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109 results on '"Maurice B. Landers"'

1. Natural History of Drusenoid Pigment Epithelial Detachment Associated with Age-Related Macular Degeneration

Author

Jeannette J. Yu, Elvira Agrón, Traci E. Clemons, Amitha Domalpally, Freekje van Asten, Tiarnan D. Keenan, Catherine Cukras, Emily Y. Chew, Frederick L. Ferris, John Paul SanGiovanni, Traci Clemons, Anne Lindblad, Robert Lindblad, Nilay Shah, Robert Sperduto, Wendy McBee, Gary Gensler, Molly Harrington, Alice Henning, Katrina Jones, Kumar Thotapally, Diana Tull, Valerie Watson, Kayla Williams, Christina Gentry, Francine Kaufman, Chris Morrison, Elizabeth Saverino, Sherrie Schenning, Barbara Blodi, Ronald P. Danis, Matthew Davis, Kathy Glander, Gregory Guilfoil, Larry D. Hubbard, Kristine Johnson, Ronald Klein, Barbara Nardi, Michael Neider, Nancy Robinson, Eileen Rosensteel, Hugh Wabers, Grace Zhang, Alan J. Ruby, Antonio Capone, Bawa Dass, Kimberly Drenser, Bruce R. Garretson, Tarek S. Hassan, Michael Trese, George A. Williams, Jeremy Wolfe, Tina Bell, Mary Zajechowski, Dennis Bezaire, Fran McIver, Anthony Medina, Jackie Pagett, Stephanie Hatch Smith, Lynn Swartz, Tom Treuter, Andrew Antoszyk, Justin Brown, David J. Browning, Walter Holland, Angella Karow, Kelly Stalford, Angela Price, Sarah Ennis, Sherry Fredenberg, Jenna Herby, Uma Balasubramaniam, Loraine Clark, Donna McClain, Michael McOwen, Lynn Watson, Michael Klein, Steven T. Bailey, Thomas J. Hwang, Andreas Lauer, J. Timothy Stout, Patty McCollum, Milt Johnson, Patrick B. Rice, Ivana Kim, John Loewenstein, Joan Miller, Lucia Sobrin, Lucy Young, Jacqueline Sullivan, Patricia Houlihan, Linda Merry, Ann Marie Lane, Ursula Lord Bator, Claudia Evans, Sarah Brett, Charleen Callahan, Marcia Grillo, David Walsh, Kamella Lau Zimmerman, Gary Edd Fish, Rajiv Anand, Lori E. Coors, Dwain G. Fuller, Rand Spencer, Robert C. Wang, Karen Duignan, Sally Arceneaux, Hank Aguado, Nicholas Hesse, Michael Mackens, Brian Swan, Wai T. Wong, Monica Dalal, Naima Jacobs-El, Catherine Meyerle, Benjamin Nicholson, Henry Wiley, Katherine Hall Shimel, Angel Garced, Janice Oparah, Greg Short, Alana Temple, Babilonia Ayukawa, Guy Foster, Darryl Hayes, Dessie Koutsandreas, Roula Nashwinter, John Rowan, Michael Bono, Denise Cunningham, Marilois Palmer, Alicia Zetina, David H. Orth, Kourous Rezaei, Joseph Civantos, Sohail Hasan, Kirk Packo, Celeste Figliulo, Pam Stanberry, Tara Farmer, Kiersten Nelson, Shannya Townsend-Patrick, Philip Rosenfeld, Royce Chen, Rishi Doshi, Sander Dubovy, Brian T. Kim, Matthew Lowrance, Andrew Moshfeghi, Zayna Nahas, Gary Schienbaum, John Vishak, Christina Weng, Zohar Yehoshua, Belen Rodriguez, Jose Rebimbas, Jane Gleichauf, Mike Kicak, Jason Mena, Tim Odem, Elizabeth Sferza-Camp, Alicia Disgdiertt, Jim Oramas, Isabel Rams, Stephanie Thatcher, Susan B. Bressler, Neil M. Bressler, Daniel Finkelstein, Steven H. Sherman, Sharon Solomon, Howard S. Ying, Rita Denbow, Deborah Phillips, Elizabeth Radcliffe, Judy Belt, Dennis Cain, David Emmert, Mark Herring, Jacquelyn McDonald, G. Baker Hubbard, Chris S. Bergstrom, Blaine Cribbs, Andrew Hendrick, Brandon Johnson, Philip Laird, Sonia Mehta, Timothy Olsen, Justin Townsend, Jion Yan, Steven Yeh, Linda Curtis, Judy Brower, Hannah Yi, Jannah Rutter Dobbs, Debbie Jordan, Michael J. Elman, Robert A. Liss, JoAnn Starr, Jennifer Belz, Charlene Putzulo, Teresa Coffey, Ashley Davis, Pamela Singletary, Giorya Shabi Andreani, Theresa Cain, Daniel Ketner, Peter Sotirakos, Suresh Chandra, Barbara A. Blodi, Michael M. Altaweel, Justin L. Gottlieb, Michael Ip, T. Michael Nork, Thomas S. Stevens, Kathryn Burke, Shelly Olson, Kristine Dietzman, Barbara Soderling, Guy Somers, Angie Wealti, Denise Krolnik, John Peterson, Sandra Reed, Thomas Friberg, Andrew Eller, Denise Gallagher, Leanne Labriola, Melissa Pokrifka, Aron Gedansky, Natalie Anthony, Cassandra Grzybowski, Dawn Matthews, Sharon Murajda-Jumba, Jessica Toro, David G. Callanan, Wayne A. Solley, Patrick Williams, Sandy Lash, Bob Boleman, Chris Dock, Michel Shami, Brenda Arrington, Ashaki Meeks, Alan R. Margherio, Paul Raphaelian, Debra Markus, Justin Langdon, Elizabeth Truax, Sandy Lewis, Brad Terry, Amy Noffke, Kean Oh, Ramin Sarrafizadeh, Scott Sneed, Julie Hammersley, Serena Neal, Mary Doran, Nan Jones, Lisa Preston, Heather Jessick, Tanya Tracy Marsh, Michael Tolentino, Adam Berger, Richard Hamilton, David Misch, Suk Jin Moon, Dawn Sutherland, Vera Dilts, Sara Henderson, Esmeralda Medina, Donald Trueman, Laura Holm, Jason Strickland, Darmakusuma Ie, Jeffrey L. Lipkowitz, Kekul B. Shah, Susan Geraghty, Beverly Sannazzaro, Morgan Harper, Krista Bayer, Mary B. Lansing, Lauren B. Fox, Rebecca Lee, Jay B. Stallman, Michael Jacobson, Sean Koh, Scott Lampert, John Miller, Mark Rivellese, Atul Sharma, Robert A. Stoltz, Stephanie Vanderveldt, Leslie Marcus, Starr Hendricks, Ryan Hollman, Grethel Betanzos, Leslie Ellorin, Shelly Fulbright, Debbie McCormick, Paul A. Edwards, Julianne Hall, Mary Monk, Melanie Gutkowski, Melina Mazurek, Janet Murphy, Katherine Gusas, Crystal Moffett, David Burley, Nicole Chesney, Katie Kilgo, Brian Rusinek, Bradley Stern, Tracy Troszak, Rhonda Baker-Levingston, Carl W. Baker, Tracey Caldwell, Tammy Walker, Lynnette F. Lambert, Tracey Martin, Mary Jill Palmer, Tana Williams, Michael A. Novak, Joseph Coney, David G. Miller, Scott Pendergast, Lawrence Singerman, Nicholas Zakov, Hernando Zegarra, Kim DuBois, Susan Rath, Lori Revella, Tammy Brink, Kim Drury, Lisa Hogue, Mary Ilc, Connie Keller, Elizabeth McNamara, Vivian Tanner, Tamara Cunningham, John DuBois, Gregg Greanoff, Trina Nitzsche, Sheila Smith-Brewer, Ricky D. Isernhagen, John W. Kitchens, Thomas W. Stone, William J. Wood, Diana Holcomb, Virginia Therrien, Michelle Buck, Jeanne Van Arsdall, Edward Slade, Todd E. Schneiderman, David J. Spinak, Jackie Gaedke, Heather Davis Brown, Dan Helgren, Jenifer Garrison Pangelinan, Lawrence Halperin, Scott Anagnoste, Mandeep Dhalla, Krista Rosenberg, Barry Taney, W. Scott Thompson, Jaclyn Lopez, Monica Hamlin, Monica Lopez, Jamie Mariano, Evelyn Quinchia, Patricia Aramayo, Rita Veksler, Michael Lee, Richard Dreyer, Irvin Handelman, Colin Ma, Mark Peters, Stephen Hobbs, Amanda Milliron, Marcia Kopfer, Michele Connaughton, A. Christine Hoerner, R. Joseph Logan, Harry J. Wohlsein, David Boyer, Thomas G. Chu, Pouya Dayani, David Liao, Roger L. Novack, Firas M. Rahhal, Richard Roe, Homayoun Tabandeh, Janet Bayramyan, Tammy Gasparyan, Connie Hoang, Janet Kurokouchi, Tammy Eileen Lo, Richard Ngo, Mary Ann Nguyen, Michael Peyton, Charles Yoon, Julio Sierra, Adam Zamboni, Jeff Kessinger, Eric Protacio, Adam Smucker, Pamela Rath, Robert Bergren, Bernard Doft, Judy Liu, Karl Olsen, Lori Merlotti, Willia Ingram, Kellianne Marfisi, Kimberly Yeckel, Heather Schultz Carmelo, Amanda Fec, Keith McBroom, David Steinberg, Marc Levy, Jody Abrams, Melvin Chen, Waldemar Torres, Peggy Jelemensky, Mark Prybylski, Tara Raphael, Diana Appleby, Charlotte Rodman, Mark Sneath, Robert H. Rosa, Vanessa Hoelscher, Adelia Castano, Jocelyn Parker, John Hoskins, Nicholas Anderson, Joseph Googe, Tod A. McMillan, James Miller, Stephen Perkins, Kristina Oliver, Jennifer Beerbower, Bruce Gilliland, Cecile Hunt, Mike Jacobus, Raul Lince, Christopher Morris, Sarah Oelrich, Jerry Whetstone, Clement K. Chan, Steven Lin, Kim Walther, Tiana Gonzales, Lenise Myers, Kenneth Huff, David M. Brown, Eric Chen, Matthew S. Benz, Richard H. Fish, Rosa Y. Kim, James Major, Tien Pei Wong, Charles Wycoff, Cassandra Cone, Debbie Goates Gilaspia, Nubia Landaverde, Robert Smith, Deneva Zamora, Veronica Sneed, Melina Vela, Eric Kegley, Craig Greven, Shree Kurup, Charles Richards, Madison Slusher, Cara Everhart, Joan Fish, Mark Clark, David Miller, Marshall Tyler, J. Michael Jumper, Arthur D. Fu, Robert N. Johnson, Brandon Lujan, H. Richard McDonald, Rosa Rodriguez, Nina Ansari, Jeanifer Joaquin, Silvia Linares, Lizette Lopez, Jessica Sabio, Sean Grout, Chad Indermill, Yesmin Urias, Roberto Zimmerman, Linda Margulies, Sara J. Schmidt, Joy L. Meier, Sherry L. Hadley, William Rosenthal, Barbara Johnson, Lois Swafford, Richard Shields, R. Scott Varner, Richard Rosen, Ronald Gentile, Melissa Rivas, Katy W. Tai, Wanda Carrasquillo-Boyd, Robert Masini, Glenn Stoller, Ken Carnevale, Diane M. LaRosa, Barbara Burger, Tereza Conway, Carla Del Castillo, Julissa Diaz, Susan Jones, Nina Mondoc, Charlene Balfour, C.H. Vitha, Jennifer Lutz, Barbara McGinley, Fadi El Baba, Ann Marie Lavorna, Renee Jones, Jean Lewis, Ruth Tenzler, Mary Salvas-Mladek, Diane Van Kesteren, W. Copley McLean, W. Zachery Bridges, Cameron Stone, Denise Ammons, Mary Lamy, Andrea Menzel, Lea Doll Raymer, Barbara Campbell, Lisa Hawkins, Leslie Rickman, Lorraine Sherlin, Paula Price, Albert Sinyai, Ronald Kingsley, Reagan H. Bradford, Robert E. Leonard, Sonny Icks, Vanessa Bergman, Brittany Ross, Russ Burris, Amanda Butt, Rob Richmond, Alice Lyon, Manjot Gill, Lee Jampol, Rukhsana Mizra, Zuzanna Rozenbajgier, Jeremy Chapman, Lori Kaminski, Andrea Degillio, Evica Simjanoski, Jeffrey Heier, Hyung Cho, Tina Scheufele Cleary, Darin Goldman, Chirag Shah, Trexler Topping, Marissa Weber, Torsten Wiegand, Jeremy Schindelheim, Joy Bankert, Jennifer Stone, Alison Nowak, Sandy Chong, Lindsay Williams, Steven Bennett, Dennis Donovan, Margaret Graham, Cullen Jones, Anne Fung, Jan-Kristine Bayabo, Razelda Bosch, Esperanza Cruz, Ashley Emerson, Alycia Fleming, Denice Barsness, Jorge Rodriguez, Marina Soboleva, Ingrid U. Scott, Esther Bowie, Kimberly A. Neely, David A. Quillen, Laura Walter, Timothy Bennett, James Strong, John Wells, Lloyd Clark, David Johnson, Peggy Miller, Mallie Taylor, Tiffany Swinford, Robbin Spivey, Michael Banach, Lawrence Ho, Richard Lanning, Thomas R. Pheasant, Jay G. Prensky, Steven Truong, Julia Teatsworth, Michelle Dietrich, Ann Wasilus, Ann Miller, Megan Rakes, Teresa Slagle, Michelle Richards, Patricia Schuessler, Lacy Stover, Paul Beer, Naomi S. Falk, Mary Beth Shannon, Jeannie Olmeda, Don Berdeen, Joseph F. Fisher, James Folk, Stephen Russell, Barbara Taylor, Connie Hinz, Jean Walshire, Heather Stockman, Bruce Critser, Stefani Karakas, Cindy Montague, Randy Verdick, Omesh Gupta, Joseph Maguire, Christopher Brady, Francis Char DeCroos, Michael Dollin, Sunir Garg, Adam Gerstenblith, Julia Haller, Allen C. Ho, Jason Hsu, Richard Kaiser, John Pitcher, Carl Regillo, Rajiv Shah, Marc Spirn, William Tasman, James Vander, Noga Senderowitsch, Michele Formoso, Michelle Markun, Cedric George, Christina Centinaro, Lisa Grande, Stefanie Carey, Elaine Liebenbaum, SriniVas Sadda, Mark Humayun, Rachel Sierra, Elizabeth Corona, Margaret Padilla, Moonseok Nu, Sylvia Ramos, Cullen Barnett, Glenn Currie, Cornelia Gottlieb, Richard Garfinkel, Daniel Berinstein, Marcus Colyer, William Deegan, Michael Min-Shyue Lai, Robert Murphy, Michael Osman, Michael Rivers, Reginald Sanders, Manfred A. von Fricken, Debbie Oliver, Jeanne Kirshon, Tanya Alexander Snowden, Thomas Blondo, Alysia Cronise, Vanessa Denny, Kylie Mendez, Janine Newgen, Justin Davis, Mike Flory, Robert Frantz, Bryan Murphy, Steve Rauch, Judy E. Kim, Jane Bachman, Thomas B. Connor, Dennis P. Han, Kimberly Stepian, David V. Weinberg, William J. Wirostko, Krissa Packard, Tracy Kaczanowski, Vesper Williams, Vicki Barwick, Judy Flanders, Dennis Backes, Joe Beringer, Kristy Keller, Kathy Selchert, Paul Bernstein, Michael Teske, Albert Vitale, Susan Allman, Bonnie Carlstrom, Kimberley Wegner, Anne Haroldsen, Deborah Harrison, Cyrie Fry, James Gilman, Glen Jenkins, Paula Morris, Michael Rauser, Joseph Fan, Mukesh Suthar, Gisela Santiago, Kara Rollins Halsey, Christy Quesada, William Kiernan, Jesse Knabb, Richard Alan Lewis, Cindy Dorenbach, Steven Spencer, Dana Barnett, Joseph Morales, Barron C. Fishburne, Jeffrey G. Gross, Michael A. Magee, Amy Flowers, Angie McDowell, Randall Price, Suber Huang, Johnny Tang, Shawn Wilker, Cherie Hornsby, Lisa Ferguson, Kirk Krogstad, Riva Adamovsky, Peggy Allchin, Kathleen Carlton, Claudia Clow, Kelly Sholtis, Stephanie Burke, Mark Harrod, Stacie Hrvatin, Geoffrey Pankhurst, Nelson R. Sabates, Michael Cassell, Komal Desai, Abraham Poulose, Felix Sabates, Yin Chen, Gary Gallimore, Yolanda Konior, Nicola Kim, Sami Uwaydat, Deborah Troillett, Karen Aletter, Robert N. Frank, Gary Abrams, James Puklin, Asheesh Tewari, Cheryl Milanovic, Melanie Bailey, David Griffith, Dena McDonald, Kit Morehead, Zlatan Sadikovic, Lisa Schillace, Elizabeth Silvis, Brian Joondeph, Nancy Christmas, Alan Kimura, Mimi Liu, Stephen Petty, John Zilis, Jenny Benitez, Cassandra Berryman Catlett, Eric Fluegel, Shane Mowry, Hoang Nguyen, David Reflow, Odette M. Houghton, Seema Garg, Maurice B. Landers, Travis Meredith, Sandy Barnhart, Megha Karmalkar, Debra Cantrell, Rona Lyn Esquejo-Leon, Linda Manor, Sue Pope, David Stines, Amelia Stokely, Dean Hainsworth, Dyann Helming, Debbie Eichelberger, Mary Paige Leaton, Chuck Hamm, Edward Chaum, Alessandro Iannaccone, Barbara Jennings, Tracy Murray, Joe Mastellone, Robert Millay, Brian Kim, Theresa Goddard, Liza Jarrett Beaudette, Nina Changelian-Aitken, Fernando Corrada, Jason Dubuque, Raymond Iezzi, Sophie J. Bakri, Jose S. Pulido, Diane Vogen, Rebecca Nielsen, Karin Berg, Jean Burrington, Shannon Howard, Joan Overend, Zbigniew Krason, Denise Lewison, Thomas Link, Kevin J. Blinder, Nicholas E. Engelbrecht, M. Gilbert Grand, Daniel P. Joseph, Gaurav K. Shah, Bradley Smith, Matthew Thomas, Rhonda Weeks, Lynda Boyd, Dana Gabel, Ron Adelman, John Huang, James Kempton, Aaron Parnes, Jennifer Dupont, Elizabeth Perotti, Victoria Donaldson, Kenneth Fong, Pamela Ossorio, Anita Agarwal, Paul Sternberg, Sandy Owings, Tony Adkins, Elaine Lok, Garvin Munn, Buddy Skellie, Neelakshi Bhagat, Monique S. Roy, Marco Zarbin, Catherine Fay, Michael Lazar, Beth Malpica, Tatiana Mikheyav, Lawrence Ulanski, Jennifer Lim, Marcia Niec, Tametha Johnson, Yesenia Ovando, Catherine Nail Carroll, Mark Janowicz, Steven Schwartz, David Cupp, Michael Gorin, Gad Heilweil, Hamid Hosseini, Jean-Pierre Hubschman, Allan Kreiger, Tara Young McCannel, Carolyn Pan, David Sarraf, Irena Tsui, Joshua Udoetek, Vinad Voleti, Logan Hitchcock, Rosaleen Ostrick, Melissa Chun, Jennie Kageyama, Nilo Davila, Kristin Lipka, Christina Shin, Cynthia Owsley, Michael Albert, Richard Feist, John Mason, Martin Thomley, Angelia Johnson, Tracy Emond, Joanna Hamela, Angela Marsh, Karen Searcey, Kia Rookard, Yu-Guang He, Rafael L. Ufret-Vincenty, Mike Molai, William Anderson, John Horna, Alan Letson, Colleen Cebulla, Susie Chang, Fred Davidorf, Jill Salerno, Laura Sladoje, Christina Stetson, Jeri Perry, Scott Savage, Cynthia Toth, Glenn Jaffe, Stefanie Schuman, Neeru Sarin, Jim Crowell, Tiffanie Keaton, Michael Kelly, Brian Lutman, Marriner Skelly, Lauren Welch, Lawrence Morse, Allan Hunter, Susanna Soon-Chun Park, Cynthia Wallace, Ember Dhillon, Marisa Salvador, Barbara Holderreed, Karishma Chandra, Sashi Kaur, Ellen Redenbo, Smiley Hom, Michael Cooney, Irene Barbazetto, James M. Klancnik, John A. Sorenson, Lawrence Yannuzzi, Maria Scolaro, Eugene Agresta, Nancy Gonzalez, Sandeep Grover, K.V. Chalam, Shailesh Gupta, Christopher Lyons, Wenhua Li, Chirag Patel, Jose Carrion, Henry Ferreyra, Amberly Rodriguez, Iliana Molina, Gabriel Balea, Pam Emory, Marlene Rico, Giorgio Siqueiros, Alexander J. Brucker, Joshua Dunaief, Juan Grunwald, Benjamin Kim, Albert M. Maguire, Brian VanderBeek, Sheri Drossner, Joan DuPont, Rebecca Salvo, Jim Berger, Cheryl Devine, Bill Nyberg, Laurel Weeney, David DiLoreto, Mina Chung, Valerie Davis, Peter MacDowell, George O. Gara, Daniel Castillo, Andrea Czubinski, Melissa Keim, Brandi Hardy, Rachel Grunhaus Hollar, Lynn Schueckler, Alice T. Lyon, Aaron Weinberg, Mira Shiloach, Nicole Pelkofer, Qin Zhou, Laura McPoland, Rajendra Apte, P. Kumar Rao, Sam Pistorius, Jamie Kambarian, Eve Adcock, Sarah Gould, Melanie Quinn, Rhonda Curtis, Amy Frost, Charla Meyer, and Greg Rathert

