Advances in diabetic retinopathy could save sight, money with more frequent eye exams

Article Abstract:

Diabetic retinopathy (disease of the retina which often leads to blindness) could be detected early enough for effective treatment if funds for screening patients every six months were made available, according to Jonathan C. Javitt, a researcher in the field of ophthalmology. Treatment with laser photocoagulation, reimbursed at $1,985 by Medicare, can prevent disease progression in many cases. The cost of blindness is approximately $12,000 per year per person, thus an adequate prevention program would save the government more than $200 million annually, according to Javitt. Resistance to an examination schedule of visits every six months often comes from primary care physicians, who believe ophthalmologists are simply trying to get more money. Another researcher, Thomas W. Gardner, is trying to develop treatments for the defect that leads to diabetic retinopathy. The defect may result from increased levels of histamines (which change blood vessels so that more fluid leaks out of them) in blood vessel walls of diabetics. Therefore, trials of antihistamine therapy in diabetics have been started. The goal of the National Coordinating Committee for the American Academy of Ophthalmology is to educate health care professionals about diabetic blindness by the year 2000 (the Diabetes 2000 program). The Committee stresses the importance of treatment when eye disease is at an early stage. Finally, the National Eye Health Education Program of the National Eye Institute will focus on patient education. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Economic aspects, Beliefs, opinions and attitudes, Diabetic retinopathy, Javitt, Jonathan C, Gardner, Thomas W

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Cryotherapy in infants with retinopathy of prematurity: a decision model for treating one or both eyes

Article Abstract:

The therapeutic use of cold to reduce blindness from retinopathy of prematurity, a bilateral inflammation of the retina in premature infants, shows that the decision to use cryotherapy largely depends on the severity of the disease, the risk of long-term side effects, and the correlation of treatment outcome and side effects for patients who have both eyes treated. Normal procedure indicates that both eyes should be treated regardless of the disease's severity if there are no probable long-term side effects. If the retinopathy of rematurity is mild, but long-term side effects are likely, physicians are recommended to treat neither eye, or only the worst eye. In cases of moderate severity, only the worst eye should be treated. In the severest cases, both eyes should be treated regardless of the likelihood of long-term side effects. Better-informed treatment recommendations require new data to assess the risks of long-term side effects and the correlations of treatment outcomes and side effects.

Health aspects, Management, Diseases, Infants (Premature), Premature infants, Medical protocols, Cold, Cryotherapy, Retrolental fibroplasia, Retinopathy of prematurity

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The accuracy of magnetic resonance imaging in patients with suspected multiple sclerosis

Article Abstract:

Magnetic resonance imaging (MRI) appears to be superior to CT scanning in confirming the diagnosis of multiple sclerosis (MS). Both an MRI scan and a CT scan were used to assist with the diagnosis of 303 patients with suspected multiple sclerosis. Two neurologists read the scans without any previous knowledge of the patients' histories. The MRI scans established a diagnosis of MS in 60 patients and definitively ruled out a diagnosis of MS in 128. Ninety-five of the scans were interpreted as possible or probable MS and 20 were interpreted as probably not MS. MRI scans were clearly better than CT scans in assisting with diagnosis. Because MRI could not completely rule out MS, physicians and patients should not be falsely reassured by a negative MRI result, especially if the patient shows clinical signs of MS.

Evaluation, Diagnosis, CT imaging, CAT scans, Multiple sclerosis, Magnetic resonance imaging

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