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1. LOCALIZATION OF MACULAR CRYSTALS ASSOCIATED WITH CHRONIC RETINAL DETACHMENT TO THE POSTERIOR HYALOID USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY

Author

Timothy P. Flood and Elizabeth A. Atchison

Subjects
Adult, Male, medicine.medical_specialty, genetic structures, Visual Acuity, Spectral domain, 01 natural sciences, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Optical coherence tomography, Vitrectomy, Ophthalmology, medicine, Humans, Macula Lutea, 0101 mathematics, Eye Proteins, Retina, medicine.diagnostic_test, business.industry, 010102 general mathematics, Retinal Detachment, Retinal detachment, Retinal, General Medicine, medicine.disease, eye diseases, medicine.anatomical_structure, chemistry, Vitreous membrane, Chronic Disease, 030221 ophthalmology & optometry, Maculopathy, sense organs, Crystallization, business, Tomography, Optical Coherence, Retinopathy
Abstract

PURPOSE To present a case of crystalline retinopathy associated with chronic retinal detachment and localize the macular crystals using spectral domain optical coherence tomography. METHODS Case Report. RESULTS A 37-year-old man with previously treated chronic retinal detachment presented with normal vision and crystalline maculopathy. Spectral domain optical coherence tomography localized the macular crystals to the posterior hyaloid membrane and on the internal limiting membrane, but not within the retina. CONCLUSION The macular crystals in crystalline retinopathy associated with chronic retinal detachment most likely originate in the subretinal space beneath the detached retina, migrate through the retinal break into the vitreous cavity, and lodge on the surface of the internal limiting membrane. When the posterior hyaloid membrane separates, the crystals, which are attached to the posterior hyaloid membrane, elevate from the retina.

Published
2021
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2. The Endophthalmitis Vitrectomy Study