Subjects
0303 health sciences, medicine.medical_specialty, Visual acuity, genetic structures, business.industry, Eye disease, Hazard ratio, Age-Related Eye Disease Study, Retrospective cohort study, Fundus (eye), Macular degeneration, medicine.disease, eye diseases, 03 medical and health sciences, Ophthalmology, 0302 clinical medicine, 030221 ophthalmology & optometry, medicine, sense organs, medicine.symptom, Prospective cohort study, business, 030304 developmental biology
Abstract

Purpose To investigate the natural history and genetic associations of drusenoid pigment epithelial detachment (DPED) associated with age-related macular degeneration (AMD). Design Retrospective analysis of a prospective cohort study. Participants Of the 4203 Age-Related Eye Disease Study 2 (AREDS2) participants, 391 eyes (325 participants) had DPED without late AMD at the time of DPED detection. Genetic analyses included 120 white AREDS2 participants and 145 Age-Related Eye Disease Study (AREDS) participants with DPED. Methods Baseline and annual stereoscopic fundus photographs were graded centrally to detect DPED, a well-defined yellow elevated mound of confluent drusen ≥433 μm in diameter, and to evaluate progression rates to late AMD: geographic atrophy (GA) and neovascular (NV)-AMD. Five single nucleotide polymorphisms (CFH [rs10611670], C3 [rs2230199], CFI [rs10033900], C2/CFB [rs114254831], ARMS2 [rs10490924]) and genetic risk score (GRS) group were investigated for association with DPED development. Kaplan–Meier analyses and multivariable proportional hazard regressions were performed. Main Outcome Measures Progression rates to late AMD and decrease of ≥3 lines in visual acuity (VA) from the time of DPED detection; association of rate of DPED development with genotype. Results Mean (standard deviation [SD]) follow-up time from DPED detection was 4.7 (0.9) years. DPED was associated with increased risk of progression to late AMD (hazard ratio [HR], 2.36; 95% confidence interval [CI], 1.98–2.82; P Conclusions This study replicates the results of previous natural history studies of eyes with DPED including the high rates of progression to late AMD and vision loss (regardless of progression to late AMD). The genetic associations are consistent with genes associated with AMD progression.

