J B Walsh

Publications (8)29.9 Total impact

• Article: High-resolution ultrasound biomicroscopy of the pars plana and peripheral retina.

  R C Gentile, D M Berinstein, J Liebmann, R Rosen, Z Stegman, C Tello, J B Walsh, R Ritch
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  ABSTRACT: This study aimed to evaluate the ability and role of ultrasound biomicroscopy in imaging the peripheral retina, pars plana, and anterior choroid. The study design was a case series. Seventeen eyes of 17 patients with a variety of clinical diagnoses involving the anterior portion of the posterior segment were studied. High-frequency (50 MHz), high-resolution (50 microns) ultrasound biomicroscopy was performed. Ultrasound biomicroscopy was capable of imaging the peripheral retina, pars plana, and anterior choroid. Images had features consistent with known histopathology. Retinoschisis consisted of one thin hyper-reflective echo and could be differentiated from a retinal detachment, which was thicker and formed a bilayered echo. A choroidal effusion could be identified as an echolucent space within the suprachoroidea, whereas a choroidal hemorrhage was moderately echodense. Inflammatory diseases, such as a sarcoid granuloma, pars planitis, and Harada's disease, were characterized by different forms of uveal thickening. A ciliochoroidal nevus was internally hyporeflective and could be measured accurately and localized. Imaging of the peripheral retina, pars plana, and anterior choroid is possible with ultrasound biomicroscopy and may aid in the diagnosis and management of pathology involving this region.
  Ophthalmology 04/1998; 105(3):478-84. · 5.45 Impact Factor
• Article: Retinal vascular occlusions complicating acute toxoplasmic retinochoroiditis.

  R C Gentile, D M Berinstein, R Oppenheim, J B Walsh
  Canadian Journal of Ophthalmology 09/1997; 32(5):354-8. · 1.47 Impact Factor
• Article: Primary choroidal tuberculoma.

  D M Berinstein, R C Gentile, S A McCormick, J B Walsh
  Archives of Ophthalmology 04/1997; 115(3):430-1. · 3.71 Impact Factor
• Article: Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge.

  P T Finger, S A McCormick, M Davidian, J B Walsh
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  ABSTRACT: Adenocarcinoma of the retinal pigment epithelium (RPE) is an uncommon intraocular tumor which has been rarely if ever diagnosed prior to enucleation. Our review of the literature suggests that when a melanotic and tuberous-shaped tumor presents in a woman with signs of uveitis one should consider the diagnosis of adenocarcinoma of the RPE. We report a case in which a 4.9-mm-tall, mushroom-shaped, moderately reflective melanotic tumor found to be present in a 50-year-old woman. Other findings included a 12 x 10-mm dense transillumination shadow and 270 deg of posterior iris synechiae. With a presumptive diagnosis of uveal melanoma the patient was treated with palladium-103 plaque radiotherapy. Within 6 months she underwent enucleation due to uncontrollable ocular pain and progressive tumor growth. Histopathologic evaluation revealed an adenocarcinoma of the (RPE). Two months after radiotherapy the eye developed acute angle-closure glaucoma, secondary retinal detachment, and a painful scleritis (a result similar to that of Greer, who treated an intraocular adenoma with radiation). Our diagnosis of adenocarcinoma of the RPE was made after enucleation. Adenocarcinomas of the RPE are rarely if ever diagnosed on clinical evaluation, should be suspected in women with a melanotic intraocular tumor and uveitis, and may respond poorly to ophthalmic plaque radiotherapy. All reported cases presenting without extrascleral extension have not metastasized.
  Albrecht von Graæes Archiv für Ophthalmologie 09/1996; 234 Suppl 1:S22-7. · 2.17 Impact Factor
• Article: Risk factors for ciliochoroidal effusion after panretinal photocoagulation.

  R C Gentile, Z Stegman, J M Liebmann, A R Dayan, C Tello, J B Walsh, R Ritch
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  ABSTRACT: To determine the incidence, duration, and risk factors for ciliochoroidal effusion after panretinal photocoagulation. Thirty-nine consecutive patients with diabetic retinopathy underwent ultrasound biomicroscopy of both eyes to image the ciliochoroidal space immediately before and 1 day after unilateral argon-green panretinal photocoagulation. Imaging was repeated on days 3, 7, and 14 in patients in whom ciliochoroidal effusion developed. Low-lying ciliochoroidal effusions were imaged in 23 (59%) of 39 eyes. Of 23 eyes, effusions resolved in 6 (26%), 12 (52%), and 5 (22%) eyes by 3, 7, and 14 days respectively. The number of laser applications (P = 0.02), shorter axial length (P = 0.01), and percentage of retinal surface area treated (P = 0.02) were associated with systemic hypertension, location of treatment, previous panretinal photocoagulation of cataract surgery, retinal surface area treated, and mean blood pressure before photocoagulation were not associated with effusion. All fellow, untreated eyes remained effusion-free. Ciliochoroidal effusion develops commonly after panretinal photocoagulation. Limiting the number of laser applications and the percentage of retinal surface area treated reduces the likelihood of this complication. Eyes with shorter axial lengths are at higher risk
  Ophthalmology 06/1996; 103(5):827-32. · 5.45 Impact Factor
• Article: Personal computer-based 3-dimensional ultrasound biomicroscopy of the anterior segment.

