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Biomedical subjects

T M Aaberg

Publications and source records attributed to T M Aaberg.

At least 73 records · Page 4Linked to original sources
PubMed1989

Subretinal membranes in proliferative vitreoretinopathy.

Subretinal membranes (SRMs) are an important but rarely identified component of proliferative vitreoretinopathy (PRV). In 153 consecutive cases that had vitreoretinal surgery for this condition and were followed for at least 6 months, SRMs were encountered in 72 eyes (47%). In 20 (28%) of the 72 eyes, the SRMs prevented complete retinal reattachment and needed to be removed or excised through one or multiple retinotomies. Intraoperative complications related to the SRMs or their removal included choroidal or retinal hemorrhage in three eyes (15%), subretinal air in three eyes (15%), and unplanned extension of the retinotomies in two eyes (10%). The 20 eyes requiring SRMs removal were followed for a median of 11 months. Retinas were reattached in 13 eyes (65%), although only 4 eyes (20%) had a visual acuity of 5/200 or better. Recognizing SRMs as a component of PVR is important in helping to maximize the anatomic success rate although the effects on visual function are not fully known.

Adult↗
PubMed1989

Results of vitrectomy for diabetic traction retinal detachments using the en bloc excision technique.

En bloc excision is a technique in which fibrovascular diabetic membranes and the posterior hyaloid are separated from the retina as a single unit. In a consecutive series of 69 eyes with diabetic traction retinal detachment treated with this technique, initial retinal reattachment was accomplished in 100% (69/69) of the eyes. With a minimum of 6 months' follow-up, the retina remained completely attached in 83% (57/69) of eyes, while the macula was attached in 88% (61/69) of eyes. Final visual acuity was 5/200 or better in 71% (49/69) of eyes. While current surgical techniques allow a high rate of anatomic success in the repair of diabetic traction retinal detachment, visual results remain limited by irreversible alterations in retinal function.

Adolescent↗
PubMed1989

Complications of endodrainage retinotomies created during vitreous surgery for complicated retinal detachment.

The authors report nine cases of endodrainage retinotomy site complications that occurred after vitreous surgery for complicated retinal detachments (RDs). Postoperative subretinal neovascularization developed in four eyes at the retinotomy drainage site. In two eyes, postoperative proliferation at a posteriorly placed endodrainage site created traction macular detachments. Redetachment due to retinotomy opening caused by postoperative drainage site proliferation developed in three eyes. The retinas of all nine eyes were eventually reattached, and vision improved from the preoperative level. These complications are related to retinal pigment epithelium and/or Bruch's membrane damage during internal subretinal fluid drainage and retinotomy endolaser photocoagulation. Careful evaluation of extrusion instruments, drainage techniques, retinotomy placement, and subsequent endolaser treatment is necessary to minimize these complications.

Adolescent↗
PubMed1988

Management of anterior and posterior proliferative vitreoretinopathy. XLV. Edward Jackson memorial lecture.

Proliferative vitreoretinopathy is a composite of anterior and posterior proliferation producing multidirectional tractional forces and resultant complex management problems. In a series of 98 consecutive cases of nondiabetic, nontraumatic proliferative vitreoretinopathy, anterior proliferation caused retinal detachment in 58 patients. Relaxation of circumferential traction created by anterior proliferation in the vitreous base and its contiguous surfaces is achieved by multiple radial incisions in the vitreous base and associated anterior retina is eliminated by incision of the displaced anterior and posterior hyaloid surfaces. The subsequent release of posterior traction and determination of residual traction by sequential fluid-air exchange before final tamponade with longer acting gas or silicone oil is described. Total retinal reattachment was achieved in 23 of 33 eyes (70%) with only posterior proliferation compared to 27 of 47 eyes (57%) with significant anterior proliferation. Retinal attachment posterior to the scleral buckle was achieved in 27 of 33 eyes (82%) and 37 of 47 eyes (79%), respectively. Although the success rate was less in eyes with anterior proliferation, the retinal reattachment rates in the two groups approached comparability as experience and understanding of the clinical significance increased.

