Biomedical subjects

Alex Melamud

Publications and source records attributed to Alex Melamud.

5 recordsLinked to original sources

PubMed2006

Introducing a new computer-based test for the clinical evaluation of color discrimination.

PURPOSE: To evaluate the Portal color sort test (PCST), a new computer-based test of color vision, by comparing it with a series of clinical tests of color vision in normal and color deficient subjects. DESIGN: Prospective clinical laboratory study. METHODS: Fifty-nine subjects with normal trichromatic vision or with congenital color vision defects underwent a series of color vision tests that included the 15-plate Ishihara test, the D-15 Farnsworth-Munsell test (D-15), the Farnsworth-Munsell 100-Hue test (FM 100-Hue), and the PCST under rigorous standardized conditions, as recommended by the respective manufacturers. The PCST generates a numerical discrimination score comparable to the FM 100-Hue. RESULTS: To test validity, discrimination scores generated by the PCST were compared with scores on the FM 100-Hue. The Spearman rank correlation between discrimination scores on the FM 100-Hue and the PCST was 0.8 (P < .001). Reliability was assessed by asking patients to retake the PCST at a later sitting. Patients retaking the PCST achieved similar scores on their second sitting as on the first. The correlation in the score between the two tests was 0.7 (95% confidence interval [CI]: 0.4-0.9, P < .001). Median (quartiles) time to complete the PCST was 3.1 minutes. This was faster than the FM 100-Hue time (P < .001), but slower than both the Ishihara and the D-15 (both P < .001). CONCLUSIONS: This study suggests that the PCST, a test of color vision deficiency, can be used effectively and reliably as a tool for screening (comparable to the Ishihara plates and the D-15) and grading (comparable to the FM 100-Hue) color discrimination ability.

Adolescent↗

PubMed2006

Retinoblastoma.

Retinoblastoma, a neuroblastic tumor, is the most common primary intraocular malignancy of childhood. Patients usually present with leukokoria (white reflex or white pupil), detected in primary care. The mean age at diagnosis is 12 months for bilateral tumors and 24 months for unilateral tumors. If untreated, almost all patients die of intracranial extension and disseminated disease within two years. However, new diagnostic and treatment methods allow for a high cure rate (93 percent five-year survival in the United States), therefore it is important that primary care physicians recognize the manifestations of this malignancy. Diagnosis is primarily by history and complete ophthalmic examination, with studies including ultrasonography of the eye and imaging of the orbits and brain. Treatment modalities include laser thermotherapy, cryotherapy, radioactive plaques, external beam radiotherapy, chemotherapy, and enucleation. Prospective parents with a family history of retinoblastoma should be referred for genetic counseling. Office evaluation for a red reflex in children should be performed until three years of age. If leukokoria is observed, the patient should be examined by an ophthalmologist within one week.

Combined Modality Therapy↗

PubMed2006

Comatic aberration as a cause of monocular diplopia.

Three patients (5 eyes) presented with complaints of monocular diplopia and no history of ocular trauma or surgery. The patients had comprehensive neuroophthalmic evaluation including manifest refraction, anterior segment and dilated fundus examination, and corneal topography. All patients also had wavefront analysis using the LADARWave system (Alcon). Two patients (4 eyes) also had hard contact lens overrefraction. The patients had a normal initial examination including corneal topography. One patient (2 eyes) did not experience resolution of diplopia with pinhole. No eye improved with manifest refraction or hard contact lens overrefraction. However, each patient had a significant amount of coma on wavefront analysis. Moreover, eyes with horizontal diplopia had horizontal coma and eyes with vertical diplopia had vertical coma as measured with the wavefront device. Higher-order optical aberrations such as coma may be associated with monocular diplopia. Wavefront technology may be useful in the workup of monocular diplopia.

Corneal Topography↗

PubMed2004

Color vision testing.

The science of color vision testing has evolved since its inception in the late 1700s. Since then, the rudimentary technique of comparing color names has been replaced by more sophisticated methods. Commonly used tests in clinical practice today include isochromatic plates, arrangement tests, anomaloscopes, and lantern tests. Each category has unique attributes that make it suitable for a particular clinical situation. The clinician should be aware of the requirements for administering and grading each test type. Factors such as the quality of the illuminant and the size of the field of view are important elements in setting up a proper color vision laboratory. Currently, no treatment exists for congenital color vision defects. However, studies show that diagnosis of these defects early in life may help children adjust better to tasks at school and may help adults understand their limitations at work. Acquired color vision defects are often used as markers of ocular pathology in the clinical setting. Different color vision tests are appropriate for diagnosing the different categories of defects. Sometimes, a battery of tests may be appropriate. This paper is a review of the current knowledge in the field of color vision testing.

Color Perception↗

PubMed2003

Ocular ethambutol toxicity.

Ethambutol is an antimicrobial agent used frequently to treat tuberculosis. The most commonly recognized toxic effect of ethambutol is optic neuropathy, which generally is considered uncommon and reversible in medical literature. We describe a 43-year-old man who developed signs and symptoms of bilateral optic neuropathy during treatment with ethambutol. This case and a review of the literature show the severe and unpredictable nature of ethambutol toxicity and its potential for irreversible vision loss despite careful ophthalmologic monitoring.

Adult↗