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S Bodanowitz

Publications and source records attributed to S Bodanowitz.

At least 19 recordsLinked to original sources
PubMed1997

Low-dose radiation therapy for age-related macular degeneration.

BACKGROUND: The study was carried out to evaluate the effect of low-dose radiation therapy in patients with age-related macular degeneration. METHODS: One hundred eyes of 78 patients (mean age 72 years) with different forms of age-related macular degeneration were treated with external beam radiotherapy between 1971 and 1989. In four fractions a total dose of 2 Gy was administered over 7 days. Radiation therapy was performed by the conventional 200-kV technique. The mean duration of follow-up period was 7 years (range 0.5 to 20 years). A control group was composed of 96 eyes from patients with AMD who received no therapy. The mean visual acuity at first presentation and the duration of follow-up was the same as in the treatment group. RESULTS: No difference in visual acuity between the treatment and control groups could be observed. After 1, 2, 5 and 10 years the mean visual acuity was equal in the radiation group and the control group. Even in subgroup analysis regarding only the eyes with exudative forms of AMD, no effect of this treatment strategy could be demonstrated. CONCLUSION: Our results suggest that low-dose radiation therapy in patients with age-related macular degeneration has no beneficial effect. However, it must be considered that the dose of 2 Gy is low in comparison to doses used in recently published studies (5-24 Gy).

Aged↗
PubMed1997

[Retinal detachment in Ehlers-Danlos syndrome. Treatment by pars plana vitrectomy].

UNLABELLED: Ehlers-Danlos syndrome (EDS) is an hereditary connective tissue disorder caused by defective collagen synthesis, the main features being hyperelasticity and vulnerability of the skin, recurrent bleeding from fragile blood vessels, and secondary deformities of the joints. Ocular involvement is a rare occurrence, e.g., corneal and scleral rupture from minor blunt injury, lens displacement, rhegmatogenous retinal detachment. To date, few reports exist concerning the treatment of retinal detachment in Ehlers-Danlos syndrome, all of them dealing exclusively with conventional scleral buckling surgery. PATIENT AND METHODS: We report on a 47-year-old male patient suffering from EDS type VI (so-called ocular type, lysine-hydroxylase deficiency). He presented with rhegmatogenous retinal detachment in his only eye. A scleral buckling procedure was not feasible because of marked scleral atrophy. A three-port vitrectomy was therefore carried out. RESULTS: During the operation, pronounced choroidal detachment and bleeding developed, subsiding within weeks postoperatively. Closure of the sclerotomies was difficult due to scleral thinning. Two revitrectomies were necessary because anterior PVR with traction retinal detachment occurred. The last revitrectomy was performed 18 months ago, and the retina has been completely reattached under 5000 cs silicone oil since then. Visual acuity is 0.1. CONCLUSION: Primary vitrectomy permits successful treatment of retinal detachment in EDS patients if a buckling procedure cannot be performed because of scleral atrophy. However, serious complications may occur. Surgical procedures other than primary vitrectomy should therefore always be carefully considered, e.g., pneumatic retinopexy, temporary balloon, dura patch with episcleral pocket.

Ehlers-Danlos Syndrome↗
PubMed1997

Silicone oil for recurrent vitreous hemorrhage in previously vitrectomized diabetic eyes.

AIMS: To investigate the clinical course of vitrectomized patients with recurrent diabetic vitreous hemorrhage who were treated by revitrectomy with silicone oil (SO) as a hemostyptic tamponade. PATIENTS AND METHODS: Fifteen patients with recurrent vitreous hemorrhage due to proliferative diabetic vitreoretinopathy were included in this retrospective study. All eyes had had at least one vitrectomy prior to use of SO and the retina was completely attached at any time before revitrectomy with SO instillation. Thirteen patients had a blind fellow eye. There were 6 males and 9 females (mean age 62.7 years, range 45-76 years). The mean duration of SO tamponade was 25.8 months (range 9-35 months). The average follow-up period was 30.4 months (range 20-48 months). RESULTS: Ten out of 15 eyes (66.6%) improved postoperatively, 9 eyes had a visual acuity of > or = 0.02 at the latest follow-up visit. Secondary glaucoma occurred in 4 eyes, leading to phthisis in 1 eye. All 5 phakic eyes developed a cataract. CONCLUSION: A revitrectomy combined with a long-term hemostyptic SO tamponade offers a chance for restoration of useful visual acuity in diabetic eyes with persistent vitreous-hemorrhage that fails to subside after cryocoagulation and vitrectomy without tamponade. Because of possible visual loss from secondary glaucoma related to intraocular SO this treatment should mainly be considered in patients with a blind fellow eye.