Published
2019

2. Progression of Geographic Atrophy in Age-related Macular Degeneration

Author

Tiarnan D. Keenan, Elvira Agrón, Amitha Domalpally, Traci E. Clemons, Freekje van Asten, Wai T. Wong, Ronald G. Danis, SriniVas Sadda, Philip J. Rosenfeld, Michael L. Klein, Rinki Ratnapriya, Anand Swaroop, Frederick L. Ferris, Emily Y. Chew, John Paul SanGiovanni, Traci Clemons, Anne Lindblad, Robert Lindblad, Nilay Shah, Robert Sperduto, Wendy McBee, Gary Gensler, Molly Harrington, Alice Henning, Katrina Jones, Kumar Thotapally, Diana Tull, Valerie Watson, Kayla Williams, Christina Gentry, Francine Kaufman, Chris Morrison, Elizabeth Saverino, Sherrie Schenning, Barbara Blodi, Ronald P. Danis, Matthew Davis, Kathy Glander, Gregory Guilfoil, Larry D. Hubbard, Kristine Johnson, Ronald Klein, Barbara Nardi, Michael Neider, Nancy Robinson, Eileen Rosensteel, Hugh Wabers, Grace Zhang, Alan J. Ruby, Antonio Capone, Bawa Dass, Kimberly Drenser, Bruce R. Garretson, Tarek S. Hassan, Michael Trese, George A. Williams, Jeremy Wolfe, Tina Bell, Mary Zajechowski, Dennis Bezaire, Fran McIver, Anthony Medina, Jackie Pagett, Stephanie Hatch Smith, Lynn Swartz, Tom Treuter, Andrew Antoszyk, Justin Brown, David J. Browning, Walter Holland, Angella Karow, Kelly Stalford, Angela Price, Sarah Ennis, Sherry Fredenberg, Jenna Herby, Uma Balasubramaniam, Loraine Clark, Donna McClain, Michael McOwen, Lynn Watson, Michael Klein, Steven T. Bailey, Thomas J. Hwang, Andreas Lauer, J. Timothy Stout, Patty McCollum, Milt Johnson, Patrick B. Rice, Ivana Kim, John Loewenstein, Joan Miller, Lucia Sobrin, Lucy Young, Jacqueline Sullivan, Patricia Houlihan, Linda Merry, Ann Marie Lane, Ursula Lord Bator, Claudia Evans, Sarah Brett, Charleen Callahan, Marcia Grillo, David Walsh, Kamella Lau Zimmerman, Gary Edd Fish, Rajiv Anand, Lori E. Coors, Dwain G. Fuller, Rand Spencer, Robert C. Wang, Karen Duignan, Sally Arceneaux, Hank Aguado, Nicholas Hesse, Michael Mackens, Brian Swan, Catherine Cukras, Monica Dalal, Naima Jacobs-El, Catherine Meyerle, Benjamin Nicholson, Henry Wiley, Katherine Hall Shimel, Angel Garced, Janice Oparah, Greg Short, Alana Temple, Babilonia Ayukawa, Guy Foster, Darryl Hayes, Dessie Koutsandreas, Roula Nashwinter, John Rowan, Michael Bono, Denise Cunningham, Marilois Palmer, Alicia Zetina, David H. Orth, Kourous Rezaei, Joseph Civantos, Sohail Hasan, Kirk Packo, Celeste Figliulo, Pam Stanberry, Tara Farmer, Kiersten Nelson, Shannya Townsend-Patrick, Philip Rosenfeld, Royce Chen, Rishi Doshi, Sander Dubovy, Brian T. Kim, Matthew Lowrance, Andrew Moshfeghi, Zayna Nahas, Gary Schienbaum, John Vishak, Christina Weng, Zohar Yehoshua, Belen Rodriguez, Jose Rebimbas, Jane Gleichauf, Mike Kicak, Jason Mena, Tim Odem, Elizabeth Sferza-Camp, Alicia Disgdiertt, Jim Oramas, Isabel Rams, Stephanie Thatcher, Susan B. Bressler, Neil M. Bressler, Daniel Finkelstein, Steven H. Sherman, Sharon Solomon, Howard S. Ying, Rita Denbow, Deborah Phillips, Elizabeth Radcliffe, Judy Belt, Dennis Cain, David Emmert, Mark Herring, Jacquelyn McDonald, G. Baker Hubbard, Chris S. Bergstrom, Blaine Cribbs, Andrew Hendrick, Brandon Johnson, Philip Laird, Sonia Mehta, Timothy Olsen, Justin Townsend, Jion Yan, Steven Yeh, Linda Curtis, Judy Brower, Hannah Yi, Jannah Rutter Dobbs, Debbie Jordan, Michael J. Elman, Robert A. Liss, JoAnn Starr, Jennifer Belz, Charlene Putzulo, Teresa Coffey, Ashley Davis, Pamela Singletary, Giorya Shabi Andreani, Theresa Cain, Daniel Ketner, Peter Sotirakos, Suresh Chandra, Barbara A. Blodi, Michael M. Altaweel, Justin L. Gottlieb, Michael Ip, T. Michael Nork, Thomas S. Stevens, Kathryn Burke, Shelly Olson, Kristine Dietzman, Barbara Soderling, Guy Somers, Angie Wealti, Denise Krolnik, John Peterson, Sandra Reed, Thomas Friberg, Andrew Eller, Denise Gallagher, Leanne Labriola, Melissa Pokrifka, Aron Gedansky, Natalie Anthony, Cassandra Grzybowski, Dawn Matthews, Sharon Murajda-Jumba, Jessica Toro, David G. Callanan, Wayne A. Solley, Patrick Williams, Sandy Lash, Bob Boleman, Chris Dock, Michel Shami, Brenda Arrington, Ashaki Meeks, Alan R. Margherio, Paul Raphaelian, Debra Markus, Justin Langdon, Elizabeth Truax, Sandy Lewis, Brad Terry, Amy Noffke, Kean Oh, Ramin Sarrafizadeh, Scott Sneed, Julie Hammersley, Serena Neal, Mary Doran, Nan Jones, Lisa Preston, Heather Jessick, Tanya Tracy Marsh, Michael Tolentino, Adam Berger, Richard Hamilton, David Misch, Suk Jin Moon, Dawn Sutherland, Vera Dilts, Sara Henderson, Esmeralda Medina, Donald Trueman, Laura Holm, Jason Strickland, Darmakusuma Ie, Jeffrey L. Lipkowitz, Kekul B. Shah, Susan Geraghty, Beverly Sannazzaro, Morgan Harper, Krista Bayer, Mary B. Lansing, Lauren B. Fox, Rebecca Lee, Jay B. Stallman, Michael Jacobson, Sean Koh, Scott Lampert, John Miller, Mark Rivellese, Atul Sharma, Robert A. Stoltz, Stephanie Vanderveldt, Leslie Marcus, Starr Hendricks, Ryan Hollman, Grethel Betanzos, Leslie Ellorin, Shelly Fulbright, Debbie McCormick, Paul A. Edwards, Julianne Hall, Mary Monk, Melanie Gutkowski, Melina Mazurek, Janet Murphy, Katherine Gusas, Crystal Moffett, David Burley, Nicole Chesney, Katie Kilgo, Brian Rusinek, Bradley Stern, Tracy Troszak, Rhonda Baker-Levingston, Carl W. Baker, Tracey Caldwell, Tammy Walker, Lynnette F. Lambert, Tracey Martin, Mary Jill Palmer, Tana Williams, Michael A. Novak, Joseph Coney, David G. Miller, Scott Pendergast, Lawrence Singerman, Nicholas Zakov, Hernando Zegarra, Kim DuBois, Susan Rath, Lori Revella, Tammy Brink, Kim Drury, Lisa Hogue, Mary Ilc, Connie Keller, Elizabeth McNamara, Vivian Tanner, Tamara Cunningham, John DuBois, Gregg Greanoff, Trina Nitzsche, Sheila Smith-Brewer, Ricky D. Isernhagen, John W. Kitchens, Thomas W. Stone, William J. Wood, Diana Holcomb, Virginia Therrien, Michelle Buck, Jeanne Van Arsdall, Edward Slade, Todd E. Schneiderman, David J. Spinak, Jackie Gaedke, Heather Davis Brown, Dan Helgren, Jenifer Garrison Pangelinan, Lawrence Halperin, Scott Anagnoste, Mandeep Dhalla, Krista Rosenberg, Barry Taney, W. Scott Thompson, Jaclyn Lopez, Monica Hamlin, Monica Lopez, Jamie Mariano, Evelyn Quinchia, Patricia Aramayo, Rita Veksler, Michael Lee, Richard Dreyer, Irvin Handelman, Colin Ma, Mark Peters, Stephen Hobbs, Amanda Milliron, Marcia Kopfer, Michele Connaughton, A. Christine Hoerner, R. Joseph Logan, Harry J. Wohlsein, David Boyer, Thomas G. Chu, Pouya Dayani, David Liao, Roger L. Novack, Firas M. Rahhal, Richard Roe, Homayoun Tabandeh, Janet Bayramyan, Tammy Gasparyan, Connie Hoang, Janet Kurokouchi, Tammy Eileen Lo, Richard Ngo, Mary Ann Nguyen, Michael Peyton, Charles Yoon, Julio Sierra, Adam Zamboni, Jeff Kessinger, Eric Protacio, Adam Smucker, Pamela Rath, Robert Bergren, Bernard Doft, Judy Liu, Karl Olsen, Lori Merlotti, Willia Ingram, Kellianne Marfisi, Kimberly Yeckel, Heather Schultz Carmelo, Amanda Fec, Keith McBroom, David Steinberg, Marc Levy, Jody Abrams, Melvin Chen, Waldemar Torres, Peggy Jelemensky, Mark Prybylski, Tara Raphael, Diana Appleby, Charlotte Rodman, Mark Sneath, Robert H. Rosa, Vanessa Hoelscher, Adelia Castano, Jocelyn Parker, John Hoskins, Nicholas Anderson, Joseph Googe, Tod A. McMillan, James Miller, Stephen Perkins, Kristina Oliver, Jennifer Beerbower, Bruce Gilliland, Cecile Hunt, Mike Jacobus, Raul Lince, Christopher Morris, Sarah Oelrich, Jerry Whetstone, Clement K. Chan, Steven Lin, Kim Walther, Tiana Gonzales, Lenise Myers, Kenneth Huff, David M. Brown, Eric Chen, Matthew S. Benz, Richard H. Fish, Rosa Y. Kim, James Major, Tien Pei Wong, Charles Wycoff, Cassandra Cone, Debbie Goates Gilaspia, Nubia Landaverde, Robert Smith, Deneva Zamora, Veronica Sneed, Melina Vela, Eric Kegley, Craig Greven, Shree Kurup, Charles Richards, Madison Slusher, Cara Everhart, Joan Fish, Mark Clark, David Miller, Marshall Tyler, J. Michael Jumper, Arthur D. Fu, Robert N. Johnson, Brandon Lujan, H. Richard McDonald, Rosa Rodriguez, Nina Ansari, Jeanifer Joaquin, Silvia Linares, Lizette Lopez, Jessica Sabio, Sean Grout, Chad Indermill, Yesmin Urias, Roberto Zimmerman, Linda Margulies, Sara J. Schmidt, Joy L. Meier, Sherry L. Hadley, William Rosenthal, Barbara Johnson, Lois Swafford, Richard Shields, R. Scott Varner, Richard Rosen, Ronald Gentile, Melissa Rivas, Katy W. Tai, Wanda Carrasquillo-Boyd, Robert Masini, Glenn Stoller, Ken Carnevale, Diane M. LaRosa, Barbara Burger, Tereza Conway, Carla Del Castillo, Julissa Diaz, Susan Jones, Nina Mondoc, Charlene Balfour, C.H. Vitha, Jennifer Lutz, Barbara McGinley, Fadi El Baba, Ann Marie Lavorna, Renee Jones, Jean Lewis, Ruth Tenzler, Mary Salvas-Mladek, Diane Van Kesteren, W. Copley McLean, W. Zachery Bridges, Cameron Stone, Denise Ammons, Mary Lamy, Andrea Menzel, Lea Doll Raymer, Barbara Campbell, Lisa Hawkins, Leslie Rickman, Lorraine Sherlin, Paula Price, Albert Sinyai, Ronald Kingsley, Reagan H. Bradford, Robert E. Leonard, Sonny Icks, Vanessa Bergman, Brittany Ross, Russ Burris, Amanda Butt, Rob Richmond, Alice Lyon, Manjot Gill, Lee Jampol, Rukhsana Mizra, Zuzanna Rozenbajgier, Jeremy Chapman, Lori Kaminski, Andrea Degillio, Evica Simjanoski, Jeffrey Heier, Hyung Cho, Tina Scheufele Cleary, Darin Goldman, Chirag Shah, Trexler Topping, Marissa Weber, Torsten Wiegand, Jeremy Schindelheim, Joy Bankert, Jennifer Stone, Alison Nowak, Sandy Chong, Lindsay Williams, Steven Bennett, Dennis Donovan, Margaret Graham, Cullen Jones, Anne Fung, Jan-Kristine Bayabo, Razelda Bosch, Esperanza Cruz, Ashley Emerson, Alycia Fleming, Denice Barsness, Jorge Rodriguez, Marina Soboleva, Ingrid U. Scott, Esther Bowie, Kimberly A. Neely, David A. Quillen, Laura Walter, Timothy Bennett, James Strong, John Wells, Lloyd Clark, David Johnson, Peggy Miller, Mallie Taylor, Tiffany Swinford, Robbin Spivey, Michael Banach, Lawrence Ho, Richard Lanning, Thomas R. Pheasant, Jay G. Prensky, Steven Truong, Julia Teatsworth, Michelle Dietrich, Ann Wasilus, Ann Miller, Megan Rakes, Teresa Slagle, Michelle Richards, Patricia Schuessler, Lacy Stover, Paul Beer, Naomi S. Falk, Mary Beth Shannon, Jeannie Olmeda, Don Berdeen, Joseph F. Fisher, James Folk, Stephen Russell, Barbara Taylor, Connie Hinz, Jean Walshire, Heather Stockman, Bruce Critser, Stefani Karakas, Cindy Montague, Randy Verdick, Omesh Gupta, Joseph Maguire, Christopher Brady, Francis Char DeCroos, Michael Dollin, Sunir Garg, Adam Gerstenblith, Julia Haller, Allen C. Ho, Jason Hsu, Richard Kaiser, John Pitcher, Carl Regillo, Rajiv Shah, Marc Spirn, William Tasman, James Vander, Noga Senderowitsch, Michele Formoso, Michelle Markun, Cedric George, Christina Centinaro, Lisa Grande, Stefanie Carey, Elaine Liebenbaum, Mark Humayun, Rachel Sierra, Elizabeth Corona, Margaret Padilla, Moonseok Nu, Sylvia Ramos, Cullen Barnett, Glenn Currie, Cornelia Gottlieb, Richard Garfinkel, Daniel Berinstein, Marcus Colyer, William Deegan, Michael Min-Shyue Lai, Robert Murphy, Michael Osman, Michael Rivers, Reginald Sanders, Manfred A. von Fricken, Debbie Oliver, Jeanne Kirshon, Tanya Alexander Snowden, Thomas Blondo, Alysia Cronise, Vanessa Denny, Kylie Mendez, Janine Newgen, Justin Davis, Mike Flory, Robert Frantz, Bryan Murphy, Steve Rauch, Judy E. Kim, Jane Bachman, Thomas B. Connor, Dennis P. Han, Kimberly Stepian, David V. Weinberg, William J. Wirostko, Krissa Packard, Tracy Kaczanowski, Vesper Williams, Vicki Barwick, Judy Flanders, Dennis Backes, Joe Beringer, Kristy Keller, Kathy Selchert, Paul Bernstein, Michael Teske, Albert Vitale, Susan Allman, Bonnie Carlstrom, Kimberley Wegner, Anne Haroldsen, Deborah Harrison, Cyrie Fry, James Gilman, Glen Jenkins, Paula Morris, Michael Rauser, Joseph Fan, Mukesh Suthar, Gisela Santiago, Kara Rollins Halsey, Christy Quesada, William Kiernan, Jesse Knabb, Richard Alan Lewis, Cindy Dorenbach, Steven Spencer, Dana Barnett, Joseph Morales, Barron C. Fishburne, Jeffrey G. Gross, Michael A. Magee, Amy Flowers, Angie McDowell, Randall Price, Suber Huang, Johnny Tang, Shawn Wilker, Cherie Hornsby, Lisa Ferguson, Kirk Krogstad, Riva Adamovsky, Peggy Allchin, Kathleen Carlton, Claudia Clow, Kelly Sholtis, Stephanie Burke, Mark Harrod, Stacie Hrvatin, Geoffrey Pankhurst, Nelson R. Sabates, Michael Cassell, Komal Desai, Abraham Poulose, Felix Sabates, Yin Chen, Gary Gallimore, Yolanda Konior, Nicola Kim, Sami Uwaydat, Deborah Troillett, Karen Aletter, Robert N. Frank, Gary Abrams, James Puklin, Asheesh Tewari, Cheryl Milanovic, Melanie Bailey, David Griffith, Dena McDonald, Kit Morehead, Zlatan Sadikovic, Lisa Schillace, Elizabeth Silvis, Brian Joondeph, Nancy Christmas, Alan Kimura, Mimi Liu, Stephen Petty, John Zilis, Jenny Benitez, Cassandra Berryman Catlett, Eric Fluegel, Shane Mowry, Hoang Nguyen, David Reflow, Odette M. Houghton, Seema Garg, Maurice B. Landers, Travis Meredith, Sandy Barnhart, Megha Karmalkar, Debra Cantrell, Rona Lyn Esquejo-Leon, Linda Manor, Sue Pope, David Stines, Amelia Stokely, Dean Hainsworth, Dyann Helming, Debbie Eichelberger, Mary Paige Leaton, Chuck Hamm, Edward Chaum, Alessandro Iannaccone, Barbara Jennings, Tracy Murray, Joe Mastellone, Robert Millay, Brian Kim, Theresa Goddard, Liza Jarrett Beaudette, Nina Changelian-Aitken, Fernando Corrada, Jason Dubuque, Raymond Iezzi, Sophie J. Bakri, Jose S. Pulido, Diane Vogen, Rebecca Nielsen, Karin Berg, Jean Burrington, Shannon Howard, Joan Overend, Zbigniew Krason, Denise Lewison, Thomas Link, Kevin J. Blinder, Nicholas E. Engelbrecht, M. Gilbert Grand, Daniel P. Joseph, Gaurav K. Shah, Bradley Smith, Matthew Thomas, Rhonda Weeks, Lynda Boyd, Dana Gabel, Ron Adelman, John Huang, James Kempton, Aaron Parnes, Jennifer Dupont, Elizabeth Perotti, Victoria Donaldson, Kenneth Fong, Pamela Ossorio, Anita Agarwal, Paul Sternberg, Sandy Owings, Tony Adkins, Elaine Lok, Garvin Munn, Buddy Skellie, Neelakshi Bhagat, Monique S. Roy, Marco Zarbin, Catherine Fay, Michael Lazar, Beth Malpica, Tatiana Mikheyav, Lawrence Ulanski, Jennifer Lim, Marcia Niec, Tametha Johnson, Yesenia Ovando, Catherine Nail Carroll, Mark Janowicz, Steven Schwartz, David Cupp, Michael Gorin, Gad Heilweil, Hamid Hosseini, Jean-Pierre Hubschman, Allan Kreiger, Tara Young McCannel, Carolyn Pan, David Sarraf, Irena Tsui, Joshua Udoetek, Vinad Voleti, Logan Hitchcock, Rosaleen Ostrick, Melissa Chun, Jennie Kageyama, Nilo Davila, Kristin Lipka, Christina Shin, Cynthia Owsley, Michael Albert, Richard Feist, John Mason, Martin Thomley, Angelia Johnson, Tracy Emond, Joanna Hamela, Angela Marsh, Karen Searcey, Kia Rookard, Yu-Guang He, Rafael L. Ufret-Vincenty, Mike Molai, William Anderson, John Horna, Alan Letson, Colleen Cebulla, Susie Chang, Fred Davidorf, Jill Salerno, Laura Sladoje, Christina Stetson, Jeri Perry, Scott Savage, Cynthia Toth, Glenn Jaffe, Stefanie Schuman, Neeru Sarin, Jim Crowell, Tiffanie Keaton, Michael Kelly, Brian Lutman, Marriner Skelly, Lauren Welch, Lawrence Morse, Allan Hunter, Susanna Soon-Chun Park, Cynthia Wallace, Ember Dhillon, Marisa Salvador, Barbara Holderreed, Karishma Chandra, Sashi Kaur, Ellen Redenbo, Smiley Hom, Michael Cooney, Irene Barbazetto, James M. Klancnik, John A. Sorenson, Lawrence Yannuzzi, Maria Scolaro, Eugene Agresta, Nancy Gonzalez, Sandeep Grover, K.V. Chalam, Shailesh Gupta, Christopher Lyons, Wenhua Li, Chirag Patel, Jose Carrion, Henry Ferreyra, Amberly Rodriguez, Iliana Molina, Gabriel Balea, Pam Emory, Marlene Rico, Giorgio Siqueiros, Alexander J. Brucker, Joshua Dunaief, Juan Grunwald, Benjamin Kim, Albert M. Maguire, Brian VanderBeek, Sheri Drossner, Joan DuPont, Rebecca Salvo, Jim Berger, Cheryl Devine, Bill Nyberg, Laurel Weeney, David DiLoreto, Mina Chung, Valerie Davis, Peter MacDowell, George O. Gara, Daniel Castillo, Andrea Czubinski, Melissa Keim, Brandi Hardy, Rachel Grunhaus Hollar, Lynn Schueckler, Alice T. Lyon, Aaron Weinberg, Mira Shiloach, Nicole Pelkofer, Qin Zhou, Laura McPoland, Rajendra Apte, P. Kumar Rao, Sam Pistorius, Jamie Kambarian, Eve Adcock, Sarah Gould, Melanie Quinn, Rhonda Curtis, Amy Frost, Charla Meyer, and Greg Rathert

Subjects
0301 basic medicine, medicine.medical_specialty, genetic structures, business.industry, Eye disease, Incidence (epidemiology), Fundus (eye), Macular degeneration, medicine.disease, eye diseases, Confidence interval, Geographic atrophy, 03 medical and health sciences, Ophthalmology, 030104 developmental biology, 0302 clinical medicine, Age related, 030221 ophthalmology & optometry, medicine, sense organs, Prospective cohort study, business
Abstract

Purpose To analyze the prevalence, incidence, and clinical characteristics of eyes with geographic atrophy (GA) in age-related macular degeneration (AMD), including clinical and genetic factors affecting enlargement. Design Prospective cohort study within a controlled clinical trial. Participants Age-Related Eye Disease Study 2 (AREDS2) participants, aged 50–85 years. Methods Baseline and annual stereoscopic color fundus photographs were evaluated for GA presence and area. Analyses included GA prevalence and incidence rates, Kaplan-Meier rates, mixed-model regression, and multivariable analysis of the square root of GA, area adjusted for covariates, including clinical/imaging characteristics and genotype. Main Outcome Measures (1) Presence or development of GA; (2) change in the square root of GA area over time. Results At baseline, 517 eyes (6.2%) of 411 participants (9.8%) had pre-existing GA (without neovascular AMD), with the following characteristics: 33% central, 67% noncentral; and the following configurations: 36% small, 26% solid/unifocal, 24% multifocal, 9% horseshoe/ring, and 6% indeterminate. Of the remaining 6530 eyes at risk, 1099 eyes (17.3%) of 883 participants developed incident GA without prior neovascular disease during mean follow-up of 4.4 years. The Kaplan-Meier rate of incident GA was 19% of eyes at 5 years. In eyes with incident GA, 4-year risk of subsequent neovascular AMD was 29%. In eyes with incident noncentral GA, 4-year risk of central involvement was 57%. GA enlargement rate (following square root transformation) was similar in eyes with pre-existing GA (0.29 mm/year; 95% confidence interval 0.27–0.30) and incident GA (0.28 mm/year; 0.27–0.30). In the combined group, GA enlargement was significantly faster with noncentrality, multifocality, intermediate baseline size, and bilateral GA (P Conclusions Analyses of AREDS2 data on natural history of GA provide representative data on GA evolution and enlargement. GA enlargement, which was influenced by lesion features, was relentless, resulting in rapid central vision loss. The genetic variants associated with faster enlargement were partially distinct from those associated with risk of incident GA. These findings are relevant to further investigations of GA pathogenesis and clinical trial planning.

