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Biomedical subjects

D M Meisler

Publications and source records attributed to D M Meisler.

At least 73 records · Page 4Linked to original sources
PubMed1989

Propionibacterium-associated endophthalmitis after extracapsular cataract extraction. Review of reported cases.

Sixteen cases of previously reported culture-proven Propionibacterium-associated endophthalmitis after extracapsular cataract extraction (ECCE) are reviewed. The inflammation was observed 2 to 10 months after surgery and occurred after laser posterior capsulotomy in four cases. Clinically, it appeared as a chronic iridocyclitis characterized by granulomatous-appearing keratic precipitates (5 cases), hypopyon (10 cases), and a white plaque on the posterior capsule or intraocular lens (IOL) implant (8 cases). Response to corticosteroid treatment was transient. Surgical intervention was required between 1 and 16 months after the inflammation began and included removal of the IOL and capsular bag via the limbus in 7 cases and pars plana vitrectomy in 11. Intravitreal antibiotics were administered in 12 cases. Postoperative visual acuity ranged from 20/20 to count fingers, with 11 of 16 patients recovering visual acuity of 20/40 or better. Propionibacterium-associated endophthalmitis should be suspected if chronic indolent intraocular inflammation develops after ECCE. Intraocular specimens should be obtained and submitted for aerobic and anaerobic culture and cytologic/histopathologic studies. Based on the clinical courses of these patients, recommendations for management are discussed.

Bacterial Infections↗
PubMed1989

High-signal periventricular lesions in patients with sarcoidosis: neurosarcoidosis or multiple sclerosis?

The vast majority of periventricular abnormalities visualized with MR imaging in patients less than 50 years old represents multiple sclerosis (MS) lesions. There are many other causes of periventricular lesions, most of which can be differentiated from MS on the basis of history and physical or MR findings. Five cases of biopsy- or Kveim test-proved sarcoidosis with MR findings consistent with MS are reported. Each of these patients, diagnosed as having sarcoidosis, had symptoms identical to those seen in MS. Although these patients have not had histologic characterization of the intraparenchymal lesions seen on MR, they illustrate the difficulty of differentiating sarcoidosis with CNS involvement from MS in some patients on the basis of clinical, radiographic, electrodiagnostic, or CSF testing. This series contributes to a growing body of evidence that neurosarcoidosis probably should be included in the differential diagnosis of isolated periventricular lesions in patients less than 50 years old.

Adult↗
PubMed1988

Corneal edema related to accidental Hibiclens exposure.

Five patients developed corneal edema presumably caused by accidental preoperative ocular exposure to Hibiclens. In all cases, the patients complained of ocular pain after surgery. Conjunctival inflammation and corneal epithelial defects were found in all patients. Between two and ten weeks after exposure, stromal and epithelial edema, with a predilection for the inferior cornea initially, developed in all patients. The corneal edema resolved in three patients in approximately six months, leaving mild stromal scarring and reduced endothelial cell counts. The corneal edema in the other two patients progressed to diffuse bullous keratopathy, which eventually required penetrating keratoplasty. We recommend that Hibiclens be avoided in preoperative preparation of the facial skin to prevent accidental ocular exposure.

Accidents↗
PubMed1988

Pseudophakic bullous keratopathy with Intermedics model 024 (Hessburg) anterior chamber intraocular lenses.

We report the development of pseudophakic bullous keratopathy in 18 eyes following implantation of Pharmacia Intermedics Ophthalmics model 024 (Hessburg) anterior chamber intraocular lenses. Eight of these intraocular lenses were implanted during uncomplicated intracapsular cataract extractions. Mean onset of corneal edema was 21.4 months after lens implantation. Patients with this type of lens already implanted in their eyes require close follow-up for complications.

Aged↗
PubMed1988

Epithelial downgrowth.

We present a surgically treated case of epithelial downgrowth with clinicopathologic correlation and special emphasis on the ultrastructural findings. Long-term follow-up revealed a salvaged eye, but with only peripheral vision due to glaucomatous optic atrophy.

