Showing papers in "British Journal of Ophthalmology in 1979"
TL;DR: Long-term assessment of eyes in which silicone oil injection had been used in the treatment of retinal detachment with massive preretinal retraction showed that they were probably caused not by any toxic effect of silicone oil but by obstruction of normal metabolic exchange at the silicone-tissue interface.
Abstract: Long-term assessment of eyes in which silicone oil injection had been used in the treatment of retinal detachment with massive preretinal retraction was undertaken in 92 consecutive patients. While a high incidence of complications, particularly cataract, was confirmed, this study showed that they were probably caused not by any toxic effect of silicone oil but by obstruction of normal metabolic exchange at the silicone-tissue interface. The incidence of complications causing deterioration of vision or serious symptoms was not found to be high, and navigating vision was well preserved.
238 citations
TL;DR: A series of comparative exposures to both argon and krypton lasers have been made at 3 locations in a human retina as discussed by the authors, i.e., the fovea, the macula, and intra-retinal vessels.
Abstract: A series of comparative exposures to both argon and krypton lasers have been made at 3 locations in a human retina--the fovea, the macula, and intraretinal vessels. In the fovea argon irradiations resulted in damage to both the inner and outer retinal layers as a result of absorption within the pigment epithelium and the macular pigment, while krypton exposures damaged the outer retina and the choroid. In the macula both systems resulted in damage to the outer retina, and again sufficient krypton radiation passed into the choroid to induce blood vessel occlusion, haemorrhage, and oedema. When intraretinal vessels were irradiated, only with argon was sufficient energy absorbed within the vessels to damage them or their surroundings in the inner retina. The implications of these findings are discussed in relation to the therapeutic uses of lasers.
176 citations
TL;DR: The bias of the symposium is towards the solution of specific everyday problems, and the level of discussion varies widely between traditional views and controversial and stimulating statements.
Abstract: first meeting, and Douglas Anderson is the moderator of the second meeting, consisting of 7 cases of angle closure glaucoma. The panels consist of eminent researchers into glaucoma and are different in each symposium (except for Robert Shaffer, who was present in both, and whose comments are always to the point, profound yet essentially practical). The case presentations are halted at certain points for discussions and generalisations, and much ground is covered. The bias of the symposium is towards the solution of specific everyday problems, and, not unexpectedly, the level of discussion varies widely between traditional views and controversial and stimulating statements. It is clearly impossible to discuss the 19 chapters individually, but perhaps a few statements and opinions may be singled out for their interest. Assessment of the diurnal variations in pressure is best carried out by sporadic checks at the clinic at different hours, or by home tonometry; inpatient hospital phasing is not so reliable, as it involves a profound change in the patient's routine. Almost all the panelists commonly used the water drinking test, but tonography is no longer a routine investigation, being reserved for special cases. A recent spate of litigation cases in the US concerning juvenile glaucoma prompts several panelists to perform tonometry on every co-operative subject regardless of age. However, Shaffer would limit this to cases with suspicious-looking discs and to those persons in whom it can be carried out in a reasonably short time. Epinephrine almost certainly improves outflow facility fairly rapidly and not, as was thought, after a long latent period. The peak of its dose-response curve appears to be at the 1 % concentration of active drug in the short term, though it may be as high as 2% in the long term (Bernard Becker). Stability of adrenaline solution is greater with the bitartrate and the hydrochloride (Epifrin, Glaucon) than with the borate (Epinal, Eppy), but the borate compounds are more comfortable to use. Although little statistical evidence has been adduced, there is an impression that the disc cup changes more readily if it is already large (John Hetherington). In ocular hypertension the pressure responses to, and patient tolerance of, treatment are important factors in deciding when and how much to treat. In drainage operations vitreous aspiration is increasingly recommended to prevent sealing up of the drainage aperture by vitreous. Provocative tests in angle closure glaucoma remain essentially unreliable. The least unsatisfactory tests are the dark room test and the prone test. Mydriatic tests give many false positives. Neither the patient's advanced age nor a considerable degree of widening of the angle with pilocarpine should weaken our resolve to operate on every case of acute angle closure glaucoma (Pollack). However, tonography has a place in evaluating the chances of success of peripheral iridectomy after an acute attack: if C < 0 1, we can expect over 75% of failures (Shaffer). The volume is beautifully presented and contains several illustrations and clear tables. JOHN ROMANO
164 citations
TL;DR: It was confirmed that this treatment hastens resolution of the serous detachment and no evidence was found to suggest that treatment influences the final visual outcome in eyes with initial visual acuity of 6/12 or better.