Published
2018

3. Current management of diabetic tractional retinal detachments

Author

Maurice B. Landers, David J. Browning, and Michael W. Stewart

Subjects
0301 basic medicine, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Bevacizumab, genetic structures, Fundus Oculi, medicine.medical_treatment, vitrectomy, Visual Acuity, Vitrectomy, Angiogenesis Inhibitors, Review Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, lcsh:Ophthalmology, medicine, Humans, Fluorescein Angiography, Rubeosis iridis, Diabetic Retinopathy, business.industry, Diabetes, Retinal Detachment, Disease Management, Retinal, Vitreoretinal surgery, Diabetic retinopathy, tractional retinal detachment, medicine.disease, eye diseases, Surgery, Ophthalmology, 030104 developmental biology, chemistry, Current management, lcsh:RE1-994, Intravitreal Injections, 030221 ophthalmology & optometry, Tamponade, sense organs, business, Tomography, Optical Coherence, medicine.drug
Abstract

Twenty-five percent of diabetes-related vision loss stems from complications of proliferative diabetic retinopathy (PDR). Panretinal photocoagulation has been the preferred treatment of high-risk PDR for decades and more recently intravitreal injections of drugs that inhibit the actions of vascular endothelial growth factor have become popular. But despite these treatments PDR may progress uncontrollably to advanced pathologies such as traction retinal detachments (TRDs), combined traction/rhegmatogenous retinal detachments (TRD/RRDs), vitreous hemorrhages, rubeosis iridis, and traction maculopathies, which produce mild-to-severe loss of vision. TDR have long been the most common indication for PDR-related vitreoretinal surgery. Vitrectomy surgery is indicated for recent (6 months duration) may also benefit. Combined TRD/RRD represents a particularly challenging surgical condition but advances in surgical instrumentation, dissection techniques, and post-operative tamponade have produced excellent success rates. The recent development of small-gauge vitrectomy systems has persuaded most surgeons to switch platforms since these appear to produce shorter surgical times and quicker post-operative recoveries. Pre-operative injections of bevacizumab are frequently administered for persistent neovascularization to facilitate surgical dissection of pre-retinal fibrosis and reduce the incidence of post-operative hemorrhages. Recent trends toward earlier surgical intervention and expanded indications are likely to continue as surgical instrumentation and techniques are further developed.

Published
2018

5. Vitrectomy for center-involved diabetic macular edema

Author

Michael W. Stewart, David J. Browning, Chong Lee, and Maurice B. Landers

Subjects
medicine.medical_specialty, Visual acuity, genetic structures, Intraclass correlation, medicine.medical_treatment, Diabetic macular edema, vitrectomy, Vitrectomy, law.invention, 03 medical and health sciences, 0302 clinical medicine, Optical coherence tomography, Randomized controlled trial, Interquartile range, law, Ophthalmology, medicine, 030212 general & internal medicine, Original Research, center-involved diabetic macular edema, medicine.diagnostic_test, business.industry, Retrospective cohort study, Clinical Ophthalmology, eye diseases, 030221 ophthalmology & optometry, medicine.symptom, business, diabetic macular edema, spectral domain OCT
Abstract

David J Browning,1 Chong Lee,1 Michael W Stewart,2 Maurice B Landers III3 1Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, NC, 2Mayo Clinic, Jacksonville, FL, 3Kittner Eye Center, University of North Carolina, Chapel Hill, NC, USA Purpose: To determine the effect of vitrectomy for center-involved diabetic macular edema (CI-DME). Methods: This was a retrospective study of 53 eyes of 45 patients who had vitrectomy for CI-DME and were followed up for at least 12months. Charts were reviewed for visual acuity (VA), central subfield mean thickness measured by optical coherence tomography, presurgical and postsurgical interventions for CI-DME, and number of office visits in the first 12months after surgery. Preoperative spectral domain optical coherence tomography was performed on 38 patients, and they were graded for ellipsoid zone (EZ) intactness by three independent graders with assessment of agreement between graders using intraclass correlation coefficients and Bland–Altman analysis. Results: The median VA improved from 20/100 (interquartile range [IQR], 20/63–20/200) at baseline to 20/63 (IQR, 20/32–20/125) at 12months. The median central subfield mean thickness improved from 505µm (IQR, 389–597µm) at baseline to 279µm (IQR, 246–339µm) at 12months. Intergrader agreement for EZ intactness was moderate (intraclass correlation coefficients 0.4294–0.6356). There was no relationship between preoperative intactness of the EZ and the 12-month change in VA. Conclusion: Vitrectomy consistently thins the macula in CI-DME and, on average, leads to clinically significant improvement in VA comparable in size to that reported with serial intravitreal anti-vascular endothelial growth factor injections. A large, comparative, prospective, randomized clinical trial of these two treatments is needed to determine which is more effective and cost-effective. Keywords: center-involved diabetic macular edema, diabetic macular edema, vitrectomy, spectral domain OCT

Published
2016

6. Response: Pars plana vitrectomy for treatment-naïve diabetic macular edema with or without vitreomacular traction

Author

Maurice B. Landers, Zofia Michalewska, Ron A. Adelman, Jerzy Nawrocki, Michael W. Stewart, and Maciej Bednarski

Subjects
0301 basic medicine, Pars plana, medicine.medical_specialty, Visual acuity, medicine.medical_treatment, Diabetic macular edema, Visual Acuity, Vitrectomy, Vitreomacular traction, Macular Edema, Therapy naive, 03 medical and health sciences, 0302 clinical medicine, Traction, Ophthalmology, medicine, Humans, Diabetic Retinopathy, business.industry, General Medicine, Traction (orthopedics), 030104 developmental biology, medicine.anatomical_structure, 030221 ophthalmology & optometry, medicine.symptom, business
Published
2018

7. Response to Vitrectomy in diabetic macular edema

Author

Maciej Bednarski, Zofia Michalewska, Jerzy Nawrocki, Maurice B. Landers, Michael W. Stewart, and Ron A. Adelman

Subjects
medicine.medical_specialty, Diabetic Retinopathy, Visual acuity, business.industry, medicine.medical_treatment, Diabetic macular edema, Visual Acuity, MEDLINE, Vitrectomy, General Medicine, medicine.disease, Macular Edema, Ophthalmology, Diabetes mellitus, Diabetes Mellitus, medicine, Humans, medicine.symptom, business
Published
2019

8. Vitrectomy in the management of diabetic macular edema in treatment-naïve patients

Author

Zofia Michalewska, Maciej Bednarski, Michael W. Stewart, Ron A. Adelman, Maurice B. Landers, and Jerzy Nawrocki

Subjects
0301 basic medicine, Pars plana, Adult, Male, medicine.medical_specialty, Visual acuity, genetic structures, Fundus Oculi, medicine.medical_treatment, Visual Acuity, Vitrectomy, Macular Edema, 03 medical and health sciences, 0302 clinical medicine, Ophthalmology, medicine, Clinical endpoint, Humans, Macula Lutea, Fluorescein Angiography, Macular edema, Aged, Retrospective Studies, Aged, 80 and over, Diabetic Retinopathy, medicine.diagnostic_test, business.industry, Retrospective cohort study, General Medicine, Diabetic retinopathy, Middle Aged, Fluorescein angiography, medicine.disease, eye diseases, 030104 developmental biology, medicine.anatomical_structure, 030221 ophthalmology & optometry, Female, sense organs, medicine.symptom, business, Tomography, Optical Coherence, Follow-Up Studies
Abstract

To determine the efficacy of vitrectomy in eyes with treatment-naïve diabetic macular edema (DME).Consecutive patients with treatment-naïve DME who underwent pars plana vitrectomy with internal limiting membrane peeling at a single institution were identified from the electronic medical records. Morphologic and visual acuity changes from baseline were analyzed at both the primary temporal endpoint (6 months) and the final examination with the investigators. The primary outcome measures included changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT).Forty-four eyes of 44 patients were included in this retrospective study. The mean BCVA improved significantly from baseline until the 6-month primary endpoint (1.35 logMAR vs 0.83 logMAR, p0.001) and stabilized through the final examination (0.77 logMAR). The BCVA improved by at least 0.1, 0.3, and 0.6 logMAR in 26 (60%), 24 (55%), and 14 (32%) of eyes, respectively, whereas it worsened by 0.3 logMAR in only 1 (2%) eye. Final BCVA correlated inversely with duration of diabetes (p = 0.01), presence of an epiretinal membrane (p = 0.02), and initial visual acuity (p = 0.03). Mean CRT decreased significantly from baseline through 6 months (595 µm vs 266 µm; p0.001), and edema recurred in only 3 eyes (6%), one of which was subsequently treated with intravitreal bevacizumab.Pars plana vitrectomy significantly improves macular edema and visual acuity in eyes with treatment-naïve DME. Prospective randomized trials are needed to better determine the efficacy of early vitrectomy.

Published
2017

9. Correspondence

Author

Michael W. Stewart, Maurice B. Landers, David J. Browning, Toshinori Murata, Masahito Ohji, Jerzy Nawrocki, and Jay K. Chhablani

Subjects
Male, Ophthalmology, Diabetic Retinopathy, Laser Coagulation, Ranibizumab, Vitrectomy, Humans, Angiogenesis Inhibitors, Female, General Medicine, Macular Edema
Published
2016

10. Management of post-vitrectomy persistent vitreous hemorrhage in pseudophakic eyes

Author

Maurice B. Landers and Anna D Perraki

Subjects
Adult, Male, Intraocular pressure, medicine.medical_specialty, Visual acuity, Pseudophakia, genetic structures, medicine.medical_treatment, Lens Capsule, Crystalline, Visual Acuity, Intraocular lens, Vitrectomy, Postoperative Complications, Ophthalmology, medicine, Humans, Prospective Studies, Intraocular Pressure, Aged, Diabetic Retinopathy, Laser Coagulation, business.industry, Middle Aged, Cataract surgery, medicine.disease, eye diseases, Vitreous Hemorrhage, Surgery, Treatment Outcome, Vitreous hemorrhage, Capsulotomy, Female, Laser Therapy, sense organs, Safety, medicine.symptom, business, Laser coagulation
Abstract

Purpose To prospectively assess the effect of neodymium:yttrium-aluminum-garnet peripheral capsulotomy on postvitrectomy hemorrhage in diabetic patients with a posterior chamber intraocular lens (IOL) implant and an intact posterior capsule. Design Interventional case series. Methods This is a prospective case series, clinical practice. Patients Five vitrectomized, diabetic, pseudophakic patients with persistent vitreous cavity hemorrhage remaining after vitrectomy were selected. They all had a posterior chamber IOL implant with an intact posterior capsule. Additionally, they had all undergone laser panretinal photocoagulation in the involved eye in the past for diabetic retinopathy. Neodymium:yttrium-aluminum-garnet laser capsulotomy outside the optic of the IOL was performed in victrectomized diabetic patients to treat the remaining vitreous cavity hemorrhage. Visual acuity, intraocular pressure (IOP), and fundus examination were measured and done immediately after the laser procedure, in 7 days and in approximately 3 months. Results The visual acuity was improved at the time of the first follow-up. However, a mild elevation of IOP was noticed in some patients, which was treated with topical dorzolamide. The final visual acuity was dramatically improved, to 20/30 or better, and the IOP was normalized without medication within a few weeks in all five cases. No neovascularization of the iris or elsewhere was noticed in any case. Conclusions Neodymium:yttrium-aluminum-garnet laser peripheral capsulotomy appears to be a safe and effective management procedure in treating postvitrectomy hemorrhage in diabetic patients who have previously undergone cataract surgery with posterior chamber lens implant, intact posterior capsule, and extensive panretinal photocoagulation. The vitreous hemorrhage cleared completely in all five cases.

Published
2003

11. Computer-automated quantification of plus disease in retinopathy of prematurity

Author

Julien Jomier, Maurice B. Landers, David K. Wallace, and Steven R Aylward

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Posterior pole, Retinopathy of prematurity, Cryotherapy, medicine.disease, Tortuosity, Surgery, Plus disease, Ophthalmology, Pediatrics, Perinatology and Child Health, medicine, Dilation (morphology), business
Abstract

Background In some cases of retinopathy of prematurity (ROP), it difficult to determine with certainty whether plus disease is present or absent. We have developed a computer program that captures digital images from a video-indirect ophthalmoscope, identifies and traces the major posterior pole blood vessels, measures the dilation and tortuosity of each vessel, and calculates whether or not an eye has plus disease. Our purpose was to determine the accuracy of the computer program in comparison with two masked examiners. Methods A representative sample of posterior pole images from 20 premature infants, 10 normal and 10 representing various degrees of dilation and tortuosity, was extracted from our video database and analyzed by the computer program as well as by two masked examiners experienced in the diagnosis of ROP. The standard photograph from the Cryotherapy for ROP study, representing the minimum degree of dilation and tortuosity required for plus disease, was also digitized, analyzed, and used as a numeric comparison for the automated determination of plus disease. Results Of the five images determined to have plus disease by both examiners, four were calculated to have plus disease by the computer program (80% sensitivity). Of the 11 images without plus disease, 10 were calculated not to have plus disease by the computer program (91% specificity). Conclusions Our computer program has very good sensitivity and specificity compared with masked examiners’ determination of the presence or absence of plus disease. Automated analysis of dilation and tortuosity of posterior pole blood vessels has the potential to remove subjectivity from the determination of plus disease.

Published
2003

12. Multimodality Diagnostic Imaging in a Case of Sympathetic Ophthalmia

Author

Emil Anthony T. Say, David Fleischman, Maurice B. Landers, and John D. Wright

Subjects
Ophthalmology, medicine.medical_specialty, business.industry, Sympathetic ophthalmia, Medical imaging, Immunology and Allergy, Medicine, Radiology, business, medicine.disease, Multimodality
Published
2012

13. Immediate hyphema after intravitreal injections of ranibizumab

Author

Seema Garg, Travis A. Meredith, Maurice B. Landers, and Veronica Kon Graversen

Subjects
medicine.medical_specialty, Aspirin, genetic structures, business.industry, General Medicine, Macular degeneration, medicine.disease, Exudative age-related macular degeneration, eye diseases, Ophthalmology, Choroidal neovascularization, medicine, Branch retinal vein occlusion, sense organs, medicine.symptom, Ranibizumab, business, Macular edema, Hyphema, medicine.drug
Abstract

PURPOSE To report two cases of immediate hyphema formation after the intravitreal injection of ranibizumab. METHODS Retrospective case reports. RESULTS A patient with choroidal neovascularization caused by exudative age-related macular degeneration and a patient with cystoid macular edema caused by branch retinal vein occlusion underwent an intravitreal injection of 0.5 mg/0.05 mL of ranibizumab. The development of hyphema was seen immediately after the intravitreal injection in both cases. One patient was pseudophakic, taking 325 mg of aspirin daily. The other patient was phakic without any anticoagulation history. CONCLUSION To the best of our knowledge, this is the third report of the development of hyphema associated with intravitreal injections.

