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1.
Ophthalmic Surg Lasers Imaging ; 36(2): 122-8, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15792313

RESUMO

BACKGROUND AND OBJECTIVE: To investigate clinical features and visual acuity outcomes associated with the use of regional anesthesia with monitored anesthesia care (RA/MAC) versus general anesthesia for open globe injuries in adult reparable eyes. PATIENTS AND METHODS: Retrospective, consecutive case series including all adults with open globe injuries repaired at Bascom Palmer Eye Institute between 2000 and 2003. RESULTS: The study included 238 eyes of 238 patients with a median age of 41 years. RA/MAC was employed in 141 (59%) eyes and general anesthesia in 97 (41%) eyes. Patients who had RA/MAC were significantly (P< .001) more likely to have anterior wound location (64% corneal/limbal vs 50%), shorter wound length (6.5 vs 12 mm), and formed anterior chamber (82% vs 56%), and were significantly less likely to have an afferent pupillary defect (12% vs 43%). The improvement from presenting visual acuity to each postoperative follow-up interval was similar for the two groups. CONCLUSIONS: RA/MAC is a reasonable alternative to general anesthesia for selected patients with open globe injuries.


Assuntos
Anestesia por Condução/métodos , Anestesia Geral/métodos , Ferimentos Oculares Penetrantes/cirurgia , Monitorização Intraoperatória , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
2.
Am J Ophthalmol ; 136(4): 670-7, 2003 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-14516807

RESUMO

PURPOSE: To present the detailed clinical findings of a large family with hereditary motor and sensory neuropathy type VI (HMSN VI), a syndrome featuring optic atrophy. DESIGN: Observational case series. METHODS: A detailed history was obtained and physical examination was made of the extended family of the proband for evidence of neurologic dysfunction. The OPA1 gene was screened for mutations by direct DNA sequencing. RESULTS: Twelve of 97 family members examined are affected with signs of HMSN VI. Three other members have either optic atrophy or peripheral neuropathy, thus allowing an appreciation of the full clinical spectrum of disease. No mutations were found in the OPA1 gene. CONCLUSIONS: This family demonstrates the variable expressivity of this disorder as well as incomplete penetrance. This is the largest known family with HMSN VI. No association was found with changes in the OPA1 gene.


Assuntos
Neuropatia Hereditária Motora e Sensorial/complicações , Atrofia Óptica Autossômica Dominante/complicações , Adulto , Idoso , Criança , Análise Mutacional de DNA , Feminino , GTP Fosfo-Hidrolases/genética , Neuropatia Hereditária Motora e Sensorial/genética , Neuropatia Hereditária Motora e Sensorial/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Atrofia Óptica Autossômica Dominante/genética , Atrofia Óptica Autossômica Dominante/patologia , Disco Óptico/patologia , Linhagem , Síndrome , Acuidade Visual
3.
Ophthalmol Clin North Am ; 17(1): 21-31, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15102511

RESUMO

Optical coherence tomography provides high-resolution cross-sectional images of macular pathology in vivo. Owing to its noninvasive noncontact nature and use of near-infrared illumination of the fundus, it is well tolerated by patients. The images can be obtained without dilation and are highly reproducible,quantifying retinal thickness with an axial resolution of 10 microm. These qualities make OCT a powerful diagnostic tool complementary to fluorescein angiography, photography, and biomicroscopy. Optical coherence tomography has proved to be particularly useful for the clinical evaluation of vitreoretinal interface disorders and alterations of the structural anatomy of the macula, such as from edema, choroidal neovascularization, and detachment of the neurosensory retina or RPE. The information obtained from high-resolution evaluation of retinal anatomy allows the diagnosis of conditions that are difficult to establish with biomicroscopy or angiography and improves the clinician's ability to make the optimal treatment decision. The quantitative assessment of OCT allows an objective means to monitor disease progression and therapeutic response.A logical application of this technology is the evaluation of underlying macular pathology in patients considering cataract extraction. Uncovering vitreomacular traction, epiretinal membranes, occult choroidal neovascular membranes with minimal CME, subretinal fluid accumulation, and RPE detachments greatly impacts the clinical management of cataract patients and the weighing of surgical risks and benefits. OCT is a uniquely powerful means of visualizing retinal morphology and pathology that may not be revealed using current techniques of biomicroscopy, fluorescein angiography, or B-scan ultrasonography, and serves as the newest adjunct in diagnostic technology.


Assuntos
Macula Lutea , Doenças Retinianas/diagnóstico , Doenças Retinianas/terapia , Tomografia de Coerência Óptica , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Retina ; 24(4): 591-601; quiz 666-7, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15300081
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