摘要:

AbstractIn a prospective study 82 patients recently diagnosed with simple or capsular glaucoma were randomized to receive primary argon laser trabeculoplasty or pilocarpine treatment. A 2‐year follow‐up showed a better success rate in the laser group, with less need for additional therapy. The average intraocular pressure and peak pressure was lower and the daytime pressure variation was significantly less in the laser group. The better increase in facility of outflow in the laser group was not statistically significant. In capsular glaucoma, laser treatment resulted in a significantly lower average pressure than with medication. In simple glaucoma the effect was about the same in the two treatment groups. Increase in facility of outflow was significantly better in simple glaucoma than in capsular glaucoma. High initial intraocular pressure gave a significantly lower success rate. Primary argon laser trabeculoplasty as a single glaucoma treatment seems advantageous in comparison to medication with pilocarpine for regulating intraocular press

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05008.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractMitomycin is an antibiotic with antineoplastic activity which inhibits fibroblast proliferation in the operative field in glaucoma filtering surgery. The authors retrospectively evaluated the effectiveness of trabeculectomy with mitomycin‐C as an initial surgical procedure in uncomplicated (primary open angle) glaucoma in 17 eyes of 17 patients; 12 eyes of 12 patients that received standard trabeculectomy constituted the control group. Mitomycin was applied at a concentration of 0.5 mg/ml for 3 min to the episclera and 2 min under the scleral flap. Median values for preoperative intraocular pressure was 43 mmHg (range 26–65) in the control group and 40 mmHg (range 30–60) in the mitomycin group (p ≥ 0.05, Mann‐Whitney U‐test). After an average follow‐up of 17 months, median postoperative IOP was 10 mmHg (range 3–18) in the control group and 4 mmHg (range 1.1–20) in the mitomycin group (p<0.05, Mann‐Whitney U‐test). Percentage IOP drop was 75.6% in the control group (range 30.8–93.5%) and 89.6% (range 54.2–98%) in the mitomycin group (p0.05, Fisher exact test), the number of hypotonous eyes (having an average IOP ≤ 5 mmHg) was significantly higher in the mitomycin‐C group compared to the controls (p<0.05, Fisher exact test). Mitomycin established a well formed bleb and reduced the IOP more effectively than did the standard filtering procedure (p<0.05, Mann‐Whitney U‐test); however, further work is necessary to evaluate the long‐term complications of mitomycin‐C surgery such as hypotony. This would help clear any doubts about

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05009.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThirty‐seven patients with normal visual fields and open angles in both eyes, and lens exfoliation in only one eye, were examined for intraocular pressure, and optic disc topography was determined from stereo‐photographs of the fundi with the computerized three‐dimensional image analyzer. The rim‐to‐disc radius ratios at intervals of 30° were obtained with the instrument. The mean intraocular pressure of the exfoliative eyes (17.5 ± 2.9 mmHg) was significantly higher than that of the nonexfoliative eyes (15.9 ± 2.8 mmHg). In the exfoliative eyes, the mean rim‐to‐disc radius ratio at the inferior‐temporal was significantly smaller, and the higher the intraocular pressure of the exfoliative eye in comparison with that of the nonexfoliative eye, the smaller were the rim‐to‐disc radius ratios at the inferior‐temporal and inferior radii. In the exfoliative eyes, pressure‐dependent changes are observable in the inferior and inferior‐temporal areas of the optic dis

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05010.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractElectrophysiological methods like pattern electroretinogram and pattern visual evoked potentials may be the best approach for early glaucoma detection, as they have demonstrated to be sensitive to the ganglion cells functional changes. Reported values of both P50 and N95 pattern electroretinogram components differ widely, a fact perhaps related to a heterogeneous grouping of patients suffering from ocular hypertension and glaucoma, rather than to the type of technique utilized. This study is based on a total of 42 subjects: 14 normals, 16 subjects suffering from ocular hypertension, and 12 patients with glaucoma, with 79 eyes examined. Pattern electroretinogram and pattern visual evoked potentials were used as successive techniques. Setting condition for pattern electroretinogram, such as low temporal frequency (2 Hz), 30 min check size, high contrast (99%) and luminance (93 cd/m2), identified the N95 component as the best index for early glaucoma detection. In the control group N95 mean amplitude was 1.62μV ± 0.59 SD and showed almost significant difference with ocular hypertension (p = 0.07) and highly significant difference with the glaucoma group (p<0.01), with decrement of 58.6% in the glaucoma group. P50 mean amplitude, on the contrary, did not show significant differences among the groups (Newman‐Keul test), its reduction in glaucoma being 28%. The mean pattern visual evoked potentials latency was also highly significant between glaucoma and control groups, but not between ocular hypertension and control groups; the mean amplitude did not show significant differences. A proportion of 26.6% abnormal pattern electroretinogram was found in the group suspected of having glaucoma where conventional methods had proved normal. Pattern visual evoked potentials had a proportion of 23.3% abnormal values and must be regarded as a complementary test. This is most important from a clinical standpoint since a decision on treatment to prevent glaucoma and a strict control of the affected eyes have to be underta