Author

Mark W. Johnson, Bernard H. Doft, Sheryl F. Kelsey, Michael Barza, Louis A. Wilson, Charles C. Barr, Stephen R. Wisniewski, Andrew K. Vine, Barbara A. Blodi, Susan G. Elner, Laurie M. Jessup, Sharad Khanderia, Carl L. Pierson, Julie Willis, Frances McIver, Sally Stanley, Scott R. Sneed, Antonio Capone, Thomas M. Aaberg, Jennifer I. Lim, Paul Sternberg, Diana S. Coffman, Cameile N. Moore, Susanne K. Gardner, Frederick S. Nolte, Ann Fremstad, Deborah Gibbs, James Gilman, Ray Swords, H.Edith Aguilar, Travis A. Meredith, Vinod Lakhanpal, Faith D. Christian, A. Hood, Richard S. Schwalbe, Emery E. Billings, William Buie, James J. Mallonee, Mary Ann Millar, Sharon Verbeek, Peter A. Campochiaro, Carol B. Palardy, Lois Reynolds, James D. Dick, Dennis Cain, Donald J. D'Amico, Albert R. Frederick, Michael G. Morley, Richard D. Pesavento, Carmen A. Puliafito, Trexler M. Topping, Susan M. Finn, Laura A. Raymond, Ann Sullivan Baker, Barbara Paton, Claudia Evans, Jeffrey Napoli, Christine Kierman, Kathryn Makris, Tom McInnes, Wini T. Reidy, Ruth White, Richard A. Garfinkel, A.Raymond Pilkerton, Robert A. Frantz, Gill B. Abernathy, Jay G. Barbaccia, H.Russell Ensey, Carol A. Ormes, Choong H. Park, Joel Caplan, Kathryn Russell, Robert Toma, Kirk H. Packo, Serge de Bustros, Timothy P. Flood, Louis Glazer, Maggie DeAlba, Evangeline Evanich, Michael A. Montwill, Jeri J. Rothman, Gail Ruderman, Melodie Beard, William Landau, Min H. Shen, Martha Gordon, Sharon Graff, Kathy Kwiatkowski, Loreen Pappas, Douglas Bryant, Don Doherty, Frank Morini, Linda Arredondo, Bruce R. Garretson, Carlos Gerena, Maureen Hunt, Sharon M. Kinnaird, Toni Neri, Thomas A. Rice, Michael A. Novak, Pamela S. Rowe, Scott Jamieson, Deborah Newberry, Glenn R. Rech, Michael J. Dul, Livia Kinser, Krystyna Strozewski, Susan Clark-Rath, Marty DeLisio, David L. Dempsey, Donna Kukula, Anne Pinter-Smith, Sheila Smith-Brewer, Tracey Ludwig, Robert B. Chambers, Frederick H. Davidorf, Cindy S. Taylor, Karen N. Hale, William J. Buesching, Chhanda Chaudhuri, Nanci J. Cover, Gail R. Shortlidge, Michael J. Keating, Scott J. Savage, Paula Andrzejewska, Susan Cometet, Jill D. Milliron, Rob Richmond, Lori Schneider, Debra Weisenberger, Herbert L. Cantrill, Robert C. Ramsay, Amy B. Brallier, Timothy P. Johnson, Edith E. Rossing, Kathleen A. Knauth, Martha M. Monahan, Neal W. Oestreich, Kenneth F. Clark, Anita M. Glennen, David L. Yarian, Stuart N. Green, Steven R. Leff, Leo Masciulli, Margaret M. Lucido, Edward J. Ludwig, Charlotte L. Marano, Linda Peters, Kim Joho, Doris C. Volkert, Finn Andersen, Donna Coffey, Alex Schlosser, Ann Honeywell, Robert N. Mames, William T. Driebe, George A. Stern, Amye Francis, Z.Suzanne Zam, Rhonda Cooper, Darla Gaskins, Diana J. Shamis, Melinda Willingham, Kay Barker, Harry Rosa, Scott M. Friedman, Thomas W. Gardner, George W. Blankenship, Carole J. Coyle, Christopher J. Bero, Cindy Halas, Suzanne Schick, Jean Walker, Denise Cunningham, H.Michael Lambert, Pamela S. Clogston, Pamela M. Frady, S.Neal Gardner, Michael S. Osato, Louise Carr, James Shigley, Pedro F. Lopez, Lawrence P. Chong, Donald A. Frambach, Lupe CisnerosMargaret^Padilla, Edmond Ming Yee, Tamako Nakamura, A.Frances Walonker, Ronald Morales, Tracy Nichols, Maria E. Huete, Peter E. Liggett, Richard R. Ober, Beth Quillen-Thomas, Mark Williams, Steven M. Bloom, Pamela J. Greene, Greg K. Whittington, Mark E. Martin, Glen Watson, Betty Jenkins-Curry, Leigh A. Gilkey, Steven Huelsman, Dennis P. Han, Thomas C. Burton, William F. Mieler, Jose S. Pulido, Frederick H. Reeser, Janet L. Newman, Kathy