Aged↗
PubMed1996

[Retinal tear in retinochoroiditis toxoplasmotica].

PATIENT: A 29-year-old white female presented with an episode of recurrent focal toxoplasmic retinochoroiditis in her right eye. Apart from a white active lesion between the temporal vascular arcades, marked vitreous opacification was present. Treatment with oral pyrimethamine and sulfadiazine led to resolution of retinochoroiditis activity including vitreous clearing within 10 weeks. Another 3 weeks later, a fresh peripheral retinal tear was noted on routine fundus examination of the right eye. While the left eye showed no signs of vitreoretinal pathology, biomicroscopy revealed a posterior vitreous detachment and marked vitreous degeneration in the right eye of this emmetropic patient. Prophylactic laser treatment was performed. No further abnormalities were observed during a 5 months follow-up period. CONCLUSION: Retinal tears (and rhegmatogenous retinal detachment) are rare complications of toxoplasmic retinochoroiditis. However, a tear may occur due to vitreoretinal traction following postinflammatory structural alteration of the vitreous. Thus, in toxoplasmic retinochoroiditis the diagnostic attention should not be limited to the evaluation of optical transparency of the vitreous. Vitreous structure should be assessed as well and if structural changes are noted, repeated ophthalmoscopy is mandatory in order to detect retinal tears and rhegmatogenous retinal detachment timely.

Adult↗
PubMed1996

Vitrectomy in diabetic patients with a blind fellow eye.

Results of pars plana vitrectomy for complications of proliferative diabetic retinopathy were analysed in 32 consecutive patients with a blind fellow eye due to diabetic eye disease. The mean follow-up period was 22.3 months. Only 16% of all eyes examined had received full scatter photocoagulation prior to referral for vitrectomy. Out of 9 eyes with vitreous haemorrhage, 8 improved to a visual acuity of > or = 0.2 postoperatively. Amid 23 eyes which were vitrectomized for advanced traction retinal detachment, only 4 eyes improved to a postoperative visual acuity of > or = 0.02. In this group 12 eyes deteriorated after vitrectomy, 3 eyes progressing to no light perception. The postoperative visual outcome after vitrectomy for traction retinal detachment in this group of diabetics with a blind fellow eye (mean postoperative visual acuity 0.03 +/- 0.05) was significantly worse (p < 0.000) compared to a group of 196 patients with a seeing fellow eye who were vitrectomized for traction retinal detachment at our clinic (mean postoperative visual acuity 0.09 +/- 0.11). Therefore we conclude that traction retinal detachment in this subgroup of patients is a particularly severe presentation of diabetic retinopathy with a guarded functional prognosis after vitrectomy. Our results demonstrate the importance of timely full scatter photocoagulation and early vitrectomy in eyes with progressive fibrovascular proliferation not responding to panretinal photocoagulation. We conclude that especially diabetic patients with a blind fellow eye must be followed closely and assigned to vitrectomy at an earlier stage of their disease in order to improve functional prognosis.

Adult↗
PubMed1996

Management of retinal redetachment following silicone-oil removal.