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05011.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractFour hundred and twenty‐five eyes of 213 institutionalized geriatric patients (mean age 83.9 years), were studied. Fundus could be seen in 136 patients, in 234 glaucomatous eyes and in 37 eyes without glaucoma. A separate group of 100 control patients, matched according to age, sex and reasons for institutionalizing (mean age 81.3 years) was also studied. Fundus could be seen in 78 patients. There was no difference in the occurrence of diabetes mellitus among the study group and controls, but cerebral thrombosis occurred statistically significantly more often in glaucoma patients than in the controls. Macular degeneration occurred in 41% (56/136) of the glaucoma patients; in 27% (63/234) of glaucomatous eyes and in 43% (16/37) of nonglaucomatous eyes. Macular degeneration occurred bilaterally in less than half of the glaucoma patients. Macular degeneration occurred in 37% (29/78) of the control patients and bilaterally in most of the patient

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05012.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractDuring the period January 1988 to August 1990, 48 anterior chamber intraocular lenses were implanted during primary cataract surgery. In 6 eyes an anterior chamber intraocular lens was implanted after intracapsular cataract extraction, in 42 eyes after extracapsular cataract extraction complicated by posterior capsular or zonular rupture. Of the 40 cases which had been followed for at least 6 months (mean 23 months), 5 eyes (12.5%) developed clinically significant cystoid macular oedema. All these eyes had an extracapsular cataract extraction with a posterior capsular tear and anterior vitrectomy and in addition all had some other surgical or postoperative complications. Thus, in this series of complicated cataract surgery, cystoid macular oedema was an important cause of visual impairment but cystoid macular oedema was hardly due to the presence of an anterior chamber intraocular lens.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05013.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractThe relationship between severity of background retinopathy, and prior long‐term glycaemic control was studied. Ninety patients with background retinopathy and Type 1 diabetes mellitus, diabetes duration ≤25 years, and HbA1cmonitored>5 years (on average 9.2 years with 32 HbA1cmeasurements) were included. All patients had microaenurysms/haemorrhages, 33 had hard exudates, 27 soft exudates, 8 IRMA (intraretinal microangiopathy), three venous beading, and no patient had macula oedema. Patients with mean HbA1c>8% had higher relative risks for all kinds of background retinopathy, compared to patients with HbA1c≤7%. In multiple regression analysis, long‐term glycated haemoglobin had significant impact on all types of background retinopathy. Women had lower scores for all types of background retinopathy. No sex differences in HbA1c, age, or duration were found. We conclude that poor long‐term glycaemic control is a major risk factor for all types of background re

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05014.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractDetection sensitivity to light decrements created on a cathode ray tube was measured along the nasal horizontal meridian of the central visual fields of 5 normal subjects. Decremental (light offset = negative contrast = dark‐on‐bright) static stimuli were presented at 6, 12, 18, 24 and 30° eccentricity. Detection thresholds to rectangular stimuli of both 4 and 16 mm2(Goldmann equivalent size III and IV, respectively) were determined with ascending staircase single‐crossing technique under various Snellen visual acuity levels. Detection sensitivity diminished with increasing amounts of plus lens‐induced refractive blur. One log unit decrease in visual acuity resulted in elevation of detection thresholds for an average of 3.8 contrast decibels (dB) using size III offset stimuli. The effect of blur was less with size IV offset stimuli which resulted in an average of 0.9 dB elevation in detection thresholds. The larger size decremental stimuli provided a wider dynamic range, less interindividual variation in stimulus visibility and more resistance to refractive error than those obtained with the smaller size

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05015.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractIn a previous experimental study on anaesthetized cat it was shown that a short latency (35–40 ms) cortical potential changed polarity due to the presence or absence of a pattern in the flash stimulus. The results suggested one pathway of neuronal activation in the cortex to a pattern that was within the level of resolution and another to patterns that were not. It was implied that a similar difference in impulse transmission to pattern and non‐pattern stimuli may be recorded in humans. The present paper describes recordings of the short‐latency visual evoked response to varying light flash checkerboard pattern stimuli of high intensity in visually normal and amblyopic children and adults. When stimulating the normal eye a visual evoked response potential with a peak latency between 35 to 40 ms showed a polarity change to patterned compared to non‐patterned stimulation. The visual evoked response resolution limit could be correlated to a visual acuity of 0.5 and below. In amblyopic eyes the shift in polarity was recorded at the acuity limit level. The latency of the pattern depending potential was increased in patients with amblyopia compared to normal, but not directly related to amblyopic degree. It is concluded that the short latency, visual evoked response that mainly represents the retino‐geniculo‐cortical activation may be used to estimate visual resolution below 0.5 in acuity level. The possible value of the method in analyzing general maturation and lesions in the visual system i

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05016.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

AbstractRetinal morphometry was assessed in 7 dogs from a colony of Labrador Retrievers with dystrophic retinas at 1, 2, 3, 4 and 18 months of age. Rod outer segment length and outer nucelar layer width were measured in the central, midperipheral and peripheral retina at six locations along the vertical meridian. Early striking regional differences in onset and rate of progression were characteristic for this inherited retinal degeneration. Notably, some areas of the retina developed fully and normally before degenerating. The central parts of the vertical meridians showed slightly disorganized rod outer segments already at 1 month af age and they were significantly shorter than those of control animals at 3 and 4 months (p<0.01 and p<0.001, respectively). The rod outer segments of the midperipheral and peripheral regions were, however, comparable to control animals as late as at 4 months of age. At 18 months the rod outer segments of dystrophic animals were significantly shorter in all retinal regions (p<0.0005). At that age the outer nuclear layer of the dystrophic animals had become significantly thinner than that of control animals in all retinal regions (p<0.001), indicating a clear visual cell loss. It is reasonable to characterize this as a retinal degeneration having a relatively slow progression, which enhances its relevance to conditions of clincial significance.

ISSN:1755-375X    

DOI:10.1111/j.1755-3768.1994.tb05017.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY