A retained intraocular surgical needle 2 years after cataract extraction.
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Biomedical subjects
Publications and source records attributed to B S Foster.
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OBJECTIVE: To characterize the presentation, role of diagnostic imaging, and course in patients with optic nerve avulsion. METHODS: A retrospective review of medical records of all 6 patients with optic nerve avulsion who were seen at the Massachusetts Eye and Ear Infirmary, Boston, from January 1, 1991, to July 31, 1995. RESULTS: The initial visual acuity ranged from 20/100 to no light perception. All 6 patients underwent neuroimaging, including computed tomography, magnetic resonance imaging, or both. B-scan ultrasonography was performed on 4 patients, and the condition of 1 patient was evaluated with color Doppler ultrasonography to assess the optic nerve vasculature. In 1 patient, a computed tomographic scan was suggestive of an optic nerve avulsion. Neuroimaging in the other 5 patients, including 2 patients who underwent magnetic resonance imaging, failed to demonstrate an avulsion. During a follow-up period of up to 25 months, 4 patients showed no improvement in visual acuity, 1 patient improved from no light perception to bare light perception, and 1 patient improved from 20/100 to 20/25. CONCLUSIONS: These data suggest that final visual outcome was dependent on initial postinjury visual acuity. Neuroimaging, B-scans, and Doppler ultrasonography were usually not helpful in establishing the presence of optic nerve avulsion, although they may be useful in evaluating comorbid conditions.
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PURPOSE: The purpose of the study is to determine the effect of photodynamic therapy in the destruction of experimental pigmented choroidal melanomas > or = 3 mm in thickness using a liposomal preparation of benzoporphyrin derivative, verteporfin. METHODS: Pigmented choroidal tumors were established in 32 New Zealand albino rabbit eyes. Animals were treated with daily injections of cyclosporine, and tumor growth was followed by serial fundus examinations and ultrasonography. When a tumor exceeded 3 mm in thickness (tumor height ranged from 3.1-4.6 mm), the authors administered benzoporphyrin derivative intravenously (1 mg/kg) and irradiated the tumor at 692-nm through an argon-pumped dye laser at different total light doses ranging from 60 to 120 J/cm2. Control animals were treated with light or benzoporphyrin derivative only. Each animal then was followed-up for 4 to 6 weeks by fundus photography, fluorescein angiography, and ultrasonography. RESULTS: All animals treated with benzoporphyrin derivative and light at fluences of > or = 80 J/cm2 showed complete tumor arrest. In contrast, both control groups showed continuous tumor growth in all animals with tumors filling most of the vitreous cavity by 3 weeks. Histologic examination results of tumors treated with dye plus light immediately after treatment showed prominent vascular closure. No vascular changes were noted in the control eye treated with light or dye alone. Examination results of the eyes that showed tumor regression after a 4-week follow-up period showed tumor necrosis and extensive infiltration of mononuclear cells and pigment-laden macrophages at the tumor site. CONCLUSIONS: These data suggest that photodynamic therapy may have a role in the management of pigmented choroidal melanomas.
In the pediatric population, retinoblastoma must be included in the differential diagnosis of intraocular or orbital inflammation, especially if the case is atypical of unresponsive to medical therapy. Diffuse infiltrating retinoblastoma, a rare subtype of retinoblastoma, often presents as unilateral intraocular inflammation, usually occurs in older children, and may contain insufficient calcification for detection by CT scan. Orbital inflammatory signs may also be associated with intraocular retinoblastoma. The clinician must perform a thorough ocular examination in these cases with the suspicion of retinoblastoma. He or she must also understand the subtleties of noninvasive imaging in such cases. The goal is to diagnose this tumor more accurately and expediently so that treatment and counseling can be provided without delay.
An analytical method was developed for enantiomeric determination of amphetamine and methamphetamine in human urine. The enantiomers were isolated from urine by solid-phase extraction, and diastereomers were formed by derivatization with the chiral Marfey's reagent (1-fluoro-2,4-dinitrophenyl-5-l-aniline amide). The diastereomers were separated by reversed-phase high-performance liquid chromatography in a water/methanol mobile phase and detected by absorbance spectrophotometry at 340 nm. Linear standard curves were obtained for all four enantiomers over a concentration range of 0.16-1.00 mg/L in urine. The detection limit was 0.16 mg/L urine for each enantiomer, and the limit of quantitation was 0.40 mg/L. The urine of 10 decedents was analyzed by this method and by a previously published precolumn derivatization procedure using (-)-1-(9-fluorenyl)ethyl chloroformate (FLEC) as the derivatizing agent and fluorescence detection. Comparison of the results of the two methods by linear regression showed comparable results for both d-amphetamine and d-methamphetamine. Neither method detected the presence of the l-enantiomers in the urine samples.