Abstract: In a prospective randomised trial of argon laser photocoagulation in the management of central serous retinopathy it was confirmed that this treatment hastens resolution of the serous detachment. No evidence was found to suggest that treatment influences the final visual outcome in eyes with initial visual acuity of 6/12 or better.
143 citations
142 citations
TL;DR: Clinical and pathological findings in 40 consecutive patients seen with primary tumours arising from the lacrimal gland are presented and methods of dealing logically with their problems are suggested.
Abstract: This paper presents the clinical and pathological findings in 40 consecutive patients seen with primary tumours arising from the lacrimal gland. Twenty patients had a benign mixed-cell tumour. They presented in a recognisable clinical manner with a painless mass in the region of the lacrimal gland which slowly enlarged over a period of at least 1 year before consultation. Twenty patients had a carcinoma of the lacrimal gland. They had a short history and experienced pain. On clinical grounds they could not be distinguished from inflammatory lesions in the region of the lacrimal gland. The method of treating these 2 groups of patients is described and methods of dealing logically with their problems are suggested.
129 citations
TL;DR: In this article, a study of the changes in refraction as a sample of 148 children grew between the ages of 1 and 3 1/2 years was made of the refraction changes in the horizontal and vertical meridia of individual eyes.
Abstract: A study has been made of the changes in refraction as a sample of 148 children grew between the ages of 1 and 3 1/2 years. There was no decrease in hypermetropia, but there was a significant decrease in the incidence of astigmatism. Study of the changes in the refraction in the horizontal and vertical meridia of individual eyes gave clear evidence of a trend towards emmetropia if the initial refraction in either meridian was myopic or less than +2.50 D. Above that level the refraction became more or less hypermetropic.
124 citations
TL;DR: In a morphological survey of 73 human retinae spanning 9 decades, and including 20 retinae which were obtained from eyes enucleated for malignant melanomas, nodular excrescences were noted in the outer segments of rods with an incidence which increased with age.
Abstract: In a morphological survey of 73 human retinae spanning 9 decades, and including 20 retinae which were obtained from eyes enucleated for malignant melanomas, nodular excrescences were noted in the outer segments of rods with an incidence which increased with age. These structures were sectioned in both their vertical and horizontal axes and on electron microscopical examination were seen to result from the localised convolution of affected outer segments. The topographic morphology of such convolutions is described and their modes of formation are discussed.
119 citations
TL;DR: The histological features of 234 conjunctival biopsies from Africans in Malawi have been re-examined, with particular emphasis on ultraviolet radiation as the main aetiological factor.
Abstract: The histological features of 234 conjunctival biopsies from Africans in Malawi have been re-examined. The appearances of solar keratosis, pinguecula, and pterygium are presented as part of a continuous spectrum of the same pathological process and aetiology, which may lead to carcinomatous change. The results are discussed with regard to the specific geographical distribution of such lesions found by other workers, with particular emphasis on ultraviolet radiation as the main aetiological factor.
103 citations
TL;DR: This volume provides ophthalmologists with further information on the complex motor and sensory integration occurring in the brain and subserving the visual organ, whose function he strives to maintain.
Abstract: Eye Movements and the Higher Psychological Functions. Ed. JOHN W. SENDERS, DENNIS F. FISHER, and RICHARD A. MONTY. Pp. 394. £21-00. John Wiley: London. 1978. This volume reports the proceedings of a conference held in February 1977 in Monterey, California. The conference was the second on this subject, the proceedings of the first having been published in 1976. It is in some ways refreshing to relate the cerebral control of ocular movements to the higher visual functions for which they have been developed. This also introduces a practical element which some of the recent volumes on eye movements have omitted in their concentration on the neurophysiological, neuroanatomical, or biomedical aspects of the control of eye movements. Thus the reader who does not possess an up-to-date account of eye movement control is gently introduced by Robinson and Goldberg to the visual substrate of eye movements. This platform enables him to delve deeper into saccadic suppression, the role of eye position in space perception, and the co-ordination of eye movements in perception. A whole section is devoted to eye movements in the process of reading, and this is followed by a section on eye movements in looking at static and dynamic displays. Searching for NINA (after Hirshfeld) emphasises the pattern of eye movement search when the subject is asked to find the word NINA camouflaged in a picture. The final section discusses recordings of eye movements to assess patterns of search used in driving a car and analysing a chest x-ray. This volume provides ophthalmologists with further information on the complex motor and sensory integration occurring in the brain and subserving the visual organ, whose function he strives to maintain. It is worthy of perusal by those interested in broadening their knowledge, and the extensive bibliography provides an opportunity to delve more deeply. M. D. SANDERS
99 citations
TL;DR: The histological sections of 74 retinoblastoma patients were reviewed, and a new system is proposed to cover the whole spectrum of the disease and to offer a reliable guide to prognosis and treatment.
