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S Waltman

Publications and source records attributed to S Waltman.

9 recordsLinked to original sources

The natural history of retinopathy in insulin-dependent juvenile-onset diabetes.

We determined the cross-sectional natural history of retinopathy by prospective study of 461 insulin-dependent juvenile-onset diabetics. In so doing, we compared the sensitivity of ophthalmoscopy, photography, and fluorescein angiography in detecting retinopathy. Photography was far more reliable than ophthalmoscopy in detecting early retinopathy and equivalent to angiography. Retinopathy was not present at diagnosis of diabetes. After a lag period, the prevalence of retinopathy rose in sigmoidal fashion, reaching 50% at just over seven years duration, and asymptotically approaching 90% at 17--50 years. Proliferative retinopathy was first seen at 13 years duration, and its prevalence rose to 26% at 26--50 years. From the natural history we computed the dimensions of a proposed clinical trial to test the effect of tight metabolic control in prevention of retinopathy.

Diabetes Mellitus, Type 1↗

Alteration of the blood-retinal barrier in experimental diabetes mellitus.

Vitreous fluorophotometry was used to evaluate the integrity of the blood-retinal barrier to fluorescein in hooded rats. Streptozotocin-induced diabetes mellitus caused a breakdown of this barrier within ten days. Normalization of blood glucose levels with insulin significantly reduced (P less than .005) the increased permeability. This functional microangiopathy might prove to be the earliest detectable change in the retinal circulation in experimental diabetes.

Animals↗

Transplant size and elevated intraocular pressure. Postkeratoplasty.

Elevated intraocular pressure after keratoplasty is a well-recognized phenomenon both in aphakia and in combined lens extraction and penetrating keratoplasty. Ninety-two consecutive cases of penetrating keratoplasty procedures were studied. These were randomly assigned to group A or B. Group A received a donor transplant 0.5 mm larger than the recipient bed. Group B received donor buttons equal in size to the recipient bed. Intraocular pressure was measured preoperatively and daily until the patients were discharged. Group A, which had aphakic penetrating keratoplasty or the combined procedure (0.5-mm larger button), also had significantly lower intraocular pressures (P less than .001) than group B (same size button). There was no difference in postoperative intraocular pressure between groups A and B for those who had phakic penetrating keratoplasties. A larger donor size can alleviate induced "aphakic keratoplasty glaucoma."

Aged↗

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Malaria (1969).

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Adult↗