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At least 343 records · Page 19Linked to original sources
PubMed2000

Middle cerebral artery blood flow velocity in elite power athletes during maximal weight-lifting.

Cerebral blood flow velocity (CBFV) has been shown to significantly increase during dynamic exercise (running) secondary to increases in cardiac output. Static exercise (weight-lifting) induces supraphysiological arterial pressures up to 450/380 mmHg, and thus may alter CBFV. Catastrophic brain injuries such as stroke, cerebral hemorrhage, subarachnoid hemorrhage, retinal hemorrhage and retinal detachment have been associated with weight-lifting. A recent study has shown that intra-ocular pressure (IOP), which is an indirect measure of intracranial pressure, elevates to pathophysiologic levels during weight-lifting. Recent CBFV studies instituting Valsalva have demonstrated decreases in CBFV from 21%-52%. To date, no studies have examined CBFV during maximal weight-lifting to elucidate the cerebrovascular responses to extreme pressure alterations. We recruited nine elite power athletes, including a multi-world record holder in powerlifting, for a transcranial Doppler study of middle cerebral artery blood flow velocity at rest and during maximal weight-lifting. All subjects' resting blood flow velocities were within normal ranges (mean 64.4 +/- 9.5 cm sec2). Blood flow velocities were significantly (p < 0.0001) decreased in all subjects during maximal lifting (mean 48.4 +/- 10.1 cm sec2). Linear regression analysis demonstrated a significant inverse linear relationship in the net change of blood velocities from rest to maximal lift for each subject (r = 0.8585, p < 0.001). This study demonstrates that blood flow velocities are significantly decreased during heavy resistance training. The drop in CBFV during weight-lifting was significantly less than previous Valsalva studies, which likely reveals the cardiovascular, baroreflex, and cerebrovascular system adaptations occurring in these elite power athletes.

Adult↗
PubMed2000

Disease of the equine posterior segment.

The appearance of the equine fundus is reviewed from the perspective of differentiating normal variations from disease, and the descriptions have been updated to include recently published ocular fundic abnormalities. Most pathological lesions are identified near the optic nerve head, and typically involve depigmentation or hyperpigmentation. Depending upon configuration and appearance, linear pigmented bands may reflect the course of the vortex veins, the transition from tapetal to nontapetal fundus, or indicate chorioretinitis or equine motor neuron disease. Choroidal vasculature is readily apparent in color-dilute (subalbinotic) horses and must be differentiated from hemorrhage. Retinal hemorrhages in foals are common and may occur independently to hypoxic ischemic encephalopathy. Retinal cysts may signal more significant disease in the eye such as anterior segment dysgenesis. Prominence of gray or tan-colored material on or near the optic nerve head may represent traumatic optic neuropathy, benign optic neuropathy, proliferative optic neuropathy or actual neoplasia.

Journal Article↗
PubMed1998

Anatomy of the shaken baby syndrome.

Shaken baby syndrome refers to the constellation of nonaccidental injuries occurring in infants and young children as a consequence of violent shaking. The typical victim of shaken baby syndrome is a male infant younger than six months of age who is alone with the perpetrator at the time of injury. Occurrence of the syndrome is unrelated to race, gender, socioeconomic status, or education. The characteristic injuries observed in shaken baby syndrome include subdural hemorrhages, retinal hemorrhages, and fractures of the ribs or long bones. Although each of these injuries may result from violent shaking of the victim, the most severe brain injuries result from the addition of a forceful impact of the infant's or child's head against a firm surface. The unique anatomic features of the infant's head and skeletal system, which account for the type and pattern of injuries observed in shaken baby syndrome, are emphasized in this article.

Battered Child Syndrome↗
PubMed1986

Macular edema in association with severe carotid artery obstruction.

In seven eyes of six patients (four men and two women, 55 to 72 years old), with macular edema associated with severe carotid artery stenosis, the ipsilateral carotid obstruction was 90% or more. Concomitant fundus signs, such as midperipheral retinal hemorrhages, retinal arterial narrowing, and neovascularization of the optic disk, were observed. All eyes demonstrated leakage of fluorescein dye from the retinal vessels and optic disk.

