Severe invasive beta haemolytic group A streptococcal cellulitis and eyelid necrosis treated with linezolid.
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Acetamides↗
Biomedical subjects
D B Byles
Publications and source records attributed to D B Byles.
Does frequency doubling technology perimetry reliably detect neurological visual field defects?
AIM: To determine the ability of frequency doubling technology (FDT) perimetry to detect visual field defects of neurological origin. METHODS: A total of 15 eyes of nine patients who all had complete hemianopias or quadrantanopias underwent the FDT 20-5 screening mode test and Humphrey 24-2 SITA Fast visual field test (HFA). The FDT results were scored according to the number of abnormal test locations (out of a maximum of 4) in each affected quadrant. FDT locations showing a defect of P< 2% were considered abnormal. RESULTS: Of the 15 eyes, six showed complete superior quadrantanopic and nine complete hemianopic field defects on HFA. Of 96 FDT test locations in these quadrants or hemifields only 38 were abnormal on FDT testing (40%). For the quadrantanopic field defects, five out of 24 locations were abnormal (21%). For the hemianopic field defects, 33 out of 72 locations were abnormal (49%). In three eyes (two with quadrantanopias and one with complete hemianopia), FDT perimetry failed to demonstrate any corresponding abnormality. CONCLUSIONS: The FDT screening test can fail to demonstrate complete hemianopic and quadrantanopic field defects. Users should be aware of this deficiency when using FDT to screen for field defects.
Adolescent↗
Anterior uveitis as a side effect of topical brimonidine.
PURPOSE: To report anterior uveitis as a late side-effect of topical brimonidine tartrate 0.2% (Alphagan; Allergan Inc., Irvine, California). METHODS: Four patients aged 79 to 91 (mean, 83) years, who developed acute anterior uveitis while using topical brimonidine for chronic glaucoma, were clinically evaluated for causes of uveitis. When the inflammation had completely cleared, topical brimonidine was recommenced in one eye only to determine causality. RESULTS: All four patients developed acute granulomatous anterior uveitis, which resolved rapidly on stopping brimonidine and receiving treatment with topical corticosteroids. The uveitis occurred 11 to 15 (mean, 13.8) months after commencement of brimonidine 0.2% twice daily. None of the patients had a previous history of uveitis, and no other identifiable cause of uveitis was found. In all patients, on rechallenge with brimonidine instilled twice daily to one eye, uveitis recurred within 3 weeks in that eye only. CONCLUSIONS: These findings suggest that brimonidine can cause anterior uveitis as a late side effect. The inflammation settles rapidly on stopping the medication and on using topical corticosteroids and recurs on rechallenge with brimonidine.
Acute Disease↗
Ectopia lentis et pupillae. A hypothesis revisited.
BACKGROUND: Ectopia lentis et pupillae (ELeP) is a rare congenital inherited disorder characterized by lenticular and pupillary ectopia. Recent speculation on its pathogenesis is based on clinical observation and includes a neuroectodermal defect or persistence of fetal vasculature. None of these reports included histopathology or imaging studies. STUDY DESIGN: Case report and literature review. INTERVENTION: The authors examined a 55-year-old woman with ELeP using 10-MHz and 50-MHz ultrasonography to demonstrate the structural abnormalities present. Five patients (eight eyes) who had undergone cataract extraction without lens implantation were also examined. RESULTS: In the patient with ELeP, the right pupil was displaced inferiorly and the left temporally. An ultrasound scan at 10 MHz showed both lenses lying inferiorly in the vitreous. An ultrasound scan at 50 MHz allowed detailed examination of the anterior segment, including the iris and ciliary body, and showed two main features in each eye, including a lack of definition of ciliary processes, except in that quadrant toward which the pupil was displaced, and a membrane-like structure extending forward and attaching to the proximal pupil margin. The membrane passed over the tips of the ciliary processes to a more posterior origin. CONCLUSIONS: The only histologic reports of this condition are from the beginning of this century in the German literature. Ultrasonography at 50 MHz allows high-resolution in vivo imaging of anterior structures that are not clinically visible. The authors' findings in this case of ELeP are sufficiently different from those of non-ELeP-related aphakia to suggest that they are not solely due to aphakia. Furthermore, the authors' findings are very similar to the only histologic reports suggesting that the pupillary and lenticular ectopia results from mechanical tethering of the pupil with zonular disruption. This hypothesis has not been discussed in the recent literature.
Anterior Eye Segment↗
Paralytic strabismus.
The use of sophisticated imaging techniques has led to a greater understanding of the mechanisms of some forms of strabismus. In particular, studies of strabismus in high myopia have demonstrated abnormal muscle courses and provided a basis for corrective surgery. Although injection of botulinum toxin has a place in modern strabismus management, there have been few controlled studies validating its use. An important paper in the review period directly compares botulinum with surgery to confirm its effectiveness for at least one indication.
Animals↗
Paralytic and incomitant strabismus.
In the year under review, published work has concentrated on two main topics. The first is the etiology, pathophysiology, and natural history of paralytic and incomitant strabismus. No major studies were published but some interesting findings are discussed. The second is surgical results, largely assessed by uncontrolled retrospective data analysis. Also, a number of useful tips for patient management have emerged.
Cranial Nerve Diseases↗