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

Ocular fluorophotometry was performed in 24 patients with hypertension due to toxemia of pregnancy and in ten normal subjects. Patients showing features of accelerated hypertension in the fundus (eg, hemorrhage, cotton-wool spots, and disc edema) were excluded from the study. Fluorescein concentrations in the aqueous and posterior vitreous increased significantly in toxemic patients compared with those in normal subjects; the blood-aqueous barrier was disrupted earlier than the blood-retinal barrier. Nevertheless, these barriers were only disrupted when the arterial diameter was altered. Ocular fluorometric abnormalities disappeared after delivery in all but two cases.
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PMID:Ocular fluorophotometric and angiographic findings in toxemia of pregnancy. 377 78

Fluorescein angiographies of the iris and retina were performed both in normal individuals (104) and in patients suffering from hyperlipoproteinemia (48), maturity-onset diabetes (184), systemic hypertension (12) and atherosclerosis (12). While hyperpermeation of dye located at the pupillary border was seen in 7.7% of the normals, leakages occurred in 66.6% of the hyperlipoproteinemics and in 79% of the recent maturity-onset diabetics. Paraclinical examination of the normal subjects with pathologic dye transit revealed vascular risk factors in each case. Thus, fluorescein iris angiography is a suitable method of detecting vascular damage in cases of metabolic disorder as early as possible.
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PMID:[Value of iris fluorescence angiography in the early diagnosis of vascular lesions]. 406 83

A series of 24 eyes in 23 patients is described showing solitary silent venous papillary loops. These loops are usually associated with a considerable degree of ocular hypertension, presenting when this hypertension is being investigated. They are silent, usually with no previous ocular history, single with a large diameter, affecting veins at the optic disc and not extending into the vitreous. The optic disc is cupped, but usually not more than 0.6 disc diameter, there is good central vision and either a full visual field or only early field loss. Fluorescein angiography shows the loops to be competent with no evidence of any other retinal vascular abnormality. Rarely loss of central vision may occur due to progression to advanced glaucoma. The condition is distinct from prepapillary vascular arterial papillary loops, neovascularization at the optic disc and optociliary shunt vessels. It is also distinct from the venous collateral vessels which develop at the optic disc after acute central or branch retinal vein occlusion. These collaterals are usually multiple, the accompanying ocular hypertension is of lesser degree, cupping of the disc and field loss are usually much more advanced and, while visual acuity may be normal, it is often grossly reduced. On fluorescein angiography all these cases of venous collaterals after retinal vein occlusion showed evidence of other retinal vascular dysfunction. Solitary silent venous papillary loops appear to develop from venules on the optic disc as a bypass to a low grade venous occlusion which is seldom clinically manifest. They form a distinct entity with a good prognosis if the accompanying ocular hypertension is carefully controlled.
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PMID:Solitary silent venous papillary loops and ocular hypertension. 652 79

Leakage of fluorescein to the vitreous has been reported in diabetes and systemic hypertension. We have done detailed studies in normal subjects to look for determinators of possible leakage in this population. Twenty-nine healthy males, aged 18-67 years, were studied in the morning after an overnight fast. Fluorescein 17 mg/kg body weight was injected intravenously and blood drawn 5, 10, 15, 30, 45, 75 and 120 minutes later for measurement of ultrafiltrable fluorescein. Ocular fluorophotometry was performed before, 60 and 120 min after the injection. Mean fluorescein (+/- SD) in the posterior vitreous was 8.1 (+/- 5.5), middle vitreous 4.7 (+/- 6.0) and aqueous 240 (+/- 142) ng/ml after 60 minutes. At 120 minutes, a significant increase to 12.2 (+/- 8.6), 9.4 (+/- 9.3) and 317 (+/- 139) ng/ml was found in the three regions, p less than 0.05. At 60 minutes, age related significantly to posterior and middle vitreous concentrations, Spearmans rho = 0.49 and 0.61, as well as to aqueous concentrations, rho = 0.51 (p less than 0.01). Blood pressure related only to aqueous concentrations, at 60 minutes, rho = 0.42, p less than 0.05. When the intraocular measurements were corrected for average preceding ultrafiltrable fluorescein, age remained significantly related only to vitreous readings and blood pressure to aqueous readings.
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PMID:Ocular fluorophotometry in normal subjects. 667 47

Hypertensive choroidopathy was noted in seven patients with accelerated or malignant hypertension. The acute lesion consisted of white areas of retinal pigment epithelial necrosis with overlying serous detachments of the retina. The detachments varied in size. Fluorescein staining of the damaged pigment epithelium and leakage into the subretinal space were demonstrated in several of these patients. Medical control of the BP resulted in a rapid disappearance of the detachment with minimal permanent ophthalmoscopic changes. Reperfusion of the choriocapillaris was suggested by the fluorescein angiogram. Patients with poor control of BP demonstrated at old sites of serous detachments more extensive retinal pigment epithelial pigmentary changes. Some lesions show a central hyperpigmented core surrounded by pigment atrophy (chronic Elschnig's spots). We suspect that choroidal vascular changes predominate when acute elevation of BP is present, whereas a more gradual onset of hypertension results in retinal vascular changes.
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PMID:The eye in accelerated hypertension. II. Localized serous detachments of the retina in patients. 670 70