A. Werner, Paul J. Pisarzewicz, Nina A. Reinerio, Mary Lee K. Walloch, Zuzana Wilmer, Jan Laabs, Ruth Picchiottino, Jim Phillips, Walter Wipplinger, Gary W. Abrams, Dale T. Jurkiewicz, Margaret L. Leet, Paul Mandel, Kim Metzger, Lori Suchla, Denise Zarling, Mark W. Balles, Edwin H. Ryan, William H. Knobloch, Sally M. Cook, Darlette G. Luke, Patricia Ferrieri, Norynne M. Schiminsky, Anne Genia, David A. Philiph, Elizabeth K. Stinson, Linda M. Wright, William C. McMichael, Sandy J. Mielke, Lisa J. Ponwith, Peter Reed Pavan, Scott E. Pautler, Marion L. Coats, Nancy M. Kirk, Sharon M. Millard, Frank C. Castellano, Charlotte R. Edwards, Angela Marquardt, Amy J. McCormack, Michael T. McCormick, Bernard Renshaw, Angela Restuccia, Monica Campbell, Nell Christopher, L.Scott Garrett, Demetrios G. Halkias, Kim Hothersall, Karen Mickler, Thomas S. Minnick, Cheryl Burr, Wyatt Saxon, Miguel A. Arcacha, Steve Carlton, Sonya K. Edison, Marc J. Mallis, Tamre L. Sayers, Thomas W. Sudds, Robert J. Tiberia, Sherry Wolabaugh, Reagan H. Bradford, David W. Parke, Thomas C. Wolf, Janie M. Shofner, Lee E. Tobey, Harold G. Jensen, Dinah Sanchez, Janie Shofner, Russell Burris, Kellie K. Drake, Kay R. Grissom, J.James Rowsey, Charles P. Wilkinson, Gary C. Brown, William E. Benson, Jay L. Federman, Alfred C. Lucier, Joseph I. Maguire, Lov K. Sarin, Eric P. Shakin, Arunan Sivalingam, William Tasman, James F. Vander, Nancy Ward, Clement A. Weisbecker, Caroline L. Agnew, Richard Lambert, Terrance Torner, Kathy Carlson, Gerrie Franchine, Michelle S. Serfass, Robert L. Bergren, Louis A. Lobes, Karl R. Olsen, Jeffrey S. Rinkoff, Donna J. Metz, Margaret N. Leonard, Lisa M. Karenchak, Regis P. Kowalski, Lynn A. Wellman, Linda A. Wilcox, Alan F. Campbell, David R. Steinberg, Gary L. Vagstad, Kimberly A. Flook, Mary M. Good, Beverly J. Keenen, Kim A. Mellinger, Raymond R. Margherio, Morton S. Cox, Patrick L. Murphy, Michael T. Trese, Jane C. Werner, George A. Williams, Patricia E. Manatrey, Janet L. Prote, Richard Lucarotti, Susan Martin, Jeff Band, Grace Bostic, Kristi Gumming, Beth Mitchell, Virginia S. Regan, Craig Bridges, Sam Cox, Gary Houston, John Johnson, Pat Streasik, Betty Wood, Mark S. Blumenkranz, Lisa Cayo, Virginia Kaye, Carmen Luz Valenzuela, Ira K. Orgel, Lon S. Poliner, Paul E. Tornambe, Sarah V. Cannon, Janet L. Nielsen, Anne Carlson, Pauline Chan, Lynne Drake, Martha Grim, Corky Peterson, Lynn A. Borg, Joann Gillyatt, Conny Beyer, Mark E. Hammer, W.Sanderson Grizzard, Theresa L. Shannon, Janet R. Traynom, Melinda J. Collado, Dennis W. McManus, Daniel E. Sweeney, Donald H. Adams, Thomas T. Watson, Michael V. Antworth, Johanna Glacy Araos, Mark A. Greenwald, Mohsen Habib, Sandra K. Myers, Karen M. Ockers, Judy-Ann Thibodeau, Brett Watkins, Philip T. Nelsen, J.Gregory Rosenthal, Fay V. Mintz, Michael Biedenbach, Nicholas J. Leonardy, Sue M. Lawniczak, Chuck Bork, George Hageage, Evelyn B. Hunter, MarLynn J. Marshall, Patricia Roman, Rick Hill, Thomas Hofbauer, Jack Lemanowicz, Howard P. Cupples, Gladys I. Guzman, Richard J. Brodeur, Donald Yee, Edward C. Delaha, Stanley L. Geyer, Stacey Slovis, William J. Shields, Susan Lauber, Karl Michelitsch, Aaron Kassoff, Sharon Watling, JoAnne C. Buehler, Jeffrey McVay, Gale K. Podobinski, Robert L. Sillett, Shirley Groer, Brian Avery, Steven H. Belle, James Boles, Linda Henry, Sarah J. Shema, Linda Titus-Emstoff, Matthew Davis, Yvonne L. Magli, Larry Hubbard, Suzanne Thomas, Donald F. Everett, Richard Mowery, Donald Everett, Kathryn Davis, Stanley Azen, Preston Covey, Brooks McCuen, Andrew Packer, and Jeffrey Robin