Abstract: The histological sections of 74 retinoblastoma patients were reviewed. The extent of optic nerve invasion was correlated with choroidal/scleral extension. Choroidal invasion carries 100% survival provided that the sclera, iris, and whole optic nerve are not also involved. Invasion of the optic nerve beyond the lamina cribrosa also carries 100% survival provided that the resection line is free and that invasion does not involve the sclera or iris. Plentiful rosettes were usually found in those tumours that had not extended beyond the choroid or as far as the resection line of the optic nerve and were therefore associated with a good prognosis. The absence of rosettes did not necessarily indicate a poor prognosis. The site of metastases was related to optic nerve and scleral/extrascleral extension. The various systems of staging retinoblastoma are compared, and a new system is proposed to cover the whole spectrum of the disease and to offer a reliable guide to prognosis and treatment.
TL;DR: Cycloplegic refraction of 1-year-old children is technically possible and is acceptable to mothers as a method for screening children for visual defects and the possibility that meridional hypermetropia could be the basic defect in squint and amblyopia is discussed.
Abstract: Cycloplegic refraction of 1-year-old children is technically possible and is acceptable to mothers as a method for screening children for visual defects. The range of refractions found in a sample of 186 1-year-old children is reported. Prediction of which children are significantly at risk for squint and/or amblyopia is possible on the basis of refractions at age 1 year according to the criteria selected for an 'abnormal' refraction. Bilateral hypermetropia and/or astigmatism or anisometropia at age 1 year was significantly (P less than 1 in 10 000) associated with a child eventually being found to have squint or amblyopia. Both the age of screening and criteria of abnormality will probably need modification. +2.50 or more D hypermetropia in any one meridian of either eye at age 1 year was even more significantly (P = 0.000 000 05%) associated with squint and/or amblyopia. The possibility that meridional hypermetropia could be the basic defect in squint and amblyopia is discussed.
TL;DR: Thirty-two eyes with subluxated and disclosed lenses were surgically managed by means of the vitrophage for those cases in which subluxation or dislocation of lenses into the vitreous was not associated with other complications such as glaucoma, perforating injuries, and retinal detachment.
Abstract: Thirty-two eyes with subluxated and disclosed lenses were surgically managed by means of the vitrophage. The best results were obtained for those cases in which subluxation or dislocation of lenses into the vitreous was not associated with other complications such as glaucoma, perforating injuries, and retinal detachment. No major intraoperative or postoperative problems were seen in uncomplicated cases during a follow-up period ranging from 5 to 45 months.
TL;DR: A study of 105 eyes in which intraocular injection of silicone oil was used to treat retinal detachment with massive preretinal retraction showed that early results were encouraging, and anatomical and visual results correlated well.
Abstract: A study of 105 eyes in which intraocular injection of silicone oil was used to treat retinal detachment with massive preretinal retraction showed that early results were encouraging, and anatomical and visual results correlated well. Operative complications had little influence on the immediate outcome, the reasons for failure being poor case selection or inadequate surgical technique. When a deterioration occurred during the postoperative period it was found to be associated with late complications, particularly cataract; redetachment occurred in only a small number (12%) of cases.
TL;DR: It has been found that diabetic patients take longer to adapt and that their absolute thresholds are raised and the degree of elevation in the final threshold correlates with the duration of diabetes.
Abstract: The effect of diabetes mellitus on the normal dark adaptation curve is investigated. It has been found that diabetic patients take longer to adapt and that their absolute thresholds are raised. The degree of elevation in the final threshold correlates with the duration of diabetes.
TL;DR: It is postulate that the presence of contractile fibroblasts (myofibro Blasts) in the vitreous may provide the mechanism for Vitreous traction.
