Showing papers by "Gary C. Brown published in 1990"

Basic fibroblast growth factor levels in the vitreous of patients with proliferative diabetic retinopathy.

Abstract: • A two-site enzyme-linked immunosorbent assay was used to quantitate levels of basic fibroblast growth factor in the vitreous from 36 patients undergoing vitrectomy for a variety of retinal conditions, including proliferative diabetic retinopathy, macular pucker, and retinal detachment with and without proliferative vitreoretinopathy. Basic fibroblast growth factor levels ranged from undetectable to 52 ng/mL. In patients with proliferative diabetic retinopathy, basic fibroblast growth factor levels were greater than or equal to 30 ng/mL in 8 of 17 specimens. Of the 8 patients with elevated basic fibroblast growth factor levels, 6 had evidence of active proliferative disease (ie, neovascularization of the disc or iris), whereas in the patients who had undetectable levels only 2 of 9 had evidence of neovascularization of disc and none had neovascularization of the iris. In the rhegmatogenous retinal detachment group, 2 of 10 eyes had elevated basic fibroblast growth factor levels, while none in the macular pucker group had elevated levels. Our study documents increased levels of basic fibroblast growth factor in vitreous specimens from patients with proliferative diabetic retinopathy, particularly those with active proliferative retinopathy. The role of basic fibroblast growth factor in the pathogenesis of various retinal disease entities is discussed.

Retinal Toxicity of Intravitreal Gentamicin

Abstract: The short- and long-term effects of a 10-mg dose of intravitreal gentamicin were studied in the subhuman primate eye with regard to the changes in clinical appearance, fluorescein angiography, electroretinography, histopathologic finding, and electron microscopy. The gentamicin produced retinal whitening with a cherry-red spot, generalized vascular incompetence, diffuse retinal necrosis, thrombosis of the large retinal blood vessels, widespread loss of the retinal capillary pericytes and endothelial cells, and a rapid extinction of the electroretinogram.

Central retinal vein obstruction and axial length.

Abstract: The axial lengths of 24 consecutive adult eyes with unilateral central retinal vein obstruction (CRVO) were compared with those of contralateral unaffected eyes and those of a control population. The lengths of the two eyes of persons with a unilateral CRVO were not significantly different. By contrast, eyes of persons with CRVO averaged 0.67 mm (approximately 2 diopters) shorter than their control counterparts (P = .03). This anatomic difference may be a factor in the development of CRVO.

Giant Retinal Tears-Reply

Abstract: In Reply —We thank Dr Meredith for his interest in our report describing the use of sodium hyaluronate to unfold giant tears We agree that his technique of filling the eye partially with a gas bubble can be effectively used to repair certain giant tears, and we have employed a similar method ourselves Numerous techniques have been described for the repair of giant retinal tears There is certainly no universal consensus in the vitreoretinal field as to which technique is better We believe that if the clinician is aware of the numerous modalities that can be employed, he or she can individualize the treatment to that which is best for each patient

Re-operation following pars plana vitrectomy for the sequelae of proliferative diabetic retinopathy.

Abstract: A review of 306 eyes undergoing pars plana vitrectomy for the complications of proliferative diabetic retinopathy revealed that 26 (8.5%) required a second vitrectomy operation. Among the eyes that required repeat vitrectomy, the eventual visual acuity ranged from 20/20 to 20/400 in 35% and was no light perception in 31%. Reasons for subsequent surgery included recurrent vitreous hemorrhage in 54% of eyes, retinal detachment in 42% and neovascular glaucoma in 4%. Twelve eyes (46%) remained with a permanent retinal detachment despite attempts at surgical repair, and eleven of these twelve eyes subsequently developed rubeosis iridis.

Computerised visual field deficits in tears of the retinal pigment epithelium.

Abstract: Retinal Pigment epithelial tears have been well documented as a complication of pigment epithelial detachment in patients with age related macular degeneration. Spontaneous and iatrogenic separation of detached retinal pigment epithelium, with subsequent retraction and exposure of the underlying choriocapillaris and Bruch9s membrane, usually results in poor visual function in the affected areas. However, exact characterisation of the resultant scotomas has not been previously described. We present two patients with spontaneous pigment epithelial tears who underwent Octopus computerised visual field analysis. The density and characteristics of their associated field loss is compared with their clinical and fluorescein angiographic appearance.

Sodium Hyaluronate and Giant Retinal Tears-Reply

Abstract: In Reply. —We take note of the letter by Lavin and Leaver and appreciate the forum to present a rebuttal. Our article simply describes an alternative technique that can be considered for the repair of GRTs of 180° or greater with extreme folding of the retina. We do not deny that other authors have demonstrated impressive results concerning the surgical repair of GRTs and specifically stated so in our study. Had prior success rates been 100% and the vision good in all eyes, we would not have considered reporting our technique. Nevertheless, this was not the case. Several points should be clarified. It has been our experience that the retina can remain severely folded, even when epiretinal membrane formation is not present and a complete vitrectomy has been performed. Unfolding the retina, and keeping it unfolded, are among the chief obstacles to successful giant tear repair. We agree with Lavin