  R Iezzi, R B Rosen, C Tello, J Liebmann, J B Walsh, R Ritch
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  ABSTRACT: To develop a practical, inexpensive system for 3-dimensional ultrasound biomicroscopic imaging of the anterior segment with a commercially available high-frequency ultrasound imager and a personal computer. Sequential, high-frequency, ultrasound biomicroscopic images of the anterior segment were obtained with a motorized scanning control arm designed in our imaging laboratory. Images were acquired by a personal computer-based video capture device. Ultrasound slice data were then reconstructed as 3-dimensional volumetric images by a personal computer and commercially available software. Four 3-dimensional visualization formats were developed to enhance the clinical utility of high-frequency ultrasound. Rotational animation sequences were created that detailed the extent and anatomy of a filtering bleb, intraocular lens subluxation, focal angle closure from an iridociliary cyst, intraocular foreign bodies, and an iris tumor. Three-dimensional, high-frequency ultrasound of the anterior segment enhances our ability to visualize spatial relationships between adjacent anatomic structures. The low cost and ease of use of this system make widespread clinical application practical.
  Archives of Ophthalmology 06/1996; 114(5):520-4. · 3.71 Impact Factor
• Article: Imaging congenital optic disc pits and associated maculopathy using optical coherence tomography.

  D Krivoy, R Gentile, J M Liebmann, Z Stegman, R Rosen, J B Walsh, R Ritch
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  ABSTRACT: To elucidate the anatomy of congenital optic disc pits with and without maculopathy using optical coherence tomography. All patient were examined, photographed, and scanned at the New York Eye and Ear Infirmary. Ten eyes of eight consecutive patients with congenital optic disc pits were studied. Three eyes had associated serous macular detachment (group 1), four had evidence of resolved detachment (group 2), and three had no clinical macular pathologic lesion (group 3). Optical coherence tomography, a new, noninvasive, noncontact, imaging technology capable of producing cross-sectional images of the retina in vivo with high resolution ( < 17 microns) was used to obtain multiple cross-sectional images of the pit, peripapillary retina, and macula. Ophthalmologic examination and standard fundus photography were performed on all eyes. Fluorescein angiography was performed in eyes that had associated macular detachment. Communication between a schisis cavity or subretinal space and the optic nerve pit was imaged in all eyes in group 1. No such communication could be identified in groups 2 and 3. Cystic degeneration and schisis were imaged in the peripapillary retina, macula, or both in all eyes of groups 1 and 2 and in one patient in group 3. A direct communication between the subretinal space and vitreous cavity could not be identified in any eye. Schisis formation plays an integral role in the development of serous retinal detachment in the presence of congenital optic disc pits. Our findings are consistent with the theory that the optic disc pit acts as a conduit for fluid flow between the schisis cavity or subretinal space and the subarachnoid space.
  Archives of Ophthalmology 02/1996; 114(2):165-70. · 3.71 Impact Factor
• Article: Lattice degeneration of the retina and the pigment dispersion syndrome.

  P Weseley, J Liebmann, J B Walsh, R Ritch
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  ABSTRACT: Retinal detachment occurs more frequently in patients with pigment dispersion syndrome. We evaluated the incidence of peripheral retinal abnormalities known to predispose to rhegmatogenous retinal detachment in a consecutive series of 60 patients with pigment dispersion syndrome with or without glaucoma. Lattice degeneration was present in at least one eye of 12 patients (20%). Seven patients had bilateral lesions. Full-thickness retinal breaks were found in seven patients (11.7%) and two patients (3.3%) had asymptomatic rhegmatogenous retinal detachments that required scleral buckle procedures. The incidence of lattice degeneration and full-thickness retinal breaks appears to be increased in this group of patients, and may be responsible for the increased risk of rhegmatogenous detachment.
  American Journal of Ophthalmology 12/1992; 114(5):539-43. · 4.22 Impact Factor