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Biomedical subjects

W Tasman

Publications and source records attributed to W Tasman.

At least 19 recordsLinked to original sources

Diode laser photocoagulation for retinopathy of prematurity. Preliminary results.

In a prospective, randomized clinical trial comparing transscleral cryotherapy with laser photocoagulation in the treatment of "threshold" stage 3+ retinopathy of prematurity, 32 infants were treated with diode laser photocoagulation in one eye. Twenty-eight infants have been followed up for at least 3 months, and seven have been followed up for at least 1 year. Twenty-five of 28 eyes treated with diode laser photocoagulation and followed up for at least 3 months have undergone regression. Of 24 fellow eyes treated with cryotherapy and followed up for at least 3 months, 20 have undergone regression. All seven eyes treated with diode laser photocoagulation and followed up for at least 1 year have undergone regression. Of seven fellow eyes treated with cryotherapy and followed up for at least 1 year, all have undergone regression. Our results suggest that diode laser photocoagulation is as effective as cryotherapy in the treatment of retinopathy of prematurity.

Cryosurgery

Pseudophakic retinal detachments. Anatomic and visual results.

Retinal reattachment rates and visual results were analyzed in 227 consecutive primary pseudophakic rhegmatogenous retinal detachments. The overall anatomic reattachment rate was 90%, with no significant difference between the anterior chamber (AC) and posterior chamber intraocular lens groups. Visual results were significantly worse in the AC lens group (P less than 0.05). Negative prognostic indicators for reattachment included age greater than 65 years, poorer preoperative vision, larger extent of the retinal detachment, inability to identify a retinal break, longer duration of symptoms before presentation, and grades C or D proliferative vitreoretinopathy (P less than 0.05). In addition to the above factors, eyes with AC reaction, AC lenses, and macular detachment had a poorer visual prognosis.

Adult

Stop codon in the procollagen II gene (COL2A1) in a family with the Stickler syndrome (arthro-ophthalmopathy).

Linkage analysis with restriction fragment length polymorphisms for the gene for type II procollagen (COL2A1) was carried out in a family with the Stickler syndrome, or arthro-ophthalmopathy, an autosomal dominant disorder that affects the eyes, ears, joints, and skeleton. The analysis demonstrated linkage of the disease and COL2A1 with a logarithm-of-odds score of 1.51 at zero recombination. A newly developed procedure for preparing cosmid clones was employed to isolate the allele for type II procollagen that was linked to the disease. Analysis of over 7000 nucleotides of the gene revealed a single base mutation that altered a CG dinucleotide and converted the codon CGA for arginine at amino acid position alpha 1-732 to TGA, a stop codon. From previous work on procollagen biosynthesis, it is apparent that the truncated polypeptide synthesized from an allele with a stop codon at alpha 1-732 cannot participate in the assembly of type II procollagen, and therefore that the mutation would decrease synthesis of type II procollagen. It was not apparent, however, why the mutation produced marked changes in the eye, which contains only small amounts of type II collagen, but relatively mild effects on the many cartilaginous structures of the body that are rich in the same protein.

Base Sequence

Nasal retinal dragging in X-linked retinoschisis.

X-linked retinoschisis is a disorder characterized by the presence of foveal schisis and often peripheral splitting of the retina in the nerve fiber layer. The accompanying complications include vitreous hemorrhage and retinal detachment, which can lead to blindness. In this report five patients who presented during infancy or early childhood had nasal retinal dragging.

Child

Laser photocoagulation for stage 3+ retinopathy of prematurity.

Twenty-two infants with "threshold" stage 3+ retinopathy of prematurity (ROP) were entered into a prospective, randomized clinical trial to compare the efficacy of transscleral cryotherapy versus laser photocoagulation delivered by the indirect ophthalmoscope. Eighteen infants have been followed for at least 3 months. Fifteen of 16 eyes randomized to laser and 9 of 12 eyes randomized to cryotherapy showed regression. The results suggest that laser therapy is as effective as cryotherapy in the treatment of ROP (P = 0.285).

Cryosurgery

Extracapsular cataract extraction, posterior chamber lens insertion, and pars plana vitrectomy in one operation.

Extracapsular cataract extraction (ECCE), placement of a posterior chamber intraocular lens (PC IOL), and pars plana vitrectomy were combined in a single operation in 24 patients. Sixteen of these, 11 of whom are diabetic, have had 6 months or more of follow-up. In all cases, excellent visualization of the posterior segment was obtained, and the surgical objectives were achieved. No diabetic patient without preoperative neovascularization of the iris had this complication later. The advantages and disadvantages of alternative techniques are discussed.

Adult

Scleral buckling in stages 4B and 5 retinopathy of prematurity.

