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Biomedical subjects

A B Safran

Publications and source records attributed to A B Safran.

At least 73 records · Page 4Linked to original sources
PubMed1992

[Strabismus induced by peripheral vestibular lesions].

Little attention has been paid in the ophthalmological literature to strabismus resulting from lesions located in the peripheral vestibular system. However, this phenomenon is commonly encountered in clinical practice. As a rule, this kind of strabismus shows a prominent vertical component. It is generally combined with a change in perception of verticality, conjugate cyclotorsion of the eyes, and head tilt. This association is known as "ocular tilt reaction". It occurs in a number of clinical settings which are believed to be related with alteration in the otolithical and/or vertical semicircular canal pathways. Strabismus occurring as a feature of ocular tilt reaction might result from different mechanisms according to the location of the lesion, e.g. in the utricles, in the midbrain tegmentum, and in the dorso-lateral medulla oblongata. This phenomenon is illustrated here with the report of a patient suffering from Ménière disease, who underwent selective vestibular neurectomy. Methods of ophthalmological evaluation in such cases is described.

Aged↗
PubMed1992

Congenital nystagmus: rebound phenomenon following removal of contact lenses.

Symptoms resulting from congenital nystagmus can be significantly reduced by wearing corneal contact lenses. A 90 minute therapeutic trial with contact lenses was performed on a 20-year-old affected patient and produced a beneficial effect. Upon removal of the lenses however the patient showed a transient rebound phenomenon with oscillopsia lasting about 20 minutes. This phenomenon, although it might be expected in theory, has apparently not previously been observed either because it is rare or because in most patients it is not clinically apparent. The purpose of this report is not to discourage treating patients with congenital nystagmus by means of contact lenses, but rather to draw attention to the occasional occurrence of such a rebound phenomenon and to discuss its theoretical significance.

Adult↗
PubMed1992

Pain upon eye movement following digoxin absorption.

A patient who had received digoxin for 6 months experienced glare and ocular pain induced by eye movement. The symptoms lasted for 2 days and disappeared within hours after the treatment was discontinued. Four months later, digoxin was readministered. After 2 days, the symptoms reappeared but disappeared again within hours of stopping treatment. The origin of the pain is uncertain, although mechanisms related to optic nerve or ocular muscle involvement should be considered. Digoxin toxicity should be included in the differential diagnosis of pain evoked by ocular movements.

Adult↗
PubMed1991

[Multiple evanescent white dot syndrome].

MEWDS is a benign acquired disorder of the retinal pigment epithelium of unknown etiology which has been first described in 1984. Actually more than 50 cases have been reported worldwide but only 5 cases from Europe. We report 10 other cases of MEWDS, seen in the past 5 years. Their clinical presentation, perimetric and electroretinographic results, as well as their differential diagnosis will be reported.

Diagnosis, Differential↗
PubMed1990

[Eyelid tumors].

This review is intended to every general practitioner who is dealing with the daily problems of benign cystic palpebral tumors. Clinical presentation and treatment are reviewed. The necessity to recognize and treat malignant tumors of the eyelids early is re-emphasized.

Basal Cell Carcinoma↗
PubMed1990

[The role of botulinum toxin in the treatment of essential blepharospasm].

Benign essential blepharospasm is a focal dystonia consisting in involuntary closure of the eyelids. Until early 80's, therapeutic modalities included only psychotropic drugs, biofeedback and surgery, which showed limited efficiency. Recently, it has been suggested to inject botulinum toxin in affected palpebral orbicularis muscles. Used in several thousands of patients, it has been found that this procedure provides significant temporary relief from spasms of the eyelids. Local side effects are minimal, and no systemic side effects have been demonstrated in patients with blepharospasm treated with botulinum toxin.

Blepharospasm↗
PubMed1990

A controlled study of early neurologic abnormalities in men with asymptomatic human immunodeficiency virus infection.

