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  • 1
    ISSN: 1573-2622
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Documenta ophthalmologica 1 (1938), S. 79-160 
    ISSN: 1573-2622
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-2622
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In order to investigate the incidence of endophthalmitis following various types of cataract surgery, we sent a questionnaire to the members of the Dutch Intraocular Implant Club (NIOIC). Retrospectively, information was obtained about the number of performed cataract extractions, the techniques used, and the number of patients with postoperative endophthalmitis. To estimate bias by underreporting, we calculated the nationwide incidence of endophthalmitis after cataract surgery in the same period of time. The response rate to the questionnaire was 51.2%. In the reporting group the incidence of endophthalmitis was 0.11%. This incidence was comparable with the calculated nationwide incidence (0.15%). Comparison between the incidences after phacoemulsification (0.10%) and after other techniques (0.16%) showed no significant difference in the questionnaire group. A complicated cataract extraction preceded 12 out of the 38 reported cases with endophthalmitis. In conclusion, the incidence of endophthalmitis after cataract surgery in the Netherlands is comparable with the incidence reported in literature. The occurrence of complications during surgery rather than the technique used affects on the development of endophthalmitis.
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  • 4
    ISSN: 1573-2622
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Nous avons pu suivre 64 fois le procéssus de l'adaptation nocturne après une adaptation à la lumière intense. Parmi ces cas nous avons enrégistré 48 fois l'électrorétinogramme. Une lumière blanche d'intensité constante a été présentée plusieurs fois et l'amplitude de l'onde b a été mesurée. 16 fois, la courbe d'adaptation nocturne a été déterminée par le seuil subjectif. Chez une seconde personne, 9 expériences supplémentaires ont été faites avec un plus grand champ de stimulation. La fameuse angulation de l'adaptation nocturne subjective était aussi présente dans les courbes d'amplitude de l'onde b pendant l'adaptation nocturne. L'angulation se produit ici plus tôt que dans la courbe d'adaptation nocturne subjective. Plus la stimulation est intense, plus l'angulation avance. Les deux résultats ont été prouvés statistiquement. Nous pensons que le mécanisme scotoptique est stimulé plus tôt, à mesure que l'intensité de la lumière augmente. Une discordance dans les relations entre le temps et l'intensité de l'angulation peut être compensée si l'on se sert d'un grand champ de stimulation au lieu d'un petit. Dans ces conditions, le rayonnement diffus n'a pas grande importance. Avec les petits champs, l'électrorétinogramme ne dépend pas tellement de l'intensité du champ même que de l'intensité du rayonnement diffus. La courbe de la sensibilité lumineuse de l'onde b pendant l'adaptation nocturne montre, elle aussi, une angulation. Dans des conditions particulières nous avons trouvé une seconde angulation dans la courbe d'adaptation nocturne.
    Abstract: Riassunto In uno e lo stesso soggetto si è osservato 64 volte lo svolgimento dell' addattamento all'oscurità dopo un lungo adattamento alla luce. L'elettroretinogramma venne registrato in 48 dei suddetti esperimenti. A tale fine si è adoperato un lume di eccitamento bianco e constante che aveva una determinata intensità luminosa. Inoltre l'amplitudine dell'ondata “b” venne misurata. La curva dell' adattamento all'oscurità fù stabilita 16 volte coll'aiuto della soglia soggettiva dell' eccitamento luminoso. Nove esperimenti supplementari si effettuarono in un secondo soggetto. In tali esperimenti il campo dell' eccitamento era più vasto. La piega conosciuta dalla curva soggettiva dell'adattamento all'oscurità potè essere verificata nelle curve delle amplitudini dell'ondata “b” nel corso dell'adattamento all' oscurità. Tale piega appare più presto che nella curva soggettiva della soglia (dell' eccitamento luminoso), tanto più presto quanto il lume eccitante è più intenso. Ambedue i risultati dei suddetti esperimenti sono stati confermati in base a dati statistici. Come causa di questo spostamento della piega della curva si considera il fatto che l'apparato per la visione crepuscolare viene eccitato tanto più presto quanto l'intensità del lume eccitante è più forte. Fenomeni che non concordano con quest' osservazione risultano probabilmente dal fatto che in casi in cui i campi d'eccitamento sono ristretti l'elettroretinogramma dipende largamente dall' intensità del lume disperso, meno dall' intensità luminosa del campo d'eccitamento vero e proprio. Questa supposizione venne confermata da esperimenti supplementari nei quali i campi d'eccitamento erano molto vasti e perciò l'effetto del lume disperso poco importante. Da un numero considerevole di curve di amplitudini venne derivata una curva della ‘sensibilità luminosa dell’ ondata “b” che si rileva nel corso dell' adattamento all' oscurità. In tale curva apparve pure una piega la quale riguardo al tempo corrisponde quasi alla piega osservata nella curva soggettiva dell' adattamento all' oscurità. Sotto certe condizioni si riuscì anche a verificare una seconda piega nella curva dell' adattamento all' oscurità. Finora non si fa nessun tentativo di spiegare questo fenomeno.
