ISSN:0030-3755    

DOI:10.1159/000309377

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A ‘posterior hyphema’ (in analogy to the classic hyphema seen in the anterior chamber) is a collection of liquid blood at the bottom of a fluid-filled space in the posterior segment of the eye. The horizontal surface of a posterior hyphema produces strong signals echographically which, at first glance, may be confused with signals from a retinal detachment or a preretinal membrane. With the patient being examined in a supine position, a retinal detachment of the inferior posterior fundus involving the macula is suggested. Such a misdiagnosis would have serious consequences for the management of a patient and must be avoided. A simple, quick and effective (both highly sensitive and specific) echographic (A-scan and B-scan) shift technique clearly differentiates a posterior hyphema from a retinal detachment and a preretinal membrane. This shift method has been applied successfully in 62 consecutive cases of posterior hyphema. These represent 20% of 304 cases with severe posterior segment hemorrhages examined echographically in a 3-year period. With echography, the height of a posterior hyphema can be measured precisely and its consistency ranging from very liquid (‘thin’ hyphemas) to highly viscous (‘thick’ and ‘sticky’ hyphemas) can be determined. Thus, echography contributes important information about this special kind of posterior segment hemorrhage, particularly useful in previtrectomy evaluations.

ISSN:0030-3755    

DOI:10.1159/000309378

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

3 sisters with sector retinitis pigmentosa are presented; 2 had coexisting chronic angle-closure glaucoma. The clinical findings including visual fields and electrophysiologic tests, are summarized. The association of retinitis pigmentosa and glaucoma is reviewed, and the interesting concurrence of these rare diseases is discussed.

ISSN:0030-3755    

DOI:10.1159/000309379

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

A careful examination of the near response of the pupil should be part of the routine eye examination, and the clinician should have a few tricks up his sleeve for the patient who does not like to look at a near object. When the near response of the pupil is greater than the light response, there is a limited, but interesting and important differential diagnosis to be considered.

ISSN:0030-3755    

DOI:10.1159/000309380

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

Approximately 50% of patients undergoing enucleation for choroidal melanoma will eventually die of metastases. The majority of tumor related deaths will occur within 5 years of enucleation, but late metastases may occur 20–30 years after enucleation. Long-term follow-up of patients refusing treatment has shown a 100% mortality. Although recent reports have attempted to link the performance of enucleation with the development of metastases, examination of available data suggests that metastases occur preoperatively, but are subclinical at the time of enucleation. The most important variable determining prognosis in these cases is the size of the tumor at the time of diagnosis and treatment. Patients who undergo enucleation before the tumor exceeds 7 × 7 × 2 mm have an extremely favorable prognosis. Patients whose maximum tumor diameter exceeds 12 mm have an extremely poor prognosis. Metastases and extrascleral extension have both been reported to occur in tumors which failed to demonstrate growth while being followed. For these reasons we recommend immediate enucleation be carried out in all patients whose tumors exceed 7 × 7 × 2 mm and in whom the diagnosis can be confirmed by indirect ophthalmoscopy, ultrasound, fluorescein angiography, and other tests. Follow-up of non-enucleation methods of treatment of choroidal melanomas is too short to draw meaningful conclusions. The consistent finding of persistence of some tumor mass and the histopathologic presence of viable tumor cells following these treatment modalities leaves us very concerned about the long-term results in these patients. Late metastases continue to occur decades following diagnosis of a choroidal melanoma, especially if it is small. The ophthalmologist must remain aware that the results of his decision concerning treatment of a melanoma may not become apparent for many years.

ISSN:0030-3755    

DOI:10.1159/000309381

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The pattern of uveitis seen in a Caucasian population in Iowa was found to be very similar to that seen in London in spite of geographical and climatic differences in the two locations. Acute anterior uveitis was the commonest type of uveitis but fewer of the Iowa patients showed radiological evidence of ankylosing spondylitis or Reiter’s syndrome. Toxoplasmosis was responsible for 9% of cases in both series. It is concluded that genetic factors are more important than geographic location in determining the types of uveitis which occur in a Caucasian population.

ISSN:0030-3755    

DOI:10.1159/000309382

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

We compared the pattern of visual field loss in 148 patients with primary open-angle glaucoma and 63 patients with secondary glaucoma. The frequency with which each location in the visual field was defective was similar in the two conditions. The most common visual field defects in both varieties of glaucoma were superior arcuate scotomas and superior nasal steps. The similar distribution of visual field defects in primary and secondary glaucomas is consistent with a common mechanism for optic disc damage.

ISSN:0030-3755    

DOI:10.1159/000309383

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

41 patients with acquired esotropia who did not have preoperative prism adaptation were compared to 50 patients who were prism-adapted prior to surgery. Surgical success was evaluated at a postoperative period of 6 months. 82% of the patients who responded to prism adaptation had a successful surgical result as compared to only 51% of the patients who did not wear prisms preoperatively.

ISSN:0030-3755    

DOI:10.1159/000309384

出版商:S. Karger AG    

年代:1984

数据来源: Karger

ISSN:0030-3755    

DOI:10.1159/000309385

出版商:S. Karger AG    

年代:1984

数据来源: Karger

摘要:

The sheath of the optic nerve was studied in rhesus monkeys, humans, and rabbits. The sheath (i.e., dura mater and arachnoid mater) was normally found to be loose near the eyeball, with a much bigger space between the optic nerve and the sheath than anywhere else in its course, consequently presenting bulbous appearance just behind the eyeball. The space was narrowest in the region of the optic canal, with thick fibrous bands stretching from the dura mater to the pia mater of the optic nerve – so that the space assumed the character of a trabecular meshwork of closely knit fibers in the canal, with the subarachnoid and subdural spaces reduced to almost a capillary size in this region. Communication between the subarachnoid spaces of the cranial cavity and of the sheath was almost always seen; however, the extent of communication in the optic canal showed wide variation from one specimen to another. The significance of our findings in the interpretation of some clinical and pathological findings and processes is discussed.

ISSN:0030-3755    

DOI:10.1159/000309386

出版商:S. Karger AG    

年代:1984

数据来源: Karger