Previous studies have suggested an association between hyperlipidaemia and retinal venous and arterial occlusion. To investigate this association further, the retinal arterial vasculature was studied by fluorescein angiography in forty hyperlipidaemic subjects, and clinical examination and biochemical investigations, including lipid profile, were performed in 99 patients with retinal vein occlusion and forty patients without retinal vein occlusion as a comparison group. Retinal arterial abnormalities were found on fluorescein angiography in eight patients with combined hypercholesterolaemia and hypertriglyceridaemia (type IV and V hyperlipidaemia). However no abnormalities were found in patients with familial hypercholesterolaemia (type II). Fluorescein angiography was repeated after 6 months hypolipidaemic therapy in four of the patients with retinal arterial abnormalities. Progression of retinal vascular closure was observed in two patients with poor hyperlipidaemic control and improvement in two other patients with good hyperlipidaemic control. There was a significantly higher incidence of hyperlipidaemia (P less than 0.001) and glucose intolerance (P less than 0.05) in the retinal vein occlusion group when compared to the control group, and a higher incidence of hypertension in patients with either central or branch retinal vein occlusion than in the normal population. We conclude that retinal arterial abnormalities occur in type IV and V hyperlipidaemias and that both central and branch retinal vein occlusion are associated with similar risk factors to large vessel disease.
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PMID:Retinal vascular abnormalities in the hyperlipidaemias. 696 27

Fluorescein angiography is commonly used in evaluation of retinopathy. Adverse reactions are uncommon but severe cardiovascular difficulties seem to occur selectively in older men with hypertension and ischemic heart disease. The 54-year-old patient described had hypertensive crisis and resulting myocardial infarction after fluorescein angiography.
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PMID:Hypertensive crisis and myocardial infarction after fluorescein angiography. 722 79

Fluorophotometry was used to evaluate alterations in the blood-ocular barrier to fluorescein in rats with experimental hypertension. One hour after intravenous injection of fluorescein, 16.6 mg/kg, concentrations in the anterior chamber were increased from mean normotensive values of 135 micrograms/mL to 299 micrograms/mL (P = .005) in animals with severe hypertension. Fluorescein concentrations in the vitreous also were increased from 50 micrograms/mL in normotensive rats to 109 micrograms/mL (P = .005) in hypertensive animals. With increasing duration of systemic pressures above 160 mm Hg, anterior chamber fluorescein concentrations rose from base-line of 135 micrograms/mL to 210 micrograms/mL after one to four weeks of hypertension, and to 394 micrograms/mL after five to eight weeks (P = .005). Similarly, vitreous concentrations increased from baseline of 50 micrograms/mL to 76 micrgrams/mL and 136 micrograms/mL (P = .005) after the shorter and longer periods of hypertension. Control of hypertension with return of systolic pressure to below 120 mm Hg caused a reversal of the abnormal fluorescein permeability.
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PMID:Fluorophotometry and the blood-ocular barrier in experimental systemic hypertension. 736 11

Nine patients whose history suggested increased intracranial pressure (ICP), but whose funduscopic examination did not reveal papilledema, are described. Cerebrospinal fluid monitoring in seven of the cases showed abnormal pressure waves ranging from 22 to 40 mm Hg. The findings of computed tomography and isotope cisternography and the response to therapy supported the clinical diagnosis of benign intracranial hypertension (BIH). Fluorescein angiography, which was performed in five cases, was normal. None of the patients had enlargement of the blind spot; all had normal intraocular pressure. The clinical spectrum of BIH may need to be enlarged to include cases of increased ICP without clinically evident papilledema. (Neurosurgery, 7: 326-336, 1980).
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PMID:Benign intracranial hypertension without papilledema: role of 24-hour cerebrospinal fluid pressure monitoring in diagnosis and management. 744 75

This is a brief overview of multifaceted anatomical, experimental and clinical studies conducted by the author since 1955 on the optic nerve head circulation in health and disease. Conclusions, based on the accumulated information provided by these studies, are summarized. The studies on the pattern of blood supply of the optic nerve head have shown that: (a) its main source of blood supply is the posterior ciliary artery circulation, with retinal circulation supplying only the surface nerve fiber layer, (b) there is marked interindividual variation in the blood supply pattern, and (c) the blood supply in the optic nerve head has a sectorial distribution. The various factors which produce interindividual variation in the blood supply of the optic nerve head are discussed, particularly those in the posterior ciliary artery circulation; this is because all available evidence indicates that it is derangement in the posterior ciliary circulation in the optic nerve head that is primarily responsible for the common ischemic disorders of the optic nerve head, e.g. anterior ischemic optic neuropathy and glaucomatous optic neuropathy. Factors that may derange the blood flow in the optic nerve head include defective autoregulation of blood flow in it, vascular changes in its feeding arteries, hematologic abnormalities, systemic arterial hypertension and hypotension, and intraocular pressure; their roles are discussed. For better understanding and management of optic nerve head ischemic disorders, there is an urgent need for an accurate clinical method of assessment of blood flow in the posterior ciliary circulation in optic nerve head, since no satisfactory method is currently available. Redness or pallor of the optic disk on ophthalmoscopy is not a true guide to the optic nerve head vascularity as it gives no information about the state of the posterior ciliary circulation. Fluorescein fundus angiography, though far superior to the optic disk color for evaluation of optic nerve head vascularity, has a number of limitations. All these topics and various controversies about them are discussed briefly.
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PMID:The 1994 Von Sallman Lecture. The optic nerve head circulation in health and disease. 755 90


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