    Notes: Zusammenfassung Insgesamt 64 mal wurde bei einer Versuchsperson der Ablauf der Dunkeladaptation nach ausgiebiger Helladaptation verfolgt. In 48 dieser Versuche wurde das Elektroretinogramm registriert. Dazu wurde ein konstantes weißes Reizlicht bestimmter Leuchtdichte wiederholt dargeboten und die Amplitude der b-Welle ausgemessen. 16 mal wurde die Dunkeladaptationskurve mit Hilfe der subjektiven Schwellenreizleuchtdichte bestimmt. Bei einer zweiten Versuchsperson wurden 9 ergänzende Versuche unter Verwendung eines größeren Reizfeldes durchgeführt. Der Knick, der aus der subjektiven Dunkeladaptationskurve bekannt ist, ließ sich auch in den Amplitudenkurven der b-Welle im Verlauf der Dunkeladaptation nachweisen. Er tritt zeitlich früher auf als bei der subjektiven Schwellenkurve, und zwar umso eher, je intensiver das Reizlicht ist. Beide Befunde ließen sich statistisch sichern. Die Ursache für dieses Vorrücken des Kurvenknickes wird darin gesehen, daß der Dämmerungsapparat des Auges umso eher miterregt wird, je intensiver das Reizlicht ist. Eine Unstimmigkeit wird darauf zurückgeführt, daß bei Verwendung kleiner Reizfelder das Elektroretinogramm weitgehend von der Intensität des Streulichtes abhängt und weniger von der Leuchtdichte des Reizfeldes selbst. Zusatzversuche mit sehr großen Reizfeldern, bei denen Streulicht eine geringere Rolle spielt, bestätigten diese Vermutung. Aus einer größeren Anzahl von Amplitudenkurven wurde eine Kurve der “Lichtempfindlichkeit der b-Welle” im Verlauf der Dunkeladaptation abgeleitet. Auch diese Kurve zeigte einen Knick, der zeitlich mit dem Knick in der subjektiven Dunkeladaptationskurve nahezu übereinstimmt. Unter bestimmten Bedingungen ließ sich ein zweiter Knick in der Dunkeladaptationskurve nachweisen. Von einem Deutungsversuch für diesen Befund wird vorerst abgesehen.
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  • 5
    ISSN: 1573-2622
    Keywords: primary rhegmatogenous retinal detachment ; scleral buckling
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Within the scope of a Retinal Fellowship of one year, we evaluated the anatomic and functional results of scleral buckling operations in primary rhegmatogenous retinal detachments. Eighty Consecutive non-selected patients with a primary retinal detachment were operated by one surgeon (Retinal Fellow-ELH). In 55 eyes an encircling band and radial buckle(s) were placed, the other 25 eyes were treated with a segmental buckle or a combination of both. In 62 eyes subretinal fluid was drained, and in 57 eyes air or SF-6 gas was injected. The anatomic success rate after one operation was 81% (65/80 eyes) and the final success rate was 99%. 38/65 (58%) of the eyes obtained a best corrected post-operative visual acuity of ≥ 0.4. The most important cause of re-detachment was Proliferative vitreoretinopathy (PVR; 11%). Pre-operative variables that yielded an unfavourable outcome in this study were: PVR, pseudophakic eye, larger breaks, more than one break, longer duration of the detachment, and 3 or more quadrants of detachment. Our anatomic success rate and risk factors are in agreement with findings described in the literature, yet we had a high rate of PVR and many patients with a low visual acuity (58% ≤ 0.3) pre-operatively.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Documenta ophthalmologica 100 (2000), S. 43-47 
    ISSN: 1573-2622
    Keywords: phacoemulsification ; trabeculectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The outcome of combined same-site phacoemulsification, posterior chamber lens implantation and trabeculectomy was retrospectively studied in patients with cataract and moderately controlled glaucoma, with a follow-up of at least 6 months. Primary phacotrabeculectomy without antimetabolites was performed in 74 patients. Mean IOP decreased from 22.8 to 14.3 mm Hg (35.3%). A maximum IOP of 19 mm Hg without glaucoma medication was reached in 66.2%. Mean logMAR visual acuity increased from 0.58 to 0.30. Primary phacotrabeculectomy has been shown to be a safe and effective procedure with good IOP control and rapid visual rehabilitation.