Published
2014

14. Vitreous humor thermodynamics during phacoemulsification

Author

Mariana Harasawa, Veronica Kon-Jara, Jose Luis Guerrero-Naranjo, D. Ochoa-Contreras, Maurice B. Landers, Guadalupe Cervantes-Coste, Hugo Quiroz-Mercado, Guillermo Salcedo-Villanueva, and Virgilio Morales-Canton

Subjects
Pars plana, Adult, Male, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Vitrectomy, Body Temperature, Ophthalmology, medicine, Humans, Prospective Studies, Ocular Physiological Phenomena, Aged, Retrospective Studies, Phacoemulsification, business.industry, Significant difference, Combined procedure, Middle Aged, medicine.disease, eye diseases, Confidence interval, Vitreous Hemorrhage, Vitreous Body, Posterior capsular rupture, medicine.anatomical_structure, Vitreous hemorrhage, Thermodynamics, Female, sense organs, business
Abstract

The purpose of this study is to determine baseline vitreous humor temperature during a combined phacoemulsification and pars plana vitrectomy (PPV) procedure; to determine what is the temperature variation during phacoemulsification; and to compare vitreous temperature to sublingual temperature. The methods used are prospective, interventional and comparative study. Patients with a diagnosis of cataract and vitreous hemorrhage, programed for a combined procedure of phacoemulsification and PPV, were included. Patients were excluded if posterior capsular rupture existed during the anterior segment procedure. A thermoprobe was inserted through a PPV trocar. Measurement of the vitreous temperature was obtained at baseline and throughout phacoemulsification, at the end of every surgical step, and every 5 min. Sublingual temperature was measured with the same probe at the end of the surgery. Room temperature was registered. Seventeen eyes of 17 patients were included. Mean sublingual temperature was 36.5 °C (standard deviation [σ] 0.26 °C). Mean total vitreous temperature was 31.47 °C (σ 2.1 °C). Mean baseline vitreous temperature was 33.04 °C (σ 0.99 °C). Comparison of sublingual temperature with baseline vitreous temperature resulted in a significant difference (t test P

Published
2014

15. Pathogenetic Mechanisms of Retinal Detachment

Author

Kean T. Oh, M.E. Hartnett, Bernd Kirchhof, and Maurice B. Landers

Subjects
medicine.medical_specialty, business.industry, Ophthalmology, Medicine, Retinal detachment, business, medicine.disease
Published
2013

16. Contributors

Author

Michael Abràmoff, Gary W. Abrams, Anita Agarwal, Everett Ai, Lloyd M. Aiello, Lloyd Paul Aiello, Daniel M. Albert, Mathew W. Aschbrenner, Marcos Ávila, G. William Aylward, Matthew Bedell, Rubens Belfort, Jean Bennett, Chris Bergstrom, Cagri G. Besirli, Pramod S. Bhende, Susanne Binder, Alan C. Bird, Barbara A. Blodi, Mark S. Blumenkranz, H. Culver Boldt, Norbert Bornfeld, Ferdinando Bottoni, Michael E. Boulton, Sara J. Bowne, Milam A. Brantley, Neil M. Bressler, Susan B. Bressler, Andreas Bringmann, Daniel A. Brinton, Gary C. Brown, Justin C. Brown, Simon Brunner, Ronald A. Bush, Dingcai Cao, Antonio Capone, David Carruthers, Jerry D. Cavallerano, Usha Chakravarthy, Chi-Chao Chan, Waiman Chan, Steven Charles, David G. Charteris, Dong Feng Chen, Jeannie Chen, Youxin Chen, Carol Yim Lui Cheung, Emily Y. Chew, Allen Chiang, Michael F. Chiang, Ian J. Constable, Gabriel Coscas, Alan F. Cruess, Emmett T. Cunningham, Christine A. Curcio, Stephen P. Daiger, Bertil E. Damato, Janet L. Davis, Matthew D. Davis, Shelley Day, Patrick De Potter, Marc D. de Smet, Alastair K. Denniston, Ranjit S. Dhaliwal, Xiaoyan Ding, Diana V. Do, Guorui Dou, William A. Dunn, Justis P. Ehlers, Michael Engelbert, Lisa J. Faia, Benedetto Falsini, Amani A. Fawzi, Sharon Fekrat, Steven E. Feldon, Rodrigo A. Brant Fernandes, Henry A. Ferreyra, Deborah A. Ferrington, Frederick L. Ferris, Paul T. Finger, Steven K. Fisher, Gerald A. Fishman, Monika Fleckenstein, Harry W. Flynn, Andrew C. Fok, Wallace S. Foulds, William R. Freeman, Aurélien Freton, Martin Friedlander, Laura J. Frishman, Arthur D. Fu, Carlos Alexandre de Amorim Garcia Filho, Enrique Garcia-Valenzuela, Alain Gaudric, Mary Gayed, Mohamed A. Genead, Heinrich Gerding, Andrea Giani, Morton F. Goldberg, Dan S. Gombos, Lingam Gopal, Caroline Gordon, Hiroshi Goto, Evangelos S. Gragoudas, Maria B. Grant, W. Richard Green, Ronald G. Gregg, Zdenek Gregor, Giovanni Gregori, Kevin Gregory-Evans, Seanna Grob, Carl Groenewald, Hans E. Grossniklaus, Sandeep Grover, Vamsi K. Gullapalli, Aditi Gupta, Rudolf F. Guthoff, Paul Hahn, Julia A. Haller, J. William Harbour, Christos Haritoglou, Mary E. Hartnett, Barbara S. Hawkins, Shikun He, Martina C. Herwig, Florian M.A. Heussen, David R. Hinton, Frank G. Holz, Samuel K. Houston, Yan-Nian Hui, Mark S. Humayun, Yasushi Ikuno, David Isaac, Tatsuro Ishibashi, Douglas A. Jabs, Glenn J. Jaffe, Lee M. Jampol, Leonard Joffe, Mark Johnson, Mark W. Johnson, Robert N. Johnson, Antonia M. Joussen, Karina Julian, J. Michael Jumper, Peter K. Kaiser, Anselm Kampik, Robert Katamay, Christine N. Kay, Pearse A. Keane, M. Cristina Kenney, Khizer R. Khaderi, Mohamad A. Khodair, Ivana K. Kim, Tae Wan Kim, Bernd Kirchhof, Barbara E.K. Klein, Ronald Klein, Lazaros Konstantinidis, Igor Kozak, Baruch D. Kuppermann, Leanne T. Labriola, Timothy Y. Lai, Dennis S. Lam, Linda A. Lam, Maurice B. Landers, Anne Marie Lane, Erin B. Lavik, James F. Leary, Sun Young Lee, Thomas C. Lee, Loh-Shan B. Leung, David A. Lewis, Geoffrey P. Lewis, Anita Leys, Xiaoxin Li, Sandra Liakopoulos, Chang-Ping Lin, Phoebe Lin, David T. Liu, Nikolas J.S. London, Brandon J. Lujan, Yan Luo, Gerard A. Lutty, Robert MacLaren, Steven Madreperla, Albert M. Maguire, Martin A. Mainster, Nancy C. Mansfield, Arnold M. Markoe, Michael F. Marmor, Daniel F. Martin, Stephen C. Massey, Maureen A. McCall, Tara A. McCannel, J. Allen McCutchan, H. Richard McDonald, Milap P. Mehta, Petra Meier, Shannath Merbs, Travis A. Meredith, Carsten H. Meyer, William F. Mieler, Joan W. Miller, Rukhsana G. Mirza, Sayak K. Mitter, Robert A. Mittra, Yozo Miyake, Carlo Montemagno, Ala Moshiri, Prithvi Mruthyunjaya, Cristina Muccioli, Robert F. Mullins, Toshinori Murata, A. Linn Murphree, Robert P. Murphy, Philip I. Murray, Timothy G. Murray, Manish Nagpal, Perumalsamy Namperumalsamy, Sumit K. Nanda, Quan Dong Nguyen, Robert B. Nussenblatt, Kean T. Oh, Masahito Ohji, Kyoko Ohno-Matsui, Daniel Palanker, Purnima S. Patel, Anna C. Pavlick, David M. Peereboom, Mark E. Pennesi, Jay S. Pepose, Julian D. Perry, Carmen A. Puliafito, Polly A. Quiram, Rajiv Raman, Rajeev S. Ramchandran, Haripriya Vittal Rao, Narsing A. Rao, P. Kumar Rao, Sivakumar R. Rathinam, Franco M. Recchia, Kristin J. Redmond, Thomas A. Reh, Andreas Reichenbach, Robert Ritch, Philip J. Rosenfeld, Gary S. Rubin, Humberto Ruiz-Garcia, Stephen J. Ryan, SriniVas R. Sadda, Alfredo A. Sadun, Taiji Sakamoto, Alapakkam P. Sampath, Andrew P. Schachat, Steffen Schmitz-Valckenberg, Stephen G. Schwartz, Adrienne W. Scott, Jerry Sebag, Johanna M. Seddon, H. Nida Sen, Yasir Jamal Sepah, Sanjay Sharma, Tarun Sharma, Shwu-Jiuan Sheu, Carol L. Shields, Jerry A. Shields, Kei Shinoda, Dhananjay Shukla, Paul A. Sieving, Paolo A.S. Silva, Claudio Silveira, Arun D. Singh, Sylvia B. Smith, Wendy M. Smith, Lucia Sobrin, Akrit Sodhi, Elliott H. Sohn, Gisèle Soubrane, Leigh Spielberg, Sunil K. Srivastava, Oliver Stachs, Giovanni Staurenghi, Paul Sternberg, Edwin M. Stone, Ilene K. Sugino, Lori S. Sullivan, Paul Sullivan, Jennifer K. Sun, Janet S. Sunness, Ramin Tadayoni, Shibo Tang, Hiroko Terasaki, Matthew A. Thomas, John T. Thompson, Gabriele Thumann, Cynthia A. Toth, Michael T. Trese, Julie H. Tsai, Mary E. Turell, Patricia L. Turner, Nitin Udar, J. Niklas Ulrich, Russell N. Van Gelder, Jan C. van Meurs, Daniel Vítor Vasconcelos-Santos, Demetrios G. Vavvas, G. Atma Vemulakonda, Hao Wang, Yusheng Wang, James D. Weiland, Richard G. Weleber, Moody D. Wharam, Louisa Wickham, Peter Wiedemann, Henry E. Wiley, C.P. Wilkinson, David J. Wilson, Thomas J. Wolfensberger, David Wong, Ian Y. Wong, Tien Yin Wong, David M. Wu, Yanors Yandiev, Chang-Hao Yang, Chung-May Yang, Lawrence A. Yannuzzi, Miho Yasuda, Po-Ting Yeh, Zohar Yehoshua, Glenn Yiu, Young Hee Yoon, Hyeong Gon Yu, Alex Yuan, Marco A. Zarbin, Jun Jun Zhang, Kang Zhang, Mingwei Zhao, and Peng Zhou

Published
2013

17. Determination of retinal and vitreous temperature in vitrectomy

Author

Maurice B. Landers, Hugo Quiroz-Mercado, J. Niklas Ulrich, and Jessica S. Watson

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Vitrectomy, Preoperative care, Retina, Body Temperature, chemistry.chemical_compound, Hypothermia, Induced, Ophthalmology, Preoperative Care, medicine, Humans, Prospective Studies, Prospective cohort study, Vitreous surgery, Aged, Postoperative Care, business.industry, Retinal, General Medicine, Hypothermia, Middle Aged, Neurologic injury, Vitreous Body, medicine.anatomical_structure, chemistry, Female, sense organs, medicine.symptom, business, human activities, Sclera
Abstract

To maximize recovery after neurologic injury, physicians use therapeutic hypothermia of 90°F to 93°F (32.2-33.9°C). Temperatures below this are avoided because of increased side effects. The extent to which the retina is cooled during routine vitreous surgery is unknown. This study seeks to describe the temperature changes of the vitreous and retinal surface during vitreous surgery.In this prospective study of 6 patients undergoing vitrectomy, a 23-gauge thermoprobe was used to measure intraocular temperatures before, during, and after vitrectomy.Before vitrectomy, the mean midvitreous temperature was 93.1°F (33.9°C) and retinal temperature was 94.7°F to 95.4°F (34.8-35.2°C). During vitrectomy, the mean midvitreous cavity temperature was 76.9°F (24.9°C) and retinal temperature was 83.2°F to 85.1°F (28.4-29.5°C). After completion of vitrectomy and with a closed infusion line, the mean midvitreous cavity temperature was 87.0°F (30.6°C) and retinal temperature was 90.1°F to 90.9°F (32.3-32.7°C). These changes in temperature before, during, and after vitrectomy were found to be statistically significant.During routine vitreous surgery, the vitreous cavity and retina are cooled to much lower temperatures than those used in therapeutic hypothermia. Rapid rewarming occurs within the eye once the infusion line is closed.

Published
2011

18. Maintaining a watertight globe while operating with a temporary keratoprosthesis

Author

Maurice B. Landers, William L. Porfilio, Jessica S. Watson, and Thanh Thu T Tran

Subjects
medicine.medical_specialty, genetic structures, Keratoprosthesis, business.industry, Swine, General Medicine, Posterior Eye Segment, Flange, Seal (mechanical), eye diseases, Capsulorhexis, Cornea, Ophthalmology, medicine.anatomical_structure, Anterior Eye Segment, Lens, Crystalline, Surgical Wound Dehiscence, medicine, Animals, sense organs, Artificial Organs, business, Intraocular Pressure
Abstract

To demonstrate that the Landers wide-field temporary keratoprosthesis (TKP) creates a watertight seal between the tightly opposing surfaces of the TKP flange and the anterior corneal surface.In 25 and 20 enucleated, porcine eyes, a 7.5-mm and 8.0-mm trephination corneal hole was made, respectively, followed by open-sky capsulorhexis and lensectomy. A wide-field TKP with 7.2 mm trunk diameter was sutured securely onto each eye. Testing for a watertight seal was performed at an intraocular pressure of 100 mmHg of pre- and post-pars plana vitrectomy.The Landers TKP maintained a watertight seal at an intraocular pressure of 100 mmHg in 45 of 45 eyes. After standard pars plana vitrectomy, 41 of 41 eyes maintained 100 mmHg of intraocular pressure without leakage.The seal between the TKP and cornea is established at the horizontal interface between the TKP flange and the anterior corneal surface, not between the corneal stroma and TKP trunk. The Landers wide-field TKP is a reusable model that provides a clear posterior-segment view and effectively forms a watertight eye at a sustained intraocular pressure of 100 mmHg. This TKP may be used in ocular trauma where the corneal defect is up to 0.8 mm greater in diameter than the 7.2-mm TKP trunk.