Aged↗
PubMed2004

Retinal vein cannulation with prolonged infusion of tissue plasminogen activator (t-PA) for the treatment of experimental retinal vein occlusion in dogs.

PURPOSE: To evaluate the feasibility, safety, and efficacy of local thrombolytic agents directly injected into occluded retinal veins in an experimental animal model. DESIGN: Experimental animal study. METHODS: This experimental study was performed in two phases. In phase 1, 15 enucleated porcine eyes and 8 in vivo canine eyes were used for the development of the instrumentation and surgical technique required for retinal vein cannulation with prolonged intravascular infusion. In phase 2 of this study, experimental branch retinal vein occlusion was photo-chemically created using an intravenous injection of rose bengal followed by diode laser photocoagulation in eight eyes of eight dogs. Four eyes were treated by retinal vein cannulation and an injection of tissue plasminogen activator (t-PA) using a specifically designed microcatheter, while the remaining four eyes were untreated (control group). The total amount of t-PA injected intravenously ranged from 400 to 1000 mug, infused over a period ranging from 25 to 45 minutes with a mean pressure of 40 psi, resulting in a mean injection flow rate of 0.05 ml/min. The dogs underwent clinical examination, fluorescein angiography, and histologic examination. Main outcome measures were: Achievement of prolonged intravascular infusion of t-PA, changes in fundus appearance, fluorescein angiography, and histology. RESULTS: A microcatheter instrument and a surgical technique for retinal vein cannulation with prolonged intravascular infusion were developed. Cannulation and t-PA infusion for a period of at least 30 minutes was achieved in all four treated eyes with experimental branch retinal vein occlusion. No complications were recorded in all treated eyes. One week and 1 month postoperatively, treated eyes exhibited marked decreases in retinal hemorrhages, retinal vein dilation, and tortuosity, whereas nontreated eyes exhibited persistence of these findings. Fluorescein angiography demonstrated improved circulatory flow in treated relative to nontreated eyes. Histologic analysis confirmed the presence of thrombi in nontreated eyes only. CONCLUSIONS: Retinal vein cannulation with prolonged intravascular injection of t-PA is feasible and safe, and this may offer a new treatment option for retinal vein occlusion.

Animals↗
PubMed1999

Transpupillary thermotherapy for small choroidal melanoma.

PURPOSE: To report the treatment of small choroidal melanoma with transpupillary thermotherapy. METHODS: We examined a nonrandomized and uncontrolled series of 14 eyes of 14 patients who were followed up with serial ophthalmoscopy, ultrasonography, and photography. Transpupillary thermotherapy was performed upon documented evidence of tumor growth. RESULTS: After transpupillary thermotherapy, mean follow-up +/- SD was 16 +/- 6.41 months (range, 7 to 28 months) with 10 eyes followed up for at least 1 year. The mean preoperative tumor height was 1.79 +/- 0.59 mm (range, 0.78 to 2.60 mm). Six months after treatment, the mean height was 0.54 mm +/- 0.57 mm (range, 0.00 to 1.16 mm). In 10 eyes, the treated lesion flattened entirely with a mean interval between treatment and flattening of 8.7 months (range, 3 to 21 months). Three patients required retreatment for lack of regression or recurrent growth. The average time to retreatment was 11 months (range, 5 to 15 months). No eye was retreated more than once. There were three amelanotic lesions, all treated in a single session without recurrence. Complications consisted of retinal hemorrhage, retinal vascular occlusion, retinal traction, exudative serous neurosensory detachment, vitreitis, and postoperative pain. The sole treatment failure occurred in an eye treated with a juxtapapillary tumor, with recurrence developing from a previously flattened lesion. This eye was enucleated 10 months after the single initial treatment. At the time of writing, there had been no tumor-related death. CONCLUSIONS: Transpupillary thermotherapy may represent a viable treatment alternative for both pigmented and amelanotic small choroidal melanoma. Diligent follow-up is axiomatic because retreatment may be necessary. Recurrent tumors may develop from flat lesions. Juxtapapillary tumors may be at higher risk for recurrence. Definitive statements regarding the role of transpupillary thermotherapy in the management of small choroidal melanoma await 5-year and 10-year morbidity and mortality data.

