RESUMEN
To determine the role of pyridoxine in the treatment of diabetic peripheral neuropathy, 18 symptomatic diabetic patients were treated with vitamin B6 or placebo in a double-blind controlled study. Only one patient had a low plasma pyridoxal phosphate level at the start of the study. After 4 mo of treatment with pyridoxine hydrochloride (50 mg three times daily) 6 of 9 pyridoxine-treated and 4 of 9 placebo-treated patients noted significant relief from their neuropathic symptoms. There was no difference between the two groups with regard to fasting plasma glucose, motor nerve conduction velocity, or ophthalmologic examination at the beginning or at the conclusion of the study. Our results suggest that vitamin B6 deficiency is not a factor in the etiology of diabetic peripheral neuropathy. Furthermore, treating diabetic peripheral neuropathy with high dose vitamin B6 or placebo results in a similar frequency of symptomatic improvement.
Asunto(s)
Neuropatías Diabéticas/tratamiento farmacológico , Piridoxina/uso terapéutico , Adulto , Anciano , Ensayos Clínicos como Asunto , Neuropatías Diabéticas/sangre , Neuropatías Diabéticas/diagnóstico , Método Doble Ciego , Humanos , Masculino , Persona de Mediana Edad , Conducción Nerviosa , Fosfato de Piridoxal/sangreRESUMEN
Indirect (scatter) cryotherapy and photocoagulation treatments successfully obliterated peripheral neovascularization in patients with sickle cell retinopathy and talc retinopathy. Fifteen of 17 neovascular fronds in seven eyes of five patients were obliterated. This type of treatment is analogous to panretinal photocoagulation for diabetic retinopathy. Because low energy levels are used, indirect treatment of peripheral neovascularization may be a safe and effective alternative to focal treatment of feeder vessels.
Asunto(s)
Neovascularización Patológica , Enfermedades de la Retina/cirugía , Vasos Retinianos , Adulto , Anemia de Células Falciformes/complicaciones , Criocirugía , Angiografía con Fluoresceína , Humanos , Terapia por Láser , Masculino , Persona de Mediana Edad , Desprendimiento de Retina/complicaciones , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Talco/efectos adversosRESUMEN
In aphakic patients, we devised a technique for forceps removal of posterior segment intraocular foreign bodies through the corneoscleral limbus. Enlargement of the pars plana incision was not necessary.
Asunto(s)
Córnea , Cuerpos Extraños en el Ojo/cirugía , Esclerótica , Afaquia/cirugía , Córnea/cirugía , Humanos , Métodos , Esclerótica/cirugíaRESUMEN
A review of 135 consecutive cataract operations identified ten cases (7.4%) of operating microscope light retinopathy. Ophthalmoscopically, these light retinopathy lesions appeared as a focal pigment epithelial change with varying degrees of pigment clumping in the center. Fluorescein angiography accentuated the lesion by demonstrating a sharply demarcated transmission defect, occasionally with multiple satellite lesions. The shape of the lesion matched the shape of the illuminating source of the particular operating microscope used during the surgery. The most significant risk factor associated with the production of these light retinopathy lesions was prolonged operating time. Mean total operating time for the ten patients with light retinopathy was 51 minutes longer than for those without (P less than .0001). Other significant associated factors were the presence of diabetes mellitus (P less than .03), younger age (P less than .05), and the use of hydrochlorothiazide (P less than .04).
Asunto(s)
Enfermedad Iatrogénica , Luz/efectos adversos , Microscopía/métodos , Traumatismos por Radiación , Enfermedades de la Retina/etiología , Extracción de Catarata/efectos adversos , Extracción de Catarata/métodos , Complicaciones de la Diabetes , Angiografía con Fluoresceína , Humanos , Hidroclorotiazida/efectos adversos , Periodo Intraoperatorio , Oftalmoscopía , Enfermedades de la Retina/inducido químicamente , Enfermedades de la Retina/patología , Riesgo , Factores de TiempoRESUMEN
A retrospective clinical study on the sleeping habits of patients with macular degeneration was conducted to test the hypothesis that alterations in cone outer segment shedding cycles might be important in the pathogenesis of this disease. No significant difference in number of hours of sleep per night, frequency of nighttime awakening, or frequency of daytime napping was found between patients with macular degeneration and controls. This finding does not support the hypothesis at this level of inquiry. Because cone outer segment shedding is cyclical, other studies of diurnal rhythms in these subjects may be rewarding.
Asunto(s)
Ritmo Circadiano , Degeneración Macular/fisiopatología , Sueño/fisiología , Anciano , Humanos , Degeneración Macular/etiología , Estudios RetrospectivosRESUMEN
To establish the clinical and angiographic incidence of cystoid macular edema (CME) after neodymium:YAG (Nd:YAG) laser capsulotomy, the authors have prospectively studied 136 patients who underwent Nd:YAG laser discission for secondary opacification of the posterior capsule after extracapsular cataract extraction. In all patients, fluorescein angiography was obtained before the laser discission. Of the 136 patients, 78 (57%) were followed for at least 6 months, and fluorescein angiography was repeated 4 to 8 weeks after the procedure. CME did not develop in any of the patients in this series.