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  • 7
    ISSN: 1573-2622
    Keywords: proliferative vitreoretinopathy ; rhegmatogenous retinal detachment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Proliferative vitreoretinopathy (PVR) is the only cause of ultimate failure following retinal detachment surgery. This study aimed to review the rate of postoperative PVR in a series of 186 consecutive patients with primary rhegmatogenous retinal detachments. All 186 detachments were repaired with a scleral buckling procedure combined with cryotherapy. Drainage of subretinal fluid was done at the discretion of the surgeon. The mean follow-up was 12 months. In this series 152 (82%) of primary detachments were repaired succesfully with a single operation. Sixty-eight percent of patients regained 0.3 or better visual acuity, and 3% of patients were left with visual acuity of 1/60 or less. After two or more operations the retina was attached in 96% of the cases. In 12 (6%) eyes PVR was responsible for the initial surgical failure. In 4 cases PVR (grade B and limited C) was present prior to surgery. In 3 cases PVR developed within 2 days postoperatively, in 3 cases after 3–6 weeks and in another 2 cases after 8–l0 months. Eight out of 12 (66%) PVR patients had undergone cataract surgery. One PVR case had preoperative intraocular inflammation. An association between the duration of retinal detachment, or drainage of subretinal fluid and the development of PVR could not be demonstrated. In conclusion, the rate of postoperative PVR in primary rhegmatogenous retinal detachments was low. PVR preoperatively present and pseudophakia may be risk factors.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Documenta ophthalmologica 100 (2000), S. 77-98 
    ISSN: 1573-2622
    Keywords: multifocal analysis ; multifocal ERG ; stimulus delivery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract There are a wide range of variables which can influence the quality of the multifocal response. It is possible to place these variables into one of four categories. First, the method of stimulus delivery will determine the field of view, interference levels and the duration of on-state stimulation. Second, data acquisition variables such as electrode type and placement, amplifier specifications and filter bandwidth settings will have a direct impact on waveform shape and on the topographic distribution of signal amplitudes. Third, patient variables such as fixation, pupil dilation and refractive error will also contribute to the multifocal response. Fourth, there are many measurements that can be taken from multifocal recordings. In addition to standard amplitude and implicit time measures (the implicit time measure in the multifocal response is becoming increasingly important particularly in early stages of disease processes), the scalar product measure provides information on waveform shape. The conventional impulse and higher order responses will be different for different modes of stimulation such as Cathode Ray Tube (CRT) and Liquid Crystal Display (LCD) systems and latency shifts will be introduced if not corrected in software. Procedures which could lead to misleading interpretation include artefact rejection, averaging with neighbours and summing of responses. These procedures should be handled with caution.
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  • 9
    ISSN: 1573-2622
    Keywords: electroretinogram (ERG) ; glaucoma ; multifocal ; optic neuritis ; retinitis pigmentosa (RP) ; visual evoked ; visual evoked potential (VEP)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Static visual perimetry and the multifocal technique both measure the local effects of diseases of the retina and optic tract. The purpose here is to relate the measures obtained from each technique and to describe this relationship in some diseases. It is important to measure both the implicit time and amplitude of the multifocal ERG (mERG) or multifocal VEP (mVEP) responses. Some diseases affect one measure of the responses but not the other. The comparison of either measure to local sensitivity changes measured with static perimetry (e.g. the Humphrey 24-2 and 30-2) presents a problem. Different stimulus displays are employed. Further, the multifocal responses are displayed with arbitrary spacing between the responses. One approach is to measure the amplitude and implicit time of the multifocal responses and display these values on the same coordinates as in the visual field plots. This allows a qualitative comparison of fields and multifocal responses on the same scale. A second approach involves modifying the Humphrey perimeter software so that the test spots are placed in the centers of the multifocal stimuli (e.g. the center of each hexagon of the mERG display). A third approach involves estimating the thresholds for the regions of the multifocal display by interpolating from values at the standard Humphrey locations. The second and third approaches produce a one-to-one mapping of the multifocal and field measures and allow a quantitative comparison between the two. The relationship between visual fields and multifocal responses, determined through one or more of these approaches, is different depending upon whether the disease primarily affects the outer retina (retinitis pigmentosa), ganglion cell (glaucoma), or optic nerve (ischemic optic neuropathy and optic neuritis).
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  • 10
    ISSN: 1573-2622
    Keywords: dark adaptation ; electrophysiology ; night-blindness ; psychophysical testing ; retina ; vitamin A deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The standard for dark adaptation has long been the Goldmann-Weekers Dark Adaptometer™ (Haag-Streit). More recently, portable, relatively inexpensive LED-based dark adaptometers have become commercially available. These devices have potential use in areas with limited resources to screen for night-blindness, commonly caused worldwide by vitamin A deficiency. In order to determine the sensitivity to detecting changes in night vision, this study compared one such device, LKC Technologies Scotopic Sensitivity Tester-1™ (SST- 1) to the Goldmann-Weekers in patients with hereditary retinal degeneration and loss of rod function. Dark-adapted final thresholds and rod full-field ERG responses were obtained from 87 patients and 24 normal subjects. Linear regression analysis, discrepancy analysis, and receiver operator characteristic curves for both devices show that the SST-1 quantifies psychophysical rod function nearly as well as the Goldmann-Weekers, within some limitations. We conclude, therefore, that the SST-1 is a viable alternative to the Goldmann-Weekers for the screening of night-blinding retinal disorders.
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