Adult↗
PubMed1985

The raccoon ascarid. A probable cause of human ocular larva migrans.

The ability of raccoon roundworm larvae, Baylisascaris procyonis, to produce ocular larva migrans (OLM) was studied in various experimental animals. In addition, the clinical and pathologic lesions were compared to those in suspected cases of human ocular baylisascariasis, in patients with diffuse unilateral subacute neuroretinitis (DUSN). Ocular larva migrans was produced in squirrel monkeys, cynomolgus monkeys, mice, hamsters, grey squirrels, and woodchucks orally infected with B. procyonis eggs. The clinical and histologic lesions were primarily those of retinitis, retinal hemorrhages, retinal tracks, disruption, and vasculitis; pigment migration; choroiditis; vitritis; and free or encysted larvae in ocular and extraocular tissues. The lesions of experimental OLM correlated well with those of suspected cases of human ocular baylisascariasis and DUSN. Based on these studies, B. procyonis of raccoons should be considered as a probable cause of OLM and DUSN in humans.

Adult↗
PubMed1994

Prenatal cocaine exposure and the development of the human eye.

PURPOSE: The use of cocaine during pregnancy has been associated with congenital abnormalities of the developing eye. The authors report a prospective, controlled study of 40 cocaine-exposed and 40 nonexposed (control) preterm and full-term infants. METHODS: Detailed maternal and obstetric histories were obtained by chart review and interview. Infants with a positive urine toxicology screen for cocaine at birth or whose mothers tested positive for cocaine were recruited into the exposed group. Nonexposed infants were recruited at random from newborns admitted to the authors' nurseries. Mothers of these infants received routine prenatal care in the authors' clinics, and nonexposure was documented by maternal history and/or negative urine toxicologies that were available in 30% of these mother-infant pairs. General physical and ocular examinations, including measurement of axial length and intraocular pressure, were performed on all infants. RESULTS: Forty infants were recruited in each group, with gestational ages ranging from 25 to 42 weeks. Twenty-nine of the exposed infants and 26 of the control infants were full-term (gestational age, 37 weeks or older). A total of 160 eyes were examined. No differences were seen in the incidence of congenital anomalies, subconjunctival hemorrhages, retinal hemorrhages, or optic nerve abnormalities between the two groups. No differences in mean axial length (16.9 +/- 0.6 mm [exposed group] versus 17.1 +/- 0.7 mm [control group]) or intraocular pressure (15.4 +/- 3.8 mmHg [exposed group] versus 15.0 +/- 3.0 mmHg [control group]) were seen between full-term infants in both groups. Axial length correlated strongly with gestational age, birth weight, head circumference, and body length over the range of gestational ages evaluated in both groups. No effect of cocaine exposure on these correlations was demonstrated. The range of axial length was 12.1 to 18.0 mm in the exposed group and 12.4 to 18.6 mm in the control group. CONCLUSION: In this study group, no significant effect of prenatal cocaine exposure was seen on the infant eye. In both exposed and nonexposed groups, axial length measurements agreed closely with known statistical norms and correlated closely with other parameters of fetal growth.

Abnormalities, Drug-Induced↗
PubMed1997

Ocular and orbital trauma from water balloon slingshots. A clinical, epidemiologic, and experimental study.