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Eye disease, Vitrectomy, Intraocular lens, Eye infection, medicine.disease, Surgery, law.invention, Clinical trial, Ophthalmology, Endophthalmitis, Randomized controlled trial, law, medicine, Complication, business
Abstract

Purpose: The authors determine if specific features of the clinical presentation of acute postoperative endophthalmitis correlate with the microbiologic culture results. Methods: A total of 420 patients who had clinical evidence of endophthalmitis within 6 weeks after cataract surgery or secondary intraocular lens implantation were evaluated as part of a randomized clinical trial. Results of cultures performed on aqueous and vitreous specimens obtained at presentation were categorized as follows: gram-positive coagulase-negative micrococci, "other" gram-positive, gram-negative, and equivocal/no growth. Results: Eleven features of the initial clinical presentation were associated with significant differences in the microbiologic spectrum ( P Conclusions: The presenting characteristics of acute endophthalmitis after cataract surgery may be helpful in predicting the most likely culture results. Such predictions do not appear sufficiently strong to guide the initial empiric choice of intravitreal antibiotics.

Published
1997
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3. Evaluation of Grid Pattern Photocoagulation for Macular Edema in Central Vein Occlusion

Author

John G. Clarkson, Elaine Chuang, Donald Gass, Maria Pedroso, Tony Cubillas, Erlinda S. Duria, Ditte J. Hess, Isabel Rams, Marguerite Ball, Alex Gutierrez, Nayla Muniz, June Thompson, Michele Pall, Charles J. Pappas, Daniel Finkelstein, Arnall Patz, Dolores Rytel, Judy Belt, Dennis Cain, Terri Cain, David Emmert, Terry George, Mark Herring, Pete Sotirakos, David H. Orth, Timothy P. Flood, Kirk H. Packo, Toni Larsen, Nancy Perez, Doug Bryant, Don Doherty, Jay Fitzgerald, Martha Gordon, Cynthia Holod, Kathy Kwiatkowski, Celeste MacLeod, Chris Morrison, Charlotte Westcott, Michael L. Klein, David Wilson, Richard G. Weleber, Susan Nolte, Nancy Hurlburt, Mark Evans, Patrick Wallace, Peter Steinkamp, Debora Funkner, Cathy Gordon, Clement Trempe, Alex Jalkh, John Weiter, Sherry Anderson, Dennis Donovan, Tom O'Day, Gerald Friedman, Rodney Immerman, Gabriel Coscas, Gisele Soubrane, Rose Marie Haran, Christophe Debibie, Jean Gizelsky, Ingolf H.L. Wallow, Guillermo de Venecia, George Bresnick, Sandra Larson, Sandy Fuller, Bob Harrison, Gene Knutson, Michael Neider, Greg Weber, Ruth Bahr, Bonnie Grosnick, Robert Lazorik, Helen Lyngaas, Diane Quackenboss, Guy Somers, Froncie A. Gutman, Sanford Myers, Tina Kiss, Deborah Ross, Pamela Vargo, Janet Edgarton, Sue Hanson, Janet Nader, Nancy Tomsak, Lawrence J. Singerman, Hernando Zegarra, Susan Lichterman, Adrienne Fowler Kramer, Sheila Smith-Brewer, Pam Brown Rowe, Geraldine Daley, Anne Pinter, Kathy Coreno, Lori Cooper, Marty Delisio, Donna Cross, Wendy Lord, Argye Hillis, Mark W. Riggs, Cheryl KasbergPreece, M. Hasan Rajab, Krista Carlson Giniewicz, Kevin Gilmore, Carol Zimmerman, Mary Lou Lewis, Maria Cristina Wells, Julie Lord Forbes, Kathleen C. Fetzer, Heather McNish, George H. Bresnick, Lissa McNulty, Jim Baliker, Linda Alanen, Laura Gentry, Richard L. Mowery, Donald F. Everett, Robert J. Hardy, Gary Abrams, Robert N. Frank, Maureen G. Maguire, and Abner V. McCall

Subjects
education.field_of_study, medicine.medical_specialty, Visual acuity, genetic structures, medicine.diagnostic_test, business.industry, Population, Physical examination, medicine.disease, eye diseases, Vein occlusion, Surgery, Clinical trial, Ophthalmology, Grid pattern, Central retinal vein occlusion, medicine, sense organs, medicine.symptom, business, education, Macular edema
Abstract

Purpose: To evaluate the efficacy of macular grid photocoagulation in preserving or improving central visual acuity in eyes with macular edema due to central vein occlusion (CVO) and best-corrected visual acuity of 20/50 or poorer. Methods: Patients with angiographically documented macular edema due to CVO were entered into a multicenter randomized controlled clinical trial supported by the National Eye Institute. Eligibility was determined based on both clinical examination findings and photographic documentation evaluated at a photograph reading center. Eyes were assigned randomly to macular grid photocoagulation (77 eyes) or no treatment (78 eyes). Patients were followed every 4 months for 3 years or until the end of the study. The outcome measure was visual acuity. Results: The study population consisted of 155 eyes in 155 patients. There was no difference between treated and untreated eyes in visual acuity at any point during the follow-up period. Initial median visual acuity was 20/160 in treated eyes and 20/ 125 in control eyes. Final median visual acuity was 20/200 in treated eyes and 20/160 in control eyes. However, treatment clearly reduced angiographic evidence of macular edema. Conclusion: The results of this study do not support a recommendation for macular grid photocoagulation for the population meeting the Central Vein Occlusion Study macular edema group eligibility criteria.

