1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060004001
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060015003
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract In the article titled "Transpupillary Thermotherapy in Choroidal Melanomas" published in the March 1995 issue of the Archives (1995;113:315-321), in the "Patients and Methods" section on page 316, the third sentence of the fourth paragraph should have read: "For the laser lens, we used the Panfunduscope (Rodenstock, Munich, Germany), the Mainster (Ocular Instruments, Bellevue, Wash), the QuadrAspheric (Volk Optical, Mentor, Ohio), or the TransEquator (Volk Optical) lens."
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060015002
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Macula Society Announces Awards. The Executive Committee of the Macula Society, Cleveland, Ohio, presented the following medals at the Society's 18th annual scientific meeting that was held in February in Palm Beach Gardens, Fla. The Arnell Patz Medal for Excellence in Retinal Vascular Disease was presented to both John G. Clarkson, MD, and Daniel Finkelstein, MD. The J. Donald M. Gass Medal was presented to Stuart L. Fine, MD, for his outstanding contributions in the study of macula diseases. Robert Ritch, MD, Delivers Lecture. Robert Ritch, MD, Professor of Clinical Ophthalmology and Chief of the Glaucoma Service at The New York Eye and Ear Infirmary, New York, NY, delivered the Arthur J. Bedell Lecture at the 47th Annual Wills Eye Hospital Conference on March 16, 1995, in Philadelphia, Pa. Robert C. Urban, Jr, MD, Appointed Director of Glaucoma Service. Robert C. Urban, Jr, MD, has been appointed Director of the
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060016004
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060019006pmid: 7786198
Abstract An acceptable outcome of retinopathy of prematurity (ROP), whether natural or after treatment, is not synonymous with the experimentally designated "favorable outcome" of the Multicenter Trial of Cryotherapy for ROP.1 Whereas their outcome grade II—macular displacement—must include eyes with significant visual disability, surely the goal of treatment should be the prevention of macular displacement. In Table 3 of the report by the Cryotherapy for Retinopathy of Prematurity Cooperative group,1 eight of 93 eyes that had one to four sectors of stage 3+ ROP in zone II had the study's unfavorable result, ie, a retinal fold involving the macula or worse. Outcomes of an additional six eyes were considered favorable, but these eyes may be visually disabled because of macular displacement, which would be unacceptable to ophthalmologists, parents, and patients. If all the data were provided, ie, a breakdown of outcome from eyes with 1, 2, 3, or 4 References 1. Cryotherapy for Retinopathy of Prematurity Cooperative Group. The natural ocular outcome of premature birth and retinopathy: status at 1 year . Arch Ophthalmol . 1994;112:903-912.Crossref
Maldonado, Miguel J.;Menezo, Jose L.
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060019005pmid: 7786197
Abstract In the July 1994 issue of the Archives, an excellent article by Carones et al1 provided rigorous information regarding the changes in the human corneal endothelium observed 3 and 12 months after myopic photorefractive keratectomy. Four findings of key importance for the present and future of excimer laser photorefractive surgery were reported: (1) postoperatively, the average endothelial densities and morphologic features not only did not deteriorate but even improved in the case of the coefficient of variation of cell area and the percentage of hexagonality; (2) the latter were, in our opinion, correctly attributed in part to the cessation of contact lens use; (3) however, 14 (18.4%) of a total of 76 eyes studied were found to have developed an endothelial cell loss of greater than 5%, the largest loss being 16.2% at the 1-year examination; and (4) this substantial cell loss did not appear to be related to References 1. Carones F, Brancato R, Venturi E, Morico A. The corneal endothelium after myopic excimer laser photorefractive keratectomy . Arch Ophthalmol . 1994;112:920-924.Crossref 2. Hanna K, Pouliquen Y, Waring GO, et al. Corneal stromal wound healing in rabbits after 193-nm excimer laser surface ablation . Arch Ophthalmol . 1989;107:895-901.Crossref 3. MacRae SM, Matsuda M, Phillips DS. The long-term effects of polymethylmethracrylate contact lens wear on the corneal endothelium . Ophthalmology . 1994;101:365-370.Crossref
Hardy, Robert J.;Palmer, Earl A.;Flynn, John T.