The aim of the present investigation was to study the clinical course of eyes presenting with retinal redetachment after silicone-oil removal (SOR), with special regard being paid to the long-term visual outcome. Between October 1989 and September 1994, SOR was performed on a consecutive series of 262 eyes that had previously undergone vitrectomy combined with silicone-oil injection for complex retinal detachments. The records of these patients were analyzed retrospectively. The mean follow-up period after redetachment following SOR was 26.3 (range 6-45) months. Redetachment occurred in 35 eyes (13.4%), mostly within 1-3 months of SOR. Redetachment was not dependent on the surgical procedure or the underlying disease. A total of 24 eyes were revitrectomized and a stable flat retina was the result in 23 eyes (65.7%). At the latest follow-up visit, 18 eyes (51.4%) had a visual acuity (VA) of > or = 0.02 and 14 eyes (40%) had a VA of > or = 0.1. In 12 eyes (34.3%) the final VA equalled the best VA recorded before redetachment; an increase in VA occurred in 6 eyes (17.1%) and a deterioration was noted in 17 eyes (48.6%). Only 6 of the 17 eyes that deteriorated had displayed a VA of > or = 0.02 prior to SOR and lost formed vision due to redetachment; these 6 eyes represent 17.1% of the eyes presenting with redetachment after SOR and 2.3% of all 262 eyes that had undergone SOR. These observations demonstrate that revitrectomy is an effective treatment for retinal redetachment after silicone-oil removal. The final failure rate does not appear high enough to justify a contraindication for routine removal of silicone oil, especially since it remains a matter of speculation as to whether these eyes would have fared better had removal of silicone oil been avoided.

Adolescent↗
PubMed1996

Prediction of visual acuity after early vitrectomy in diabetics.

In proliferative diabetic retinopathy the indication of early vitrectomy remains controversial. At present, no decision rule exists for the assessment of the various factors predicting the postoperative visual outcome. We reviewed 75 vitrectomies in 68 diabetics from our clinic. All vitrectomies were done by one surgeon. In all cases, vitrectomy was indicated because of nonclearing vitreous hemorrhage and/or fibrovascular proliferation. A linear regression model was used to identify factors correlating with the visual outcome. By means of univariate analysis, six of nine clinical variables were found to be associated with the final visual outcome. Dividing the patients into two groups according to their preoperative visual acuity (group 1 hand movement, group 2 better than hand movement), we identified two predictors that were independently associated with the postoperative visual acuity: group 1-the visual acuity of the fellow eye (P < 0.05) and rubeosis iridis (P < 0.05); group 2-the visual acuity of the fellow eye (P < 0.001) and preexisting systemic diabetic vascular disorders (P < 0.01). Based on this model, a formula was derived to predict the visual acuity at 6 months postsurgery. For easier handling the prognostic factors of a poor visual outcome (less than 0.1) were summarized in a flow chart. The test is a useful tool for the preoperative evaluation of various risk factors and, hence, for more reliable prediction of a poor visual outcome. Thus, it may be especially useful to objectify the risk-benefit ratio for early vitrectomy in diabetics.

Diabetic Retinopathy↗
PubMed1996

[Early diagnosis and therapy of diabetic retinopathy].

Diabetic eye disease, especially diabetic retinopathy including maculopathy, is the most common cause of blindness in industrialized countries. However, if adequate treatment (photocoagulation, vitrectomy) is started timely, severe visual loss from this disease can be prevented in most instances. This paper reports on clinical findings, classification and treatment of diabetic eye disease. It is emphasized that only an effective screening and prevention strategy can lead to a reduction of blindness from diabetic retinopathy.

Adult↗
PubMed1996

In vivo observation of corneal nerve regeneration after photorefractive keratectomy with a confocal videomicroscope.

The aim of the present study was to study corneal nerve regeneration after photorefractive keratectomy (PRK) in vivo by means of a confocal videomicroscope. A total of 25 myopic eyes of 16 patients were examined biomicroscopically and with the confocal microscope (Microphthal, Hund Company, Wetzlar, Germany) before and after PRK. The mean age of the patients was 30.4 (range 21-44) years, the mean follow-up period was 13.7 (11.0-15.1) months, the mean preoperative refraction was -5.5 (-1.75 to -9.0) D, the mean amount of attempted correction was -4.75 (-1.75 to -7.5) D, the mean ablation depth was 50 (30-75) microns, and the single central ablation zone measured 6.0 mm in diameter. The postoperative refractive and visual outcome was favorable in most eyes. The mean postoperative refraction was -0.5 (-2.75 to + 0.5) D. Among the 25 eyes, 22 (88%) had +/- 1.0 D of attempted correction at 1 year and only 2 eyes showed a loss of 2 Snellen lines. Despite increased light scattering and reflection due to haze, sufficient postoperative imaging of the corneal nerve architecture was possible in all cases. Recovery of corneal innervation started from the margin of the ablation, being directed toward the center of the cornea and the epithelium. At 5-8 months following PRK, stromal nerves and the subepithelial nerve plexus took on their definite appearance. The original nerve structure was not reestablished, abnormal branching and accessory thin nerve fibers being present without exception. Confocal slit-scanning video-microscopy is a very useful technique for in vivo investigation of corneal nerve regeneration after PRK and, presumably, other keratorefractive procedures. In comparison with histology studies in animals, reinnervation of the human cornea after PRK seems to be completed earlier but follows the same morphologic principles.