Published
1995
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4. Pneumatic Retinopexy

Author

David H. Orth, Stuart N. Green, George F. Hilton, Paul E. Tornambe, W. Sanderson Grizzard, Kirk H. Packo, James S. Tiedeman, Mark E. Hammer, Timothy P. Flood, Douglas Taren, Leo Masciulli, Daniel A. Brinton, Craig M. Morgan, Lon S. Poliner, Steven R. Leff, and David L. Yarian

Subjects
medicine.medical_specialty, Randomization, Visual acuity, genetic structures, business.industry, medicine.medical_treatment, Eye disease, Retinal detachment, Cataract surgery, medicine.disease, eye diseases, Surgery, law.invention, Clinical trial, Ophthalmology, Randomized controlled trial, law, Medicine, medicine.symptom, business, Retinopathy
Abstract

The authors report 2-year follow-up information on 179 of 198 eyes (90%) enrolled in a previously published multicenter, randomized, controlled clinical trial comparing pneumatic retinopexy (PR) with scleral buckling (SB) for the management of selected retinal detachments. Scleral buckling was compared with PR with regard to redetachment after the initial 6-month follow-up period (1% versus 1%), overall attachment (98% versus 99%), subsequent cataract surgery (18% versus 4%; P less than 0.05), preoperative visual acuity (no significant difference), and final visual acuity of 20/50 or better in eyes with macular detachment for a period of 14 days or less (67% versus 89%; P less than or equal to 0.05). Reoperations after a failed PR attempt did not adversely affect visual outcome. After 2 years, PR continues to compare favorably with SB.

Published
1991
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5. Photic maculopathy after pterygium excision

Author

Kenneth O Karp, Randy J. Epstein, Timothy P Flood, and Amy L Wilder

Subjects
Adult, medicine.medical_specialty, genetic structures, Light, Fundus Oculi, Eye disease, medicine.medical_treatment, Pterygium, Lesion, chemistry.chemical_compound, Retinal Diseases, Ophthalmology, medicine, Humans, Macula Lutea, Fluorescein Angiography, Radiation Injuries, Scotoma, business.industry, Retinal, Microsurgery, medicine.disease, eye diseases, Surgery, chemistry, Maculopathy, Female, sense organs, medicine.symptom, Operating microscope, business, Complication, Conjunctiva, Follow-Up Studies
Abstract

PURPOSE: To report a patient who developed photic maculopathy after pterygium removal. METHODS: A 27-year-old woman underwent pterygium removal with a conjunctival autograft after administration of retrobulbar anesthesia. A coaxial operating microscope was used, with an estimated retinal exposure of approximately 40 minutes. RESULTS: On the first postoperative day, the patient noted a paracentral scotoma. A fluorescein angiogram on the fourth postoperative day documented a phototoxic lesion in the macula. CONCLUSIONS: Phototoxic injury to the macula may occur after pterygium removal. Ophthalmologists should take precautions to minimize prolonged intense coaxial illumination of the retina while performing any ocular microsurgery.

Published
1999

6. Occult Choroidal Neovascularization

Author

Mary Lou Lewis, Cheryl J. Hmer, Michael L. Klem, Thomas S. Stevens, Deborah A. Phillips, Andrew P. Schachat, Barbara S. Hawkins, Judith Alexander, Susan B. Bressler, Marta J. Marsh, Timothy P. Flood, Maureen G. Maguire, Suresh R. Chandra, Neil M. Bressler, Stuart L. Fine, Lawrence J. Singerman, and Noreen B. Javornik

Subjects
Ophthalmology, medicine.medical_specialty, Choroidal neovascularization, business.industry, Age related, medicine, In patient, medicine.symptom, Macular degeneration, medicine.disease, business, Occult
Published
1996
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7. Aspirin Effects on Mortality and Morbidity in Patients With Diabetes Mellitus

