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Stuart L Fine

Publications and source records attributed to Stuart L Fine.

9 recordsLinked to original sources
PubMed2005

Age-related macular degeneration 1969-2004: a 35-year personal perspective.

PURPOSE: To provide a personal perspective concerning diagnosis, treatment, and evaluation of treatment for early and late stages of age-related macular degeneration (AMD) over a 35 year period, 1969-2004. DESIGN: Literature review, personal recollections, and conversations with investigators who participated in trials to evaluate treatments for AMD. METHODS: The author reviewed the literature pertaining to evaluation and treatment of patients with AMD and conversed with investigators who, over the past 35 years, designed, conducted and participated in trials to assess new and existing treatments for AMD. RESULTS: In 1969, patients with AMD constituted a small part of a typical ophthalmic practice. From 1969 to 2004, the prevalence of AMD has increased, and the methods of evaluation and treatment have changed dramatically. The emergence of fluorescein angiography and the development of laser photocoagulation and photodynamic therapy have substantially altered clinical practice. Several promising pharmacologic interventions are now being assessed in clinical trials. Nevertheless, AMD remains the leading cause of severe and irreversible vision loss in the United States because there are no highly effective treatments available for most patients. CONCLUSIONS: Because of an aging population and the lack of highly effective treatments, late AMD remains a major unsolved problem. However, there is extensive research being conducted with support from the National Eye Institute and from industry. There is also great interest in prevention trials. Accordingly, the author is optimistic that over the next 35 years there will be significant improvements in our ability to prevent severe vision loss from late AMD.

Animals↗
PubMed2005

Laser prophylaxis for age-related macular degeneration.

BACKGROUND: Age-related macular degeneration (AMD) is the most common cause of severe and irreversible vision loss among people 50 years of age or older in many Western countries. Most of the available treatments for AMD are intended for the late stage, specifically for choroidal neovascularization (CNV). Effective preventive treatments could have an even greater impact on the vision of the millions of people at risk for vision loss from AMD. Drusen are typically the earliest lesions seen in patients with AMD and precede the development of CNV. In 1973, Gass noted the disappearance of drusen in eyes that received laser photocoagulation, which led to the hypothesis that laser-induced drusen reduction could alter the natural course of AMD. METHODS: We reviewed relevant articles found through a search of MEDLINE through February 2005 by means of the following key words, alone or in combination: drusen, laser, photocoagulation, age-related macular degeneration, macula and choroidal neovascularization. RESULTS: Reports ranging from individual cases and case series to randomized controlled pilot studies have described various laser treatment protocols and their effects on eyes with high-risk drusen but no neovascular changes. These reports provide evidence that laser photocoagulation can induce drusen reduction. Although some investigators have reported a corresponding improvement in visual function, others have found no change or even worsening. The results in several of the larger randomized controlled studies suggest that CNV may occur at an increased rate in laser-treated eyes with high-risk drusen in patients who have neovascular AMD in the other eye. The long-term effects of laser treatment in patients with high-risk drusen in both eyes and no neovascular changes have yet to be determined. INTERPRETATION: The outcome of clinical trials such as the Prophylactic Treatment of Age-Related Macular Degeneration and the Complications of Age-Related Macular Degeneration Prevention Trial will help to determine the role of laser prophylaxis in patients with AMD.

Blindness↗
PubMed2005

Pegaptanib sodium.

Explore the source record for details and available documents.

Aptamers, Nucleotide↗
PubMed2003

Incidence of exudative age-related macular degeneration among elderly Americans.

PURPOSE: To estimate the 3-year incidence of exudative age-related macular degeneration (AMD) and its treatment by laser photocoagulation in elderly Americans. DESIGN: Population-based cohort study using insurance claims data. PARTICIPANTS: A random 5% sample of Medicare beneficiaries, age 65 and older. METHODS: Incidence of exudative AMD and of laser photocoagulation for this condition was assessed based on four categories of ascertainment criteria that included procedure and diagnosis codes associated with exudative AMD, choroidal neovascularization, and its treatment. MAIN OUTCOME MEASURES: Incidence of AMD and of associated laser photocoagulation. RESULTS: Overall, the 3-year incidence of exudative AMD is estimated to be between 9.4 per 1000 and 11.4 per 1000 Americans age 65 and older (depending on ascertainment criteria), based on those diagnosed and treated by ophthalmologists for the condition. These estimates bracket the measured incidence of exudative AMD in the Beaver Dam Eye Study and lie within its 95% confidence interval. The 3-year incidence of exudative AMD with attendant laser photocoagulation was 2.3 per 1000. Women were found to have a slightly higher incidence of AMD than men using all ascertainment criteria (P < 0.001), and white Americans were found to have a fivefold-to-sixfold higher ascertainment criteria than black Americans (P < 0.001). CONCLUSIONS: The reported incidence of exudative AMD identified in the population of Medicare beneficiaries suggests that measurements on incidence for this condition derived from the Beaver Dam Eye Study can be generalized to the U.S. population.

Age Distribution↗
PubMed2002

Primary adrenal lymphoma with choroidal metastases.

PURPOSE: To describe a 71-year-old man with bilateral primary adrenal lymphoma with metastases to the choroid. DESIGN: Interventional case report. METHODS: A 71-year-old man presented with decreased visual acuity in his left eye secondary to an exudative retinal detachment. Abdominal computed tomography and percutaneous biopsy revealed non-Hodgkin large-cell lymphoma involving both adrenal glands. RESULTS: Ocular and adrenal lesions resolved after six cycles of chemotherapy with cytoxan, adriamycin, vincristine, and prednisone. Seven years after his initial diagnosis, the patient reported no recurrence of either ocular or systemic lymphoma. CONCLUSIONS: To our knowledge, this is the first case report of bilateral primary adrenal lymphoma with apparent metastases exclusively to the eye.

Adrenal Gland Neoplasms↗