Abstract: The histological findings of the wound, the vitreous, and the retina in the rabbit eye with experimental posterior penetrating injury are described. Wound healing had just begun at 3 days after injury and was well established by 9 to 12 days. It involved proliferation of cells from the episclera and from the choroid. The progression to a fibrous ingrowth from the wound occurred only in eyes with blood in the vitreous. The intravitreal fibroblastic proliferation had begen at 6 days after injury and seemed to be derived from the choroid, the nonpigmented ciliary epithelium and, posteriorly, from the optic nervehead. During the development of retinal detachment the configuration of the peripheral and posterior retina, together with the orientation of vitreous strands, suggested the presence of vitreous traction. We postulate that the presence of contractile fibroblasts (myofibroblasts) in the vitreous may provide the mechanism for vitreous traction. The retinal detachments were also characterised by epiretinal and subretinal membranes, but these were not prominent. The end-stage appearance of a soft, shrunken eye with cyclitic membrane formation and retinal detachment resembles the outcome in many human eyes after severe penetrating injuries.
TL;DR: Multivariate linear discriminant analysis of the data supported the above factors as being the variables that best predicted the development of RI, and a derived linear equation predicted 91 % of all patients studied who had central retinal vein occlusion and who developed rubeosis iridis.
Abstract: The records of 57 patients with recent central retinal vein occlusion were reviewed in order to predict the development of rubeosis iridis (RI) and neovascular glaucoma (NVG) from the initial clinical examination, colour fundus photographs, and fluorescein angiograms. Twelve patients (21 %) developed both RI and NVG, and this complication appeared to be correlated most significantly with clinical and fluoroangiographic evidence of severe retinal ischaemia. The correlation between RI and other findings was as follows: widespread capillary occlusion (86 % developed RI); absent perifoveal network (80 %); 10 or more cotton-wool spots (75 %); A-V transit time of greater than 20 seconds (75 %); severe large vessel leakage (31 %); and severe retinal oedema (60 %). Less significant correlation of RI was obtained with poor visual acuity and with associated systemic diseases. Factors of no statistical prognostic value included the patient's age, history, or evidence of pre-existing open-angle glaucoma, degree of fundus haemorrhage, capillary dilatation, disc oedema, disc capillary dilatation and leakage, leakage of small vessels in the posterior pole, and development of disc collateral vessels. Multivariate linear discriminant analysis of the data supported the above factors as being the variables that best predicted the development of RI, and a derived linear equation predicted 91 % of all patients studied who had central retinal vein occlusion and who developed rubeosis iridis.
TL;DR: It was concluded that the early changes mimicked those seen in human retinal vein occlusion, though persistent retinal oedema and preretinal neovascularisation were not identified.
Abstract: Branch and hemisphere vein occlusion were produced in rhesus monkeys by argon laser photocoagulation. The following observations were made: (1) Immediately after occlusion there was venous dilatation, delayed filling of the artery, delayed drainage by the occluded vein, and capillary leakage. (2) Two patterns of evolution were identified within the first week. In some animals the fundus changes resolved and the retina returned to normal, while in others there was progressive retinal capillary closure. (3) Those animals destined to have capillary closure had diffuse or cluster retinal haemorrhages at 24 hours. (4) Capillary closure took place over 1 week and was usually complete over large areas of retina. (5) Retinal atrophy and major vessel changes occurred over several weeks. (6) Retinal revascularisation occurred in those areas of closure, though this was often limited. It was concluded that the early changes mimicked those seen in human retinal vein occlusion, though persistent retinal oedema and preretinal neovascularisation were not identified.
TL;DR: In this paper, a technique has been developed which produces an experimental posterior penetrating eye injury that reproducibly results in traction retinal detachment in rabbit eyes, which is considered useful for further histological, electromicroscopical, electrophysiological, and ultrasound studies of posterior penetrating injuries of the eye.
Abstract: A technique has been developed which produces an experimental posterior penetrating eye injury that reproducibly results in traction retinal detachment in rabbit eyes. The standard injury is an incision through the pars plana with vitreous prolapse and incarceration; the wound is then carefully closed with microsurgical techniques. It appears that blood in the vitreous is an essential factor in the development of vitreous traction and of traction retinal detachment. The model, which has been successfully transferred to Rhesus monkey eyes, is considered useful for further histological, electromicroscopical, electrophysiological, and ultrasound studies of posterior penetrating injuries of the eye. Our immediate goal is to assess in a controlled experiment whether pars plana vitrectomy can interrupt the sequence of events leading to traction retinal detachment after a posterior penetrating injury.
TL;DR: The changes related to scleroderma occurred in the 3 types classified according to the extent of skin involvement, and many of these were considered to be age-related, and there were various incidental changes.
