{"title":"Pattern electroretinogram and computerized optic nerve-head analysis in ocular hypertension--interim results after 2.5 years.","authors":"T G Bömer, J H Meyer, M Bach, J Funk","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Evidence exists that both the pattern electroretinogram (PERG) as a parameter of ganglion-cell function and computerized morphometric disc analysis (ONHA) predict subsequent glaucomatous visual field defects in ocular hypertensive eyes. Since November 1991 we have conducted a prospective longitudinal study to evaluate the suitability of PERG and ONHA for detecting incipient glaucoma damage. Inclusion criteria were: an intraocular pressure of > or = 25 mmHG (at least two measurements taken on different days) or, in eyes with additional risk factors, > or = 23 mmHG; a normal Octopus visual field (mean defect < or = 2 dB, no local defect); and no definite glaucomatous disc cupping. After a mean follow-up period of 14.6 +/- 8.8 (range 1-33) months and with a mean intraocular pressure of 24.4 (range 18-42) mmHg, none of the 66 patients (115 eyes) converted to glaucoma. Furthermore, PERG and ONHA do not agree in their estimation of the glaucoma risk at this stage.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 1","pages":"26-30"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19623843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Falsely nonrecordable flash visual evoked cortical potentials in a diabetic eye with severe vitreous hemorrhage.","authors":"U Kellner, M H Foerster","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The examination of visual evoked cortical potentials (VECPs) prior to vitrectomy has been proposed for selection of patients with good chances for a favorable outcome following surgery. A missing single flash VECP has been considered a contraindication for further surgical treatment. A 64-year-old woman with proliferative diabetic retinopathy suffered from an intensive vitreous hemorrhage in one eye. Preoperatively, the flash VECP was nonrecordable. Intraoperatively, a dense vitreous hemorrhage and retrohyaloidal blood was found. The retina was attached. Postoperatively, the flash VECP was similar in both eyes with normal latencies. The visual acuity improved from light perception to 0.05. Severe vitreous hemorrhage may interfere with preoperative VECP recordings. A nonrecordable VECP has to be judged cautiously so as to prevent false-negative responses in eyes that could regain vision following vitrectomy and removal of the hemorrhage.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 1","pages":"23-5"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19623842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Indocyanine green videoangiography of malignant melanomas of the choroid using the scanning laser ophthalmoscope.","authors":"U Schneider, F Gelisken, W Inhoffen, I Kreissig","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The diagnostic value of fluorescein angiography (FA) in the evaluation of small suspected choroidal melanomas is limited. Indocyanine green videoangiography (ICGV) has overcome some of the problems of FA in the imaging of normal and abnormal choroidal vessels. This study was performed to reveal the role of ICGV in the detection of the intrinsic tumor vasculature of choroidal malignant melanomas. A total of 24 patients with posterior-segment malignant melanoma underwent FA and ICGV using the scanning laser ophthalmoscope. All patients were grouped into 1 of 2 categories, depending on the tumor elevation: group I 10 patients with lesions elevated to < 4 mm, and group II 14 patients with lesions measuring > 4 and < 8 mm in height. On early frames of the ICGV the borders of the tumors were better demarcated from the background and the tumors appeared larger in the basal dimension than with FA or clinical examination. ICGV was superior to standard FA in imaging intrinsic tumor vasculature. Abnormal vasculature features included different caliber size, tortuosities, corkscrew loops, irregular ramifications, and irregular staining of the vessel walls. These intrinsic tumor vessels were identified in 6 of 10 patients from group I and in 12 of 14 patients from group II. ICGV appears to add some information in the diagnosis and documentation of tumor growth. It may allow detection of pathologic tumor vessels that cannot be detected by standard FA. The borders of the tumor are better demarcated against the background by ICGV than by FA or clinical examination.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 1","pages":"6-11"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19623769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M M Gellrich, G Kade, J Gerling, M Bach, L L Hansen
