Rivka Kessner

Tel Aviv Sourasky Medical Center, Tell Afif, Tel Aviv, Israel

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Publications (5)4.16 Total impact

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    ABSTRACT: Purpose: To investigate macular changes following strabismus surgery by using optical coherence tomography (OCT). Methods: The authors prospectively evaluated 60 eyes of 30 patients undergoing unilateral extraocular muscle surgery. OCT measurements employing the fast macular thickness mapping protocol were performed 1 day prior to surgery and 1 day postoperatively. Postoperative macular changes in the study eye that was operated on (n = 30) were compared with the fellow control eye (n = 30, controls). Results: There was an increase in mean ± standard deviation central foveal thickness (CFT) in the operated eyes, from 201.63 ± 18.36 µm at baseline to 206.03 ± 22.73 µm postoperatively (P = .024). Preoperative and postoperative perifoveal outer temporal quadrant thicknesses were 220.10 ± 16.23 and 225.80 ± 14.78 µm, respectively (P = .009). There were no differences between preoperative and postoperative retinal thickness measurements for all measured areas in the control eyes. Eyes that underwent surgery involving the rectus muscles showed a trend toward a greater CFT increase compared with eyes that had oblique muscle surgery (P = .070). Conclusions: The authors found subclinical increases in the foveal and perifoveal macular thicknesses following extraocular muscle surgery. These findings could be attributed to change in the mechanical forces caused by the new position of the extraocular muscles and transmitted via the sclera or, alternatively, to postoperative inflammation and alterations in the blood-retinal barrier. The clinical implications of these findings remain to be clarified. [J Pediatr Ophthalmol Strabismus. 2016;53(1):11-15.].
    No preview · Article · Feb 2016 · Journal of Pediatric Ophthalmology & Strabismus
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    ABSTRACT: We sought to assess long-term changes in the flow parameters of retrobulbar vessels in diabetic patients. The retrobulbar circulation of 138 eyes was evaluated between 1994 and 1995 and 36 eyes were reevaluated between 2004 and 2008 (study group). They were divided into four groups: eyes of diabetic patients without diabetic retinopathy (DR), eyes with nonproliferative DR, eyes with proliferative DR, and eyes of nondiabetic patients (controls). Color Doppler imaging was used to assess the flow velocities in the major retrobulbar vessels. The resistive index (RI) was calculated and compared among the groups and between the two time periods. RI values of the central retinal artery and posterior ciliary artery had increased in the two non-DR groups and in the nonproliferative DR group, with a surprising decrease measured in eyes with proliferative DR (P= nonsignificant [NS]). Combining the nonproliferative DR and proliferative DR groups resulted in a milder increase of the RI of the posterior ciliary artery (P= NS) and the central retinal artery (P=0.02) in the DR group compared to the other groups. Our results demonstrate that an increase of the resistance in the retrobulbar vessels, as a part of DR, can lessen over time and may even be reversed.
    Preview · Article · Nov 2014 · Clinical ophthalmology (Auckland, N.Z.)
  • Rivka Kessner · Shani Golan · Adiel Barak
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    ABSTRACT: To ascertain the leading causes of endophthalmitis at the Tel Aviv Medical Center between 2003 and 2010. The design of the study is retrospective chart review. The medical records of all patients diagnosed with endophthalmitis in our center between 2003 and 2010 were reviewed for visual acuity and results of ophthalmologic examination at admission, treatment, complications, laboratory investigations, and final visual results. The etiologies of endophthalmitis after cataract surgery were compared for each year from 2003 to 2010, and after intravitreal (IVT) injection from 2006 to 2010. Eighty patients were diagnosed with endophthalmitis between 2003 and 2010: 46 male and 34 female, average age 70.7 years. A total of 27.5% were treated with IVT antibiotic injection only and 68.8% needed pars plana vitrectomy. Final visual acuity was better than counting fingers in 56.3% of cases. Surgery was almost the sole cause of endophthalmitis until 2005, when IVT injection became an important etiology. The incidence of postcataract endophthalmitis decreased significantly after 2007 and that following IVT injection decreased significantly after 2008. The leading etiology of endophthalmitis changed from postoperative endophthalmitis to endophthalmitis after IVT injection from 2003 to 2010, and the incidence of the infection as a complication of those procedures decreased.
    No preview · Article · May 2014 · European journal of ophthalmology
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    Rivka Kessner · Adiel Barak · Meira Neudorfer
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    ABSTRACT: To describe the spectral-domain optical coherence tomography (SD-OCT) findings in a case of Coats' disease, with emphasis on the intraretinal exudates. Case report of a 4.5-year-old girl who presented with total exudative retinal detachment and organized exudates in a stellate configuration. SD-OCT was performed before and after treatment, which included surgical drainage of subretinal fluid and indirect laser application during the surgery. At presentation, the SD-OCT showed an elevation of the foveal contour, with thickening of the retina, many exudates and a large quantity of subretinal fluid. Two months after the surgical treatment, SD-OCT revealed a significant reduction in the amount of subretinal fluids, but with persistence of the exudates. SD-OCT can be used as an important tool in order to describe the changes in each layer of the retina in Coats' disease. Considering the histopathological findings in Coats' disease, it is reasonable to assume that the exudates accumulate in the outer plexiform layer.
    Full-text · Article · Jan 2012 · Case Reports in Ophthalmology
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    ABSTRACT: The K65R mutation in HIV-1 reverse transcriptase (RT) can be selected by the RT inhibitors tenofovir (TDF), abacavir (ABC), and didanosine (DDI). Recently, in vitro studies have shown that K65R is selected in tissue culture more rapidly with subtype C than subtype B viruses. The prevalence of K65R in viruses sequenced at the Tel-Aviv AIDS Center was evaluated. This study analyzed retrospectively sequences from 1999 to 2007 in patients treated with TDF, ABC, and/or DDI and compared rates of mutational prevalence between subtypes. Fisher's exact test was used to determine statistical significance. Forty-four sequences from patients treated with the three above-cited drugs were analyzed. Subtypes A (n = 1), CRF01_AE (n = 4), CRF02_AG (n = 2), B (n = 21), C (n = 11), D (n = 1), F (n = 3), and G (n = 1) were represented. Seven non-B viruses had the K65R mutation, which was only found in one subtype B virus. Of these seven samples four were subtype C, one was subtype CRF01_AE, and two were subtype CRF02_AG. None of the eight viruses with K65R harbored thymidine analogue mutations. In this study, non-subtype B viruses possessed the K65R mutation at higher incidence than subtype B viruses. Subtype C viruses may be especially prone to develop this mutation. Larger studies are needed to confirm these data. Efforts should be intensified to understand better differences in drug resistance between various HIV subtypes.
    No preview · Article · Sep 2009 · Journal of Medical Virology