PubMed HealthSearch

Biomedical subjects

C Wertenbaker

Publications and source records attributed to C Wertenbaker.

13 recordsLinked to original sources

Digoxin toxicity. Recognizing the varied visual presentations.

We report three cases of digoxin toxicity presenting with decreased visual acuity, unaccompanied by the classic visual symptom of xanthopsia. Visual function improved and symptoms diminished upon lowering of blood digoxin level. Electroretinographic (ERG) abnormalities in the first case were suggestive of a cone deficit, which supports recent electrodiagnostic and labeled tracer studies implicating retinal dysfunction in the pathogenesis of digoxin toxicity. The second patient presented with visual symptoms exclusively. Evaluation of the third case was hampered by advanced retinitis pigmentosa and the presentation was complicated by a syncopal episode. Digoxin toxicity is a potentially life-threatening condition. Ophthalmologists and neurologists may be the first physicians consulted. It must be considered in the differential diagnosis in patients with otherwise unexplained visual loss.

Aged

Gradual loss and recovery of vision in temporal arteritis.

Visual loss in temporal arteritis is usually sudden and irreversible. In this article, we describe a patient who complained of slowly progressive visual loss in one eye, eventually followed by loss of vision in the other eye and ophthalmoparesis. A biopsy specimen confirmed the diagnosis of temporal arteritis. Steroid therapy resulted in almost total recovery of vision. The gradual loss and recovery of vision is attributed to reversible ischemia of the optic nerve. This case broadens the spectrum of temporal arteritis to include complaints of progressive visual loss over several months.

Aged

Acquired Brown's syndrome in children with juvenile rheumatoid arthritis.

Two children with systemic juvenile rheumatoid arthritis developed the features of Brown's syndrome coincident with an increase in disease activity. While acquired Brown's syndrome is known to occur in adults with both classical adult rheumatoid arthritis and persistent polyarticular juvenile rheumatoid arthritis, this is the first report of such an occurrence in childhood. The mechanism is likely to be an inflammatory mass which restricts the passage of the superior oblique tendon through the trochlea.

Age Factors

Downbeat nystagmus.

A patient with downbeating nystagmus in the primary position and vertical saccadic pursuit is presented. The possible etiologies of these features and their diagnostic significance is discussed.

Aged

Unusual visual symptoms.

Three cases with unusual and interesting symptomatology are presented. In each case the symptoms alone can lead the physician to an accurate localization of the lesion.

Adenoma, Chromophobe