Eye Diseases↗
PubMed1988

Cryopexy of the vitreous base in the management of peripheral uveitis.

We reviewed 27 consecutive eyes with peripheral uveitis and vitreous base neovascularization that had been treated with cryopexy and followed up for a median of 4.5 years. During the follow-up period, 21 eyes (78%) remained quiescent, whereas five eyes (18%) demonstrated intermittent inflammation, although only one of these eyes progressed to a traction retinal detachment. One eye (4%) eventually atrophied; however, this was believed to be a result of the ongoing uveitis rather than the cryopexy. The treated eyes had an average improvement of three lines in Snellen visual acuity. We found that corticosteroid therapy remains the primary treatment modality for active inflammation, and vitreous base cryopexy should be reserved for those cases which are resistant to corticosteroids, and which demonstrate active neovascularization.

Adolescent↗
PubMed1988

Anterior proliferative vitreoretinopathy.

During a four-year period, 53 of 92 eyes (58%) undergoing vitreoretinal surgery for a retinal detachment with proliferative vitreoretinopathy demonstrated anterior proliferative vitreoretinopathy. We classified anterior proliferative vitreoretinopathy according to tractional direction, location, extent, and severity. Initially, the eyes were treated with a high scleral buckle and laser endophotocoagulation as an adjunct to vitrectomy. Treatment then evolved into a direct approach in which the anterior proliferative tissue was surgically cut or excised. Of the 42 eyes followed up for at least six months, 25 (59%) were totally reattached and 18 (43%) had a visual acuity of 5/200 or better.

Adult↗
PubMed1988

Latent disseminated blastomycosis with choroidal involvement.

A 36-year-old man developed blurred vision and a cough five months after traveling to an area from where a large outbreak of acute blastomycosis had been reported. Examination revealed a left choroidal lesion in the macular region, skin lesions on the right calf, and a left lung apical infiltrate. Histopathologic examination of the skin lesion demonstrated a granulomatous inflammation and broad based, budding yeast characteristic of Blastomyces dermatitidis. Amphotericin B therapy produced a rapid resolution of both choroidal and pulmonary lesions. During a six-month follow-up, there was no evidence of recurrence.

Adult↗
PubMed1988

Surgical excision of the attached posterior hyaloid.

When vitrectomy is performed in eyes without posterior vitreous detachment, complete removal of the posterior hyaloid may be important to relieve existing vitreoretinal traction or to remove a surface for subsequent cellular proliferation. We used two alternative techniques of detaching the posterior hyaloid in an unselected consecutive series of ten patients; we used either a tapered extrusion needle or a microvitreoretinal blade to initiate separation of the posterior hyaloid at the optic disc margin. After surgical peeling of the posterior hyaloid from the retina, complete removal of the posterior vitreous and surgical relief of posterior vitreoretinal traction were facilitated.

Dissection↗
PubMed1988

Vitrectomy in the management of peripheral uveitis.

The natural history of peripheral uveitis may eventually lead to indications for vitreous surgery. Over a 7-year period, a consecutive series of 12 eyes in nine patients with peripheral uveitis underwent vitreous surgery. Indications for surgery included persistent dense vitreous inflammation, vitreous hemorrhage, traction retinal detachment (RD), and epiretinal membrane formation. Patients were followed for an average of 22 months. Six eyes (50%) required further surgery after the development of RD, recurrent vitreous hemorrhage, or cataract formation. The preoperative finding most frequently associated with postoperative complications was the presence of active neovascularization of the vitreous base. Final visual acuity ranged from 20/30 to 20/100 showing an average improvement of 5 Snellen lines. Persistent cystoid macular edema significantly limited visual improvement in five patients. Patients undergoing vitreous surgery for management of peripheral uveitis may show a significant degree of visual improvement though multiple operations may be required. Control of active neovascularization is an important factor in limiting postoperative complications and the need for further surgery.