Published
2011

19. A COMPARISON OF ARGON AND DIODE PHOTOCOAGULATION COMBINED WITH SUPPLEMENTAL OXYGEN FOR THE TREATMENT OF RETINOPATHY OF PREMATURITY

Author

Lawrence S Morse, Maurice B. Landers, Andy Hay, and Jeffrey D. Benner

Subjects
Male, medicine.medical_specialty, genetic structures, Fundus Oculi, Supplemental oxygen, medicine.medical_treatment, Lens Capsule, Crystalline, chemistry.chemical_element, Eye injuries, Eye Injuries, Ophthalmology, Lens, Crystalline, Humans, Medicine, Retinopathy of Prematurity, Prospective Studies, Tunica vasculosa lentis, Radiation Injuries, Laser Coagulation, Argon, business.industry, Infant, Newborn, Oxygen Inhalation Therapy, Infant, Retinopathy of prematurity, General Medicine, Prognosis, medicine.disease, Combined Modality Therapy, eye diseases, chemistry, Female, sense organs, Indirect ophthalmoscope, business, Laser coagulation, Follow-Up Studies, Avascular peripheral retina
Abstract

The efficacy of argon and diode laser photocoagulation of the avascular peripheral retina for threshold retinopathy of prematurity (ROP) was compared in a prospective trial. The study group included 9 premature infants (17 eyes). In each infant, one eye was treated with the diode laser indirect ophthalmoscope (LIO), and the fellow eye was treated with the argon LIO. Supplemental oxygen therapy was administered after laser treatment to all nine infants. The mean duration of the follow-up period was 9.7 +/- 2.6 months. All 17 eyes (100%) had complete regression of ROP and favorable outcomes. The diode and argon LIO appear to be equally effective in treating threshold ROP. Two patients sustained burns of the tunica vasculosa lentis and anterior lens capsule in the argon laser treated eye but not in the fellow diode treated eye. Photocoagulation with either the diode or argon LIO, combined with supplemental oxygen treatment, appears to be a promising treatment for retinopathy of prematurity.

Published
1993

20. The new lens holder for Peyman-Wessels-Landers 132D upright vitrectomy lens

Author

Masashi Kakinoki, Maurice B. Landers, Akito Hirakata, and Masahito Ohji

Subjects
Ophthalmology, medicine.medical_specialty, business.industry, medicine.medical_treatment, Vitrectomy, medicine, Lens (geology), Humans, General Medicine, Diagnostic Techniques, Ophthalmological, business
Published
2010

21. Lasers in ophthalmology: the path from theory to application

Author

Myron L. Wolbarsht and Maurice B. Landers

Subjects
Retinal blood vessels, medicine.medical_specialty, Laser safety, business.industry, Materials Science (miscellaneous), Retinal, Aqueous humor, Diabetic retinopathy, medicine.disease, Laser, Industrial and Manufacturing Engineering, law.invention, chemistry.chemical_compound, Tissue oxygenation, Optics, chemistry, law, Ophthalmology, Optic nerve, medicine, sense organs, Business and International Management, business
Abstract

The argon laser for diabetic retinopathy therapy was originally selected for photocoagulation by matching peak emission to hemoglobin absorption to maximize obliteration of retinal blood vessels. Present clinical experience in the treatment of diabetic retinopathy does not show any marked advantage of argon lasers over ruby and xenon photocoagulators not matched to hemoglobin absorption. The efficacy of photocoagulation is shown to depend upon the interaction between choroidal and retinal blood supplies in tissue oxygenation and depends upon pigment epithelium absorption to destroy rods and cones. Design specifications for new laser photocoagulators and alternative (supplemental) therapy for diabetic retinopathy are given.

Published
2010

22. Antifibrotic and uveitogenic properties of gamma interferon in the rabbit eye

Author

Maurice B. Landers, Jin Wen Li, Cynthia A. Toth, and Leonard M. Hjelmeland

Subjects
Proliferative vitreoretinopathy, Pathology, medicine.medical_specialty, Eye Diseases, genetic structures, Eye disease, Balanced salt solution, Interferon-gamma, Cellular and Molecular Neuroscience, Retinal Diseases, Panuveitis, medicine, Animals, Interferon gamma, Cells, Cultured, Lagomorpha, medicine.diagnostic_test, biology, business.industry, Retinal Detachment, Fundus photography, Fibroblasts, medicine.disease, biology.organism_classification, Fibrosis, Recombinant Proteins, eye diseases, Sensory Systems, Vitreous Body, Disease Models, Animal, Ophthalmology, Rabbits, sense organs, business, Cell Division, Retinopathy, medicine.drug
Abstract

The feasibility of gamma (gamma)-interferon injection for the treatment of ocular fibrotic conditions was studied in rabbits using recombinant rabbit gamma-interferon and the cell-injection model of tractional detachment. A toxicity study revealed that intravitreal injection of greater than 10(4) units gamma-interferon consistently produced panuveitis. For tractional detachment, 250,000 rabbit dermal fibroblasts were injected intravitreally into 20 eyes; 1 day later, 5 of these eyes received intravitreal injections of 10(4) units gamma-interferon, another 5 were given 10(6) units, and the remaining 10 received balanced salt solution. Slit-lamp examination and fundus photography were performed at regular intervals for 21 days and were graded by a masked observer. The eyes were then enucleated and processed for histology. Doses of 10(4) units gamma-interferon significantly reduced the severity of detachments, but injections of 10(6) units induced panuveitis.

Published
1992

23. The effect of unilateral intravitreal bevacizumab (avastin), in the treatment of diffuse bilateral diabetic macular edema: a pilot study

Author

Hugo Quiroz-Mercado, Raul Velez-Montoya, Maurice B. Landers, Virgilio Morales-Catón, Octavio Burgos, and Jans Fromow-Guerra

Subjects
Male, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Visual acuity, genetic structures, Bevacizumab, Diabetic macular edema, Visual Acuity, Angiogenesis Inhibitors, Pilot Projects, Antibodies, Monoclonal, Humanized, Functional Laterality, Macular Edema, Retina, Injections, Ophthalmology, Medicine, Humans, Macular edema, Aged, Aged, 80 and over, Diabetic Retinopathy, business.industry, Antibodies, Monoclonal, General Medicine, Diabetic retinopathy, Intravitreal administration, Middle Aged, medicine.disease, eye diseases, Vitreous Body, Vascular endothelial growth factor A, medicine.anatomical_structure, Treatment Outcome, Female, sense organs, medicine.symptom, business, Tomography, Optical Coherence, medicine.drug
Abstract

To investigate whether there are systemic effects of unilateral intravitreal administration of bevacizumab on the untreated eye.Twenty-three consecutive patients were enrolled in this study. All patients had a clinical diagnosis of bilateral diffuse diabetic macular edema with a central retinal thickness greater than 275 microm by Optical Coherence Tomography. They were treated with 2.5 mg bevacizumab intravitreally in the worst eye based on lines of vision, number of Early Treatment Diabetic Retinopathy Study letters, and central retinal thickness. The patients were observed every 2 weeks for 4 weeks. The Best Corrected Visual Acuity, central retinal thickness (microm), and macular volume (mm) in the untreated eye measured by Optical Coherence Tomography were recorded at every visit.The Best Corrected Visual Acuity (mean +/- SD) in the untreated eye was 34.46 +/- 17.29. Early Treatment Diabetic Retinopathy Study letters at baseline, 38.31 +/- 14.64 at 2 weeks, and 37.38 +/- 14.59 at 4 weeks. The central retinal thickness in the untreated eye was 324.77 +/- 76.51 microm at baseline, 319 +/- 75.7 microm at 2 weeks, and 315.54 +/- 78.2 microm at 4 weeks. The macular volume in the untreated eye was 8.99 +/- 1.2 mm at baseline, 9.16 +/- 1.26 mm at 2 weeks, and 8.99 +/- 1.09 mm at 4 weeks. There were no statistically significant differences between any of the measurements.Due to the lack of significant changes in the measurements of the untreated eye, the systemic effect of intravitreal bevacizumab seems to be unlikely. The small sample and low confidence of this pilot study prevent us to draw concrete conclusions.

Published
2008

24. Reproducible estimation of retinal vessel width by computerized microdensitometry

Author

Gregory S. George, Maurice B. Landers, and Myron L. Wolbarsht

Subjects
Analysis of Variance, genetic structures, Fundus Oculi, business.industry, Superior temporal vein, Reproducibility of Results, Retinal Vessels, Retinal, Objective method, Fundus (eye), eye diseases, Microdensitometer, Retinal vessel, Random Allocation, Ophthalmology, chemistry.chemical_compound, Optics, chemistry, Image Processing, Computer-Assisted, Photography, Humans, Medicine, business, Densitometry, Biomedical engineering
Abstract

An objective method for reliably estimating the width of retinal vessels is presented. A computerized microdensitometer scans film negatives of fundus photographs and reconstructs black and white images of the fundus on a visual display terminal. After this initial scan, a desired region of a retinal vessel is selected with moveable cursors, and a cross-sectional density profile through the vessel is plotted. Vessel width is determined by the half-height width of the profile of the minimum (least transmitting) and average background film densities. Measurement sites can be accurately reproduced on different negatives by landmark mapping. A series of ten fundus photographs were taken of three healthy human eyes, and the width of the superior temporal vein was measured in two places on alle negatives. The coefficient of variation of the six sets ranged from 1.2 and 3.4% with an average of 2.2%.

Published
1990

25. Pathogenetic Mechanisms of Retinal Detachment

Author

Maurice B. Landers, M.E. Hartnett, and Kean T. Oh

Subjects
medicine.medical_specialty, business.industry, Ophthalmology, medicine, Retinal detachment, medicine.disease, business
Published
2006

26. Contributors

Author

Thomas M. Aaberg, Mohamed H. Abdel-Rahman, Gary W. Abrams, Anita Agarwal, Everett Ai, Daniel M. Albert, Judith Alexander, Rajiv Anand, Gerasimos Anastassiou, G. William Aylward, Mohammed K. Barazi, David Bingaman, Alan C. Bird, Barbara A. Blodi, Mark S. Blumenkranz, James P. Bolling, Norbert Bornfeld, Susan B. Bressler, Neil M. Bressler, Daniel A. Brinton, Jeremiah Brown, Gary C. Brown, Justin C. Brown, Helmut Buettner, Serge de Bustros, Sandra Fraser Byrne, Mark T. Cahill, Peter A. Campochiaro, Ronald E. Carr, Stanley Chang, Steve Charles, Jeannie Chen, Clara A. Chen, Emily Y. Chew, Louis J. Chorich, David R. Chow, Antonio P. Ciardella, Thomas A. Ciulla, Gabriel J. Coscas, Alan F. Cruess, Lyndon da Cruz, Bertil E. Damato, Frederick H. Davidorf, Matthew D. Davis, Janet L. Davis, August F. Deutman, Ranjit S. Dhaliwal, Diana V. Do, Pravin U. Dugel, John D. Earle, Albert O. Edwards, Dean Eliott, Geoffrey G. Emerson, Sharon Fekrat, Steven E. Feldon, Frederick L. Ferris, Stuart L. Fine, Daniel Finkelstein, Steven K. Fisher, John Flannery, James C. Folk, Wallace S. Foulds, Robert N. Frank, William R. Freeman, Martin Friedlander, Laura J. Frishman, Arthur D. Fu, Gildo Y. Fujii, Ron P. Gallemore, Daniel C. Garibaldi, Enrique Garcia-Valenzuela, J. Donald M. Gass, Sandrine Gautier, Scott Geller, Morton F. Goldberg, Christine R. Gonzales, Justin L. Gottlieb, Evangelos S. Gragoudas, Ronald L. Green, W. Richard Green, Zdenek J. Gregor, Kevin Gregory-Evans, Nicole E. Gross, Vamsi K. Gullapalli, David R. Guyer, Robyn Guymer, Julia A. Haller, J. William Harbour, Joseph B. Harlan, Alon Harris, Mary Elizabeth Hartnett, Michael K. Hartzer, Barbara S. Hawkins, Heinrich Heimann, David R. Hinton, Brad J. Hinz, Stephan Hoffmann, Nancy M. Holekamp, Gary N. Holland, Carel B. Hoyng, Mark S. Humayun, Yasushi Ikuno, Douglas A. Jabs, Glenn J. Jaffe, Valérie Jallet, Lee M. Jampol, Leonard Joffe, Robert N. Johnson, Daniel P. Joseph, Eugene de Juan, J. Michael Jumper, Henry J. Kaplan, James S. Kelley, Mohamad A. Khodair, Bernd Kirchhof, Christina M. Klais, Barbara E.K. Klein, Ronald Klein, Robert W. Kline, David L. Knox, Brian R. Kosobucki, Allan E. Kreiger, Derek Y. Kunimoto, Robert Choi Kwun, Rohit R. Lakhanpal, Linda A. Lam, Maurice B. Landers, Anne Marie Lane, Michael S. Lee, Henry C. Lee, Hilel Lewis, Geoffrey P. Lewis, Wee-Kiak Lim, Eugene S. Lit, Anat Loewenstein, José Manuel Lopez, Gerard A. Lutty, Steven Madreperla, Albert M. Maguire, Martin A. Mainster, Nancy C. Mansfield, Michael F. Marmor, Bruce J. Martin, Stephen C. Massey, Elias C. Mavrofrides, Brooks W. McCuen, H. Richard McDonald, Petra Meier, Shannath L. Merbs, Travis A. Meredith, William F. Mieler, Robert F. Miller, Joan W. Miller, Peter Milne, Robert A. Mittra, Darius M. Moshfeghi, Andrew A. Moshfeghi, Ala Moshiri, Prithvi Mruthyunjaya, Toshinori Murata, A. Linn Murphree, Robert P. Murphy, Sumit K. Nanda, Quan Dong Nguyen, Robert B. Nussenblatt, Michael D. Ober, Richard R. Ober, Thomas E. Ogden, Kean T. Oh, Masahito Ohji, Karl R. Olsen, Daniel Palanker, Earl A. Palmer, Jean-Marie Parel, Carl H. Park, Jonathan E. Pederson, Christopher D. Pelzek, Jay S. Pepose, Dale L. Phelps, Stephen Phillips, Joel Pokorny, Carmen A. Puliafito, Narsing A. Rao, P. Kumar Rao, Franco M. Recchia, Thomas A. Reh, Dennis M. Robertson, Joseph E. Robertson, Gary S. Rubin, Stephen J. Ryan, Srinivas R. Sadda, Alfredo A. Sadun, José Alain Sahel, Maite Sainz de la Maza, Michael A. Samuel, George E. Sanborn, John P. Sarks, Shirley H. Sarks, Andrew P. Schachat, J. Sebag, Johanna M. Seddon, Sanjay Sharma, Val C. Sheffield, Carol L. Shields, Jerry A. Shields, Arun Singh, Raymond N. Sjaarda, Jason S. Slakter, Vivianne C. Smith, Ronald E. Smith, Sharon D. Solomon, Gisele Soubrane, Rand Spencer, Paul Sternberg, Jay M. Stewart, Edwin M. Stone, Ilene K. Sugino, Janet S. Sunness, Yasuo Tano, William S. Tasman, Matthew A. Thomas, John T. Thompson, Jennifer E. Thorne, Gabriele Thumann, Cynthia A. Toth, Michael T. Trese, Linda M. Tsai, Patricia L. Turner, Timothy H. Tweito, Paul G. Updike, Russell N. Van Gelder, Janneke J.C. van Lith-Verhoeven, Jean D. Vaudaux, Franck Villain, Albert T. Vitale, Jonathan D. Walker, Alexander C. Walsh, Hao Wang, Andrew R. Webster, James D. Weiland, John J. Weiter, Richard G. Weleber, Moody D. Wharam, A. Jeffrey Whitehead, Peter Wiedemann, C.P. Wilkinson, George A. Williams, James K.V. Willson, David J. Wilson, Peter H. Win, Lawrence A. Yannuzzi, Young Hee Yoon, Tara A. Young, Marco A. Zarbin, and Kang Zhang

Published
2006

27. Transscleral intraocular lens fixation with a 'homemade' needle and hook

Author

Maurice B. Landers and Michael W. Stewart

Subjects
medicine.medical_specialty, Polypropylene suture, Materials science, genetic structures, Hook, medicine.medical_treatment, Intraocular lens, Polypropylenes, Fixation (surgical), Lens Implantation, Intraocular, Ophthalmology, medicine, Humans, Hypodermic needle, Aged, Lenses, Intraocular, Needle holder, Sutures, Suture Techniques, eye diseases, Sensory Systems, Sclera, surgical procedures, operative, medicine.anatomical_structure, Needles, Surgery, Female, sense organs
Abstract

We describe an ab externo, transscleral, intraocular lens (IOL) fixation technique using a surgeon-fashioned 25-gauge hook, a neodymium:yttrium aluminum garnet (Nd:YAG)-modified 27-gauge needle, and 9-0 polypropylene suture. This is a simple, inexpensive technique for creating small-gauge surgical instruments to accurately and atraumatically pass 9-0 and 10-0 polypropylene sutures through sclera. Holes, through which sutures can be threaded, are "burned" near the tips of 27-gauge or 30-gauge needles with an Nd:YAG laser. Using a fine needle holder, a 25-gauge hook is fashioned from a hypodermic needle. A surgical technique incorporating 2 ab externo incisions and achieving transscleral posterior chamber IOL fixation is discussed.

