Biomedical subjects
Publications and source records attributed to D E Eifrig.
Avidin-biotin immunohistochemical staining for fibronectin was used to study 17 aphakic intraocular lens implanted globes and 12 explanted intraocular lenses. Fibronectin was identified as a component of acellular pseudophakic membranes and was also observed within lens epithelial cells and macrophages.
A 62-year-old woman without evidence of immunocompromise was evaluated for uveitis and a subretinal lesion in the right eye. Laboratory evaluation, including cerebrospinal fluid analysis, revealed no apparent cause. The diagnosis of subretinal cryptococcosis was established by transscleral needle biopsy of the subretinal mass. Treatment with intravenous amphotericin B and oral 5-flucytosine brought recovery of visual acuity to 20/30-1 and resolution of the inflammation. This patient demonstrates that ocular cryptococcal infection must be suspected, even in the absence of predisposing factors or systemic findings, and that subretinal fine-needle aspiration is an important diagnostic tool in this setting.
Anterior chamber intraocular lenses were implanted in phakic cynomolgus monkey eyes and followed clinically over two years. Significant observations included erosion and/or uveal envelopment of the haptic and a decrease in endothelial cell counts. There was good positional stability, no significant inflammation, initial ocular hypotension that returned to normal intraocular pressure, and no evidence of cataracts or cystoid macular edema.
Anterior chamber intraocular lenses were implanted in 50 phakic primate eyes and followed by serial histopathology for two years. Significant observations included corneal endothelial alterations, haptic erosion into and encapsulation by peripheral iris and ciliary body, and chronic low grade inflammation.
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Two patients with diabetes had extracapsular cataract extraction with intraocular lens (IOL) implantation. Both developed rubeosis iridis and neovascularization within the lens capsule supporting the IOL, a condition we have termed rubeosis capsular. Argon laser treatment was ineffective in both patients. One patient was successfully treated by virectomy with endophotocoagulation. The other patient had a vitrectomy which was followed by a fibrinoid reaction, continued inflammation, rubeosis, and phthisis bulbi.
We surgically removed lenses and as much retina as accessible in one eye of six pigmented rabbits which were followed for up to four months postsurgically. Clinically, pre-RPE membranes were noted to form within the first weeks after surgery, and eyes remained hypotensive in the absence of notable inflammation. Morphologic studies demonstrated a variable response of RPE, ranging from atrophy to hypertrophy and hyperplasia. Pre-RPE membranes appeared to arise from both the RPE as well as from tags of peripheral retina and were of two morphologic types: spindle cell-collagenous membranes, and a highly cellular glial membrane. Bone formation within collagenous membranes was seen in four of six eyes studied.
Sections of seven human epiretinal membranes of diverse pathologic origin were labeled with antibodies to cellular retinaldehyde binding protein (CRALBP) and two intermediate filament proteins: glial fibrillary acidic protein (GFAP) and vimentin. All of the membranes studied contained heterogeneous cell populations that exhibited diverse morphologic characteristics. Double labeling with both anti-GFAP and anti-CRALBP positively identified one of the cellular components in these membranes as Müller's glia. In addition, other epiretinal cells exhibited immunolabeling patterns consistent with those found in fibrous astrocytes and retinal pigment epithelial (RPE) cells normally. The results demonstrate that a double-labeling method using CRALBP antibodies, in combination with antibodies to other appropriate antigens, can be used to distinguish between the different epiretinal cell types.
Toxic effects of high doses of monomeric methylmethacrylate were demonstrated in rabbit eyes. These effects were not related to surgical manipulation. Monomeric methylmethacrylate caused limbal hyperemia, corneal edema, corneal neovascularization, iris engorgement, anterior chamber inflammation, iris atrophy, and cataract. The doses of monomeric methylmethacrylate needed to produce these lesions were much higher than the amount of monomer available for leaching out of implanted intraocular lenses.
This report presents an unusual case of visual impairment following cardiac arrest during general anesthesia. The presumptive etiology was macular capillary insufficiency secondary to vascular stagnation which occurred during cardiac standstill. Ophthalmic examination confirmed areas of macular edema corresponding to localized perifoveal regional infarcts. Isolated macular infarction is not a unique condition and has been reported in hemoglobulinopathies, diabetes, and other systemic diseases.
We studied a factor VIII inhibitor spontaneously occurring in an otherwise healthy patient who underwent retinal reattachment. The clotting defect first manifested itself as a delayed hemorrhagic choroidal detachment. His bleeding diathesis was successfully managed by infusion of factor VIII concentrate, prednisone, and cyclophosphamide. Surgical procedures in patients with severe bleeding disorders present a difficult therapeutic problem which can be effectively managed by the close cooperation of the surgeon, hematologist, coagulation laboratory, and blood bank.
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A 38-year-old man with hypogammaglobulinemia and pulmonary Nocardia asteroides infection developed an intraocular Nocardia infection. The diagnosis was confirmed by examination of a specimen removed at pars plana vitrectomy. The chorioretinal infection in one eye resolved partially, with no organisms visible on histopathologic examination of the globe at autopsy. One month before the patient's death from disseminated nocardial infection, the previously uninvolved right eye developed a new metastatic nocardial chorioretinal lesion. This lesion rapidly progressed in size until the patient's death and showed on postmortem examination the presence of organisms characteristic of N asteroides.
Sixty-one patients with retinal pigment epitheliitis were studied. Fifty-two eyes in 40 patients were followed for 2 years. Good central visual acuity was maintained in more than 80% of these eyes. The differential diagnosis of retinal pigment epitheliitis and the characteristic findings are described.
This report summarized the findings in 40 rabbit eyes undergoing extracapsular cataract extraction, 20 of which underwent intraocular lens implantation. The parameters of postoperative evaluation are shown to be limited by the susceptability of the rabbit cornea to corneal edema in the early postoperative phases. The only apparent parameter of statistical importance in this series, however, was the day at which the intraocular lens implanted eye returned to normal compared to the day that the non-implanted eye returned to normal. The fact that there is a 13-day difference in these eyes and the fact that this difference is statistically significant may be important. Pathologic examination of lens implanted eyes has shown that the surgical objectives of intracapsular loop fixation are quite feasible. Microscopic study also showed that there is minimal tissue response to the materials placed in the anterior chamber in this type of surgery.
An adult worm was isolated from the left upper eyelid of a man, eight years after he had left an area in which L loa is endemic. We described his case in order to draw attention to some differences between reported features of the disease in areas in which the worm is endemic and in areas in which it is not.
The fixation of two-loop intraocular plastic lenses has been studied in the laboratory. Twenty rabbit eyes underwent extracapsular lens extraction and placement of plastic lens loops within the capsular remnants. Placement was successful in 25 of 40 (62.5%) attempts. The placement of intracapsular lens loops was studied histologically, and the structural alterations were seen to be minimal. There was virtually no cellular response to the implantation of the plastic lenses, even in the areas of tissue contact.