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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We produced experimental renovascular malignant arterial hypertension by a modified Goldblatt's procedure in 60 rhesus monkeys (25 one-kidney model and 35 two-kidney model), and studied various macular lesions by detailed serial ophthalmoscopy, and stereoscopic color fundus photography and fluorescein fundus angiography on a long-term follow-up. The various lesions which developed in the macular region included retinal edema, cystic retinal changes, serous retinal detachment, retinal pigment epithelial changes (initially acute focal and later degenerative lesions), and lipid deposits. In addition to these, the usual retinal lesions associated with hypertensive retinopathy, e.g., focal intraretinal periarteriolar transudates, cotton-wool spots and retinal hemorrhages, were also frequently seen in the macular retina. Findings on the various lesions are described in detail, and the pathogenesis of macular edema in malignant arterial hypertension is discussed.
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PMID:Macular lesions in malignant arterial hypertension. 274

Retinal arterial macroaneurysms represent a distinct clinical entity. Macroaneurysms are seen in the elderly with a marked female predominance and a strong association with hypertension and arteriosclerotic vascular changes. The classic appearance provides an easy diagnosis; however, variable presentations, such as subretinal hemorrhage, macular exudate, and epiretinal membranes can make the diagnosis difficult. The differential diagnosis of retinal arterial macroaneurysms include retinal telangiectasia, angiomatosis retinae, venous macroaneurysms, background diabetic retinopathy, and cavernous hemangioma. The clinical characteristics of the reported cases are summarized, and our series of 60 patients is presented. The natural history of most macroaneurysms is spontaneous involution without loss of vision. However, visual loss may occur secondary to macular edema, exudate, hemorrhage and neurosensory retinal detachment, and photocoagulation may expedite visual recovery. Photocoagulation treatment may be applied directly to the macroaneurysm, indirectly by surrounding the macroaneurysm, or as a combination of these two methods.
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PMID:Retinal arterial macroaneurysms. 305 91

Spontaneous (not experimentally induced) systemic hypertension was detected in 5 male dogs that were examined because of apparent blindness caused by intraocular hemorrhage and/or retinal detachment. Secondary causes of hypertension, including renal, adrenal, and thyroid disease, were investigated. Four of the dogs had glomerulonephropathy, renal insufficiency, and proteinuria. Four dogs had compensatory cardiac hypertrophy. Hypertension in 4 of 5 dogs was associated with glomerulosclerosis with chronic renal insufficiency, bilateral adrenocortical hyperplasia, adrenocortical adenoma with renal amyloidosis, and immune-mediated glomerulonephritis with chronic renal insufficiency, respectively. The fifth dog was determined to have essential hypertension. The dogs were treated for their primary diseases. Sodium restriction alone was inadequate to reduce blood pressure; 4 of the dogs also required antihypertensive medications.
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PMID:Spontaneous systemic hypertension in dogs: five cases (1981-1983). 317 Mar 25

Recent experimental work has shown that, under normal conditions, most subretinal fluid is absorbed rapidly by active transport across the retinal pigment epithelium (RPE). However, in the presence of damage to the RPE blood-retinal barrier, subretinal fluid is rapidly cleared by passive forces. Thus, it is apparent that RPE defects do not by themselves cause serous retinal detachment. A hypothesis is presented that some serous detachments occur because normal metabolic transport systems of the RPE have been damaged, while the blood-retinal barrier remains intact to prevent passive drainage of the subretinal space. Under these conditions, a focal RPE "leak" can overload the system so that the serous fluid accumulates and persists. Photocoagulation of a leaking point can facilitate resolution of the fluid, but as long as the underlying metabolic dysfunction of the RPE persists, recurrence is possible. Some forms of serous detachment may thus be viewed as diffuse rather than focal ocular disorders in which the transport capability of the RPE has been damaged; such damage can result from systemic pathology such as adrenergic stress (e.g., central serous chorioretinopathy) or vascular disease (e.g., hypertension).
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PMID:New hypotheses on the pathogenesis and treatment of serous retinal detachment. 320 82

A comparison between results obtained by pattern electroretinography (ERG), Ganzfeld cone and rod-ERG was made in 7 patients suffering from melanoma, glaucoma and retinal detachment. It was shown that the extent of the lesions, not seen ophthalmoscopically, can be well monitored by the second harmonic component of pattern electroretinography in cases where conventional Ganzfeld ERG's do not reveal defects. Especially damage caused by acute glaucoma attacks and those stemming from chronic hypertension can be well differentiated.
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PMID:Clinical applications of pattern electroretinography: melanoma, retinal detachment and glaucoma. 340 17

Experimental renovascular malignant arterial hypertension was produced, by modified Goldblatt's procedures, in 60 rhesus monkeys, and hypertensive fundus changes were studied in detail (by serial ophthalmoscopy and fluorescein fundus angiography in all monkeys on a long-term follow-up, and pathologically in 29 eyes). In hypertensive choroidopathy, retinal pigment epithelial (RPE) lesions and serous retinal detachment (RD) were the classic ophthalmoscopic lesions, whereas fluorescein fundus angiography and histopathologic studies revealed marked abnormalities in the choroidal vascular bed, in addition to the changes in the RPE. The RPE lesions could be subdivided into initial acute focal lesions (due to focal RPE infarction), and degenerative lesions, which developed later and were progressive in nature, maximally involving the macular and peripheral regions of the fundus. The RD developed most commonly in the posterior pole and infrequently involved the peripheral retina. The choroidal vascular bed showed impaired circulation and extensive occlusive and ischemic changes. These studies revealed that hypertensive choroidopathy is as important a fundus change as hypertensive retinopathy. The pathogenesis of hypertensive choroidopathy is discussed in detail; the evidence indicates that it is due to choroidal ischemia, and that hypertensive choroidopathy and retinopathy are two independent and unrelated manifestations of renovascular malignant hypertension.
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PMID:Fundus lesions in malignant hypertension. VI. Hypertensive choroidopathy. 380 99

