Faculty Bibliography

A series of 75 well-defined, consecutive patients with subretinal neovascularization secondary to a variety of macular diseases were treated with krypton red laser (KRL) photocoagulation and are reported on prospectively. Two thirds of the patients had subretinal neovascularization secondary to involutional (senile) macular degeneration. Most patients had clinical and/or fluorescein angiographic manifestations of neovascularization that posed a poor visual prognosis. The technique of treatment using the krypton red wavelength, as well as special considerations in the pre- and post-operative management, are reviewed. The results suggest that this wavelength is effective in the successful, anatomic elimination of subretinal neovascularization and improvement of the visual status with certain potential advantages compared to conventional argon blue-green laser (ABGL) radiation. Since this clinical study is void of randomization and controls, no absolute conclusions can be made with regard to the effectiveness of this form of treatment compared to other laser treatments or to the natural course of the macular diseases themselves. However, the results of this study are extremely encouraging, warranting further investigation

The theoretical rationale, the histopathologic evidence, and the preliminary clinical studies related to krypton red laser (KRL) photocoagulation of the ocular fundus are reviewed. The authors report on their experience with currently available laser systems using this wavelength (647.1 nm) for photocoagulation of retinal vascular proliferative diseases and chorioretinal diseases associated with exudative manifestations. A histopathologic and clinical comparison of argon blue-green laser (ABGL), the pure argon green laser (AGL), and the krypton yellow laser (KYL), with reference to photocoagulation treatment of the ocular fundus is also discussed

A prospective, controlled study utilizing topical 1% aqueous indomethacin was employed in an attempt to determine the incidence of aphakic cystoid macular edema (ACME) following cataract surgery. The incidence of ACME in the indomethacin-treated group was significantly less than in the control group five weeks after cataract surgery (36% vs 18%; P less than 0.02). There was no significant difference in the two groups ten weeks after surgery when studied by fluorescein angiography (34.6% vs 21%; P less than 0.10). The biochemical and pharmacological rationale for the use of the antiprostaglandin indomethacin in the management of ACME was reviewed. This revealed sufficient experimental and clinical evidence for continued research in the area of prostaglandin inhibitors for the possible prevention or treatment of this disorder

Surgical management of selected macular epiretinal membranes is possible through the use of microsurgical pars plana vitreoretinal membranectomy. Visual improvement can be significant with resolution of traction retinal detachment and retinal distortion. Complications are similar to other forms of vitreous surgery. In a series of 9 selected cases with severe reduction of visual acuity secondary to macular pucker, microsurgical membranectomy was performed with encouraging results

In patients treated with oral indomethacin for four weeks after intracapsular cataract extraction, five of 57 eyes (9%) had cystoid macular edema four to six weeks postoperatively as shown by fluorescein angiography. In a control group not treated with indomethacin, 15 of 34 eyes (44%) had cystoid mascular edema. Oral indomethacin, therefore, caused a statistically significant decrease in the incidence of aphakic cystoid macular edema

Fluorescein angiographic patterns reveal a wide variety of anatomical, pathological and physiological information which, correctly interpreted, contributes to the differential diagnosis of fundus diseases and to the evaluation of appropriate therapeutic approaches. A schema for interpretation of the fluorescein angiogram is presented, following a logical progression from the initial determination of abnormal hypofluorescence of hyperfluorescence to the evaluation of the specific locations and features of the patterns, and their relationships to various disorders

We observed choroidal neovascularization with associated macular detachment in three cases of benign choroidal nevi. Successful obliteration of the neovascular membranes was performed with argon laser photocoagulation with maintenance of good central visual acuity.