Aged↗
PubMed1988

Ring stromal opacity in lens-corneal adhesion.

Severe congenital corneal clouding may be associated with abnormal anterior segment development (dysgenesis). Often, congenital corneal opacities preclude visualization of intraocular anatomy. In this report, five eyes of four patients with congenital corneal clouding and lens-corneal adhesion (LCA) are described. All had a ring- or doughnut-shaped haze within the stroma surrounding a central clear corneal zone delineating the adhesion. Recognition of LCA is pivotal in planning surgical therapy for eyes with congenital corneal clouding. As a clue to recognition of this anomaly, the ring-shaped stromal opacity may aid in diagnosis of this phenomenon and in avoidance of surgical complications.

Cornea↗
PubMed1986

Chronic Propionibacterium endophthalmitis after extracapsular cataract extraction and intraocular lens implantation.

We studied six cases of chronic, indolent intraocular inflammation that occurred after extracapsular cataract extraction and posterior chamber intraocular lens implantation. The inflammation was characterized by a delayed onset, and in three cases had the clinical appearance of a granulomatous iridocyclitis. Cultures of intraocular specimens obtained from six eyes yielded Propionibacterium; five yielded P. acnes. Pleomorphic gram-positive bacilli consistent with Propionibacterium were identified in cytologic or histopathologic studies in four of the six culture-positive cases. After surgical and medical therapy, the inflammation resolved. Postoperative Propionibacterium endophthalmitis may masquerade as a chronic iridocyclitis.

Aged↗
PubMed1986

Cutaneous malignant melanoma metastatic to the vitreous.

A 38-year-old man previously had a cutaneous malignant melanoma excised from his right shoulder. He presented to our clinic with neovascular glaucoma, corneal edema, large pigmented keratic precipitates, anterior chamber reaction, and pigmented aggregates in the vitreous of his left eye. There were no other ocular findings. Subsequent enucleation was performed and the globe was studied histopathologically. Special stains and electron microscopy showed the presence of both macrophages and malignant melanin-producing cells within the vitreous. The diagnosis of cutaneous malignant melanoma metastatic to the vitreous was made based on these findings. This is a rarely reported clinical entity, for which a high index of suspicion should be maintained.

Adult↗
PubMed1986

Susceptibility of Acanthamoeba to cryotherapeutic method.

Acanthamoeba keratitis is becoming an increasingly well-known clinical entity. The Acanthamoeba species in their encysted state are resistant to antimicrobial agents, resulting in corneal infections that are refractory to medical therapy. Corneal cryotherapy has been used to treat Acanthamoeba keratitis with varying and equivocal success. We subjected trophozoites and cysts of two species of Acanthamoeba recovered from corneal infections to trials of in vitro freeze-thaw-refreeze cryotherapeutic methods. The trophozoites of both species were killed in all trials. However, the cysts of both species survived all trials. Cryotherapy may not be an effective means to eliminate Acanthamoeba cysts from the cornea.

Amebiasis↗
PubMed1986

Susceptibility of Acanthamoeba to soft contact lens disinfection systems.

Members of the genus Acanthamoeba are increasingly recognized as agents of indolent, chronic, infectious keratitis. Recently, Acanthamoeba corneal infection has been reported in some persons who wear soft contact lenses. In this study, three "heat" and three "cold" soft contact lens disinfection systems were tested according to the manufacturers' instructions against Acanthamoeba castellanii and Acanthamoeba polyphaga in separate trials, and with appropriate controls. Suspensions of Acanthamoeba cysts or trophozoites of each species were tested individually. Each of the three heat disinfection units killed all acanthamoebae in one cycle in all trials. A chlorhexidine 0.005%/thimerosal 0.001% solution killed A. castellanii trophozoites and cysts, but those of A. polyphaga survived. Trophozoites and cysts of both species survived an alkyl triethanol ammonium chloride 0.013%/thimerosal 0.002% solution and a hydrogen peroxide 3% preparation. Heat disinfection overall appears to be more effective in killing Acanthamoeba trophozoites and cysts as compared to cold disinfection methods.

Amoeba↗