摘要:

The conservative treatment as well as photocoagulative therapy of central retinal and branch vein occlusion is reported on. In spite of encouraging reports in the literaure on medical treatment with anticoagulants and antithrombocyte aggregation drugs, photocoagulation via the xenon-arc or argon-laser method should be preferred. The indication for photo-coagulation depends on fluorescein angiographical controls with the ability to distinguish beween reversible and irreversible retinal changes, thus assuming prognostic significance. In cases of central retinal vein occlusion one should begin with photocoagulation soon after the onset of the disease to prevent new vessel formation in the retina and iris with following vitreal hemorrhage and secondary angle-closure glaucoma. In cases of branch vein occlusion a more conservative approach with regular fluorescein angiographical controls are proposed, because the natural course and the prognosis without therapy will be good in most cases.

ISSN:0030-3755    

DOI:10.1159/000308957

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

The various possibilities of treating arterial retinal occlusions are reviewed. Although thrombolysis is regarded today as the most dependable therapeutic method it has the most contraindications and carries the highest risk. There are less contraindications to anticoagulative treatment. The results are, however, not as good as with thrombolysis. The action of vasodilators is only positive if an intensive general cardiovascular treatment also takes place. Attempts to influence the viscosity of blood via xanthine derivatives (also to increase glucose metabolism) appear promising as do the antithrombocyte aggregation action of acetylsalicylic acid. Low molecular dextran solutions (plasma expanders) have also been used with success although these also demand a general stabilization of the circulation.

ISSN:0030-3755    

DOI:10.1159/000308958

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

A thorough examination of the supra-aortal vessels can explain the causes of circulatory ocular fundus changes. The Doppler ultrasonic method seems to be the best for this purpose. The main risk factors for cerebral vessels are high blood pressure and diabetes, and they should be medically treated. The use of prophilactic cardiac glycosid therapy seems unwarranted since a physiological cardiac insufficiency due to age exists just as little as the so-called ‘old heart’. Hypotension that would not require a medical treatment as such needs treatment, however, if suspicious fundus changes are present. Vasodilators do not improve the cerebral circulation, but preparations diminishing blood viscosity are here advisable. In cases of acute obstruction a fibrinolytic approach seems reasonable. A prophylactic treatment with antisclerotics is certainly to late when clinical manifestations occur.

ISSN:0030-3755    

DOI:10.1159/000308959

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Circulatory disorders of the optic nerve may be classified into acute and chronic lesions as well as into anterior and posterior ones. In general, anterior lesions clinically prevail; they are located around the lamina cribrosa and are pathogenetically explained as a consequence of decreased blood flow in the posterior ciliary arteries as well as in the perilaminar capillaries. The symptoms of the acute anterior lesions are described. The optic nerve head infarction may be induced by various circulatory disorders such as arteriosclerosis, diabetes, elevated blood pressure, giant cell arteritis or other collagen diseases, but also by others. The particular importance of giant cell arteritis is stressed. The prognosis of acute anterior ischemic optic neuropathy is poor, possibilities of treatment are discussed. The chronic anterior lesion is considered to be caused by an imbalance between intraocular pressure and the perfusion pressure in the posterior ciliary arteries and consequently in the perilaminar capillaries. The clinical signs (‘low tension glaucoma’) are described, the therapeutic measures, although limited, are outlined. The ischemic lesions of the posterior part of the optic nerve are less well defined. However, theoretical considerations as well as clinical experience suggest that such lesions occasionally occur taking either an acute or a chronic course.

ISSN:0030-3755    

DOI:10.1159/000308960

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Diagnosis and therapy of retinal and uveal circulatory disorders should be based mainly on two pathophysiologic principles: (1) an autoregulation is effective in the retinal circulation only but absent in the choroidal circulation and (2) circulatory disorders may be caused not only by a reduced but also by an increased blood flow.The clinical evaluation of an individual retinal circulatory disoder depends on the interpretation of the dynamics of visual disurbances, detection of vascular type or fiber bundle defects in the visual field, repeated estimation of blood flow velocity by direct ophthalmoscopy or fluorescence antiography, and detection of specific fundus signs such as focal ischemia (cotton wool spots) or development of a collateral circulation and true neovascularization. For the indirect assessment of disturbances of the choroidal circulation certain subjective symptoms, alterations of the pigment epithelium, and edema and focal defects of the choriocapillaries are of importance. The stereobiomicroscopy of the fundus with a slitlamp and fluorescence angiographic studies of the sectorial distribution of the choroidal filling are valuable diagnostic aids.

ISSN:0030-3755    

DOI:10.1159/000308961

出版商:S. Karger AG    

年代:1980

数据来源: Karger

摘要:

Experimental ultraviolet keratitis was performed in rabbit eyes in two series. Using optic-enzymatic tests we investigated pyruvate and lactate levels of the anterior eye segment after biomicroscopic controls of the damaged corneal epithelium. Comparing the untreated control eyes we found again the lactate concentration gradient of the cornea and aqueous humor. Lactate levels of the stroma and aqueous humor of the anterior chamber were reduced significantly, while the lactate pyruvate ratio was increased in corneal epithelium and reduced in the aqueous. The direct influence of ultraviolet radiation on nucleoproteins was discussed.

ISSN:0030-3755    

DOI:10.1159/000308962

出版商:S. Karger AG    

年代:1980

数据来源: Karger

ISSN:0030-3755    

DOI:10.1159/000308963

出版商:S. Karger AG    

年代:1980

数据来源: Karger