[Vision and road safety].
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Biomedical subjects
Publications and source records attributed to S Tinning.
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It is well known that radiation from welding arcs can cause keratoconjunctivitis and 'glassblower's cataract'. In literature only few cases of welding arc maculopathy have been reported. Three cases are presented.
The effect of different dosages of ganciclovir on proved cytomegalovirus chorioretinitis was tested in a randomized trial on 11 homosexual men with AIDS. The effect of 5 mg/kg/day was as good as 10 mg/kg/day. The lower dosage had less toxicity.
The paper presents a new test method for investigations of threshold curves for the resolving power of the eye and for exact measurements of visual acuity. This method measures static visual acuity within confidence limits of 9% compared to the acuity steps in Snellen notation of 33% to 50%. Furthermore, the method introduces the slope of the threshold curve as a parameter of suggested importance in the judgement of visual capability. The test mathematic is based on a method described by Finney (1952) for calculations on dose-response curves. To calculate the results and the test statistics an iterative curve fitting programme was designed to be run on a micro-computer. By connecting the presentation system and the response panel to the same computer the test could be performed almost automatically. The new test method was used to study visual acuity measured by projected ortotypes compared to acuity when measured by printed ortotypes. Tests using projected ortotypes were found to equal traditional acuity measurements, but the test results stressed the need for perfect and adjusted optics when projecting systems are used in visual acuity test.
In 116 diabetic eyes scheduled for vitreous surgery, the visual evoked potential (VEP) after flash stimulation was recorded prior to surgery. Latencies of the flash evoked potentials show a distribution suggestive of a Gaussian curve with an abnormal extension. Dividing the material into two groups based on a latency shorter or longer than 100 milliseconds revealed a highly significant difference in the visual improvement following surgery between patients with a short and patients with a long latency (P less than 0.001). With a latency longer than 100 millisec. most patients showed no visual change after operation, and among the few who did the change, consisted more often in visual reduction than improvement. Additional investigations in the study reveal that it is likely that the prolonged latency of the flash VEP is due to pathology of the retina or visual pathways.
To determine whether or not the electrophysiological status of the eye can give information as to the result of vitreous surgery, the visual evoked potential to flash stimulation was measured prior to vitreous surgery. Seventy-four eyes were submitted to surgery. Latencies of flash evoked potentials showed a distribution suggestive of a Gaussian curve with an abnormal extension. Dividing the material into 2 groups based on a latency longer or shorter than 100 millisec revealed a highly significant difference in visual improvement after surgery between patients with long latency and patients with short latency (P less than 0.001). With a latency longer than 100 millisec the patient has an almost equal chance of visual improvement or visual reduction by surgery. The frequency of operative complications was twice as high in patients with latency longer than 100 millisec compared to patients with a latency shorter than 100 millisec.
Based on a period of introduction with the vitrectomy technic the visual acuity results in 143 consecutive cases performed between 1976 and 1980 are related to the anamnestic information, the pre-, per- and post-operative findings. In this introductional period the patients referred had longstanding retinovitreal changes, and, because of lack of prognostic parameters, all patients were offered surgery regardless of the observed pathology. All vitrectomies were carried out with the Klöti macrostripper and diathermy unit, without any additional instrumentation. From the results of these early cases, we have changed our surgical method to a three-port entrance with a separate infusion canula, a separate fiberoptic illumination and an interchange between vitrector, automatic scissors, hook, stilleto, vacuo needle, forceps and intravitreous photocoagulation through a third port. Diabetics should be offered vitrectomy if vitreous haemorrhages last for more than 3 months. Vitrectomy is considered useless or contraindicated in diabetics with lack of light perception or light projection, neovascular glaucoma, extinguished visual evoked potential. Only an improvement in the peripheral vision can be expected in diabetics with macular detachment. In rhegmatogenous detachment cases with intravitreal traction, vitreous operations should be performed only where intraretinal or retroretinal changes do not prevent mobilization or unfolding of the retina. Traumatic vitreoretinal disorders should be operated upon early.
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A case of primary acquired melanosis of the conjunctiva is reported. During the 18 years of observation the patient developed a malignant melanoma in the iris, and seven years later a malignant melanoma appeared in the lower lid. The iris melanoma may be an extension from the precancerous melanosis, but the most likely explanation is that the condition represents two independent diseases.
A translocation of a part of the long arm of a chromosome No. 1 onto the long arm of a chromosome No. 6 was observed in a 2 1/2-year-old boy with mental retardation, harelip, cleft palate and congenital glaucoma. Different banding methods revealed that the translocation t(1;6)(q23;q27) apparently was balanced. The conncection between the patients' symptoms and the chromosomal rearrangement might be fortuitous or produced by the chromosome aberration.
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