BACKGROUND: Although neurologic complications are frequent in the acquired immunodeficiency syndrome, their incidence and progression in early human immunodeficiency virus (HIV) infection remain controversial. The goal of this study was to assess neurologic manifestations in asymptomatic carriers of HIV. METHODS: We studied 29 HIV-seropositive homosexual men and 33 seronegative homosexual controls by means of neurologic and neuropsychological examinations, magnetic resonance imaging (MRI), and electrophysiologic tests (electroencephalography, multimodal evoked-potential tests, and otoneurologic tests). After six to nine months, the tests were repeated in 27 seropositive men and 30 controls. The investigators were blind to the serologic status of the subjects. RESULTS: The seropositive subjects had a mean CD4+ lymphocyte count of 635 X 10(6) per liter. Neurologic and neuropsychological examination, MRI, and measurements of pattern visual evoked potentials did not show significant differences between the two groups. The latencies of the median-nerve somatosensory evoked potentials were slightly prolonged in the seropositive men. The initial electroencephalogram was judged abnormal in 8 of 27 of the seropositive subjects (30 percent) as compared with none of the controls, with a slowing of fundamental activity, anterior spread [corrected] of alpha rhythm, subnormal reactivity, and unusual anterior theta activities. These findings were confirmed by computerized spectral analysis. The second electroencephalogram was abnormal in 10 of 25 of the seropositive men (40 percent). The otoneurologic evaluation identified abnormalities in the central auditory or vestibulo-ocular pathways in 34 percent of the seropositive men (10 of 29), as compared with 6 percent of the controls (2 of 33), on the first examination and in 44 percent (12 of 27) and 7 percent (2 of 30), respectively, on the second examination. Altogether, electrophysiologic abnormalities were found in 67 percent of the seropositive men (18 of 27) and 10 percent of the controls (3 of 30) (P less than 0.00005). CONCLUSIONS: In persons with asymptomatic HIV infection, electrophysiologic tests may be the most sensitive indicators of subclinical neurologic impairment. Electrophysiologic abnormalities are far more common in asymptomatic carriers of HIV than in controls and tend to progress over time.

Adult↗
PubMed1990

Helicoid peripapillary chorioretinal degeneration.

Study of a father and son who had helicoid peripapillary chorioretinal degeneration suggests that a progressive tearing and retraction of the retinal pigment epithelium or of Bruch's membrane around the optic disk may be involved in the disorder's pathogenesis. We presume that this tearing results primarily from dysplastic abnormalities of the retinal pigment epithelium that surrounds the optic disk. The dystrophic lesions progress slowly and may affect the macula and even the peripheral retina.

Child↗
PubMed1990

Threshold perimetry in tilted disc syndrome.

Twelve consecutive patients (17 eyes) with tilted disc syndrome underwent quantified visual field examination with the G1 Octopus program (Interzeag AG, Schlieren, Switzerland). Visual fields were abnormal in all cases. Although field loss was more pronounced in the superotemporal quadrant (P less than .001), it also involved the other three quadrants, thus demonstrating that optic nerve hypoplasia in tilted disc syndrome is apparently not entirely sectorial. Linear regression analysis showed that an increase in mean defect correlated with increase in myopic refractive error (P less than .05). However, the increase in myopic refractive error was found to be related to a decrease in corrected loss variance (P less than .05), indicating that in tilted discs with higher myopia, field loss is more homogeneous. With this series of patients, short-term fluctuation was within normal ranges in all visual fields, showing that this may be an additional clue for differential diagnosis from acquired disorders.

Adult↗
PubMed1990

[The Gray Scale of the Octopus N1 perimetry analysis program in neuro-ophthalmology].

The gray scale of the Octopus neuro-ophthalmologic program N1 shows the difference between actual values and age-related normality. This permits optimal visualization of slight relative scotomas. The interpolation algorithm is computed for the four individual quadrants of the visual field, enabling either lateral hemianopic or fascicular defects to be sharply delineated. In addition, the N1 program automatically provides a global, nonsectorial gray scale which is useful for demonstrating visual defects which are not delineated by either the horizontal or the vertical meridian.

Algorithms↗
PubMed1990

[Optic neuropathy and Lyme disease].

Lyme disease should be included in the differential diagnosis of acquired optic nerve disorders. Protean clinical manifestations of Lyme disease, diagnostic clues and treatment are reviewed.

Humans↗
PubMed1990

Inferonasal quadrant of the visual field is not constricted in patients with infantile esotropia when evaluated by means of automated perimetry.

It has been stated that the inferonasal quadrant of the visual field is constricted in patients with dissociated vertical deviation. If this were true, it would be of clinical importance when assessing the visual field of patients with infantile esotropia. In addition, it could corroborate the hypothesis of an abnormal chiasmatic decussation in this condition. To assess this issue, we compared the sensitivity in the two inferior quadrants of the visual field in two groups of subjects by means of automated perimetry. The first group included 18 patients with infantile esotropia and the second, 14 normal subjects. Findings did not show any significant difference between these two groups of subjects and therefore indicate that changes in the inferonasal quadrant of the visual field are unlikely to occur as a result of infantile esotropia. The hypothesis of abnormal chiasmatic decussation in infantile esotropia is reconsidered, based on these results.

Adolescent↗