Abstract: Thirty-eight patients with scleroderma (progressive systemic sclerosis) without renal failure were subjected to detailed clinical ophthalmic assessment. Abnormalities were frequent. However, many of these, including lens opacities, vitreous frosting, and arteriosclerotic changes, were considered to be age-related, and there were various incidental changes. Posterior subcapsular lens opacities in one patient were probably corticosteroid-induced. Changes related to scleroderma included eyelid abnormalities (stiffness or tightness in 11, telangiectasia in 8), deficient tear secretion (14 cases), and conjunctival abnormalities (injection 19 cases, vascular sludging 27 cases). Iris light reflux (6 cases) was possibly related to scleroderma. The changes related to scleroderma occurred in the 3 types classified according to the extent of skin involvement.
TL;DR: Sphenoidal mucocele is added to the other complications previously reported, and accordingly a classification of the various ways that fibrous dysplasia can affect the ocular structures is proposed.
Abstract: Three cases of craniofacial fibrous dysplasia are reported, all presenting to the ophthalmologist first. They all had ocular complications due either to direct involvement of the orbital bones or to secondary complications. Sphenoidal mucocele is added to the other complications previously reported, and accordingly a classification of the various ways that fibrous dysplasia can affect the ocular structures is proposed.
TL;DR: The case history of a patient with a retained wooden orbital foreign body is presented and the diagnostic limitations of orbital CAT scanning and ultrasonography are illustrated.
Abstract: The case history of a patient with a retained wooden orbital foreign body is presented. The report illustrates the diagnostic limitations of orbital CAT scanning and ultrasonography. Systemic corticosteroid therapy facilitated the localisation and surgical removal of the foreign body.
TL;DR: Panretinal photocoagulation prevented the development of rubeosis and neovascular glaucoma in susceptible eyes.
Abstract: Thirty-three patients with central vein occlusion were evaluated for the effects of scatter xenon arc panretinal photocoagulation. Thirty-four eyes (2 eyes of 1 patient) were randomly divided into a treatment (15 eyes) and a nontreatment group (19 eyes). The average follow-up per eye has been 29 months. The visual prognosis was not significantly better in either group. There was no difference in the development of fundus neovascularisation between groups. None of the patients in the treated group developed rubeosis or neovascular glaucoma. Two patients in the nontreatment group initially had rubeosis and 3 developed it after entry. All 5 involved eyes developed neovascular glaucoma. A significantly greater amount of central retinal capillary drop-out was present in the untreated eyes that developed rubeosis than those untreated eyes which did not. The eyes in the treated group had a similar range of capillary drop-out area, but none of these eyes developed rubeosis or neovascular glaucoma. Panretinal photocoagulation prevented the development of rubeosis and neovascular glaucoma in susceptible eyes.
TL;DR: The serum retinol-binding protein and prealbumin levels in children with corneal ulcers following measles were below normal, but a group of malnourished children without eye complaints following measleswere found to have even lower levels, indicating that a specific deficiency of vitamin A does not appear to be the primary cause of these ulcers, though it may be a contributory one.
Abstract: Acute corneal ulceration in malnourished children is the commonest cause of childhood blindness in Northern Nigeria and usually develops after measles. Other severe diseases in malnourished children rarely precipitate corneal ulceration. A survey in a school for blind children showed that 69% of the children were blind from corneal disease, and a survey of children with corneal scars showed that at least 42% were caused by ulceration after measles. The clinical appearance of the active ulcers was very varied. The serum retinol-binding protein and prealbumin levels in children with corneal ulcers following measles were below normal, but a group of malnourished children without eye complaints following measles were found to have even lower levels. Thus a specific deficiency of vitamin A does not appear to be the primary cause of these ulcers, though it may be a contributory one. A specific measles keratitis and secondary herpes simplex infectious may be local factors contributing to this ulceration, and there is nearly always a background of protein calorie malnutrition. Racial factors may also be of some significance.
TL;DR: Acycloguanosine was equally effective when given intravenously in the form of its sodium salt, and could be detected in the tear fluid in inhibitory concentrations when given by mouth, and was relatively free from toxicity.
Abstract: Acycloguanosine, a recently developed compound with high inhibitory activity against viruses belonging to the herpes group, has been evaluated in experimental herpes simplex keratitis in rabbits in comparison with trifluorothymidine and preparations of idoxuridine and vidarabine at present in clinical use. All compunds were used in the form of ophthalmic ointments which were applied 5 times a day at intervals of 2 hours. Treatment began on the third day of infection and was continued for 4 days. Complete cure was obtained with acycloguanosine and idoxurdine; trifluorothymidine and vidarabine were considerably less effective. Acycloguanosine was equally effective when given intravenously in the form of its sodium salt, and could be detected in the tear fluid in inhibitory concentrations when given by mouth. The compound was relatively free from toxicity.