{"title":"Pattern, flicker, and flash electroretinography in human immunodeficiency virus infection: a longitudinal study.","authors":"M M Gellrich, G Kade, J Gerling, M Bach, L L Hansen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To study electroretinographic (ERG) changes in the course of human immunodeficiency virus (HIV) disease, 42 eyes without retinitis were examined twice or more. During 9.6 months of mean observation time the visual acuity did not change. We found progressive functional impairment for the first, second, and third neurons of the visual pathway: the pattern-ERG amplitude (retinal ganglion-cell function) decreased by 11%, the b-wave amplitude (bipolars mediated by Müller cells) decreased by 13%, and the a-wave amplitude (dominated by rods) diminished by 21%. The flicker amplitude (dominated by cones) decreased by 20%. All of the latter four changes were significant (P < 0.02). Damage to the retina in HIV infection cannot solely be explained by visible changes in HIV retinopathy.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"5 1","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19623841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prophylactic Nd:YAG-laser iridotomy versus surgical iridectomy: a randomized, prospective study.","authors":"O Schwenn, F Sell, N Pfeiffer, F Grehn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Both surgical iridectomy and YAG-laser iridotomy have been shown to prevent angle-closure glaucoma. However, it remains unknown as to which procedure is superior. We therefore conducted a prospective randomized study, which compared the effect of the two methods on visual acuity, intraocular pressure, endothelial cell density, depth of the anterior chamber, and iris configuration as well as acceptance by the patients. A total of 30 patients, who were treated for acute angle-closure glaucoma in one eye, were subjected to either surgical iridectomy or Nd:YAG-laser iridotomy in the other eye according to a randomized protocol. All patients were followed for 12 months by examination at the 1st, 6th, and 12th month post treatment. No significant difference between the two treatments was found regarding visual acuity or intraocular pressure. The peripheral anterior chamber increased in depth following both methods, whereas the central depth of the anterior chamber was unaffected. A better gonioscopic visibility of the trabecular meshwork resulted from the increased width of the chamber angle. Whereas the number of endothelial cells remained constant in the patients treated with laser iridotomy, a small decrease was observed in the group of patients who underwent iridectomy (-7.2% after 12 months; difference not significant). The subjective acceptance by the patients was better in the group treated with laser iridotomy. We conclude that the two methods are equivalent with regard to intraocular pressure and visual acuity. The constant number of endothelial cells and the better acceptance by the patients suggest Nd:YAG-laser iridotomy to be the preferable method for prophylaxis of acute angle-closure glaucoma.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"4 6","pages":"374-9"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19723993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical investigation of the combination of a scanning laser ophthalmoscope and laser Doppler flowmeter.","authors":"G Michelson, M J Langhans, M J Groh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In this report we present the clinical applications of a new noninvasive method of imaging in high definition the topography of perfused retinal vessels. By the combination of a laser Doppler Flowmeter with a scanning laser system the retinal circulation can be visualized and quantified. The principles of measuring blood flow by laser Doppler flowmetry are based on the laser Doppler effect: laser light scattered by a moving particle is shifted in frequency. The scanning laser system is a modified laser scanning tomograph (technical data: retinal area of measurement, 2.7 x 0.7 mm; 10 degrees field with 256 points x 64 lines; horizontal digital resolution, 10 microns; wave-length, 670 nm; light power, 100 micro W; data acquisition time, 2.048 s). Every line is scanned 128-times at a line-sampling rate of 4000 Hz. By the performance of discrete fast fourier transformation over 128 intensities of each retinal point the laser Doppler shift is calculated for each retinal point. With these data a 2-dimensional map of the retinal perfusion with 256 x 64-points is created. The brightness of the picture point is coded by the value of the Doppler shift. By this method we examined health eyes with normal intraocular pressure (IOP) and artificially increased IOP and eyes with glaucomatous optic nerve atrophy, proliferative diabetic retinopathy with areas of capillary occlusion, arterial hypertension with microinfarction of the retina, and central retinal artery occlusion. The application of \"scanning laser Doppler flowmetry\" (SLDF) leads to the visualization of perfused vessels and capillaries of the retina in high resolution. The examination of perfused retinal arterioles, veins, and capillaries by this method represents the anatomical situation. In SLDF the area of normal or impaired retinal circulation becomes visible (capillary nonperfusion, proliferative vascular structures), whereby the extent of the perfusion is proportional to the brightness of the imaged vessel; the brighter the vessels or capillaries, the higher the blood flow inside the vessels. Retinal areas with low capillary flow are \"dark\" and show no visible vessel. In imaging of an eye with central retinal artery occlusion, retinal arterioles, veins, or capillaries were invisible due to the lack of retinal perfusion. Only ciliary-source vessels of the optic nerve head were bright and visible, indicating normal ciliary circulation. SLDF facilitates the visualization of perfused retinal capillaries and vessels in high resolution. The representation of the function of the retinal circulation by SLDF leads to an image similar to the anatomical situation. The two-dimensional mapping of local blood flow leads to a physiological picture of the retinal perfusion with visible vessels and capillaries.