Twenty-two eyes with traction retinal detachment (RD) secondary to retinopathy of prematurity (ROP) in 21 infants were treated by scleral buckling in combination with external cryotherapy and drainage of subretinal fluid. Anatomic reattachment of the retina was achieved in 13 (59%) of 22 eyes. Of those patients achieving anatomic reattachment with follow-up of 18 months or more, four (40%) of ten had 20/400 or better visual acuity.

Cryosurgery

Rhegmatogenous retinal detachment following cryotherapy in retinopathy of prematurity.

Three patients who had been treated with transscleral cryotherapy to the avascular retina for stage 3+ retinopathy of prematurity with threshold disease had total rhegmatogenous retinal detachments develop. In each case, the retinal detachment developed more than 1 year after treatment and resulted from a tear at the junction of the treated and untreated retina. Rhegmatogenous retinal detachment is a late complication of transscleral cryotherapy that to our knowledge has not previously been documented.

Child, Preschool

Progressive visual loss in adults with retinopathy of prematurity (ROP).

Two visually monocular patients with retinopathy of prematurity, followed up for 14 and 5 years, developed progressive visual loss in their twenties and thirties, respectively. In one patient, who underwent no surgery, visual acuity deteriorated from 20/30 to 20/400 over a 14-year period. The second patient had surgery for retinal detachment. Visual acuity after surgery was 20/60. In the ensuing 2 years it dropped to counting fingers and the visual field constricted to 10 deg. We suggest that changes in the retinal pigment epithelium may compromise the photoreceptors in some ROP patients, thus leading to visual deterioration.

Adult

Pseudophakic retinal detachment after YAG laser capsulotomy.

Eighteen eyes that developed pseudophakic retinal detachment after YAG laser capsulotomy were reviewed. There did not appear to be any relationship to the energy used, or the size of the capsulotomy. The majority of eyes had only one retinal break and these were located superior-temporally two-thirds of the time. High-risk characteristics for post-YAG retinal detachment included high myopia, lattice degeneration, and retinal detachment in the fellow eye.

Humans

Macular degeneration in angioid streaks.

This study examines different clinical parameters and the occurrence of macular degeneration in a series of 110 patients with angioid streaks of the fundus. Among the parameters considered were: age of the patient at the time of ocular diagnosis, associated systemic disease, optic nerve drusen, peau d'orange appearance in the fundus, number of radiating angioid streaks as well as their length, width, and distance from the fovea. Statistically significant correlations were found between the occurrence of macular degeneration (of the exudative hemorrhagic type) and the following: angioid streak length, distance from the fovea, and the diffuse type or 'cracked egg-shell' fundus appearance.

Adolescent

Posterior scleritis. A cause of diagnostic confusion.

The referring diagnoses in seven women with posterior scleritis included intraocular neoplasm, retrobulbar tumor, choroiditis, and idiopathic central serous choroidopathy. In all cases, a localized area of intense posterior scleritis was responsible for the misdiagnosed ocular findings. Features that helped to correctly identify posterior scleritis were as follows: female sex; a history of anterior scleritis; a fundus mass the same color as normal adjacent pigment epithelium; choroidal folds; serous retinal detachment with cloudy fluid; early pinpoint leaking spots from fluorescein angiography; and thickening of the posterior coats of the eye, retrobulbar edema, and high internal reflectivity on ultrasonography. Corticosteroids given for retrobulbar or systemic effect provided effective treatment.

Adult

Late complications of retrolental fibroplasia.

A modified classification of cicatricial RLF has been presented. Particular emphasis is placed on myopia, one of the hallmarks of grade i cicatricial RLF. Whether or not this is axial myopia is still open to question, but since the more myopic eye was usually longer by ultrasonic measurement than the less myopic eye, actual enlargement of the eye must play some role. Other features noted in grade I RLF were retinal pigmentation, vitreous membranes, and equatorial retinal folds. In grade II the most significant finding was dragging of the retina. It was noted that in all cases of dragging of the retina there were also peripheral retinal changes. Even more important, however, was the fact that peripheral retinal changes are often present when there are no changes in the posterior pole. Neovascularization, elevated retinal vessels, lattice degeneration, and retinal breaks were other features of grade II retinopathy. Significant was the fact that the incidence of lattice in patients with cicatricial RLF (15%) was more than twice that of the normal population. Grade III RLF was characterized by falciform retinal folds, and grade IV, by retinal detachment. Thirty-nine retinal detachments were rhegmatogenous and usually had temporal retinal breaks. Retinal detachments of a tractional exudative variety (14 eyes) tended to occur earlier in life than the rhegmatogenous variety. In infants, they were preceded by increased tortuosity of the vessels in the posterior pole and, sometimes, accumulation of exudation, both ominous prognostic signs.

Adolescent