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060019007
Abstract In reply For years, the Multicenter Trial of Cryotherapy for ROP investigators have devoted countless hours to studying the relation between stage 3 ROP and eventual outcome. The risk for an unfavorable outcome depends on multiple variables, only one of which is the extent of stage 3 disease. A more posterior location (zone) of ROP and the presence of plus disease are important indexes of ROP severity. Rapidity of disease progression is also significant.1The requested subgrouping of fundus outcome data shows no significant difference in the rate of occurrence of unfavorable outcome (P=.65) across the 4 clock hours of ROP. The lowest rate of unfavorable fundus outcome, 6.1%, was for eyes with 4 clock hours of stage 3 ROP, and the highest rate, 15.7%, was for eyes with 3 clock hours.In response to Dr Hindle, there is probably no perfect way to ensure against adverse outcomes References 1. Schaffer DB, Palmer EA, Plotsky DF, et al, on behalf of the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Prognostic factors in the natural course of retinopathy of prematurity . Ophthalmology . 1993;100:230-236.Crossref 2. Cryotherapy for Retinopathy of Prematurity Cooperative Group. Multicenter Trial of Cryotherapy for Retinopathy of Prematurity: one-year outcome—structure and function . Arch Ophthalmol . 1990;108:1408-1416.Crossref 3. Reynolds J, Dobson V, Quinn GE, et al, for the Cryotherapy for Retinopathy of Prematurity Cooperative Group. Prediction of visual function in eyes with mild to moderate posterior pole residua of retinopathy of prematurity . Arch Ophthalmol . 1993;111:1050-1056.Crossref
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060020009pmid: 7632298
Abstract In the abstract of their article in the January 1994 issue of the Archives, Dr Ritch et al1 state that "psychoactive drugs should be prescribed cautiously in patients with known narrow angles." This conclusion is overinclusive. The majority of currently prescribed psychoactive medications are not at all or are only mildly anticholinergic and have not been reported to elicit acute angle closure. The selective serotonin reuptake inhibitors (eg, fluoxetine hydrochloride [Prozac], paroxetine hydrochloride [Paxil]), often first-line antidepressant therapy, are devoid of anticholinergic activity, as are benzodiazepine anxiolytics, lithium, and other mood stabilizers. However, some of the older tricyclic antidepressants (amitriptyline hydrochloride, imipramine hydrochloride, doxepin hydrochloride, protriptyline hydrochloride, and triimipramine hydrochloride), some antipsychotics (thioridazine hydrochloride, chlorpromazine hydrochloride, and others), and clearly drugs like benztropine mesylate are indeed anticholinergic and could potentially trigger acute angle closure. Although few documented cases of a temporal association between ingestion of drugs with anticholinergic properties References 1. Ritch R, Krupin T, Henry C, Kurata F. Oral imipramine and acute angle closure glaucoma . Arch Ophthalmol . 1994;112:67-68.Crossref
Epstein, Nancy E.;Goldbloom, David S.
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060020008pmid: 7786199
Abstract The case series reported by Dr Ritch et al1 in the January 1994 issue of the Archives clearly points out the risks of the use of such highly anticholinergic tertiary amine antidepressants as imipramine hydrochloride in patients known to have narrow angles. In each case, ophthalmological awareness of the narrow angles preceded rather than resulted from imipramine treatment. The authors conclude by recommending close monitoring by an ophthalmologist for patients with narrow angles "for whom treatment with tricyclic antidepressants is indicated." We believe that this recommendation is incomplete. The development in the last decade of new classes of antidepressants that are virtually devoid of any anticholinergic effects provides an important therapeutic alternative for such high-risk patients. The selective serotonin reuptake inhibitors such as fluoxetine hydrochloride, fluvoxamine maleate, sertraline hydrochloride, and paroxetine hydrochloride are effective and welltolerated antidepressants that have become extremely popular. Even if a tricyclic antidepressant must be References 1. Ritch R, Krupin T, Henry C, Kurata F. Oral imipramine and acute angle closure glaucoma . Arch Ophthalmol . 1994;112:67-68.Crossref
1995 Archives of Ophthalmology
doi: 10.1001/archopht.1995.01100060021011pmid: 7786200
Abstract Hypopyon uveitis secondary to rifabutin therapy in seven patients with acquired immunodeficiency syndrome (AIDS), reported by Saran et al1 in the September 1994 issue of the Archives, was diagnosed during treatment for systemic Mycobacterium avium complex (MAC) infection. We found three cases of acute uveitis without hypopyon in patients with AIDS who were taking a prophylactic dosage of 300 to 450 mg/d of rifabutin. Report of Cases. Case 1. A 51-year-old white homosexual man with a CD4 count of 0.02X 109/L (20/μL) but with no history of AIDS-defining opportunistic infections developed acute uveitis 14 weeks after beginning prophylaxis for MAC infection (rifabutin, 450 mg/d). Other medications included fluconazole, 200 mg/d; a steroid inhaler (beclomethasone) as needed; oxybutynin chloride, 5 mg twice a day; paroxetine hydrochloride, 20 mg/d; and acyclovir, 3200 mg/d. The patient presented with sudden onset of photophobia and pain in the left eye.Examination of the left References 1. Saran BR, Maguire AM, Nichols C, et al. Hypopyon uveitis in patients with acquired immunodeficiency syndrome treated for systemic Mycobacterium avium complex infection with rifabutin . Arch Ophthalmol . 1994;112:1159-1165.Crossref 2. Fuller JD, Stanfield LED, Craven DE. Rifabutin prophylaxis and uveitis . N Engl J Med . 1994;330:1315.Crossref 3. Shafran SD, Deschenes J, Miller M, Phillips P, Toma E. Uveitis and pseudo-jaundice during a regimen of clarithromycin, rifabutin, and ethambutal . N Engl J Med . 1994;330:438-439.Crossref 4. Nightingale SD, Cameron DW, Gordin FM, et al. Two controlled trials of rifabutin prophylaxis against Mycobacterium avium complex infection in AIDS . N Engl J Med . 1993;329:828-833.Crossref
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