Author

Sheldon M. Buzney, Michael J. Elman, W. Harry Hannon, Stuart L. Fine, Robert L. Jack, Gerald J. Doyle, Robert N. Frank, Stanley M. Kopelow, Paul Segal, Jose Cunha-Vaz, James E. Myrick, Frederick C. Goetz, Mary Jane Prior, William E. Benson, Thomas C. Burton, Michael L. Klein, Thomas W. Miller, Morton F. Goldberg, Donald Bergsma, Morton S. Cox, Richard Baker, Dayton T. Miller, Richard F. Dreyer, David H. Orth, Gary Cassel, Ronald Klein, Everett Ai, Richard D. Hornichter, Stephenie Lucas, William S. Tasman, Thomas M. Aaberg, Jose Briones, Lynn E. Hauser, Edgar Thomas, Michael A. Bloome, Genell L. Knatterud, Gary C. Brown, Robert E. Kalina, Arnall Patz, Ronald J. Prineas, Matthew D. Davis, Richard Chenoweth, Michael T. Trese, Gerald A. Williams, Denis Carroll, Neil L. Ross, Lawrence Basso, F. Tempel Riekhof, Paul Beer, Robin Ewart, Thomas S. Stevens, Dana H. Clarke, Craig G. Wells, Frank L. Myers, Robert C. Ramsay, Lawrence I. Rand, James L. Kinyoun, Philip Silver, Richard S. Ruiz, C. Ronald Lindberg, Thomas A. Rice, Jose C. Briones, Hunter L. Little, George W. Blankenship, Robert P. Murphy, Yvonne L. Magli, George H. Bresnick, Alan L. Shabo, Daniel Seigel, Jerry Cavallerano, James C. Liang, Timothy P. Flood, Jayant Malhotra, Edward Ehrlich, Laurence Arend, Richard S. Crow, J. Terry Ernest, J. Wallace McMeel, Charles A. Garcia, Richard L. Mowery, Lloyd M. Aiello, Rodney L. Immerman, Hak-Joong Kim, Charles Vygantas, Frederick H. Reeser, Fred W. Whitehouse, David D. Bayse, Jack O. Sipperley, Elaine W. Gunter, James K. Kingham, Norman P. Blair, Steven Winokur, Larry D. Hubbard, Suresh R. Chandra, A. Ramos Umpierre, Ramachandiran Cooppan, Jerry P. Palmer, Russell M. Dixon, Lance Turkish, Byron J. Hoogwerf, Thaddeus E. Prout, John Cavender, William H. Knobloch, John J. Weiter, Steven V. Guzak, Gary W. Abrams, Patrick L. Murphy, Joseph A. Kufera, Marian R. Fisher, Roy A. Goodart, Ann E. Ballen, Robert Biesbroeck, Emily Y. Chew, Gerald R. Friedman, Harold B. Weiss, Ingolf H. L. Wallow, Franca Barton, Herbert L. Cantrill, Harry W. Flynn, David Newsome, Steven B. Cohen, George A. Williams, Akbar Rahmani, James K. Hooper, Gregory S. Brinton, William A. Bohart, J. Archibald McNamara, Michael Teske, Raymond R. Margherio, Richard Hohl, Irvin Handelman, Harish Bhatia, Abdul C. Asmal, Edward J. Winter, Trexler M. Topping, Robert Sorenson, Aaron Kassoff, Raúl Pérez, Kirk H. Packo, Travis A. Meredith, Maria Warth, Mohammed Z. Wafai, S. Shah, Gary Arsham, Rudolph M. Franklin, Frederick L. Ferris, José Berrocal, and Robert L. Poole

Subjects
medicine.medical_specialty, Aspirin, business.industry, Incidence (epidemiology), General Medicine, Diabetic retinopathy, medicine.disease, Placebo, law.invention, Surgery, Randomized controlled trial, law, Diabetes mellitus, Relative risk, Internal medicine, medicine, business, Kidney disease, medicine.drug
Abstract