Adolescent↗
PubMed1988

Perisilicone proliferation after vitrectomy for proliferative vitreoretinopathy.

From 1983 to 1986, silicone oil injections were used to treat 31 patients with retinal detachment (RD) and advanced proliferative vitreoretinopathy (PVR). In 19 eyes (61%), perisilicone proliferation (PSP) developed causing recurrent RDs in 15 eyes (49%). At an average of 5 weeks after surgery, PSP occurred and was characterized by extensive transparent preretinal membranes with denser focal areas. Microscopic examination of five preretinal membranes showed droplets of silicone oil and necrotic cells on the silicone side and glial or retinal pigment epithelial cells, or both, on the retinal side, often in layers separated by extracellular matrix. Silicone oil was present in periretinal membranes removed several months after the intraocular silicone had been evacuated indicating that silicone within cells may persist despite the removal of silicone. The use of silicone oil to provide tamponade in eyes with recurrent PVR is associated with a high incidence of periretinal proliferation that frequently leads to recurrent RD and visual failure.

Adolescent↗
PubMed1988

Reticular-like pigmentary patterns in pseudoxanthoma elasticum.

Of 14 consecutive patients with pseudoxanthoma elasticum (PXE), 9 (64%) had a spectrum of peculiar, sometimes reticular, pigmentary changes in the retina. Ten of 18 (56%) eyes had a random scattering of small, round pigment dots throughout the macula and around the optic nerve, sometimes extending to the equator. In four of 18 (22%) eyes, the pigment clumps appeared in lines, resembling a string of pearls. These strings occasionally radiated from the macula in a spoke-like fashion. In 4 of the 18 (22%) eyes, the pigment clumping occurred in a fishnet, or truly reticular, pattern. Of the 18 eyes in these 9 patients, 12 (67%) had subretinal neovascularization. Of the ten eyes in the five patients who did not show this pigmentary change, two (20%) had subretinal neovascularization.

Adult↗
PubMed1988

Canthaxanthine-induced retinal pigment epithelial changes in the cat.

Canthaxanthine retinopathy in humans is a retinal crystalline deposition associated with ingestion of canthaxanthine, an over-the-counter oral tanning agent. In this study cats were fed doses of canthaxanthine varying from 2 mg/kg/day (an equivalent standard human dose) to 16 mg/kg/day for up to six months. Indirect opthalmoscopy showed progressive development of an orange sheen in the retina overlying the tapetum lucidum without evidence of crystal formation. Electroretinograms performed at one and two months showed no significant change from baseline examination. On light and transmission electron microscopic examination, the retinal pigment epithelium of the experimental animals showed an increase in cell height and a regional vacuolization due to an enlargement and disruption of some phagolysosomes and the development of cytoplasmic spaces. These observations suggest that further studies should be conducted on humans who ingest canthaxanthine to assess structural and functional alterations, especially in the pigment epithelium.

Animals↗
PubMed1987

Intrusion of retinal tacks.

We examined nine patients in whom retinal tacks intruded into the eye and lodged in the subretinal space, preretinal space, vitreous cavity, or anterior chamber. Complications included retinal pigment epithelium atrophy; retinal phlebitis; vitreous hemorrhage; focal corneal, iris, and retinal injury; and corneal edema. The intrusion of the retinal tacks did not apparently cause, but was associated with retinal redetachment in five patients. Factors associated with intrusion of the retinal tacks included absence of a barb at the end of the tack to anchor it to the sclera, absence of a groove in the tack, a short shaft, incomplete penetration of the retina, choroid, and sclera by the tack, self-inflicted trauma to the eye, placing a scleral buckle after inserting the tacks, and reproliferation of periretinal membranes. In four patients the intruded tacks did not cause any complications. In four patients the intruded tacks were removed without complications and in the remaining five patients, they were left in the eye.

Adolescent↗