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Biomedical subjects

S F Byrne

Publications and source records attributed to S F Byrne.

At least 19 recordsLinked to original sources
PubMed2000

Echographic features of medulloepithelioma.

PURPOSE: To evaluate the echographic features of medulloepithelioma that may assist in establishing the diagnosis. METHODS: Retrospective review identified four eyes with medulloepithelioma studied with echography. Clinical records, echographic findings, histopathologic tumor features, and the clinical course were reviewed. RESULTS: The initial preoperative diagnosis of medulloepithelioma was uncertain, based on clinical findings alone in three cases but was accurate when echographic findings were combined with clinical findings in all four cases. Cysts posterior to the iris were detected on clinical examination in only two cases, but were revealed on echography in all four cases. Additional echographic findings included irregular high internal reflectivity (n = 4), irregular tumor surface (n = 3), molding around intraocular structures (n = 3), and internal vascularity (n = 2). CONCLUSIONS: The diagnosis of medulloepithelioma is not always apparent on clinical examination alone. Echographic findings of a highly reflective, irregularly structured tumor with associated cystic changes involving the ciliary body region may help establish a presumed diagnosis of medulloepithelioma.

Anterior Eye Segment↗
PubMed2000

B-scan ultrasonographic findings in the stages of idiopathic macular hole.

PURPOSE: To prospectively evaluate the relationship between the posterior hyaloid membrane (PHM) and the retina in eyes with idiopathic macular hole. METHODS: Ninety-four eyes of 94 consecutive patients with macular hole underwent complete ophthalmologic examination, contact lens biomicroscopy, and B-scan ultrasonography and/or vitreoretinal surgery. RESULTS: In 93 of 94 patients (99%), the relationship between the PHM and posterior retina could be visualized during echographic examinations or at surgery. Among these 93 patients, the PHM was detectable biomicroscopically in 36 (39%). Persistent PHM attachment to the foveola with partial separation of the PHM from the perifoveal retina was evident with ultrasonography in 5 of 6 patients (83%) with stage 1 hole and in 12 of 18 patients (67%) with stage 2 hole. When axial views were included, separation of the PHM from the perifoveal retina was evident in 13 of 13 patients (100%) with stage 1 and stage 2 hole. Separation of the PHM from the fovea and perifoveal retina with attachment to the peripapillary retina was evident with ultrasonography in 65 of 65 patients (100%) with stage 3 macular hole and pseudo-operculum and was evident biomicroscopically in 22 of the 65 patients (34%) in this group. CONCLUSIONS: These findings suggest that high-resolution axial and paraxial ultrasonographic examination directly on the surface of the eye is more sensitive in detecting separation of the PHM from the retina than biomicroscopy in idiopathic macular holes. The perifoveal detachment of the PHM may be involved in the pathogenesis of macular holes.

Adult↗
PubMed1996

Echographic findings in benign reactive lymphoid hyperplasia of the choroid.

BACKGROUND: Benign reactive lymphoid hyperplasia is an uncommon uveal tumor. Misdiagnosis may lead to unnecessary enucleations. Clinical evaluation alone is usually not sufficient to diagnose this tumor. OBJECTIVE: To evaluate the utility of standardized echography in the recognition of this disease. METHODS: Retrospective review of the medical and echographic records of 6 patients with choroidal involvement of benign reactive lymphoid hyperplasia. RESULTS: Extraocular episcleral lymphoid nodules were present in 5 of the 6 patients and were usually seen as a late manifestation of the disease. Two patients had repeated echography after treatment of the tumor and showed marked regression of the episcleral nodules. CONCLUSIONS: A combination of clinical and echographic findings can assist in the accurate diagnosis of this rare uveal tumor. The presence of episcleral nodules on standardized echography supports the diagnosis.

Aged↗
PubMed1996

Echographic evaluation and findings in metastatic melanoma to extraocular muscles.

PURPOSE: Metastatic melanoma to the extraocular muscles is an extremely rare condition characterized by marked enlargement of the involved muscles. The authors describe the echographic characteristics of metastatic melanoma to extraocular muscles. METHODS: The authors used standardized echography (standardized A-scan and contact B-scan) to examine two patients known to have malignant melanoma elsewhere with metastatic melanoma to the extraocular muscles. Both patients had orbital lesions with similar echographic characteristics. RESULTS: Echographically, metastatic melanoma to an extraocular muscle spares the tendon and produces marked thickening of the muscle belly fibers. Other echographic findings include low internal reflectivity, regular internal structure, and vascularity (similar to uveal melanoma). These previously unreported echographic features may be unique to metastatic melanoma to an extraocular muscle. CONCLUSION: Echography can be a useful adjunct in detecting and diagnosing suspected metastatic melanoma to the extraocular muscles in patients with clinical signs of an orbital mass and known melanoma elsewhere or in the absence of a known primary lesion.