Adult↗
PubMed1996

Corneal reinnervation after photorefractive keratectomy and laser in situ keratomileusis: an in vivo study with a confocal videomicroscope.

The purpose of this study was to compare the regeneration of corneal nerves after photorefractive keratectomy (PRK) versus laser in situ keratomileusis (LASIK) in vivo with a confocal videomicroscope. In all, 15 eyes that had undergone PRK and 15 eyes that had been subjected to LASIK were compared with a confocal in vivo slit-scanning video-microscope. The subepithelial nerves were observed preoperatively and at 3, 6, and 12 months postoperatively. In all eyes, good microscope images of the subepithelial nerve plexus could be obtained preoperatively. Because of postoperative light reflection and scattering in the treated area, subepithelial nerve-fiber regeneration could be followed satisfactorily only in seven eyes after PRK and in five eyes following LASIK. In the eyes treated with PRK, recovery of subepithelial reinnervation started from the margin of the ablation zone, being directed toward the center of the cornea. At 8 weeks postoperatively, rarefied subepithelial nerve fibers were visible at the edges, and after 3 months, single nonbranched nerve fibers could be visualized in the center of the ablation zone. At 6-8 months following PRK, subepithelial nerve regeneration seemed to be completed; however, abnormal branching and accessory thin nerve fibers were present without exception. After LASIK, corneal nerve-fiber regeneration followed the same course described for PRK except that regenerated subepithelial nerve fibers were barely visible in the center after 6 months. Further changes in nerve structure were visible for up to 12 months postoperatively. Recovery of corneal sensitivity in humans has been reported to start at 4-6 weeks after PRK and is said to be completed within 6-12 months of surgery. Slit-scanning videomicroscope findings were in accordance with these observations.

Cornea↗
PubMed1995

[Keratitis punctata superficialis caused by self-injury].

PATIENT: A 57-year-old patient with diabetes mellitus presented with therapy-resistant superficial punctate keratitis in his only eye. Finally self-injury was suspected. After unsuccessful medical treatment of three weeks' duration the disease could be healed promptly after application of an eyepad: the patient admitted self-manipulation. CONCLUSION: In all patients with ocular pathology of uncertain origin, especially in corneal lesions, self-inflicted injury should be part of the diagnostic consideration.

Bandages↗
PubMed1995

[Evaluating vision after photorefractive keratectomy within the scope of legal police service requirement 300].

BACKGROUND: The Polizeidienstvorschrift (PDV) 300 is a regulation which prescribes visual requirements for applicants to the German Police Service. Among other demands, uncorrected visual acuity (VA) of both eyes must be at least 0.5 before age 18 and at least 0.3 after age 21. The spherical equivalent of spectacle correction is ordained to fall into the range between -2.0 and +3.0 dpt. To date, recommendations for the assessment of excimer laser photorefractive keratectomy (PRK) with a view to Police Service applicants are still lacking. PATIENTS: Two applicants with myopic astigmatism were treated by PRK in order to meet the refractive requirements for entering the German Police Service. The first patient was judged fit for service two weeks after PRK was performed on his right eye. At this time uncorrected VA was 1.0 VA under glare conditions and contrast sensitivity had not been tested. The second patient had a stable postoperative refraction with an uncorrected VA of 1.0 in both eyes at six months postoperatively. VA under glare conditions and contrast sensitivity were normal. However, the medical service of the police authority demanded an additional follow-up of six months before judging this applicant fit for service. CONCLUSIONS: Before excimer laser PRK is performed in myopic police service applicants, a careful examination should rule out disorders of the visual system which are not related to the refractive error and may preclude admission into the police service. After PRK in this group of persons, a postoperative standard follow-up of at least six months should be demanded. Since fitness for night driving, self-defence ability and good orientation under difficult visual conditions are mandatory for police officers, any ophthalmologic certificate should make definite statements about glare and contrast sensitivity.

