOSE: To analyze visual and anatomic results following surgical repair of cytomegalovirus (CMV)-related retinal detachment (RD) without silicone oil permanent tamponade. METHODS: We analyzed five consecutive patients (six eyes) with acquired immunodeficiency syndrome and CMV-related RD that were repaired with pars plana vitrectomy with peeling of the posterior hyaloid, laser photocoagulation, encircling scleral buckle, and intraocular gas tamponade. RESULTS: Preoperative vision ranged from 20/40 to hand motion. Total retinal reattachment was achieved in five of six eyes (83%). Macular reattachment was achieved in all eyes. Mean postoperative visual acuity was 20/40 (range 20/30-20/60). Mean postoperative follow-up was 12 months (range 7-19 months). All patients in this series presented with low preoperative CD4+ T-lymphocyte counts (mean, 24 cells per microL) and received highly active antiretroviral therapy. One retina (Patient 1) redetached 7 months after initial repair and was successfully reattached without using silicone oil. Postoperatively, visual acuity remains 20/30, and total retinal reattachment has been maintained for 16 months. CONCLUSION: Good anatomic and visual success can be achieved and maintained in CMV-related RD without the use of silicone oil.

AIDS-Related Opportunistic Infections↗
PubMed1995

Clinicopathologic correlation of an epiretinal membrane associated with a recurrent macular hole.

PURPOSE: To describe the clinicopathologic features of an epiretinal membrane associated with a recurrent, full-thickness idiopathic macular hole and speculate on the mechanism(s) contributing to its recurrence 1 year after initially successful closure of pars plana vitrectomy and gas tamponade (SF6). METHODS: After fixation of the 2 x 1 mm specimen in a mixture of 1% glutaraldehyde and 4% formaldehyde followed by 2.5% glutaraldehyde, postfixation with osmium tetroxide, and standard dehydration, the specimen was embedded in epoxy resin. Ultrathin sections were stained with uranyl acetate and lead citrate for transmission electron microscopy. RESULTS: Ultrastructural examination disclosed a fibrocellular membrane composed of Müller cells and fibrous astrocytes. Native collagen was entrapped in the matrix in some areas. CONCLUSION: Those cells that may lead to the closure of an idiopathic macular hole may also contribute to its recurrence if the reparative process goes awry.

Cell Membrane↗
PubMed1993

Vitreous surgery for macular holes.

BACKGROUND: To surgically treat patients with macular holes, the authors previously reported both anatomic (re-attachment) and visual success (2 lines of improvement) in a series of 52 eyes. They now have operated on an additional 118 eyes using similar techniques, for a total of 170 eyes. METHODS: After ophthalmologic examination and history, the authors operated on suitable patients. The surgical objectives included relief of all tangential traction and retinal tamponade with intraocular gas. All eyes were followed for at least 6 months postoperatively. RESULTS: In the total population of 170 eyes, anatomic success was achieved in 73% and vision improved at least two lines in 55%. Twenty-nine percent (49/170) of patients had a visual acuity of 20/40 or better at last examination. Patients with symptoms of less than 6 months' duration managed better than those with symptoms of longer duration (P = 0.3001). In the former group of 66 eyes, anatomic success was achieved in 80% (n = 53), whereas visual acuity improved at least two lines in 68% (n = 45) and at least four lines in 55% (n = 36). CONCLUSIONS: The authors suggest that macular hole surgery may provide meaningful improvement in visual acuity in most patients, especially in those whose symptoms are of less than 6 months' duration.

Aged↗
PubMed1992

Clinicopathologic study of bilateral macular holes treated with pars plana vitrectomy and gas tamponade.

The clinicopathologic findings of light and electron microscopic examination of a 78-year-old woman who underwent successful bilateral pars plana vitrectomy for bilateral stage III macular holes are reported. Examination disclosed anatomical repair of the full-thickness macular holes by glial cell proliferation in the left eye. The hole apparently collapsed with no glial cell proliferation in the right eye. The photoreceptors adjacent to the healed macular holes appeared normal. Defects in the internal limiting membrane in the foveal area were noted in both eyes.

Aged↗
PubMed1991

Vitreous surgery for idiopathic macular holes. Results of a pilot study.

Idiopathic macular holes are generally considered an untreatable condition. We used modern vitrectomy techniques to evaluate two questions: (1) Is it possible to reattach the retina around the macular hole? (2) If it is reattached, will the patient's central vision improve? In 30 (58%) of 52 patients, we were able to reattach successfully the detached macula with our surgical procedure. In 22 (73%) of the 30 patients in whom the macula was successfully reattached, there was an improvement in visual acuity of two lines or better. In the 22 patients in whom reattachment of the macular hole was not obtained, there was no significant improvement in visual acuity. Thus, the overall success rate for improved vision postoperatively was 42% (22/52). Complications related to surgery were observed in eight patients (15%) early in our experience with this procedure and included increase in the size of the macular hole, mottling of the retinal pigmented epithelium, and a vascular occlusion. Our clinical observations indicate that the treatment of macular holes by vitrectomy may offer some promise for this otherwise untreatable condition. In patients in whom reattachment was successful, the technique used appeared to allow for clinically significant improvements in visual acuity. However, additional work on increasing surgical success and minimizing surgical complications, as well as a further understanding of the mechanism of retinal reattachment, is required before widespread use of this procedure for treating macular holes.

