The CR3-45 NM Canon nonmydriatic fundus camera detects relevant diabetic retinopathy with high sensitivity. To determine whether examination of one eye per patient would suffice for screening purposes, 473 pairs of standard 45 degree fundus Polaroid prints obtained with the Canon camera were assessed from 167 patients with and 306 without diabetic retinopathy. On the basis of considering only one eye per patient, absence of retinopathy would have been diagnosed in 336 patients, with 9% of the diagnoses false negative. One hundred thirty-seven of the 167 patients with retinopathy in at least one eye would have been diagnosed correctly by considering one eye per patient (sensitivity 82%, specificity 100%). Thus, a standard 45 degree fundus Polaroid print from one eye per patient may suffice for screening purposes if the picture is free from diabetic abnormalities. Otherwise, both eyes should be examined immediately, and the patient should be referred to an expert ophthalmologist who specializes in diabetic retinopathy for confirmation of the diagnosis and staging of diabetic retinopathy status.
With a mode-locked Nd:YAG laser set at various energy levels, anterior and posterior capsular and cortical lesions were produced in the lens of rabbits. Biomicroscopic and Scheimpflug examinations showed the anterior lesion to be healing in a whitish scar that was restricted to the area of the original lesion. Histology and transmission electron microscopy (TEM) demonstrated the proliferation of epithelial cells that produced a new, continuous, basement membrane-like capsule. In the area of the lesion collagenous material, myofibroblast-like cells and macrophages were found. Laser-induced lesions in the posterior lens capsule and lens protein resulted in damage to the capsule and grey opacity of the lenticular proteins, which remained unchanged for 6 weeks. Neither inflammatory nor epithelial cells appeared within the locally damaged lens. Macrophages migrated from the vitreous into the lesion; they were observed either in intercellular clefts or within a lens fibre, almost completely taking up their cross section.
Three patients with endothelialization of the anterior chamber - 2 with Chandler's syndrome and 1 with Cogan-Reese syndrome - were followed up by means of iris angiography and specular microscopy over a period of several years. The endothelial angiographic changes occurred simultaneously in all cases; the more pronounced the endothelial changes, the more severe the iris changes. Since iris stroma and corneal endothelium develop from a common mesenchymal origin, and the extent of the changes they undergo is similar in the course of the diseases in question, a close relationship between Rieger's mesodermal dysgenesis, Chandler's syndrome and Cogan-Reese syndrome is postulated.
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