摘要:

Diabetes mellitus is a significant cause of visual morbidity worldwide. Progress continues in the identification of cellular elements involved in the pathogenesis of diabetic eye disease. Most notable is a greater elucidation of the role of vascular en-dothelial growth factor. Studies on the epidemiology and clinical course of diabetic eye disease provide a basis for examination, prognosis, and treatment of affected patients.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Recent population-based studies suggest that the fundus lesions of hypertension also occur in people without hypertension. In experimental studies, hypertensive lesions, which used to be the backbone of older classifications of the severity of hypertension, did not correlate sufficiently with severity to allow reliable grading. Hypertensive retinopathy, choroidopathy, and optic neuropathy are independent processes. Vascular narrowing appears to occur early in the disease process, whereas retinal hemorrhages and retinal lipid may occur later. Branch vein occlusion is a complication of hypertension, whereas open-angle glaucoma may not be. Choroidal neovas-cularization in the fellow eyes of patients with macular degeneration is associated with high blood pressure. Laser treatment for this disorder is less effective in patients with high blood pressure than it is in normotensive individuals, which suggests that choroidal neovascularization may be an expression of chronic hypertensive choroidopathy. Hypertensive optic neuropathy, a variant of ischemic optic neuropathy, has delayed onset compared with retinopathy and, in experimental studies, has not been linked to the severity of hypertension. Given these findings, it may be better to describe than to grade fundus lesions. In either event, it is important to take blood pressures accurately. Fundus lesions suggest high blood pressure. Sphygmomanometry is more specific and reliable than fundus-copy in making that diagnosis.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Giant cell arteritis is a systemic disease that can have devastating ophthalmic consequences. New insights into the epidemiology and pathophysiology of the disease may improve early diagnosis and treatment.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Sarcoidosis remains an enigmatic disease with serious ocular morbidity. Recent literature continues to expand our knowledge of the ocular manifestations and their sequelae. Advances in diagnostic clinical testing are reviewed, including updates on angiotensin-converting enzyme levels, gallium scanning, bronchoalveolar lavage, and transbronchial lung biopsy.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Ocular manifestations of rheumatic disease are common and varied. The presentation of uveitis in psoriatic arthritis and inflammatory bowel disease differ from typical HLA-B27-associtated uveitis. Giant cell arteritis continues to be a common cause of visual loss. Early diagnosis is crucial to limiting visual loss. Once visual loss has occurred, the need for oral versus intravenous steroids is controversial. Chronic uveitis associated with juvenile rheumatoid arthritis may be less prevalent than previously shown. However, poor visual outcomes continue to occur and efforts to identify visual prognosticators are being made. Ocular involvement in Behpet's disease, if untreated, leads to blindness. Azathioprine has been shown to improve visual prognosis. Concurrent central nervous system disease has been correlated to a poor visual prognosis.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Systemic infections occasionally present with ocular involvement. Prompt diagnosis and management, aided by an internist, may lead to resolution of the infection without severe ocular sequelae. Recent literature discussing atypical ophthalmic manifestations, treatment options, or transmission risks of the following diseases is reviewed: infection with hepatitis viruses, toxoplasmosis, tuberculosis, bacteremia, and endogenous mycotic endophthalmitis.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

AIDS-related eye disease is changing rapidly. New clinical entities have been reported, most numerous of which are the uveitis syndromes in patients with elevated CD4+counts. Advances in management of cytomegalovirus retinitis (CMVR) include laser demarcation as an alternative to vitrectomy with silicone oil injection in macula-sparing cytomegalovirus-related retinal detachments and discontinuation of maintenance therapy in select patients with quiescent CMVR and elevated CD4+counts. Screening guidelines have been proposed for childhood CMVR. Serial fundus photography has been recommended to improve follow-up evaluation of CMVR. A method to improve intraocular lens calculation in silicone-filled eyes has been offered. The rapidity and extent to which drug resistant cytomegalovirus infection develops has been elucidated. And the controversy of oral ganciclovir prophylaxis for cytomegalovirus disease has been argued from several angles. The following article reviews these and other advances in the understanding of AIDS-related eye disease.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Cancer may affect the eye and orbit by a direct effect of metastatic neoplastic infiltration or compression or by circulating antibodies involving paraneoplastic retinal degeneration. Metastatic tumor to the uvea is the most common form of an intraocular malignant process. The choroid is the most common site for uveal metastasis; metastases to the ciliary body, iris, retina, optic disc, and vitreous are rare. Approximately one third of patients have no history of primary cancer at the time of ocular diagnosis. Breast and lung carcinomas for women and lung and gastrointestinal carcinomas for men most commonly metastasize to the eye and orbit. The short-term prognosis for vision is usually good but the systemic prognosis is poor. The visual paraneoplastic syndromes encompass several distinct clinical and pathologic entities including carcinoma-associated retinopathy, melanoma-associated retinopathy, and bilateral diffuse melanocytic uveal proliferation. The first affects photoreceptors, the second is thought to affect bipolar cell function, and the third targets the uveal tract. Identification of circulating antibodies against retinal proteins (recoverin, 23-kD retinal protein; 46-kD and 60-kD retinal proteins) serves to recognize the paraneoplastic nature of the patient's symptoms, which frequently develop before the cancer is diagnosed. No therapy exists to stop the inexorable progressive loss of vision. Metastasis to the eye and orbit and paraneoplastic disorders represent a very bad prognostic sign. Recognition of their visual symptoms and ocular findings should alert the ophthalmologist to the possibility of cancer and systemic evaluation should be pursued.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The classic clinical triad of Graves' disease is hyperthyroidism, diffuse goiter, and exophthalmos. Caring for those undergoing the orbital changes of Graves' ophthalmopathy is often challenging, even as our understanding of the disease progresses. New therapeutic modalities for both Graves' disease and the associated orbitopathy have hastened rehabilitation and improved outcomes, although this disease continues to elude definitive cure.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A review of the ocular manifestations of pediatric disease is in some ways a review of pediatrics itself. A paper this size cannot hope to be comprehensive in scope or encyclopedic in detail. Instead, we have chosen to touch on recent developments in pediatrics that we feel may be of particular interest to the ophthalmologist, as well as certain areas of pediatric ophthalmology that make it clear that a child's ocular disease takes place in the larger context of the growing child.

ISSN:1040-8738    

出版商:OVID    

年代:1998

数据来源: OVID