1/15. Human psychophysical analysis of receptive field-like properties: V. Adaptation of stationary and moving windmill target characteristics to clinical populations.This paper describes the application of several key parameters of a windmill-shaped target (used in determinations of the psychophysical transient-like function) to clinical populations as a diagnostic tool for static perimetry. A technique for independently analyzing sustained- (Westheimer function) and transient-like retinally-based psychophysical responses is outlined, and stimulus characteristics, reliability and diagnostic potential of the tests are examined. Several particularly interesting clinical cases (one closure of a branch retinal arteriole) and two senile macular degeneration patients) are presented for illustrative purposes. In addition, a tentative 'working hypothesis' is presented as a basis for extensive future analysis of various clinical populations.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/15. Retinal venous macroaneurysm associated with premacular hemorrhage.To report an unusual association of a retinal venous macroaneurysm with premacular hemorrhage in a 50-year-old man, using a case report method. The patient exhibited a dense premacular hemorrhage in the left eye. fluorescein angiography demonstrated that the source of bleeding was an isolated retinal venous macroaneurysm. The anterior surface of the hematoma was opened with an argon green laser, resulting in rapid clearing of the premacular hemorrhage and improvement in vision. Treatment of the retina surrounding the macroaneurysm to prevent recurrence of bleeding was ineffective to achieve occlusion of the lesion. No recurrent hemorrhage occurred during the observation period. Retinal venous macroaneurysm, a quite rare condition, may be complicated by premacular hemorrhage. argon green laser may be useful in treating such hemorrhage. Hemorrhagic detachment of the internal limiting membrane or subhyaloid hemorrhage in the macula may occur after retinal vessel rupture with physical exertion (Valsalva retinopathy) or in retinal vascular diseases, such as proliferative diabetic retinopathy, and retinal arterial macroaneurysm. Arterial macroaneurysms are a common, well-described retinal vascular disorder. In contrast to retinal arterial macroaneurysms, retinal venous macroaneurysms are quite rare. In this article we describe a patient who presented with premacular hemorrhage that was caused by a retinal venous macroaneurysm. The hematoma and the macroaneurysm were treated with argon green laser.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
3/15. Leber's miliary aneurysms associated with telangiectasia of the nasal mucosa.A 20-year-old woman, treated with cryopexy and xenon- and argon-laser photocoagulation for Leber's miliary aneurysms in her right eye, suffered from repeated epistaxis. She underwent an endoscopy that showed an unusual number of telangiectatic veins. Laboratory results and routine physical and neurologic examinations showed normal values. Dematologic examination revealed no signs of hereditary hemorrhagic telangiectasis (Osler's disease). Nevertheless, it seems reasonable to assume that the combination of microvascular disturbances in one eye and in the nasal mucous membrane is not a coincidental finding.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
4/15. Hyponatremic seizures in infancy: association with retinal hemorrhages and physical child abuse?We present two cases of infants with hyponatremic seizures who had an unexpected finding of retinal hemorrhages. A review of the literature found no prior association between hyponatremic seizures and retinal hemorrhages. The retinal hemorrhages found in the first patient were a result of shaken baby syndrome (SBS) and associated with long bone fractures and a subdural hematoma. The second patient had retinal hemorrhages and cerebral edema, presumed to be a result of SBS. We suggest that children who become hyponatremic owing to neglect, lack of education, or intentional water poisoning may be at risk for other forms of child abuse. Additional research needs to be done to further elucidate the relationship between hyponatremic seizures and child abuse.- - - - - - - - - - ranking = 0.66666666666667keywords = physical (Clic here for more details about this article) |
5/15. Purtscher retinopathy in the battered child syndrome.Purtscher retinopathy is a hemorrhagic angiopathy that occurs after sudden compression of the thorax. Virtually all reported cases have been in adults who have decreased visual acuity, retinal hemorrhages and exudates, and no other neurological signs. By contrast, in infants, hemorrhagic retinopathy is rarely benign, and generally is considered to indicate intracranial hemorrhage, usually an acute subdural hematoma. Two battered infants had seizures and associated chest injury. There were retinal hemorrhages and exudates, unaccompanied by clinically important intracranial hemorrhage. At follow-up, the hemorrhagic retinopathy had resolved without sequelae; development was normal, and seizures had not recurred. Purtscher retinopathy thus should be added both to the differential diagnosis of hemorrhagic retinopathy in infancy and to the list of physical signs suggesting child abuse.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
