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Treatment of Coats' disease with photocoagulation.

71 eyes with Coats' disease were treated with photocoagulation. By coagulation of the abnormal vessels the disease process could be halted in 64 eyes over a mean observation time of 2 years and 3 months after completion of treatment. In 51 of these eyes the lipoid deposits regressed. In only 7 eyes a progression of the disease could not be prevented. Complications of photocoagulation treatment were not observed.

Follow-Up Studies↗

Unusual association of Eales disease with multifocal neurological deficit.

A man who had suffered from Eales disease at the age of 20 presented an acute Brown-Séquard spinal syndrome when he was 30, followed shortly after by paralysis of the right abducens and recurrent laryngeal nerves. Steroid treatment apparently relieved the myelopathy while the neurological deficits have remained unchanged for the past 14 years. In view of the clinical and CSF findings the neurological deficits are attributed to the same disease process as that underlying the peripheral retinal abnormalities characteristic of Eales disease rather than to multiple sclerosis.

Abducens Nerve↗

Krypton red laser photocoagulation of peripapillary subretinal neovascular membranes.

The visual outcome of 20 eyes of 20 patients with peripapillary subretinal neovascular membranes (SRNVM) treated with krypton red laser photocoagulation (KRLP) was studied. Complete obliteration of the SRNVM was achieved in all eyes in the study. In 18 of 20 patients, the visual acuity improved or remained the same during an average follow-up of 9.9 months. There were no treatment-related complications. The efficacy of KRLP in the management of patients with peripapillary SRNVM is discussed.

Aged↗

Experimental occlusion of the retinal vein.

We used a pars plana approach to experimentally induce retinal vein occlusions (RVO) in cats by the application of electric energy near the veins at the optic nerve head. This experimental model was utilized to study the natural evolution of thrombosis in the cilioretinal veins, which are located near the lamina cribrosa in the cat. We observed that occlusion of the retinal veins occurs by the formation of a thrombus and that with time there is associated endothelial cell proliferation and recanalization in each instance.

Animals↗

Course of disturbance of EOG in retinal vessel occlusions.

More than 60 patients with retinal vessel occlusions were examined using the electro-oculogram (EOG) ramp test. In the course of the disease a systematic disturbance of the slow oscillation of the corneoretinal potential occurred. First, the latency of the light peak increased. Then the peak decreased and was reached up to 5 min later than in the healthy eye. In the final stage the basic level dropped to about half of the normal value and light response was absent. During the next few weeks an improvement in the basic level took place, but usually this did not involve improved vision.

Adult↗

Fundus changes associated with Behçet's disease.

Between 1973 and 1987 we recorded 300 cases of Behçet's disease with fundus changes. Our routine preview of each case included examination with the Goldman three-mirror contact lens, ophthalmoscopy, referral for laboratory tests, color fundus photography and, most importantly, fluorescein angiography. The ophthalmological findings led to the proper diagnosis in 254 (85%) of our cases. Fluorescein angiography revealed incipient fundus changes in 38 eyes of 19 medically diagnosed patients with no visual complaints and normal fundi on ophthalmoscopy. Eighty-six percent of our cases had or developed diverse fundus changes bilaterally. The fundus changes we encountered most frequently were hyperemia of the optic disc, macula edema, retinal edema, vascular sheathing, retinal exudate, and retinal hemorrhage. With the exception of eyes with very poor prognoses, only 184 of the 403 eyes that were followed up for 3-120 months (median 12) experienced new insults in the posterior segment; 40 of these became totally blind while 59 maintained their visual status. Early diagnosis is necessary for proper treatment patients with Behçet's disease. Fluorescein angiography is required for early diagnosis and for monitoring the posterior segment involvement closely. This is the most characteristic and often the most serious consequence of Behçet's disease; it may also the first indicator of the disease.

Adolescent↗

Inverted eyelashes in patients with type 1a glycogen storage disease.