PURPOSE: The authors report the findings of 17 patients with ophthalmic injuries produced by launched water balloons; they determine water balloon kinetic energies in experimental and theoretical studies. METHODS: Six case summaries are presented; one case report was retrieved from the literature; ten injuries were reported to the Consumer Product Safety Commission. Energies were determined by field trials and calculations. RESULTS: Injuries included periorbital edema and ecchymoses, orbital contusions and hematomas, maxillary sinus hematomas, facial hypesthesia, eyelid lacerations, subconjunctival hemorrhages, corneal edema and abrasions, hyphemas, traumatic iritis, iris sphincter ruptures, iris atrophy, angle recession, iridodialysis, traumatic cataract, vitreous hemorrhages, retinal hemorrhages, macular hole formation, optic atrophy, and bony orbital wall fractures. Epidemiologic analysis revealed that children and young adults, more often males, were injured, most commonly in the warm weather months. In field trials, maximum water balloon velocities ranged from 38 to 41 m/sec (85-92 mph) with kinetic energies from 176 to 245 joules; by calculation, maximum velocities ranged from 42 to 54 m/sec (95-121 mph) with kinetic energies from 141 to 232 joules. In a field demonstration, a slingshot-launched water balloon exploded a watermelon. CONCLUSION: Energies are comparable to or greater than those experienced with a variety of common objects, including some rifle bullets that are known to cause serious ophthalmic injuries. These energies are far in excess of those required to perforate a cornea, rupture a globe, or fracture the bony orbit. This study demonstrates the serious and potentially vision- and life-threatening injuries inflicted by these "toys."

Adolescent↗
PubMedDate not supplied

Severe ischemic maculopathy in a patient with West Nile virus infection.

A 60-year-old man with diabetes mellitus had a sudden decrease in vision in his right eye 3 weeks after confirmed West Nile virus infection. Visual acuity in the right eye was 20/400. Fundus examination showed bilateral multifocal chorioretinitis, which was associated with proliferative diabetic retinopathy in the right eye and severe nonproliferative diabetic retinopathy in the left eye. There were deep, dense retinal hemorrhages, retinal opacification, and retinal arterial sheathing in the macula of the right eye. Fluorescein angiography revealed extensive capillary nonperfusion in the macular area of the right eye. Six months later, vision remained unchanged and a choroidal neovascularization developed over a chorioretinal scar in the same eye.

Chorioretinitis↗
PubMed2000

Primary antiphospholipid syndrome manifested as venous stasis retinopathy.

Primary antiphospholipid syndrome is a condition in which antiphospholipid antibodies may be present without any associated medical disorder. Thrombosis is the hallmark of this syndrome. We report the case of a 22-year-old female with the chief complaint of floating spots in the right eye for two months. No underlying connective tissue disease or systemic disease was noted. Ophthalmic examination revealed retinal hemorrhage, retinal vein engorgement and optic disk swelling in the right eye only, and normal visual acuity in both eyes. Retinal fluorescein angiography showed venous stasis and branch vein leakage in the right eye. An antibody profile revealed the presence of immunoglobulin G anticardiolipin antibodies, which confirmed the diagnosis of primary antiphospholipid syndrome.

Adult↗
PubMed1996

Ocular and orbital trauma from water balloon slingshots: a clinical, epidemiological, experimental, and theoretical study.

PURPOSE: To report the clinical findings of 17 patients with ocular/orbital injuries produced by launched water balloons; to determine water balloon kinetic energies in experimental and theoretical studies. METHODS: Six case histories are presented, 1 case was retrieved from the medical literature, and 10 cases were reported to the National Injury Information Clearinghouse of the United States Consumer Product Safety Commission. The energies were determined by field trials and calculations. RESULTS: Injuries included orbital contusions and hematomas, facial hypesthesia, eyelid lacerations, subconjunctival hemorrhages, corneal edema and abrasion, hyphemas, traumatic iritis, iris sphincter ruptures, iris atrophy, angle recession, iridodialyses, traumatic cataract, vitreous hemorrhages, retinal hemorrhages, macular hole formation, optic atrophy, and bony orbital wall fractures. Epidemiological analysis revealed that children and young adults, more often males, were injured, most commonly in the warm weather months (May through September). In field trials, maximum water balloon velocities ranged from 38 to 41 m/sec (85 to 92 mph) with kinetic energies from 176 to 245 J; by calculation, maximum velocities ranged from 42 to 54 m/sec (95 to 121 mph) with kinetic energies from 141 to 232 J. In a field demonstration a 300-g water balloon launched horizontally from a distance of 20 ft exploded a 12-kg watermelon. Classic physics calculations are presented to explain the complex bio-mechanical interactions between the water balloon and the eye. CONCLUSION: Kinetic energies of launched water balloons are comparable to or greater than kinetic energies experienced with a variety of common objects, including file bullets, which are well known to cause serious ocular and orbital injuries. In addition, these energies are far in excess of those required to perforate a cornea (0.7 to 1.7 J), rupture a globe (1 to 5.3 J), or fracture the bony orbit (1.8 to 14.7 j). Thus, this study demonstrates the serious and potentially vision- and life-threatening injuries inflicted by these "toys."