6/15. Vitreoretinal traction and perimacular retinal folds in the eyes of deliberately traumatized children.The pathophysiology of perimacular folds in eyes of deliberately traumatized children is disputed. The authors reviewed the clinical and forensic records and systemic and ocular findings at autopsy of three children with perimacular retinal folds who died after being violently shaken. Two of the children suffered direct head trauma in addition to being shaken; one patient was violently shaken without any physical or forensic evidence of direct head trauma. No direct ocular trauma was detected. In each case, the vitreous had partially separated from the retina but remained attached to the internal limiting membrane at the apices of the folds and the vitreous base, implicating traction in the pathogenesis of these folds. Although some intraocular findings in deliberately traumatized children may be explained by direct head injury, the possibility of both direct head trauma and shaking must be considered. Perimacular folds may develop without direct ocular or head trauma and may constitute evidence supporting violent shaking.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
7/15. Spontaneous retinal haemorrhages.Five patients are described with spontaneous retinal haemorrhages. In two patients small retinal hemorrhages occurred at the posterior pole, in one of them after physical exertion. In three patients multiple small round haemorrhages occurred in the retina, in one of them after physical exertion, in two of them associated with large preretinal subhyaloidal haemorrhages. The haemorrhages developed at relatively young age and only in one eye, and cleared rapidly with good visual outcome. physical exertion as pathogenic factor was only observed in two patients.- - - - - - - - - - ranking = 0.33333333333333keywords = physical (Clic here for more details about this article) |
8/15. Measurement of metamorphopsia in the presence of ocular media opacities.Opacities in the cornea, crystalline lens, and vitreous may make conventional measurements of retinal/visual function of little value. Here, we present two psychophysical hyperacuity tests that are designed to detect and quantify retinal distortions even in the presence of substantial opacities. One test makes use of a two-dot vernier display in which directional bias as well as vernier acuity can be estimated. The second test is a multi-dot hyperacuity bisection task, which resembles a simplified Amsler grid test. By varying the spatial parameters of these stimuli, metamorphopsia may be quantified. The method is applicable both in clear and occluded ocular media.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
9/15. Traumatic retinoschisis in battered babies.Five infants who were victims of physical abuse had extensive bilateral retinal hemorrhages on initial evaluation and subsequently developed signs of permanent retinal damage. None showed external evidence of trauma to the eyes. vitreous hemorrhage developed after a delay of several days or more in three cases that were followed closely from the time of the traumatic incident. In several eyes, apparent intraretinal blood-filled cavities were seen acutely in the macular region and elsewhere. Late scarring of the macula typically had a cystic or crater-like configuration. electroretinography showed loss or reduction of the positive B-wave with preservation of the negative A-wave in every case. We propose that splitting of the retina resulting from the direct mechanical effects of violent shaking was responsible for all of these findings.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
10/15. Retinal receptive field-like properties and Stiles-Crawford effect in a patient with a traumatic choroidal rupture.Simple psychophysical techniques were used in order to assess layer-by-layer retinal functions in a patient with sub-retinal fluid due to a choroidal rupture following ocular trauma. A substained-like and a transient-like function believed to reflect retinal receptive-field-like properties, and an indicator of retinal receptor orientation (the Stiles-Crawford effect) have been followed in time. Central visual acuity was also measured. Initially all measured functions provided anomalous responses in affected retinal areas. Of interest here is the nature and order of recovery of the measured response functions. Most notable was the rapid rate of recovery of receptor orientation and the slower rate of recovery of the transient-like function.- - - - - - - - - - ranking = 0.16666666666667keywords = physical (Clic here for more details about this article) |
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