Published
2005

28. A new, non-contact wide field viewing system for vitreous surgery

Author

Maurice B. Landers, Virgilio Morales, Izak F. Wessels, Paul Whalen, and Gholam A. Peyman

Subjects
Materials science, business.industry, Image quality, education, Field of view, Vitreoretinal surgery, Equipment Design, Ophthalmologic Surgical Procedures, Operating table, Wide field, Retina, law.invention, Lens (optics), Vitreous Body, Ophthalmology, Optics, law, Vitrectomy, Humans, sense organs, Prism, business, Vitreous surgery
Abstract

Purpose To report a new, noncontact wide field viewing system for vitreoretinal surgery. Design Device description: A noncontact wide field viewing system consisting of adjustable hinged arm and a combined condensing lens and reinverting prism has been developed. The arm clamps onto the operating table or wrist rest and holds the lens system in the air above the eye. Methods For vitreoretinal surgery, a new, relatively inexpensive noncontact wide field viewing system consisting of an adjustable hinged arm and a combined condensing lens and reinverting prism has been developed. The combination condensing lens and reinverting prism is used without a microscope–mounted inverter. The optical component may be sterilized with ethylene oxide, peracetic acid, or glutaraldehyde. Other components may be steam autoclaved. Results The new, noncontact wide field viewing system has been used satisfactorily in more than 200 vitrectomies at seven medical centers. It provides an excellent view of the vitreous and retina. Conclusion A new, noncontact wide field viewing system for vitreoretinal surgery has been developed with satisfactory image quality and a field of view comparable to contemporary noncontact panoramic viewing systems.

Published
2003

29. Computer-automated quantification of plus disease in retinopathy of prematurity

Author

David K, Wallace, Julien, Jomier, Steven R, Aylward, and Maurice B, Landers

Subjects
Retinal Diseases, Infant, Newborn, Humans, Retinal Vessels, Retinopathy of Prematurity, Single-Blind Method, Diagnosis, Computer-Assisted, Software
Abstract

In some cases of retinopathy of prematurity (ROP), it difficult to determine with certainty whether plus disease is present or absent. We have developed a computer program that captures digital images from a video-indirect ophthalmoscope, identifies and traces the major posterior pole blood vessels, measures the dilation and tortuosity of each vessel, and calculates whether or not an eye has plus disease. Our purpose was to determine the accuracy of the computer program in comparison with two masked examiners.A representative sample of posterior pole images from 20 premature infants, 10 normal and 10 representing various degrees of dilation and tortuosity, was extracted from our video database and analyzed by the computer program as well as by two masked examiners experienced in the diagnosis of ROP. The standard photograph from the Cryotherapy for ROP study, representing the minimum degree of dilation and tortuosity required for plus disease, was also digitized, analyzed, and used as a numeric comparison for the automated determination of plus disease.Of the five images determined to have plus disease by both examiners, four were calculated to have plus disease by the computer program (80% sensitivity). Of the 11 images without plus disease, 10 were calculated not to have plus disease by the computer program (91% specificity).Our computer program has very good sensitivity and specificity compared with masked examiners' determination of the presence or absence of plus disease. Automated analysis of dilation and tortuosity of posterior pole blood vessels has the potential to remove subjectivity from the determination of plus disease.

Published
2003

30. A Glass Micropipette Holder for Ophthalmic Surgical Procedures

Author

Jeffrey D. Benner, Leonard M. Hjelmeland, Melvin T. Magliocco, Maurice B. Landers, Cynthia A. Toth, and Lawrence S Morse

Subjects
Microsurgery, Ophthalmology, Retinal Diseases, business.industry, Pipette, Humans, Medicine, Glass, Surgical procedures, business, Biomedical engineering
Published
1993

31. Stainless Steel Micropipette for Subretinal Surgery

Author

Lawrence S Morse, Andy Hay, Cynthia A. Toth, Jeffrey D. Benner, Leonard M. Hjelmeland, Maurice B. Landers, and Melvin T. Magliocco

Subjects
medicine.medical_specialty, business.industry, Pipette, Equipment Design, Stainless Steel, Surgical Instruments, Retina, Surgery, Ophthalmology, Retinal Diseases, medicine, Animals, Humans, Subretinal fluid, business
Published
1992

32. Antiviral chemoprophylaxis after occupational exposure to human immunodeficiency virus: why, when, where, and what

Author

Maurice B. Landers and Victoria J. Fraser

Subjects
medicine.medical_specialty, Infectious Disease Transmission, Patient-to-Professional, Combination therapy, HIV Infections, Antiviral Agents, Virus, Drug Administration Schedule, Occupational medicine, Zidovudine, Acquired immunodeficiency syndrome (AIDS), Indinavir, Occupational Exposure, medicine, Humans, Intensive care medicine, business.industry, virus diseases, Lamivudine, medicine.disease, Ophthalmology, Chemoprophylaxis, Immunology, Drug Therapy, Combination, Preventive Medicine, business, medicine.drug
Abstract

Purpose To update ophthalmologists on recent developments in the area of antiviral chemoprophylaxis after occupational exposure to human immunodeficiency virus (HIV). Background information is provided by which to make an informed decision about whether to initiate antiviral chemoprophylaxis against HIV infection. Methods We discuss why HIV postexposure prophylaxis should be considered; when prophylaxis should be initiated; where prophylaxis medications should be located in the operating or emergency room; and what medications might be used and the factors influencing their selection. Recent provisional recommendations by the United States Centers for Disease Control and Prevention and the International AIDS Society-USA are reviewed along with literature dealing with antiviral chemoprophylaxis against HIV infection. Results Recommendations are made for specific antiviral chemoprophylaxis after occupational exposure to HIV based on the Centers for Disease Control and Prevention and the International AIDS Society-USA provisional recommendations. Uncertain areas and the minor discrepancies in these two reports are discussed. Conclusions Prevention of HIV transmission after accidental occupational exposure is possible. Combination therapy is more effective than monotherapy in treating HIV infections. Zidovudine (AZT or ZDV) is effective in postexposure prophylaxis; the combination of zidovudine and lamivudine (3TC) and indinavir (IDV) has greater antiretroviral activity than zidovudine alone does. The requirements for effective HIV postexposure prophylaxis may be somewhat different than those for optimum HIV treatment in the chronically ill HIV-positive patient. Ophthalmologists should have an in-depth knowledge of current thinking regarding HIV pathophysiology and treatment.

Published
1997

33. An infusion temporary keratoprosthesis for pars plana vitrectomy

Author

Jeffrey D. Benner and Maurice B. Landers

Subjects
Pars plana, medicine.medical_specialty, Retinal breaks, genetic structures, Keratoprosthesis, Eye disease, medicine.medical_treatment, Vitrectomy, Methylmethacrylate, Prosthesis Design, Catheterization, Cornea, Corneal Opacity, Retinal Diseases, Ophthalmology, Medicine, Humans, Methylmethacrylates, Intraoperative Complications, business.industry, Corneal opacity, Prostheses and Implants, medicine.disease, Cannula, eye diseases, Surgery, medicine.anatomical_structure, Silicone Elastomers, Drainage, sense organs, business
Abstract

Purpose To develop a temporary keratoprosthesis with integrated infusion cannula to minimize retinal complications during pars plana vitrectomy in eyes with an opaque cornea. Methods The wide-field temporary keratoprosthesis has been modified to include an integrated infusion cannula. The 20-gauge cannula runs from the periphery of the corneal flange, bends 90 degrees, and enters the eye after passing through the periphery of the corneal cylinder. Results The infusion wide-field temporary keratoprosthesis has been used successfully in three cases without the need to place a separate infusion, which risks iatrogenic retinal breaks or retinal dialyses. Droplet condensation on the posterior surface of the infusion temporary keratoprosthesis was reduced compared with the standard temporary keratoprosthesis. Conclusion We have developed a wide-field temporary keratoprosthesis with an integrated infusion cannula for use during pars plana vitrectomy in eyes with severe corneal opacity. This device eliminates the risk of complications related to the pars plana infusion cannula.

Published
1996

34. Fibrinolysis of experimental subretinal haemorrhage without removal using tissue plasminogen activator

Author

Lawrence S Morse, Jeffrey D. Benner, Leonard M. Hjelmeland, and Maurice B. Landers

Subjects
Retinal degeneration, Pathology, medicine.medical_specialty, medicine.medical_treatment, Eye disease, Tissue plasminogen activator, Cellular and Molecular Neuroscience, Plasminogen Activators, Fibrinolysis, medicine, Animals, Retina, Vascular disease, business.industry, Retinal Hemorrhage, medicine.disease, Sensory Systems, Ophthalmology, medicine.anatomical_structure, Concomitant, Tissue Plasminogen Activator, Cats, business, medicine.drug, Retinopathy, Research Article
Abstract

AIMS/BACKGROUND: Human recombinant tissue plasminogen activator (rt-PA) fibrinolysis of subretinal haemorrhage with concomitant removal has been shown to reverse the natural history of photoreceptor degeneration in experimental subretinal haemorrhages if evacuated within 7 days. The aim of the study was to determine whether fibrinolysis of subretinal haemorrhage without concomitant removal would offer a simpler approach with similar photoreceptor sparing. METHODS: A neodymium YAG laser was used to create experimental subretinal haemorrhages beneath the holangiotic retina of the cat. Tissue plasminogen activator (10 micrograms/ml) was injected into 4 day old subretinal haemorrhages to evaluate its effect on altering the natural history of retinal degeneration. Light and electron microscopy were used to study the histopathological effect. RESULTS: The injection of rt-PA into large 4 day old subretinal haemorrhages without concomitant removal did not alter the natural history of retinal degeneration. In fact, a second focus of retinal degeneration occurred at a gravity dependent inferior site where the subretinal haemorrhages had migrated. CONCLUSIONS: There was no therapeutic benefit from the injection of rt-PA into subretinal haemorrhages without con-comitant removal in this cat model.

Published
1996

35. Comparison of techniques for transscleral diode photocoagulation in the rabbit

Author

Lawrence S Morse, Jane C. Galustian, Jeffrey D. Benner, Leonard M. Hjelmeland, Michele C. Lim, and Maurice B. Landers

Subjects
medicine.medical_specialty, Laser Coagulation, genetic structures, business.industry, General Medicine, Treatment parameters, Laser, Energy requirement, eye diseases, Retina, law.invention, Sclera, Ophthalmology, medicine.anatomical_structure, law, medicine, Animals, sense organs, Rabbits, business, Short duration, Diode, Retinal hole
Abstract

PURPOSE To assess the optimum probe design and treatment parameters for transscleral diode laser retinopexy. METHODS Transscleral diode photocoagulation was performed on the eyes of Dutch-belted rabbits using three different transscleral probes: a straight, 400-microns diameter probe; a prism-tipped 400-microns diameter probe; and a prism-tipped 900-microns diameter probe. RESULTS Transscleral diode photocoagulation with all three probe types was an effective method of ablating the retina and creating chorioretinal adhesions. Both the burn diameter and the mean radiant output energy requirement increased as the burn duration and probe aperture diameter was increased. Explosive retinal holes were encountered in 12% of the burns created with the straight probe. The use of the prism-tipped probes significantly reduced the incidence of retinal holes to < 4% (P < 0.005). Histopathologically, all burns were grade III in intensity with severe choroidal injury. In many of the burns, there was histopathologic evidence of thermal injury to the inner sclera. The frequency of these inner scleral changes was reduced with a long burn duration (5 seconds). CONCLUSION This study confirms that diode transscleral photocoagulation is a feasible method of thermal retinopexy. The use of the prism-tipped probes and long duration burns resulted in the fewest adverse reactions.

Published
1995

36. Fibrinolytic-assisted removal of experimental subretinal hemorrhage within seven days reduces outer retinal degeneration

Author

Lawrence S Morse, Jeffrey D. Benner, Maurice B. Landers, Leonard M. Hjelmeland, and Andy Hay

Subjects
Retinal degeneration, medicine.medical_specialty, Time Factors, Fundus Oculi, Eye disease, Retina, chemistry.chemical_compound, Ophthalmology, medicine, Animals, Photoreceptor Cells, Thrombolytic Therapy, Bleb (cell biology), T-plasminogen activator, business.industry, Retinal Degeneration, Retinal detachment, Retinal Hemorrhage, Retinal, medicine.disease, Recombinant Proteins, Surgery, Disease Models, Animal, medicine.anatomical_structure, chemistry, Tissue Plasminogen Activator, Cats, Laser Therapy, business, Retinopathy
Abstract

Purpose: To better determine the surgical window for removing experimental subretinal hemorrhages in the cat model and to compare the histopathologic effect of such removal with the natural history of untreated subretinal hemorrhages. Methods: Twenty-three large experimental subretinal hemorrhages were created with a neodymium:YAG laser focused through a preformed retinal bleb in a cohort of cats. Fourteen subretinal hemorrhages were observed without treatment, six were removed at 7 days through a micropipette after injecting 10 μg/ml of human recombinant tissue plasminogen activator (rt-PA) into the subretinal space, and three were removed through an access retinotomy without the use of rt-PA. The tissues from these eyes were examined with light and electron microscopy 14 to 28 days after creation of the subretinal hemorrhages. Results: Severe outer retinal degeneration was evident by day 14 in all of the untreated subretinal hemorrhages 3 disc diameters or greater in size. In contrast, the outer retinal architecture was better preserved in the eyes that underwent rt-PA—assisted removal of their subretinal hemorrhage that was 3 disc diameters or greater on day 7. In these eyes, mild abnormalities such as abnormally short and misaligned photoreceptor outer segments with vacuolization were present within the retina that was formerly located over the hemorrhage center. The eyes that underwent subretinal hemorrhage removal through an access retinotomy without rt-PA on day 7 had a low-lying retinal detachment and outer retinal degeneration. Conclusion: Removing experimental subretinal hemorrhages within 7 days of their occurrence with the assistance of rt-PA and an ultramicrosurgical approach may reduce outer retinal degeneration in the cat model.

