ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Retinal arterial occlusions occur secondary to a multitude of mechanisms. The evaluation and workup of a patient with a retinal arterial occlusion depends on many factors, including the age and the systemic health status of the patient. Retinal arterial occlusions in the young typically occur by somewhat different mechanisms than do arterial occlusions in older adults. This article reviews the recent literature related to the etiology and diagnostic evaluation of retinal arterial occlusions in young people as well as potential new managements.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The treatment of cytomegalovirus retinitis (CMV-R) has improved considerably in the past two years. Local ocular therapy has proved to be effective and provides significant advantages over systemic therapy with regards to better control, preventing progression, avoiding bone marrow and renal toxicity. Direct intraocular injections of anti-CMV drugs and the sustained-release ganciclovir device are the mainstay of local therapy. The ganciclovir intraocular device has undergone rigorous testing and has recently been approved for clinical use. This review describes the surgical procedure, recommendations for use, and exchange and management of associated retinal detachment. In addition, the results of the initial studies and the multicenter, randomized clinical trial are discussed. Current data available from the Study for the Ocular Complications of AIDS (SOCA) and AIDS Clinical Trials Group (ACTG) studies are summarized in the context of CMV-R management.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Golf-related ocular injuries have been reported since the early 1900s. Although this type of ocular injury is fortunately a relatively rare occurrence, the effects are usually devastating. The purpose of this article is to review the mechanism of golf injuries, the prognosis for different types of golf-related injuries, and how such injuries might be prevented.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Angiogenesis is a fundamental component of normal development and pathologic processes within the eye. Complications due to abnormal ocular neovascularization remain the leading cause of visual loss throughout the world today. Neovascularization and the associated increase in vascular permeability are the underlying threats to vision in such diverse conditions as diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity, exudative age-related macular degeneration, sickle cell retinopathy, radiation retinopathy, and numerous others. Although it has been appreciated for nearly one-half century that the clinical findings associated with ocular neovascularization suggest an etiology involving the elaboration of growth factors, the exact molecules involved and their mechanisms of action have remained incompletely understood. Recent developments in this rapidly evolving field have begun to elucidate the major factors responsible for modulating the neovascularization common to these conditions and have significant theoretic implications for the development of novel, nondestructive, pharmacologic treatment modalities.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Endophthalmitis following penetrating eye injuries has a relatively poor prognosis due to the underlying eye trauma and the frequency of more virulent organisms such as Bacillus species. Risk factors for infection include 1) retained intraocular foreign body, 2) a rural injury setting, 3) delay in primary wound closure, and 4) disruption of the crystalline lens. Although endophthalmitis is difficult to distinguish from traumatic changes, recognition of early clinical signs of endophthalmitis, such as hypopyon, vitritis, or retinal periphlebitis, is important and early treatment is recommended. Comprehensive prophylactic antibiotic treatment at the time of injury repair combined with timely diagnostic vitrectomy and injection of intravitreal antibiotics when infection is suspected may significantly improve visual acuity outcomes following penetrating injuries. Treatment includes intravitreal, periocular, and systemic antibiotics. Intravitreal and periocular corticosteroids are also recommended. Recent and past literature supporting these recommendations, as well as the authors' specific prevention and treatment protocols for post-traumatic endophthalmitis, is included in this review.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Cataract surgery is a known risk factor for retinal detachment. The risk for retinal redetachment after cataract surgery in eyes that have previously undergone retinal detachment repair is not well documented but has recently been investigated. Eyes that have undergone previous scleral buckling surgery have good potential for positive visual outcome after cataract surgery, with a low rate of intraoperative complications and a low risk for recurrent retinal detachment. Eyes with complicated retinal detachments that have undergone vitrectomy as part of surgical repair may have a higher rate of intraoperative complications, including difficulty with nuclear expression during planned extracapsular cataract extraction and capsular tears during irrigation and aspiration. The risk for recurrent retinal detachment in these eyes is not known.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Repair of rhegmatogenous retinal detachment is successful in approximately 90% of cases. Assuming all retinal breaks are identified and closed, the most common reason for eventual failure of surgery is the development of proliferative vitreoretinopathy, accounting for the failure of 7% to 10% of primary repairs and an increased proportion of secondary procedures. Recurrent retinal detachment complicated by proliferative vitreoretinopathy is now most frequently treated by pars plana vitrectomy with intraoperative peeling of membranes. During the 1990s, a better understanding of the nature of recurrent retinal detachment due to proliferative vitreoretinopathy has grown concomitantly with more experience using various vitreoretinal techniques to manage these complicated cases. This article reviews the latest developments in vitreous surgery to repair recurrent retinal detachments due to proliferative vitreoretinopathy, focusing on the most recent reports in the literature.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The results of the Central Vein Occlusion Study (CVOS) guide the management of macular edema and neovascularization. This study did not show that grid-pattern laser photocoagulation had a significant beneficial effect for the management of decreased visual acuity caused by perfused macular edema in eyes with central retinal vein occlusion (CRVO). Panretinal laser photocoagulation (PRP) was shown to be beneficial for eyes with at least 2 clock hours of iris neovascularization or any angle neovascularization. PRP has not been advocated as prophylaxis for ischemic eyes before the formation of neovascularizationAlthough treatment of the ocular consequences of CRVO may be guided by the CVOS data, management of the underlying cause of CRVO-the occluded vein itself-was not addressed in the study. Recently, several reports have suggested restoring venous outflow by 1) creating a laser-induced or surgically induced chorioretinal anastomosis, 2) administering recombinant tissue plasminogen activator (rt-PA), 3) cannulating the retinal vein transvitreally, or 4) transecting the posterior scleral ring.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Cytomegalovirus (CMV) optic neuritis is a rapidly blinding disease. Untreated eyes have a final visual acuity of no light perception. Treated eyes maintain visual acuity of approximately 20/100. Relapse occurs often in subjects maintained on single- dose ganciclovir and is controlled by double-dose ganciclovir. Central visual field testing is indicated to detect indolent cases of optic neuritis, because relapse can be silent with stable visual acuity and fundus appearance. Survival of patients with CMV optic neuritis is comparable to that of a matched group having CMV retinitis alone. Early recognition and therapy of CMV papillitis protect against irreversible visual loss. CMV papillitis does not carry a worse prognosis for survival than CMV retinitis alone.

ISSN:1040-8738    

出版商:OVID    

年代:1997

数据来源: OVID