Adult↗
PubMed1996

Intraoperative echographic localization of iodine 125 episcleral radioactive plaques for posterior uveal melanoma.

PURPOSE: Plaque radiotherapy has been reported to have a higher relapse rate than charged-particle radiotherapy for posteriorly located uveal melanomas, which also are more technically difficult to localize accurately. The authors used intraoperative echography in patients with posterior uveal melanoma to determine the rate of inaccurate localization of iodine 125(125I) episcleral plaques using standard localization techniques. METHODS: The authors reviewed the records of 29 consecutive patients with medium-sized posterior uveal melanomas who underwent 125I episcleral plaque radiotherapy with intraoperative echographic verification of plaque placement. RESULTS: After careful plaque placement using standard localization techniques, 4 of 29 plaques (14%) did not cover at least one tumor margin. All four of these plaques were associated with posterior tumors with at least one margin posterior to the temporal arcades. Two (7%) additional juxtapapillary plaques were displaced away from the sclera by the optic nerve. In all six cases, it was possible to immediately reposition the plaque to achieve coverage of all tumor margins. CONCLUSIONS: Placement of 125I episcleral radioactive plaques for posteriorly located uveal melanomas using standard localization techniques occasionally results in suboptimal plaque positioning. Intraoperative echography can identify plaques that are localized poorly and allows immediate adjustment to achieve optimal plaque positioning.

Brachytherapy↗
PubMed1996

Venous stasis orbitopathy: a clinical and echographic study.

AIMS: A variety of acute and chronic orbitopathies may be distinguished by standardised echography. Venous stasis orbitopathy (VSO) often presents with orbital signs when secondary to cavernous sinus and middle cranial fossa disorders. In this study, the aim was to assess whether differentiation between vascular and nonvascular causes of VSO could be made on the basis of clinical and echographic features at the time of presentation. METHODS: This study comprised 37 patients with echographic features of VSO (17 patients with arteriovenous fistulae, confirmed by computed tomography imaging or angiography, and 20 patients with non-vascular diseases). Excluded were patients with orbital mass lesions detected by echography and muscle enlargement due to other causes (for example, orbital myositis). Patients with a suspected mass involving the orbital apex and echographic features of VSO were included. After full neuro-ophthalmic and ocular examination, both orbits were examined to document maximal thickness and reflectivity of four recti muscles and compared with the normal contralateral orbit with standardised A-scan (Kretz-technik 7200MA or Ophthascan) and contact B-scan (Ultrascan or Ophthascan S). RESULTS: Cumulative ocular recti muscle thickness was significantly greater in patients with arteriovenous fistulae compared with the non-fistula group (23.3 (SD 3.7) and 17.8 (2) mm, p = 0.001). Clinically, the presence of a bruit and a uniocular rise in intraocular pressure were significantly greater in the fistula group of patients. CONCLUSIONS: Standardised echography is a safe and non-invasive method of diagnosing VSO in patients presenting with signs of proptosis, ophthalmoplegia, and inflammation of the conjunctiva. Furthermore, using these standard techniques the two major causes of VSO (arteriovenous fistulae and compressive mass lesions) could be differentiated.

Aged↗
PubMed1994

Clinical and echographic findings in idiopathic orbital myositis.

We performed a retrospective chart review of 100 patients with idiopathic orbital myositis, who were of ages 9 to 84 years. Data from 75 patients gave the following results. Females were affected more than twice as often as males. Fifty-one patients (68%) had single muscle involvement, with the lateral and medial recti affected most frequently (38 cases [33%] and 33 cases [29%] of muscles, respectively). In 34 patients (45%), affected muscles functioned normally; the remaining 55% (63 muscles) were fairly equally distributed between paretic (20%), restrictive (20%), or combined paretic and restrictive (15%) myopathies. Analysis of muscle function, echographic findings, and duration of symptoms indicates that within days of onset of symptoms, the affected muscle is initially enlarged but retains normal function. Within the first two weeks, continued enlargement results in muscle paresis. The muscle may then enter a partially or completely restrictive phase, which may become permanent. Fifty-one patients (68%) responded well to systemic corticosteroids, although 11 patients (15%) had further recurrences of the disease. Seven patients (9%) later developed thyroid eye disease after initially having unimuscular orbital myositis. We advocate early institution of corticosteroids in order to avoid permanent restrictive myopathies.

Adolescent↗
PubMed1994

Follow-up and ultrasonographic examination of patients with macular pseudo-operculum.