Published
1994

37. The Landers Trunkless Temporary Keratoprosthesis

Author

Thanh Thu T Tran, Maurice B. Landers, and Jessica S. Watson

Subjects
Pars plana, medicine.medical_specialty, Intraocular pressure, genetic structures, Keratoprosthesis, Swine, medicine.medical_treatment, Vitrectomy, Seal (mechanical), Eye Enucleation, Cornea, Prosthesis Implantation, Ophthalmology, Surgical Wound Dehiscence, medicine, Animals, Polymethyl Methacrylate, Polyglactin 910, Capsulorhexis, Sutures, business.industry, Suture Techniques, Equipment Design, Prostheses and Implants, eye diseases, Surgery, medicine.anatomical_structure, sense organs, business, Keratoplasty, Penetrating
Abstract

Objective To demonstrate the watertight seal created by the new wide-angle Landers trunkless temporary keratoprosthesis (T-TKP). Methods In 20 enucleated, porcine eyes, a 7.5-mm trephination was made, followed by capsulorrhexis and lensectomy. The T-TKP was sutured securely onto each eye. Testing the watertight seal at an intraocular pressure of 100 mm Hg was performed before and after pars plana vitrectomy. Results In all 20 eyes, the T-TKP maintained its watertight seal at an intraocular pressure of 100 mm Hg before and after vitrectomy. Conclusion The Landers T-TKP is a reusable device that provides a clear view and watertight eye in the presence of corneal trephinations up to 7.5 mm in diameter. Because of its unique trunkless design, as demonstrated in the laboratory, the T-TKP should allow the surgeon greater flexibility than previous models in cases of ocular trauma.

Published
2011

38. Intraocular fluid cultures after primary pars plana vitrectomy

Author

Steven M. Cohen, Maurice B. Landers, Jeffrey D. Benner, and Lawrence S Morse

Subjects
Pars plana, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Eye disease, Vitrectomy, Vitreous cavity, Eye Infections, Bacterial, Endophthalmitis, Postoperative Complications, Staphylococcus epidermidis, Ophthalmology, medicine, Humans, biology, Acinetobacter, business.industry, Middle Aged, Staphylococcal Infections, biology.organism_classification, medicine.disease, eye diseases, Mima polymorpha, Surgery, Vitreous Body, medicine.anatomical_structure, Intraocular fluid, sense organs, business, Acinetobacter Infections
Abstract

To determine what organisms enter the eye and remain in the eye after pars plana vitrectomy, vitreous cavity aspirates were cultured postoperatively. Two of 33 (6%) consecutive eyes undergoing primary pars plana vitrectomy had positive cultures. One sample grew a single colony of Staphylococcus epidermidis , the second grew two colonies of Acinetobacter lwoffi. Neither of these eyes developed endophthalmitis. This study demonstrates that bacteria enter the eye at a low rate during pars plana vitrectomy and that the eye on which a vitrectomy has been performed is capable of clearing a low inoculum of bacteria.

Published
1992

39. Comparison of photocoagulation with the argon, krypton, and diode laser indirect ophthalmoscopes in rabbit eyes

Author

Morgan Huang, Lawrence S Morse, Jeffrey D. Benner, Leonard M. Hjelmeland, and Maurice B. Landers

Subjects
Choroid Hemorrhage, medicine.medical_specialty, genetic structures, medicine.medical_treatment, chemistry.chemical_element, Retina, law.invention, chemistry.chemical_compound, Optics, law, Ophthalmology, Medicine, Animals, Laser Coagulation, business.industry, Ophthalmoscopes, Krypton, Far-infrared laser, Retinal, Ablation, Laser, eye diseases, Sclera, Vitreous Hemorrhage, Ophthalmoscopy, medicine.anatomical_structure, chemistry, sense organs, Choroid, Rabbits, business
Abstract

Purpose: The purpose of this study is to compare photocoagulation with the argon green, krypton red, and diode infrared laser indirect ophthalmoscopes in an experimental setting. Methods: Photocoagulation was performed with each of the laser indirect ophthalmoscopes in a grid pattern within one sector of the same eye of 14 Dutch-belted rabbits. Treatment was performed either with or without scleral depression. Measurements of the retinal burn diameters were performed after hemisecting the globes, and the burns were examined with light microscopy. Results: Variation in burn intensity and diameter (10% to 28%) was common with all 3 laser indirect ophthalmoscopes. Five times more output energy was required to make equivalent burns with the diode laser indirect ophthalmoscope than with the argon or krypton laser indirect ophthalmoscopes. Choriovitreal hemorrhages only occurred during scleral depression. Histopathologically, the argon green laser indirect ophthalmoscope burns spared the choroid and inner sclera, while the intense krypton and diode burns had full-thickness choroidal involvement and even thermal injury to the inner sclera. Scleral depression reduced the mean energy required to create equivalent burns with all three laser indirect ophthalmoscopes. There was a 10% to 40% reduction in the mean retinal burn diameter with scleral depression (argon green, P P P Conclusion: Photocoagulation with the argon green, krypton red, or diode infrared laser indirect ophthalmoscopes is a safe and effective method of retinal ablation. Decreasing the posterior nodal distance of the eye with scleral depression will produce a smaller spot on the retina with the laser indirect ophthalmoscope.

Published
1992

40. Ultramicrosurgical removal of subretinal hemorrhage in cats

Author

Cynthia A. Toth, Jeffrey D. Benner, Leonard M. Hjelmeland, Lawrence S Morse, and Maurice B. Landers

Subjects
Retinal degeneration, Pathology, medicine.medical_specialty, Microsurgery, Fundus Oculi, Eye disease, medicine.medical_treatment, Retina, chemistry.chemical_compound, Hematoma, medicine, Animals, CATS, business.industry, Retinal Hemorrhage, Retinal, medicine.disease, Recombinant Proteins, Ophthalmology, Disease Models, Animal, medicine.anatomical_structure, chemistry, Tissue Plasminogen Activator, Cats, business, Retinopathy
Abstract

Subretinal hemorrhages are associated with progressive degeneration of the outer retina and a corresponding poor visual prognosis. Mixed results have been reported in previous attempts to remove such subretinal hemorrhages. We developed an ultramicrosurgical system that used the control of a stereotactic micromanipulator to direct a micropipette tip through a small retinotomy into the subretinal space in three cat eyes. Low-dose recombinant tissue plasminogen activator was then introduced into the subretinal space around the subretinal hemorrhage via a controlled microinfusion system. The recombinant tissue plasminogen activator solution facilitated clot lysis and subsequent removal through the micropipette. Light- and electron-microscopic analysis of histopathologic specimens disclosed good preservation of retinal architecture in the three cat eyes in which experimental subretinal hemorrhages were removed. This was in contrast to the retinal degeneration observed in similar but untreated experimental subretinal hemorrhages.

Published
1992

41. Evaluation of a commercial recombinant tissue-type plasminogen activator preparation in the subretinal space of the cat

Author

Cynthia A. Toth, Maurice B. Landers, Jeffrey D. Benner, Leonard M. Hjelmeland, and Lawrence S Morse

Subjects
Retinal degeneration, Pathology, medicine.medical_specialty, medicine.medical_treatment, Biology, Tissue plasminogen activator, Retina, law.invention, chemistry.chemical_compound, law, Fibrinolysis, medicine, Animals, Photoreceptor Cells, Bleb (cell biology), Pigment Epithelium of Eye, Dose-Response Relationship, Drug, Retinal Degeneration, Retinal, medicine.disease, Molecular biology, Epithelium, Recombinant Proteins, Ophthalmology, medicine.anatomical_structure, chemistry, Tissue Plasminogen Activator, Recombinant DNA, Cats, Pharmaceutical Vehicles, Plasminogen activator, medicine.drug
Abstract

To explore the feasibility of using human recombinant tissue-type plasminogen activator in the management of subretinal hemorrhage, we examined the toxic effects of a commercial preparation of human recombinant tissue-type plasminogen activator in the subretinal space of the holangiotic retina of the cat. Various concentrations of human recombinant tissue-type plasminogen activator and controls were infused into the subretinal space with a glass micropipette (40- to 60-microns tip) to form a retinal bleb. Concentrations from 2.5 mg/L to 200 mg/L were well tolerated without ultrastructural toxic effects, while 1000 mg/L of human recombinant tissue-type plasminogen activator caused severe, irreversible toxic effects to the photoreceptor-retinal pigment epithelium complex. This toxic effect appeared to be due to the carrier vehicle rather than the human recombinant tissue-type plasminogen activator protein itself. Our results demonstrate that commercially prepared human recombinant tissue-type plasminogen activator can be safely used in the subretinal space of the cat with the range necessary for fibrinolysis.

Published
1991

42. Fibrin directs early retinal damage after experimental subretinal hemorrhage

Author

Lawrence S Morse, Cynthia A. Toth, Leonard M. Hjelmeland, and Maurice B. Landers

Subjects
Pathology, medicine.medical_specialty, genetic structures, Fundus Oculi, Eye disease, Tissue plasminogen activator, Fibrin, Retina, chemistry.chemical_compound, Ophthalmology, Subretinal hemorrhage, medicine, Animals, Bleb (cell biology), biology, Retinal damage, business.industry, Retinal Degeneration, Retinal Detachment, Retinal detachment, Retinal Hemorrhage, Retinal, General Medicine, medicine.disease, eye diseases, Disease Models, Animal, medicine.anatomical_structure, chemistry, biology.protein, Cats, sense organs, business, Retinopathy, medicine.drug
Abstract

• Subretinal blood within the macula may cause visual loss in a number of macular diseases. The clinical and histopathologic effects of experimental subretinal hemorrhage were evaluated in the cat. Subretinal hemorrhages were produced by creating a focal neurosensory retinal detachment with micropipette techniques, then inserting a needle tip transsclerally to allow choroidal blood to fill the bleb. Experimental lesions were examined clinically and with light and electron microscopy during a 14-day postoperative period. Initial observations included clot organization with retraction of fibrin strands. In six of nine clots more than 1 hour old, fibrin was associated with tearing of sheets of photoreceptor inner and outer segments. Later degeneration progressed to involve all retinal layers overlying the densest areas of fibrin in the clots. Hemorrhages into subretinal blebs containing tissue plasminogen activator did not form fibrin strands or cause photoreceptor tearing. These findings highlight the potential for improved retinal survival if organized subretinal clot can be eliminated soon after formation.

Published
1991

43. A new inexpensive pump for vitreoretinal surgery

Author

David Maberely, Maurice B. Landers, Michael W. Stewart, and Christian L. Serdahl

Subjects
medicine.medical_specialty, business.industry, Vitreoretinal surgery, Equipment Design, Retina, Surgery, Surgical Equipment, Vitreous Body, Ophthalmology, Air pump, medicine, Cost analysis, Surgical equipment, Drainage, Humans, business, Vitreous surgery
Abstract

An inexpensive and reliable fluid-gas exchange system has been developed for vitreous surgery. The system relies on a fish-tank air pump and was compared with the Grieshaber Air System in several laboratory and operating room situations. No significant differences were found between the two systems. Details of the Davis Ocular Air Pump are provided along with a cost analysis.

Published
1991

44. Argon laser photocoagulation for advanced retinopathy of prematurity

Author

Christian L. Serdahl, Maurice B. Landers, James B. Ruben, and H. Christopher Semple

Subjects
medicine.medical_specialty, business.industry, Ophthalmoscopes, Infant, Newborn, Retinopathy of prematurity, Light Coagulation, medicine.disease, Cryosurgery, Vitreous Hemorrhage, Ophthalmology, medicine, Argon laser photocoagulation, Humans, Retinopathy of Prematurity, Laser Therapy, Postoperative Period, business
Published
1990

45. Optic disk neovascularization in juvenile rheumatoid arthritis

Author

H. Christopher Semple, Maurice B. Landers, and Lawrence S Morse

Subjects
Pars plana, medicine.medical_specialty, Proliferative vitreoretinopathy, genetic structures, Fundus Oculi, Optic Disk, Optic disk, Visual Acuity, Cataract Extraction, Triamcinolone Acetonide, Cataract, Ophthalmology, medicine, Humans, Fluorescein Angiography, Neovascularization, Pathologic, business.industry, digestive, oral, and skin physiology, Retinal detachment, medicine.disease, Cannula, eye diseases, Arthritis, Juvenile, Retinal Tear, medicine.anatomical_structure, Child, Preschool, Vitreous hemorrhage, Female, sense organs, business, Vitreous base
Abstract

pupillary margin so that the flow of infusion fluid is downward into the vitreous cavity of the aphakic eye and, hence, away from the corneal endothelium (Fig. 2). The infusion cannula can be sewn onto the sclera in a manner similar to that of a standard pars plana infusion cannula. It is thus possible to approach the vitreous base with a minimal chance of the infusion cannula creating new retinal tears. We have used this infusion cannula successfully on several patients who had severe proliferative vitreoretinopathy and in trauma patients who have dense vitreous hemorrhage and preoperative ultrasonic evidence of a retinal detachment.

Published
1990

46. How Does Vitrectomy Affect Diabetic Macular Edema?

Author

Maurice B. Landers and Einar Stefánsson

Subjects
Ophthalmology, medicine.medical_specialty, Text mining, business.industry, medicine.medical_treatment, Diabetic macular edema, medicine, Vitrectomy, Affect (psychology), business
Published
2006

47. Retinal Vessel Caliber and Diabetic Retinopathy

Author

Maurice B. Landers, Myron L. Wolbarsht, and Einar Stefánsson

Subjects
Retinal vessel, Ophthalmology, medicine.medical_specialty, Caliber, business.industry, Disease progression, medicine, Vasodilation, Diabetic retinopathy, medicine.disease, business, Surgery
Published
2005

48. Author reply

Author

Maurice B. Landers, Gholam A. Peyman, Paul Whalen, Izak F. Wessels, and Virgilio Morales

Subjects
Ophthalmology
Published
2003

49. Hyperoxia and Transient Resolution of Vascular Vasodilation and Tortuosity in Threshold Retinopathy of Prematurity

Author

Jeffrey D. Benner and Maurice B. Landers

Subjects
medicine.medical_specialty, Vasodilation, Anesthesia, General, Light Coagulation, Tortuosity, Muscle, Smooth, Vascular, Internal medicine, medicine, Humans, Retinopathy of Prematurity, Hyperoxia, business.industry, Infant, Newborn, Infant, Retinal Vessels, Retinopathy of prematurity, medicine.disease, Oxygen, Ophthalmology, medicine.anatomical_structure, Vasoconstriction, Anesthesia, Cardiology, medicine.symptom, business, Infant, Premature, Retinopathy, Blood vessel
Published
1993

50. Ulnar Neuropathy as a Complication of Macular Hole Surgery

Author

William B. Snyder, Maurice B. Landers, Nancy M. Holekamp, Travis A. Meredith, John T. Thompson, Adrienne J. Berman, and Steven Williams

Subjects
Male, medicine.medical_specialty, Visual acuity, genetic structures, medicine.medical_treatment, Posture, Elbow, Visual Acuity, Vitrectomy, Electromyography, Ulnar neuropathy, medicine, Humans, Macular hole, Aged, Retrospective Studies, Fluorocarbons, Dysesthesia, medicine.diagnostic_test, business.industry, Middle Aged, Retinal Perforations, medicine.disease, Surgery, body regions, Ophthalmology, Peripheral neuropathy, medicine.anatomical_structure, Female, medicine.symptom, Ulnar Neuropathies, business
Abstract

Objective To report a series of patients manifesting ulnar neuropathy as an extraocular complication following macular hole surgery and facedown positioning. Methods Retrospective chart review of 7 patients identified by the operating surgeon as developing ulnar neuropathy during the immediate postoperative period after undergoing vitrectomy surgery with fluid-gas exchange for macular hole followed by at least 1 week of strict facedown positioning. Results All 7 patients developed symptoms of ulnar neuropathy, including paresthesias, dysesthesias, pain, weakness, and muscle atrophy. Signs included abnormal electromyogram, prolonged nerve conduction velocities, and impaired neurologic clinical test results in patients examined. Symptoms did not resolve with cessation of facedown positioning, and with follow-up ranging from 3 to 24 months all patients had persistent symptoms. All patients had positioned themselves with their arms continuously flexed. Three of 7 patients had placed pressure directly on their bent elbows. Conclusions Ulnar neuropathy is an extraocular complication of macular hole surgery that can be attributed to arm position during postoperative facedown positioning. Surgeons performing macular hole surgery should caution their patients to minimize the amount of time spent with their elbows in a flexed position. Particular effort should be made to minimize pressure on the bent elbow.

Published
1999

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