Objectives. —This report presents information on the effects of aspirin on mortality, the occurrence of cardiovascular events, and the incidence of kidney disease in the patients enrolled in the Early Treatment Diabetic Retinopathy Study (ETDRS). Study Design. —This multicenter, randomized clinical trial of aspirin vs placebo was sponsored by the National Eye Institute. Patients. —Patients (N=3711) were enrolled in 22 clinical centers between April 1980 and July 1985. Men and women between the ages of 18 and 70 years with a clinical diagnosis of diabetes mellitus were eligible. Approximately 30% of all patients were considered to have type I diabetes mellitus, 31% type II, and in 39% type I or II could not be determined definitely. Intervention. —Patients were randomly assigned to aspirin or placebo (two 325-mg tablets once per day). Main Outcome Measures. —Mortality from all causes was specified as the primary outcome measure for assessing the systemic effects of aspirin. Other outcome variables included cause-specific mortality and cardiovascular events. Results. —The estimate of relative risk for total mortality for aspirin-treated patients compared with placebo-treated patients for the entire study period was 0.91 (99% confidence interval, 0.75 to 1.11). Larger differences were noted for the occurrence of fatal and nonfatal myocardial infarction; the estimate of relative risk was 0.83 for the entire follow-up period (99% confidence interval, 0.66 to 1.04). Conclusions. —The effects of aspirin on any of the cardiovascular events considered in the ETDRS were not substantially different from the effects observed in other studies that included mainly nondiabetic persons. Furthermore, there was no evidence of harmful effects of aspirin. Aspirin has been recommended previously for persons at risk for cardiovascular disease. The ETDRS results support application of this recommendation to those persons with diabetes at increased risk of cardiovascular disease. (JAMA. 1992;268:1292-1300)

Published
1992
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8. Iatrogenic Choroidal Neovascularization After Krypton Red Laser Photocoagulation

Author

Timothy P. Flood, Kirk H. Packo, and David H Orth

Subjects
medicine.medical_specialty, genetic structures, Red laser, business.industry, Eye disease, Krypton, chemistry.chemical_element, Macular degeneration, medicine.disease, eye diseases, Neovascularization, medicine.anatomical_structure, Choroidal neovascularization, chemistry, Ophthalmology, Medicine, sense organs, Choroid, medicine.symptom, business, Retinopathy
Abstract

A major cause for failure of krypton red laser photocoagulation in patients with exudative age-related macular degeneration has been the development of recurrent choroidal neovascularization adjacent to the previously treated areas. After reviewing the possible causes of recurrences, it is apparent that a certain number are iatrogenic, ie, induced by krypton red laser causing disruption and damage to the pigment epithelium-Bruch's membrane-choroidal complex. We describe three separate episodes in two patients of iatrogenic recurrent choroidal neovascularization after krypton red laser photocoagulation.

Published
1989
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9. Pneumatic Retinopexy

Author

Paul E. Tornambe, George F. Hilton, Lon S. Poliner, Daniel A. Brinton, Timothy P. Flood, David H. Orth, Kirk H. Packo, Stuart Green, Steven R. Leff, Leo Masciulli, David L. Yarian, W. Sanderson Grizzard, Mark E. Hammer, Douglas L. Taren, Craig M. Morgan, and James S. Tiedeman

Subjects
medicine.medical_specialty, Proliferative vitreoretinopathy, Visual acuity, business.industry, medicine.medical_treatment, Eye disease, Retinal detachment, Cryotherapy, Fundus (eye), medicine.disease, eye diseases, Surgery, Clinical trial, Ophthalmology, medicine, medicine.symptom, business, Retinopathy
Abstract

Pneumatic retinopexy was compared with scleral buckling in a multicenter (7 centers), randomized, controlled, clinical trial with 198 patients. Admission criteria included detachments with retinal break(s) no greater than 1 clock hour in size, within the superior two thirds of the fundus, without significant proliferative vitreoretinopathy (PVR). All patients were followed for at least 6 months. Scleral buckling was compared with pneumatic retinopexy with regard to single-operation reattachment (82 versus 73%), reattachment with one operation and postoperative laser/cryotherapy (84 versus 81 %), overall reattachment with reoperations (98 versus 99%), final visual acuity of 20/50 or better in eyes with preoperative detachment of the macula for 2 weeks or less (56 versus 80%), PVR (5 versus 3%), and new retinal breaks (13 versus 23%). Complications, including reoperations, as measured by the "score" system, were similar. The anatomic results of the two operations were not significantly different ( P > 0.05), but pneumatic retinopexy had less morbidity and better postoperative visual acuity ( P = 0.01). Pneumatic retinopexy is recommended for cases meeting the admission criteria.

