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Sanjeev Nath, M.D.
Eye Institute and Laser Center
New York, NY
A 37-year-old Hispanic female presented 5 years ago with a 20-year history of an
“untreatable” retinal degeneration. At presentation, with high plus reading glasses, our patient
was able to read magazine print at about 4 inches, but with some difficulty, and felt that her
ability to read was worsening. The patient also complained of difficulty seeing at night.
image of left eye. Numerous pisciform
Unaided vision was 10/400 in each eye. Goldmann IOP’s were 23 OD and 24 OS. On
flecks throughout the retina and maculopathy-charac-
viewing the fundus with a slit lamp its appearance explained the visual difficulties. Further
teristic of Stargardt’s disease. Also seen are severallarge floaters.
testing was performed; Pachymetry was 498u OD and 505u OS. Threshold fields revealed
central Scotomas about 12x15 degrees in size OU, but fixation was erratic. Flash ERG’s
The pisciform flecks and the appearance of the macula define the full presentation of
Stargardt's disease. Since the Flash ERG was normal, we need to consider another diagnosis
to explain her peripheral and night vision problems. Another important observation is that
the discs appear to have asymmetric cupping, glaucoma is obviously indicated. High IOP’s
Although there is no known treatment for Stargardt’s, glaucoma is treatable. The recognition
that a patient can have more than one disorder, some of which are treatable and others not,
must be considered. We have been seeing this patient over the last 5 years and controlling
IOP has proven challenging. She has had several selective laser trabeculectomies in each eye
ResMax™ image of the right eye. In this view the
and is presently taking Alphagan and Travatan. Fortunately, there is no evidence that either
“beaten bronze” appearing maculopathy associated
disorder has progressed while she has been under our care. The ability to capture in one high
with Stargardt’s and the asymmetric cupping seen in
resolution image, the total extent of the damage to the retina caused by the two conditions in
glaucoma are clearly viewed. NFL in the superior
this case, is unique to the Optos imaging platform contained within the P200®C.
Although the patient is dilated yearly, opto
map® images are obtained twice a year when the
patient is not dilated and allow us to monitor for change in the posterior pole as well as in
the mid and far peripheral retina in a highly efficient manner.
Optos plc is a leading and rapidly growing medical technology company for the design, development, manufacturing and marketing of devices that image the retina. The Company has gained regulatory clearance (CE and FDA 510(k)) to market itsthird device - P200®C. The P200®C is aimed at practices looking for advanced clinical capabilities. With a view up to 82% of
Zoomed view of ResMax™ image of the left eye.
the retina in a simultaneous, single image, Optos’ technology provides an unequalled combination of wide-field retinal imaging,
Here the cupping of the optic disc and an inferior
speed and convenience for both practitioner and patient.
Titel proefschrift : Molecular Mechanisms of Antibiotic Resistance in Helicobacter pylori Door : Monique Gerrits Promotiedatum : 2 december 2004, Erasmus MC, Rotterdam Ruim 4 miljoen Nederlanders zijn besmet met Helicobacter pylori, een bacterie die de maagmucosa koloniseert. Een infectie met deze bacterie is chronisch en resulteert meestal in maagontsteking, maar kan ook leiden tot
A C T U A L I Z A C I Ó N E N E L T R A T A M I E N T O A N T I T R O M B Ó T I C O D E L S Í N D R O M E C O R O N A R I O A G U D O Novedades en el tratamiento antitrombótico en intervencionismo coronario Álvaro Merino, Andrés Grau, Ignacio Segura y Eduardo Alegría-Barrero Institut Cardiològic. Clínica Rotger. Palma de Mallorca. Baleares. España. El objetivo de este artículo e