75 eyes underwent intracapsular cataract extraction with primary Choyce Mk IX anterior chamber lens implantation. None of these eyes had a traumatic or a secondary cataract, and follow up ranged from 3 to 27 months, 6 months or more for 80% of the eyes. Final visual acuity was 3/6 or better for 67 eyes (89,3%). The most frequent cause of poor final VA was cystoid macular edema in 4 cases (i.e., a 6,7% rate of significant CME). One lens was removed because it was too short and unstable with no adverse effect on the eye. One case of chronic severe corneal epithelial dystrophy occurred after uneventful surgery in a patient who had been treated for facial pain by chemical destruction of trigeminal nerve. Retinal detachment occurred in two eyes, and was successfully reattached by surgery. The presence of the implant posed no added difficulty in performing scleral buckling. In one eye, severe hypertension occurred post-operatively, this has been controlled by medical therapy and until now the eye retains very good vision. It is to be noted that in this case vitreous loss occurred at the time of lens implantation surgery. Growing experience helped us to deal effectively with the specific problems posed by these lenses, all of them in fact minor and easily controlled: iris tuck if the eye is too soft and the air bubble too large, propeller phenomenon if the implant is too short, and eye tenderness if it is too long. Our results ate very encouraging and remain good for those of our patients whose follow up is longer than 18 months.
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PMID:[Choyce's Mk IX implants after intracapsular extraction. Short and middle-term results]. 633 26

The present study is a two year-follow up of 105 eyes (including 27 aphakic eyes), operated on retinal detachment by silicone oil injection after pars plana vitrectomy. This procedure was chosen either as an initial treatment (37 eyes) or after a classical treatment by external indentation had failed (68 eyes). All cases of retinal detachment were of bad prognosis: macular hole, massive periretinal proliferation, isolated or associated with a tear. Cases of vitrectomy with silicone injection for proliferative retinopathy due to diabetes or hemoglobinopathy were excluded. Operations were performed under a surgical microscope with the help of a corneal contact lens (Goldmann, Kl oti or O' Malley ). Functional and anatomical results, as well as complications, were evaluated at least 2 years after treatment. In 24,7% of cases, vision was improved as compared to preoperative visual acuity. Cataract was a constant complication in all phakic eyes, as silicone oil had not been removed within the first 6 months. Intraocular hypertension developed frequently both in phakic and in aphakic eyes (29,5 and 33% of cases, respectively) and responded poorly to medical or surgical treatment. Other complications occurred less frequently. They were corneal edema, conjunctival hyperemia and uveitis. Pain imposed the evisceration of 2 eyes. These complications were the consequence of silicone oil toxicity and/or the mechanical effects of intraocular oil. Besides treatment-associated complications, early (36 during the first 6 months) as well as late (2 between the 12th and 18th months) recurrences of retinal detachment were observed. In contrast to these fair functional results, anatomical results were good in most cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of retinal detachment by vitrectomy and injection of silicone oil. Long-term results and complications in 105 cases]. 647 Apr 12

Nineteen eyes of 17 patients were examined for complications associated with a retinal macroarterial aneurysm. 13 of 17 patients were feminine and over 70 years of age and 15 had longstanding systemic hypertension. Visual loss associated with retinal macroarterial aneurysms was related to macular hemorrhage, exudate, or serous retinal detachment. Twelve eyes had retinal hemorrhages associated with the macroarterial aneurysm. Hemorrhages were subretinal and/or preretinal of which some diffused into the vitreous. Seven eyes were treated by direct argon laser photocoagulation of the aneurysm giving an arterial occlusion. Five eyes received perianeurysmal photocoagulation without occlusion of the arteriole. Five eyes received no laser treatment because their exudate or hemorrhage was not threatening the fovea and these evolved towards cicatrisation without a drop in visual acuity. Improvement in visual acuity was noted with both types of photocoagulation. But, direct photocoagulation was found less preferable since an absolute scotoma may be created by the area deprived of arterial flow. Perianeurysm photocoagulation was found to be effective, and is indicated in cases of deep exudate and edema that may threaten the fovea. Treatment is questionable when hemorrhage is the predominant complication.
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PMID:[Retinal arterial macroaneurysms]. 654 43

Operative complications of pars plana lensectomy included mechanical failure, blocked fragmenting needle, air bubbles in the irrigating tubing, miosis, inadvertent iridectomy, hemorrhage, lens remnants in the posterior pole, metal fragments from the fragmenting needle, retinal hole, and retinal detachment. Postoperative complications included hypotony, hypertension, hemorrhage, lens remnants, cystoid maculopathy, retinal hole, retinal detachment, and sterile endophthalmitis.
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PMID:Pars plana lensectomy by ultrasonic fragmentation: 1984--Part II: Operative and postoperative complications--avoidance or management. 670 96


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