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Biomedical subjects

D J Karr

Publications and source records attributed to D J Karr.

9 recordsLinked to original sources
PubMed1994

Visual outcomes of macular retinoblastoma after external beam radiation therapy.

PURPOSE: To determine the risk factors that influence the visual outcomes of patients with macular retinoblastoma who are treated with radiation therapy. METHODS: The medical records of all patients with macular retinoblastoma treated with radiation therapy between 1980 and 1990 were reviewed. Ten patients were entered into the study. Features analyzed included patient age, laterality of eye involvement, location and size of macular tumor(s) at the time of diagnosis, treatment course, and most recent visual acuity. FINDINGS: Ten of 11 eyes (10 patients) were successfully treated with external beam radiation. Eight patients obtained visual acuities ranging from 20/25 to 20/100; two patients had visual acuities of 20/200 or less. The best visual acuities were noted in patients whose tumor(s) did not involve the fovea and were relatively small. The worse visual acuities were noted in patients with binocular vision whose tumors invaded the fovea and were larger in size. In two of three patients in whom both eyes were retained, superimposed amblyopia developed in the eye with macular retinoblastoma. CONCLUSION: The authors' findings indicate that most patients with macular retinoblastoma who are treated with external beam radiation have favorable visual outcomes, but final visual acuity depends on the size of the tumor and involvement of the fovea. Patients in whom both eyes are retained are predisposed to further visual loss from amblyopia.

Eye Neoplasms↗
PubMed1989

Management and visual acuity results of monocular congenital cataracts and persistent hyperplastic primary vitreous.

Sixty-two patients, 48 with a diagnosis of persistent hyperplastic primary vitreous (PHPV) and 14 with monocular congenital cataract (MCC) are reported. Nineteen patients with a diagnosis of PHPV and all patients with MCC received surgery with attempted visual rehabilitation. Early age of surgery, prompt optical correction with contact lens and aggressive patching therapy are required for successful visual rehabilitation. Glaucoma, retinal or optic nerve pathology, surgery later than three months of age or combinations of these factors were associated with poor prognosis. Isolated microphthalmos was not correlated with poor prognosis. Binocular fixation pattern was used to monitor patching therapy. Optokinetic nystagmus, visual evoked potentials or forced preferential looking were not employed. Of the 33 patients who underwent surgery, 10 (30%) achieved good (greater than or equal to 20/50) visual acuity, 8 (24%) achieved fair (20/60 to 20/100) and 15 (46%) achieved poor vision. In selected patients with the diagnosis of PHPV or MCC, visual rehabilitation can be achieved.

Age Factors↗
PubMed1986

Visual acuity results following treatment of persistent hyperplastic primary vitreous.

The visual acuity outcome of patients with persistent hyperplastic primary vitreous (PHPV) was reviewed. A total of 48 patients with the diagnosis of PHPV were seen at the University of Iowa, Iowa City, from 1971 through 1984. Twenty-five patients were managed nonsurgically, of which 23 had a poor visual acuity outcome (less than or equal to 5/200). Two with mild cases had visual acuities of 20/100 and 20/30. Twenty-three patients were treated surgically. Five of these had no further postoperative rehabilitation. Eighteen patients underwent surgery and aggressive optical and occlusion therapy. Eight of these 18 patients (44%) had postoperative visual acuities of 20/200 or better. These eight patients represent 17% of the study population. Therefore, lensectomy-membranectomy procedures for the purpose of effecting visual development are reasonable therapeutic options in patients with PHPV in whom the findings are primarily anterior in nature, surgery is performed at an early age, and aggressive amblyopia therapy is instituted.

Amblyopia↗
PubMed1985

Radial keratotomy complicated by sterile keratitis and corneal perforation. Histopathologic case report and review of complications.

A 35-year-old physician had radial keratotomy (RK) for correction of myopia. Combined radial and transecting circumferential incisions were used which resulted in wound gape, persistent epithelial defect, and severe sterile keratitis. Progressive corneal decompensation required an initial patch graft followed by a penetrating keratoplasty four months after RK. Histopathology of the cornea demonstrated epithelial edema and persistent incisional epithelial plug formation, deep and superficial vascularization, variable incision depth (superficial to full thickness), endothelial cell loss, and inflammatory cell infiltration at all levels of the cornea. A review of the reported complications of RK is included in the discussion of this case.

Adult↗
PubMed1982

Retrolental fibroplasia. Experience over two decades in one institution.

We examined 1,849 consecutively admitted premature infants weighing 2000 gm or less at birth for retrolental fibroplasia (RLF). Proliferative RLF was diagnosed frequently in low birth weight infants who were more likely to survive with modern neonatal intensive care. Cicatricial RLF was more likely to result from proliferative RLF and to be more severe in lower birth weight infants, but most affected eyes retained useful vision. Comparison of cases diagnosed over the 20 years of this study suggest that cicatricial RLF in recent years is less likely to result in severe visual disability. Improving survival rates for lower birth weight infants mandate continued surveillance for RLF and study of improved oxygen monitoring techniques.

Female↗
PubMedDate not supplied

An unusual case of cellulitis associated with a Molteno implant in a 1-year-old child.

The Molteno seton implant has recently been used in pediatric patients with advanced childhood glaucoma, who would otherwise have been treated with cyclodestructive surgery. We report a case of Molteno implant (first stage) associated with orbital cellulitis in a 1-year-old child. The presence of the implant was initially unrecognized until, in the course of evaluation for orbital cellulitis, computerized tomography of the orbit suggested a foreign body. We believe this is the first report of a complication associated with the first stage of this procedure.

Cellulitis↗