TL;DR: There was complete loss of the capillary endothelium and pericytes, and the acellular capillaries were invaded by proliferating glial cell processes, so producing permanent capillary closure.
Abstract: Experimental retinal vein occlusion in monkeys was followed by an immediate increase in capillary permeability which was accompanied by retinal oedema. This functional capillary change was followed at about 6 hours after occlusion by structural damage to the capillary wall. Thrombus formation occurred in the damaged vessels, and areas of stasis were thus produced with associated retinal haemorrhages. Finally, there was complete loss of the capillary endothelium and pericytes, and the acellular capillaries were invaded by proliferating glial cell processes, so producing permanent capillary closure.
TL;DR: It is suggested that an environmental factor such as blurred vision may be relatively more important as a cause of squint/amblyopia than a genetically determined neurological abnormality.
Abstract: 215 preschool siblings of children presenting with squint/amblyopia were screened by refraction after cycloplegia. The presence of +2.00 or more D of spherical hypermetropia in both eyes, or +1.00 or more D sphere or cylinder of anisometropia was significantly associated (P=0.0779%) with that child being identified 2+ years later as having either squint or amblyopia or both. Astigmatism of +1.50 or more D in either eye was significantly associated with anisometropia (P=0.000 0013%). If bilateral hypermetropia of +2.00 or more DS and/or +1.50 or more D of astigmatism in either eye had been taken as criteria for abnormality (ignoring anisometropia), there was a more significant association (P=0.0025%) between refraction and squint/amblyopia in these siblings. Such a child had 4 times more chance of having a visual defect than one who had no error of refraction when screened. These findings suggest that an environmental factor such as blurred vision may be relatively more important as a cause of squint/amblyopia than a genetically determined neurological abnormality.
TL;DR: A very high degree of interocular congruence is observed in the patterns of both kinetic visual field defects and threshold profiles and in abnormalities of foveal colour discrimination and visual acuity in patients with retinitis pigmentosa.
Abstract: Bilateral symmetry of disorders of vision is examined in 60 typical patients with retinitis pigmentosa. We observed a very high degree of interocular congruence in the patterns of both kinetic visual field defects and threshold profiles and in abnormalities of foveal colour discrimination and visual acuity. Abnormalities of foveal colour vision are highly correlated with the extent of visual field loss.
TL;DR: Peripheral iridectomy for primary acute angle-closure glaucoma controlled the condition without any need for further medical or surgical therapy in 72% of cases.
Abstract: For the past 12 years peripheral iridectomy has been used as the initial surgical procedure after an acute attack of angle-closure glaucoma. The operation has been performed 2 to 5 days after the pressure has been controlled medically and has been followed routinely by prophylactic peripheral iridectomy in the fellow eye. Peripheral iridectomy for primary acute angle-closure glaucoma controlled the condition without any need for further medical or surgical therapy in 72% of cases. Careful and frequent follow-up within the first 4 postoperative months is essential to prevent further field loss, which can occur very rapidly if the pressure is not adequately controlled. If the pressure remains uncontrolled, further surgery should not be delayed. It was impossible to decide which patients would eventually need trabeculectomy when they first attended in the acute attack. Peripheral iridectomy as a prophylactic procedure was entirely effective in preventing an acute angle-closure attack in the fellow eye.
TL;DR: The lesions were studied retrospectively, and those in which the neovascular tissue did not underlie the fovea, and therefore were treatable, were identified and conclusions were drawn.
Abstract: During a 1-year period 398 new patients were seen with disciform macular degeneration (530 eyes). The lesions were studied retrospectively, and those in which the neovascular tissue did not underlie the fovea, and therefore were treatable, were identified. The following conclusions were drawn: (1) Treatment is possible in most patients with good acuity and few with poor acuity. (2) Treatment is possible in a large proportion of patients with a short history and few with a long history of visual loss. (3) As many as 50% of all patients with senile disciform macular degeneration may be amenable to treatment if seen early enough in the course of their disease. (4) Over one-third of eyes with lesions that are untreated have a visual acuity of 6/60 or better 3 years after the onset of symptoms. (5) If a controlled trial proves that treatment is beneficial, these results emphasise the need for rapid referral and show that these patients will generate a large additional clinical load.