Adolescent↗
PubMed1995

[Simultaneous bilateral rhegmatogenous retinal detachment].

BACKGROUND: Rhegmatogenous retinal detachment (RD) has a strong bilateral tendency. It results from a chronic degenerative process, wherein both eyes are involved. However, simultaneous RD of both eyes is a rare finding. In a retrospective study we investigated the clinical course as well as risk factors in this kind of manifestation. METHODS: From 1989 to 1994, 931 patients underwent operation because of RD in our ophthalmologic department. Eleven of these patients presented a simultaneous bilateral RD exceeding one hour. We excluded patients with consecutive retinal detachments and retinal detachments deriving from intraocular surgery, trauma, tractive hole formation or heredodegeneration. RESULTS: Seven out of 11 patients with simultaneous bilateral retinal detachment were under 35 years of age. All of these presented multiple round holes (3-19). Horse-shoe tears were causative in 6 eyes; these patients all were over 50 years of age. There was a preponderance of males (73%) in our study. Nine patients were myopic with diopters ranging from -0.5 to -11.25. Retinal reattachment by a single intervention was achieved in 21 eyes, whereas 3 eyes had to undergo a second operation for a redetachment. CONCLUSION: Simultaneous bilateral RD, the most severe type of a retinal resp. vitreoretinal degenerative process, occurs predominantly in patients under the age of 35 with multiple bilateral round holes. We therefore conclude that multiple round holes in this group of patients are not to be regarded as a benign form of degeneration.

Adolescent↗
PubMed1995

Panophthalmitis with acute scleral necrosis after brachytherapy of a malignant melanoma of the ciliary body.

A 52-year-old man who presented with a large ciliochoroidal malignant melanoma was treated by application of a 106Ru plaque. At 8 days after removal of the plaque, severe panophthalmitis with rapidly progressive scleral necrosis at the site of the tumor made enucleation inevitable because of impending perforation of the globe. Microscopic examination revealed an intense inflammatory response and almost complete necrosis of the tumor and overlying sclera. Possible mechanisms for the occurrence of this rare complication are discussed.

Acute Disease↗
PubMed1988

Endogenous sugar-binding proteins in human breast tissue and benign and malignant breast lesions.

Binding of carbohydrate moieties was detected in tissue sections of human breast by employing two types of labeled ligands: neoglycoproteins (chemically glycosylated, histochemically inert carrier protein) and desialylated naturally occurring glycoproteins. Paraffin-embedded, formalin-fixed sections from 40 benign and malignant breast lesions were examined for the presence and distribution of endogenous sugar receptors, employing a panel of 13 biotinylated neoglycoproteins, representing carbohydrates commonly found in naturally occurring glycoconjugates, and four biotinylated glycoproteins. Benign and malignant breast lesions revealed staining with mannosylated carrier neoglycoprotein in comparison to normal breast. A mixed pattern of staining localization and intensity was seen for different types of malignancy with this neoglycoprotein. Similarly, receptors for lactose and N-acetylglucosamine could only be detected within the cytoplasm for certain types of malignancy. Their nuclear localization, however, could also be seen in normal breast specimens. The extent of staining with different glycoproteins, containing different types of galactoside-terminal sugar chains, also appeared to differ between various types of breast cancer. The detection of endogenous sugar receptors by neoglycoproteins is proposed to contribute to an understanding of malignancy-associated alterations in the structure of their potential physiological ligands, the glycoconjugates. Changes in the structure and abundance of such glycoconjugates have commonly been detected with the use of plant lectins in histopathologic studies.

Breast Neoplasms↗