We examined three adult Japanese patients who had a history of decreased hepatic glucose-6-phosphatase activity. All three patients had increased bilateral subcutaneous (SC) fat in the lower eyelids and inverted eyelashes. One patient additionally showed retinal hemorrhages and microaneurysms in both fundi. The inverted eyelashes may have been related to type 1a glycogen storage disease.

Adipose Tissue↗

Cortical hypoxic-ischemic brain damage in shaken-baby (shaken impact) syndrome: value of diffusion-weighted MRI.

Shaken-baby syndrome (SBS) is a type of child abuse caused by violent shaking of an infant, with or without impact, and characterized by subdural hematomas, retinal hemorrhages, and occult bone fractures. Parenchymal brain lesions in SBS may be missed or underestimated on CT scans, but can be detected at an earlier stage with diffusion-weighted MRI (DW-MRI) as areas of restricted diffusion. We demonstrate the value of DW-MRI in a 2-month-old baby boy with suspected SBS. The pattern of diffusion abnormalities indicates that the neuropathology of parenchymal lesions in SBS is due to hypoxic-ischemic brain injuries, and not to diffuse axonal injury.

Brain↗

Multiple thoracic vertebral compression fractures caused by non-accidental injury: case report with radiological-pathological correlation.

We report a 21-month-old boy with multiple contiguous thoracic vertebral compression fractures involving eight vertebral bodies, attributable to non-accidental injury. No subluxation was associated, however, there was extensive injury to the upper cervical and lower lumbar regions of the spinal cord. Anterosuperior beaking, thought to represent a previous injury, was evident in a mid-lumbar vertebra. Clinical examination revealed bilateral retinal hemorrhages and retinoschisis. Death occurred as a result of severe brain edema with bilateral subdural and subarachnoid hemorrhages. Radiological-pathological correlation is presented.

Fatal Outcome↗

[Retinal vein occlusions].

There are still gaps in understanding the etiology and pathogenesis of circulatory disorders of the central retinal vein. Although various new therapeutic approaches have been developed in the past few years, existing therapy forms are subject to controversy and available data are to some extent inconsistent. This discussion in the German-language literature is associated with varied and nonuniform terminology, which should do justice in particular to concepts of pathomechanism and degree of specificity. The general designation, "occlusion" seems to be the most suitable of all available terms since this implies no conclusions on possible etiological factors. Retinal vein occlusions develop at different sites and to varying extents. Depending on t he location of the occlusion, they can be classified into occlusions of the central vein, hemicentral vein, major branch vein, and macular branch vein. This overview provides information on the current knowledge of the pathogenesis and both established approaches and those in ongoing clinical trials for the treatment of central venous and branch vein occlusions.

Diagnosis, Differential↗

Intraocular pressure changes during high-altitude acclimatization.

BACKGROUND: To evaluate the relationship between hypobaric hypoxia acclimatization and intraocular pressure (IOP) during ascent, acclimatization, and descent between 2286 m and 5050 m. METHODS: The following acclimatization-indicative physiological parameters were compared daily with IOP changes in eight healthy climbers of the 2003 Greek Karakorum expedition in altitude stages between 500 m and 5050 m: hemoglobin oxygen saturation (PO2), resting heart rate, blood pressure, retinal findings, and the Lake Louise score for acclimatization grading. RESULTS: IOP decreased significantly in the ascent phase (0.58 mmHg/100 m) and recovered (0.71 mmHg/100 m) during acclimatization and descent. A direct proportional correlation between decreases in PO2 and IOP was evaluated. Arterial blood pulse and pressure increased during acclimatization, while IOP decreased. No retinal hemorrhages were observed in well-acclimatized and incompletely acclimatized climbers. CONCLUSIONS: Every new active exposure to hypobaric hypoxia in the ascent phase induced a decrease in the IOP parallel to the PO2 decrease and to the level of acclimatization. The results from our study suggest that IOP changes are related to hypoxia-induced respiratory alkalosis and acclimatization stage, which could be used as a simple mobile screening test for acclimatization level to reveal acute mountain sickness and its severe consequences.

Acclimatization↗