Yazar "Lahey, J. Michael" seçeneğine göre listele

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  • Küçük Resim Yok
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    Akut santral retinal ven tıkanıklığında intravitreal doku plazminojen aktivatörünün görsel prognoza etkisi
    (2000) Tunç, Murat; Lahey, J. Michael; Fung, Donald; Kearney, John
    GİRİŞ: Bu çalışmada akut dönemdeki santral retinal ven tıkanıklığı (SRVT) olgularında intravitreal doku plazminojen aktivatörü (dPA) uygulamasının görsel prognoza etkisini araştırmak amaçlanmıştır. GEREÇ ve YÖNTEM: Başlangıç dönemindeki (<21 gün içinde gelişen ve görsel semptomları olan) 23 SRVT olgusu üzerinde pilot bir çalışma yürütülmüştür. Hastalar, uygulanacak tedavi konusunda bilgilendirildikten ve onayları alındıktan sonra, etkilenen gözlerde vitreus içerisine 65-100 µg dPA enjeksiyonu uygulanmıştır. Altı aylık takip neticesinde görsel sonuçlar değerlendirilmiş, iskemik olmayan gruplar istatistiksel yöntemlerle karşılaştırılmıştır. BULGULAR: 23 SRVT olgusunun sekizinde (% 34) görme keskinliği 0.5'in üzerine çıktı. Onbeş olguda (% 65) ise görmeler başlangıç görmesine göre daha iyiydi veya aynı düzeyde kaldı. Olguların hiçbirinde regmatojen retina dekolmanı, göz içi enfeksiyon veya neovasküler glokom gelişmedi. İskemik ve iskemik olmayan gruplar arasında tedavinin görsel sonuçları açısından istatistiksel anlamlı bir fark tespit edilmedi. (p>0.05) SONUÇ: SRVT'nda erken dönemde uygulanan intravitreal dPA enjeksiyonu ciddi yan etkilere yol açmaksızın iyi bir görsel prognoz sağlamıştır.
  • Küçük Resim
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    Hypercoagulable states and central retinal vein occlusion
    (2003) Lahey, J. Michael; Kearney, John J.; Tunç, Murat
    Central retinal vein occlusion is a common cause of permanent visual loss. Work up and laboratory evaluation of patients requires the clinician to rule out hypertension, diabetes, hyperlipidemia, and glaucoma. Patients without an identifiable risk factor are often subject to extensive testing for primary and secondary thrombophilias. The purpose this paper is to review the literature to determine which of these tests is associated with central retinal vein occlusion. Antiphosphotipid antibodies and elevated plasma homocysteine levels appear to be the tests associated most commonly in patients with central retinal vein occlusion in most controlled studies. Primary thrombophilias are found rarely when screening patients with central retinal vein occlusion. Extensive testing for thrombophilias is not warranted in the vast majority of patients with central retinal vein occlusion. Older patients with any of the common vascular risk factors do not require thrombophilic screening. By carefully selecting the patients who are evaluated for thrombophilias, the likelihood of finding true-positive tests is increased. © 2003 Lippincott Williams & Wilkins.
  • Küçük Resim Yok
    Öğe
    Laboratory evaluation of hypercoagulable states in patients with central retinal vein occlusion who are less than 56 years of age
    (Elsevier Science Inc, 2002) Lahey, J. Michael; Tunç, Murat; Kearney, John; Modlinski, Barbara; Koo, Howard; Johnson, Robert N.; Tanaka, Stephen
    Purpose:To investigate whether hypercoagulability plays a role in thrombus formation in patients withcentral retinal vein occlusion (CRVO) who are less than 56 years of age. Design: Prospective, observational case series with retrospective comparative controls. Participants and Controls: Participants included 55 consecutive patients with CRVO less than 56 years of age. The laboratory's age-matched control groups were used to compare results for the same tests. Methods: Fifty-five patients with CRVO less than 56 years old (mean age, 44 years) underwent laboratory evaluation for homocysteine, activated protein C resistance, protein C activity, protein S activity, antithrombin III activity, antiphospholipid antibodies, and anticardiolipin antibodies. The results were compared with previously drawn age-matched control groups obtained by the same laboratory for statistical significance. Main Outcome Measures: Patients were considered to have a positive test if their results were outside the laboratory's established range. Results: Fifteen of 55 patients (27%) had one positive test result suggesting hypercoagulability. Compared with the control groups, these patients less than 56 years old with CRVO had a higher incidence of coagulation abnormalities by laboratory testing. Among the parameters tested, hyperhomocysteinemia and circulating antiphospholipid antibodies were significantly more common in the CRVO patients (P < 0.05) compared with age-matched controls. Conclusions: Hypercoagulability may play a role in the pathogenesis of CRVO in patients less than 56 years old. The cause of CRVO remains multifactorial, and laboratory tests suggesting hypercoagulable states alone cannot account for the cause in most of these patients less than 56 years of age. The authors recommend examining blood pressure, intraocular pressure, complete blood count, glucose levels, and a lipid panel on all patients with CRVO. When tests for these common risk factors for CRVO are negative, consider ordering selected tests in young patients with CRVO to rule out thrombophilias, especially in patients with bilateral CRVO, a history of previous thrombosis, or family history of thrombosis.