Adolescent↗
PubMed1998

Evaluation of ocular safety: tirapazamine plus cisplatin in patients with metastatic melanomas.

Ninety-six patients with metastatic melanoma treated with two consecutive tirapazamine-cisplatin combination chemotherapy regimens were followed for signs of therapy-related ocular toxicity. Baseline and follow-up data were obtained such that each patient acted as his own control. A battery of vision-related tests was performed. These included: best corrected visual acuity, color vision, retinal fundus examination and electro-oculograms (EOG). A brief health-related quality of vision test was administered at each follow-up visit to detect and evaluate self-perceived changes in visual status. In the first study, 48 patients received i.v. tirapazamine over 2 h at 260 mg/m2 (group 1) while in the second study 48 patients (group 2) received i.v. tirapazamine at 390 mg/m2. Visual system assessment was conducted at three timepoints: first at baseline, then at 6 weeks post-baseline, i.e. after two courses of chemotherapy and visit two upon discontinuation of therapy. There was no difference in visual acuity between group 1 and group 2 at baseline, follow-up 1 or at follow-up 2. Grouped data indicate that visual acuity was not affected by either dosage of chemotherapy. Group 1 at baseline found 15% below the normal EOG cutoff point, increasing to 23% at follow-up 1 and increasing at follow-up visit 2 to 33%. Group 2 demonstrated the same EOG findings, but the results were more magnified: baseline, 24%; follow-up 1, 44%; and follow-up 2, 44%. After eliminating those with abnormal color vision baselines, 21% (nine of 42) group 1 patients demonstrated abnormal color vision total error scores at follow-up 1 and 16.7% (four of 24) at follow-up 2. Few individuals showed changes in the higher dosage group. With the exception of one person in each dosage group, all changes were along the blue-yellow (tritan) axis, which is associated with acquired color defects. Of 96 patients examined, proven fundus changes were found in only four subjects. These fundus findings included retinal hemorrhages, retinal nerve fiber layer infarcts (cotton wool spots) and small retinal pigment epithelium detachments. There was no systematic statistical significant difference among the various measures of visual system outcome between groups or test times. Data from all tests for individual patients in both groups reveals a sporadic distribution of changes in visual system tests. If toxicity were pronounced, one would expect consistency in the findings and all or most of the assessment tests would be abnormal for a particular patient. However, patients who were abnormal on one measure of acuity were not necessarily abnormal on the other measures.

Adult↗
PubMed1992

Oxygen-induced retinopathy in the rat: hemorrhages and dysplasias may lead to retinal detachment.

Rearing neonatal rats in hyperoxia induces the development of retinal hemorrhages and retinal dysplasia. Albino rats were placed in 80% oxygen immediately after birth and were exposed for either 5, 10, or 14 days, followed by sacrifice or exposure to normoxia for an additional 2, 4, 5, 7, 8, 10, 38, 45 or 56 days. Control rats were simultaneously raised in room air and sacrificed at the same times. All animals were enucleated and their eyes processed for light and electron microscopy. Eyecups were trimmed to facilitate cross-sectioning of the retina in the vertical meridian. No control rats showed signs of retinal hemorrhages or of dysplastic folds or rosettes. Nor did the retinas of rats killed immediately after oxygen exposure contain hemorrhages, but the incidence of retinal folds or rosettes in this group was 54%. For rats exposed to combinations of hyperoxia and brief normoxia (10 days or less), 40% suffered hemorrhages and 50% developed retinal folds or rosettes. Although hemorrhages were more prominent in rats subjected to longer periods of oxygen (73% of all rats exposed for 14 days followed by brief normoxia vs. 6% of those exposed for 5 days followed by brief normoxia), the incidence decreased with time post-exposure in room air. Hemorrhages occurred in 100% of the rats raised in oxygen for 14 days followed by 2 days in room air, and decreased to 50% by 7 days in room air and to 0% by 38 days, indicating a spontaneous resolution with time. In each case, the blood appeared to leak from the newly-forming vessels of the deep capillary net, with most of the red blood cells migrating to the subretinal space. Retinal fold or rosette formation, indicative of developmental dysplasia, occurred in a fraction of virtually all groups of exposed rats, and persisted at the longest post-exposure periods. These two manifestations of oxygen-induced retinopathy are emphasized because they lead to an abnormal separation of the retina from the epithelial layer, which may increase the likelihood of the most serious consequence of ROP--retinal detachment. In fact, all rats that endured post-exposure periods of 38 days or longer before sacrifice exhibited retinal detachment.