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"4 6","pages":"342-9"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19724095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Panophthalmitis with acute scleral necrosis after brachytherapy of a malignant melanoma of the ciliary body.","authors":"S Bodanowitz, I Strempel, W Wiegand, P Kroll","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 52-year-old man who presented with a large ciliochoroidal malignant melanoma was treated by application of a 106Ru plaque. At 8 days after removal of the plaque, severe panophthalmitis with rapidly progressive scleral necrosis at the site of the tumor made enucleation inevitable because of impending perforation of the globe. Microscopic examination revealed an intense inflammatory response and almost complete necrosis of the tumor and overlying sclera. Possible mechanisms for the occurrence of this rare complication are discussed.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"4 6","pages":"380-2"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19723994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term treatment of blepharospasm with botulinum toxin type A.","authors":"Z Nüssgens, P Roggenkämper","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The treatment of essential blepharospasm with botulinum toxin has been known for a decade and is becoming increasingly more popular. To our knowledge, only a few longterm studies in major patient populations have been published. Of a total of more than 1,600 patients, results of treatment were evaluated in 115 patients (31 men and 84 women) treated continuously for a minimum of 3 years and a maximum of 8 years (mean, 5.7 years). Patients were divided into two groups. Group I represents the \"good responders\" and contains all patients who received only 4-10 injections over that time (n = 55). Group II represents the \"poor responders, \" who received at least 20 injections over that period (n = 60). Group I received a mean of 7.1 injections, whereas group II had a mean of 24.4 injections (total, 1,855). In group I the beneficial effect lasted for an average of 14.6 weeks (range, 2-52 weeks), whereas group II had a mean beneficial effect for only 6.8 weeks (range, 0-18 weeks). The time of efficacy remained statistically stable even in the case of frequent treatment (up to 36 injections in group II). Systemic or severe long-lasting local side effects were never observed; the most frequent side effects were: group I-ptosis, 5.4%; tearing, 5.1%; double vision, 1.8%; and lid lag, 1.5%; group II-ptosis, 4.3%; tearing, 3.3% lid lag, 1.9%, and double vision, 1.6%. The treatment of essential blepharospasm with botulinum toxin is a very effective therapy with minimal and transient complications. It may be used for long-term treatment without showing a decrease in efficacy.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"4 6","pages":"363-7"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19723991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Severe occlusive retinal periphlebitis with vitreous hemorrhage in multiple sclerosis.","authors":"M Ronzani, G E Lang, P Wagner, G K Lang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Severe ocular complications in multiple sclerosis are rare. A 43-year-old patient had a history of diplopia episodes and optic neuritis in the right eye between 1979 and 1980. In 1984, multiple sclerosis had been diagnosed. The patient presented with visual deterioration in the right eye in 1992. Ophthalmoscopy and fluorescein angiography showed severe occlusive retinal periphlebitis with diffuse retinal hemorrhages and large areas of nonperfusion. At the time of presentation the patient was in general good health and presented no neurological sign. Examinations for other causes of periphlebitis were negative. Although treatment with laser therapy and corticosteroids was initiated, the patient developed recurrent vitreous hemorrhages that required pars plana vitrectomy. In 1993 the patient suffered from a general deterioration of the disease course and was treated with systemic immunosuppressive medication. Vitreous hemorrhage is a rare complication of multiple sclerosis.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"4 6","pages":"328-31"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19724092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Extension of a recent therapy for dyslexia.","authors":"M Fahle, J Luberichs","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Recently, peculiarities of visual perception were found in dyslexic patients. Therefore, we investigated visual acuity, reading and spelling capabilities, as well as peripheral letter recognition in 54 children with reading and/or spelling problems. Subsequently, the children and their parents trained at home for approximately 0.5 h daily during 2-3 months. Training consisted of reading through a small aperture and of visuomotor coordination tasks. The mean results obtained in a reading test for all patients improved significantly after the training, but less so than those recorded in previous studies on children suffering from dyslexia. Although the therapy clearly improved performance, it was less specific than previously claimed.</p>","PeriodicalId":77146,"journal":{"name":"German journal of ophthalmology","volume":"4 6","pages":"350-4"},"PeriodicalIF":0.0,"publicationDate":"1995-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19723989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}