Twenty-nine patients (30 eyes) with pseudo-opercula were followed up for six to 65 months (mean, 24 months). Visual acuity was 20/30 or better in all but one eye that was amblyopic. Only one eye developed a decrease in visual acuity and changes interpreted as a stage 1 (foveal detachment induced by tangential traction of the cortical vitreous) impending hole. After vitrectomy visual acuity returned to 20/20. Ultrasonographic examination confirmed the presence of pseudo-opercula in all 22 eyes examined. We concluded that the a pseudo-operculum is a favorable prognostic sign and that its presence is demonstrable ultrasonographically.

Adult↗
PubMed1994

Diagnostic ultrasound and pars plana vitrectomy in penetrating ocular trauma.

PURPOSE: The purpose of this study is to evaluate the accuracy of diagnostic ultrasonography in the preoperative evaluation of eyes with media opacity after penetrating ocular trauma and correlate the preoperative findings with ultimate visual outcome. METHODS: A retrospective comparison was made between the preoperative ultrasound diagnoses and the intraoperative findings in 46 eyes of 45 patients undergoing pars plana vitrectomy after penetrating ocular trauma associated with dense media opacities. The preoperative echographic findings were correlated with long-term visual and anatomic outcome. RESULTS: Preoperative echography was both sensitive and specific in evaluating traumatized eyes for retinal detachment, intraocular foreign bodies, posterior scleral wounds, and hemorrhagic choroidal detachments. The overall anatomic success rate was 87% (40/46) with 48% (22/46) of eyes obtaining visual acuity of 20/200 or better after surgery. The visual prognosis was worse in those eyes in which preoperative echography detected retinal detachment, subretinal blood, massive choroidals, or posterior exit wounds. CONCLUSION: Diagnostic echography is accurate and provides useful prognostic information in eyes with media opacity after penetrating ocular trauma.

Choroid Hemorrhage↗
PubMed1994

Macular hole syndromes. Echographic findings with clinical correlation.

BACKGROUND: Anatomic characteristics of macular holes may be difficult to define, even with contact lens biomicroscopy. With the advent of successful macular hole surgical techniques, accurate diagnosis has become increasingly important to avoid unnecessary or incorrect surgery. Echography may provide additional diagnostic information in some cases. The purpose of this study is to correlate echographic and intraoperative clinical features of macular holes. METHODS: The echographic features and intraoperative findings in 25 patients were compared. The spectrum of identifiable echographic features included (1) a thin, smooth, membrane-like surface minimally elevated over the macula (limited posterior vitreous face separation); (2) macular thickening; (3) an operculum; and (4) a complete posterior vitreous face separation. Intraoperative clinical findings included the presence or absence of (1) a thin, limited posterior vitreous face separation, (2) a subretinal fluid cuff, (3) an operculum, and (4) a complete posterior vitreous face separation. RESULTS: Echographic and intraoperative findings correlated regarding the limited posterior face separation in 23 of 25 patients, a surrounding subretinal fluid cuff (macular thickening) in 24 of 25 patients, an operculum in 19 of 25 patients, and complete posterior vitreous face separation in 24 of 25 patients. Thus, echography was very effective in detecting the position of the posterior vitreous face. Overall, echography correlated accurately with 90 (90%) of 100 of these four features. CONCLUSION: Echographic features correlate accurately with clinical features.

Fundus Oculi↗
PubMed1993

Choroidal neovascularization associated with choroidal nevi.

OBJECTIVE: We undertook a retrospective study of all choroidal nevi with overlying neovascularization seen at Bascom Palmer Eye Institute, Miami, Fla, to determine long-term effects on vision and whether the presence of neovascularization represented increased malignant potential of the lesion. DESIGN: A computer search of patients with a coded diagnosis of both a choroidal nevus and choroidal neovascularization was performed. Cases in which the neovascularization was directly overlying the nevus were used for the study. RESULTS: The records of 23 patients followed up for a mean of 6.5 years were reviewed for visual acuity, effect of treatment, and change in the size of the choroidal lesion. Fifteen of the 23 patients had a final visual acuity in the affected eye of 20/200 or better. Five of six patients treated with laser had visual improvement of 2 or more lines. Only one of these lesions showed any growth, and this was after 17 years of no growth. CONCLUSIONS: Choroidal neovascularization associated with choroidal nevi can have profound effects on vision. Laser treatment, when indicated, is effective and may be safely performed. The clinical course of these lesions, to date, does not indicate any clinically significant malignant transformation.

Adult↗
PubMed1993

Suprachoroidal hemorrhage. Clinical features and results of secondary surgical management.