Animals↗
PubMed2001

Indocyanine green and fluorescein hyperfluorescence at the site of occlusion in branch retinal vein occlusion.

BACKGROUND: In patients with branch retinal vein occlusion (BRVO), we investigated the presence of indocyanine green (ICG) and fluorescein hyperfluorescence at the site of occlusion. We also assessed the association of this feature with the clinical outcome of these patients. METHODS: Both indocyanine green (ICG) videoangiography and fluorescein angiography (FAG) were performed in 21 eyes with BRVO of less than 1 month duration. Deterioration of the disease was defined clinically as an increase in retinal hemorrhages or retinal edema. Capillary nonperfusion was quantified with computer image analysis from the FAG pictures. RESULTS: ICG videoangiography showed focal hyperfluorescence along the venous wall at the site of the affected A-V crossing in 9 of the 21 eyes, and FAG showed this feature in 10 eyes. The ICG hyperfluorescence was more prominently and focally detected than the hyperfluorescence on FAG, which was sometimes diffusely seen throughout the whole occluded area. Eight of the nine eyes showing ICG hyperfluorescence had clinical deterioration with an increase in retinal hemorrhage or edema. This deterioration occurred more frequently in eyes with hyperfluorescence and/or late leakage than in ones without these features. The mean nonperfused area was significantly larger in eyes with hyperfluorescence than in eyes without these features. CONCLUSION: The ICG hyperfluorescence at the site of A-V crossing is associated with disease deterioration in patients with fresh BRVO. The ICG hyperfluorescence was more easily detectable than the hyperfluorescence on FAG, although the difference in sensitivity between the two methods is not great.

Adult↗
PubMed1992

Retinal manifestations of ocular lymphoma (reticulum cell sarcoma).

BACKGROUND: Diagnosis and treatment of ocular large cell lymphoma may lessen visual loss and prolong life. Although reports in the literature have described retinal infiltrates in eyes with large cell lymphoma, they have focused on the more prominent vitreous and subretinal pigment epithelial findings. Eyes with retinal infiltrates and hemorrhagic retinal necrosis are usually believed to harbor a microbial infection. The authors describe 5 patients, aged 57 to 85 years, with ocular lymphoma in whom the most prominent initial findings were in the retina. METHOD: Patients presented with findings suggestive of an infectious retinal necrosis. When the initial therapy failed, investigators performed a vitreous biopsy. Two patients had a concomitant retinal biopsy. Radiation therapy was given to four patients. RESULTS: All five patients had vitreous cells. Three patients had prominent perivascular exudate. Four patients had grayish-white retinal infiltrates, and three patients had associated retinal hemorrhage. Three patients had subretinal small white spots. An edematous thickened retina developed in three patients, and hemorrhagic retinal necrosis developed in three patients. The initial diagnosis was believed to be acute retinal necrosis (ARN) in three patients, toxoplasmosis in one patient, and frosted branch angiitis in one patient. Vitreous biopsy was positive in two patients but negative in three patients. In two of these three patients, the diagnosis was established by retinal biopsy. CONCLUSION: Ocular lymphoma should be considered in the differential diagnosis of retinal vasculitis or necrotizing retinitis in a middle-aged or older patient. Retinal biopsy may be helpful in establishing the diagnosis.

Aged↗