Adult↗
PubMed1991

Cilioretinal artery occlusion in young adults with central retinal vein occlusion.

Ten patients, all younger than 50 years of age, had a temporal cilioretinal artery occlusion associated with a nonischemic central retinal vein occlusion. On fluorescein angiography, the cilioretinal artery eventually filled in all but one eye. The cilioretinal artery showed pulsations on fluorescein angiography in five eyes. The central retinal vein occlusion eventually resolved and the fundus assumed a normal appearance in all nine of the followed cases. Eight of nine eyes that underwent follow-up examination had final visual acuity of 20/30 or better. The occlusion of the central retinal vein produces an elevation of intraluminal capillary pressure because the central retinal artery continues to pump blood into the retina. Because the perfusion pressure of the cilioretinal artery is lower than the central retinal artery, it becomes relatively occluded. The prognosis for these patients is generally good unless the entire parafoveal capillary net is affected by the cilioretinal artery that is occluded.

Adult↗
PubMed1988

Expanded indications for pneumatic retinopexy.

The Collaborative Pneumatic Retinopexy Study evaluated retinal detachments (RDs) secondary to one break or group of breaks no larger than 1 clock hour located within the superior 8 clock hours of the fundus. Eyes with prominent proliferative vitreoretinopathy (PVR) were excluded. Forty eyes which exceed these criteria and were treated with pneumatic retinopexy have been retrospectively evaluated to determine what preoperative conditions limit the application of pneumatic retinopexy. Multiple breaks in multiple quadrants, large tears up to 2.5 clock hours in size, and RDs associated with a moderate degree of PVR were successfully managed with pneumatic retinopexy. The greatest number of failures were due to inferior breaks. The overall success rate for pneumatic retinopexy was 75%. New breaks occurred in 12.5% of eyes, but all of these were successfully managed.

Humans↗
PubMed1987

Pneumatic retinopexy. A collaborative report of the first 100 cases.

The preliminary experience of one surgeon, using pneumatic retinopexy for 20 consecutive cases of rhegmatogenous retinal detachment, was previously reported. The collaborative experience of six surgeons using pneumatic retinopexy for 100 cases is now reported. This series includes cases with pseudophakia, aphakia, macular detachment, macular breaks, vitreous hemorrhage, trauma, and old detachments. Initially, 91% were reattached, but seven recurrences yielded a 6-month follow-up cure rate of 84% with pneumatic retinopexy. With subsequent scleral buckling, 98% were reattached. Postoperative complications included proliferative vitreoretinopathy (3%), macular pucker (3%), and new/missed retinal breaks (7%). A review of the literature disclosed postoperative new/missed retinal breaks in nine series: 21, 3, 8, 4, 9, 7, 5, 4, and 13%. There were no cases of glaucoma, cataract, subretinal gas, endophthalmitis, or extension of the detachment into a previously attached macula. Pneumatic retinopexy offers the advantages of reduced tissue trauma, fewer complications, no hospitalization, and less expense. The major disadvantage is the need for postoperative positioning.

Cryosurgery↗
PubMed1984

Transmission of herpes simplex during CPR training.

Instruction in cardiopulmonary resuscitation (CPR) has become a standard part of training for medical personnel and is widely recommended for the lay public. We present a case report of two women, one of whom contracted herpes labialis and one of whom contracted ocular herpes simultaneously after participating as partners in a CPR training course. This case suggests that added precautions against the transmission of infectious disease should be taken by screening participants in CPR courses for signs of respiratory, oral, or facial cutaneous disease. In addition, this case underscores the crucial importance of adequately disinfecting mannequins between users and between training sessions. Specific recommendations are made.

Female↗
PubMed1984

Role of electrophysiologic testing in the preoperative evaluation of corneal transplant patients.

We performed preoperative skin electrode bright-flash ERG and VEP testing on 32 patients undergoing elective penetrating keratoplasty. Twenty-six patients had unilaterally decreased vision and six had bilateral visual impairment. By combining our quantitative electroretinogram (ERG) and qualitative visual evoked potential (VEP) results with clinical findings, we were able to predict visual outcome in 92% of cases. Our findings suggest that bright-flash ERG and VEP testing are useful adjunct studies to clinical and ultrasound findings in patients with media opacities, comparison of a and b wave amplitudes with the fellow eye may yield prognostic information, a normal ERG and VEP in the presence of an equivocal afferent pupillary defect may signal a good visual prognosis, and ERG and VEP are not reliably predictive in patients with media opacity and amblyopia or macular disease.

Adolescent↗