PURPOSE: The purposes of this study are to identify clinical features in eyes with suprachoroidal hemorrhage which portend a poor visual prognosis and to determine visual outcome in these eyes after secondary surgical management of suprachoroidal hemorrhage. METHODS: This was a retrospective study of 106 patients with suprachoroidal hemorrhages occurring in association with trauma (35), cataract surgery (30), glaucoma surgery (17), penetrating keratoplasty (6), corneal perforation (5), secondary lens implantation (3), pars plana vitrectomy (3), and other causes (7). RESULTS: Five (10%) of 49 eyes with a suprachoroidal hemorrhage and an initial retinal detachment had a visual outcome of 20/200 or better compared with 21 (43%) of 49 eyes without a retinal detachment. The presence or absence or a retinal detachment could not be determined in eight patients and all eight of these patients had a poor visual outcome. Sixteen (20%) of 82 eyes with a 360 degrees suprachoroidal hemorrhage had a visual outcome of 20/200 or better compared with 10 (47%) of 21 for those with suprachoroidal hemorrhage limited to one or two quadrants. The extent of the hemorrhage could not be determined in three eyes. Overall, 34% (14/41) of the patients with suprachoroidal hemorrhage who had a secondary surgical procedure achieved a visual outcome of 20/200 or better. Forty-three percent (6/14) who had a suprachoroidal hemorrhage during or after cataract surgery and who were treated with secondary surgical management achieved a visual outcome of 20/200 or greater. CONCLUSION: Clinical features associated with a poorer visual outcome included initial or indeterminate retinal detachment and 360 degrees suprachoroidal hemorrhage. Limited suprachoroidal hemorrhage without initial retinal detachment usually has a good visual prognosis and does not usually require secondary surgical intervention. However, if the former complication is present, secondary surgical intervention should be considered.

Choroid Hemorrhage↗
PubMed1992

Optic neuropathy in Hodgkin's disease.

Hodgkin's disease is a rare cause of infiltrative optic neuropathy, which typically evolves late in the disease course. We managed an unusual case of isolated optic neuropathy in a 21-year-old man occurring during clinical remission from Hodgkin's disease. Radiotherapy and treatment with high-dose systemic corticosteroids resulted in dramatic improvement in vision. Even without other evidence of recurrent disease, acute-onset optic neuropathy in a patient with a history of a lymphoproliferative disorder should raise the question of a reemergence of the malignancy.

Adult↗
PubMed1992

Echographic evaluation of retinal tears in patients with spontaneous vitreous hemorrhage.

We studied the ability of standardized echography to correctly diagnose a retinal tear in patients with opaque ocular media due to vitreous hemorrhage. Records were studied of 42 patients with spontaneous vitreous hemorrhage and no ophthalmoscopic view of fundus details. Of these 42 patients, 11 had an echographic diagnosis of probable retinal tear and no retinal detachment. In 10 (91%) of 11 cases, the presence and location of the tears that were diagnosed echographically were confirmed on clinical follow-up. In one patient, an area of peripheral neovascularization was mistaken for a tear. Echography failed to identify one retinal tear that was later detected on clinical examination. Therefore, we have found standardized echography to be a reliable tool in identifying retinal breaks.

Aged↗
PubMed1992

Neuroimaging of the optic nerve after fenestration for management of pseudotumor cerebri.

The mechanisms by which optic nerve-sheath fenestration is effective remain speculative. Possibilities include surgical production of a cerebrospinal fluid filtration outlet or scarring in the subarachnoid space around the nerve in the vicinity of the fenestration site, with shifting of the pressure gradient from the nerve head to the retrobulbar portion. Two patients who underwent successful optic nerve-sheath fenestration developed a cystlike structure contiguous to the fenestration site, apparently in direct communication with the optic nerve sheaths. This was shown on magnetic resonance imaging (one patient) and orbital echography (both patients). These previously unreported observations may support the hypothesis that fenestration works by creating a filtration apparatus that controls the intravaginal pressure in the subarachnoid space surrounding the orbital segment of the optic nerve.

Adult↗
PubMed1991

Diameter of normal extraocular recti muscles with echography.

To establish the range of diameters of normal extraocular muscles, we used standardized A-scan echography to measure the superior recti/levator complex, medial, lateral, and inferior recti muscles in 38 subjects with healthy orbital tissues. The relationships of age, gender, height, and weight to axial length of the globe were considered. These factors and extraocular muscle diameters were not consistently associated. Our normative data were compared with previously reported studies of extraocular muscle diameter performed with standardized A-scan and contact B-scan echography and computed tomographic scanning.

Adult↗