Published
1989
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10. The use of Fundus Photographs and Fluorescein Angiograms in the Identification and Treatment of Choroidal Neovascularization in the Macular Photocoagulation Study

Author

Susan B. Bressler, Neil M. Bressler, Michael J. Elman, Barbara S. Hawkins, Judith A. Chamberlin, Maureen G. Maguire, Timothy P. Flood, Robert P. Murphy, and Stuart L. Fine

Subjects
medicine.medical_specialty, genetic structures, medicine.diagnostic_test, business.industry, Eye disease, Fundus (eye), medicine.disease, eye diseases, Clinical Practice, Neovascularization, Ophthalmology, Choroidal neovascularization, medicine.anatomical_structure, Angiography, medicine, Optometry, sense organs, Choroid, medicine.symptom, business, Retinopathy
Abstract

The Macular Photocoagulation Study (MPS) Fundus Photograph Reading Center has developed a standard set of methods for assessing color photographs and fluorescein angiograms on study patients. For pretreatment angiograms, these methods are used to determine the location and extent of the choroidal neovascularization. For posttreatment color fundus photographs, these methods are used to assess the extent and intensity of treatment. Although these methods were developed to judge eligibility and treatment of patients enrolled in the MPS, they provide an excellent way for all treating ophthalmologists to evaluate their patients' angiograms and to assess immediately the intensity and extent of laser photocoagulation. The technique requires a microfilm reader or slide projection device to determine the completeness of treatment. The authors superimpose independent drawings made from pre- and posttreatment photographs. The techniques described can be applied readily in clinical practice. Since persistent neovascularization is highly correlated with incomplete and/or inadequate photocoagulation treatment, clinicians may adopt these Reading Center techniques to minimize the frequency of persistent neovascularization and, possibly, to reduce the frequency of visual loss in treated eyes.

Published
1989
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11. Management of breakthrough vitreous hemorrhage from presumed extramacular subretinal neovascularization

Author

David H. Orth and Timothy P. Flood

Subjects
Adult, medicine.medical_specialty, genetic structures, Eye Diseases, medicine.medical_treatment, Vitrectomy, Retinal Diseases, Breakthrough bleeding, Ophthalmology, Subretinal hemorrhage, medicine, Humans, In patient, Aged, Subretinal neovascularization, Neovascularization, Pathologic, business.industry, Retinal Hemorrhage, Retinal Vessels, General Medicine, Middle Aged, medicine.disease, eye diseases, Vitreous Body, Vitreous hemorrhage, Retinal pigment epithelial atrophy, Female, sense organs, medicine.symptom, business, Clearance
Abstract

Three patients developed vitreous hemorrhage secondary to breakthrough bleeding from presumed extramacular subretinal neovascularization. In one patient, the vitreous hemorrhage cleared spontaneously. In two other patients, trans-pars plana vitrectomy was performed. All patients regained 20/30 vision or better. Residual peripheral retinal pigment epithelial atrophy, organized subretinal hemorrhage, and/or subretinal fibrous membranes were present in all patients. A definite extramacular subretinal neovascular membrane was identified in one patient. Ocular diseases associated with subretinal neovascularization are tabulated. Indications for trans-pars plana vitrectomy in patients with breakthrough vitreous hemorrhage secondary to presumed extramacular subretinal neovascularization are proposed.

Published
1982

12. Adult Haemophilus Injluenzae Type B Vertebral Osteomyelitis

Author

Anthony W. Chow, Phyllis A. Oill, Lucien B. Guze, and Timothy P. Flood

Subjects
Fastidious organism, medicine.medical_specialty, medicine.drug_class, business.industry, Chloramphenicol, Haemophilus influenzae type, Osteomyelitis, Antibiotics, General Medicine, medicine.disease, medicine.disease_cause, Surgery, Haemophilus influenzae, Ampicillin, Immunology, medicine, Vertebral osteomyelitis, Orthopedics and Sports Medicine, business, medicine.drug
Abstract

Osteomyelitis in adults due to Haemophilus influenzae is exceedingly rare. We report a case of H. influenzae type b vertebral osteomyelitis in an adult. Review of the English literature reveals one other adult patient with H. influenzae osteomyelitis, and sporadic pediatric cases. Although a variety of predisposing host resistance factors have been postulated to account for this infection, the deficiency responsible for adult infection remains undelineated. Bone biopsy is mandatory for diagnosis when blood cultures are negative. The isolation and identification of H. influenzae may be delayed because of its fastidious growth requirements. Treatment with ampicillin or chloramphenicol appear to be most efficacious considering the antibiotic sensitivities of the organism.

Published
1978
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