Biomedical subjects
Publications and source records attributed to David L McCartney.
A case of Pseudallescheria boydii keratitis is presented. The patient was successfully treated with topical natamycin and systemic itraconazole in conjunction with penetrating keratoplasty, leading to visual acuity of 20/40.
PURPOSE: To determine whether laser in situ keratomileusis (LASIK) affects the central 30-degree visual field. SETTING: University-based ophthalmology practice. METHODS: This nonrandomized clinical trial comprised 14 normal patients (27 eyes) scheduled to have LASIK for myopia or myopic astigmatism. Automated static perimetry was performed before and 6 months after surgery using the Octopus 1-2-3 perimeter and the Dynamic-32 test strategy. Patient data included sex, age, preoperative and postoperative refractive errors, preoperative and postoperative best corrected visual acuity, preoperative corneal thickness, programmed optical zone, programmed total ablation diameter, and duration of microkeratome suction. All surgery was performed using the same Alcon LADARVision 4000 excimer laser. The main outcome measures were the mean sensitivity (MS) change in the central 15-degree visual field and the MS change in the 15- to 30-degree visual field. A multivariate analysis of the MS change as a function of preoperative clinical parameters was performed. RESULTS: There was no significant change in the MS in the central 15-degree visual field; between 15 and 30 degrees, there was a statistically significant decrease of -0.82 dB +/- 1.40 (SD) (P=.01, 2-tailed t test). The decline in MS was positively correlated with refractive error and corneal thickness; it was negatively correlated with the programmed optical zone diameter. CONCLUSIONS: Automatic static perimetry can detect decreased sensitivity in the midperipheral visual field after myopic LASIK. It may be a useful quantitative subjective test for measuring the effects of future improvements in surgical technique on vision quality.
PURPOSE: To investigate the effect of daily brimonidine tartrate 0.15% on the dark-adapted pupil diameter. DESIGN: Observational case series. METHOD: Ten normal volunteers administered brimonidine to their right eyes once daily. Four to six hours later, infrared pupil photographs were taken after dark adaptation. Measurements were performed at baseline; on treatment days 1, 5, 11, and 18; and on washout days 1 and 2. RESULTS: One subject had no response. The nine responding subjects showed an average maximum antimydriatic effect of -1.63 mm (range, -0.57 mm--2.30 mm); all subjects experienced tachyphylaxis. Five subjects showed rebound mydriasis (mean maximum rebound +0.87 mm larger than baseline; range 0.50 mm-1.22 mm). The untreated pupil also responded, showing antimydriasis (two subjects), rebound mydriasis (two subjects), or paradoxical direct mydriasis (one subject). CONCLUSIONS: Once-daily use of brimonidine tartrate to prevent dark-induced pupil dilation can lead to tachyphylaxis and rebound mydriasis.
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The role of other non-perfringens Clostridium species in endophthalmitis infections has not been analyzed. We describe a case of non-perfringens Clostridium endophthalmitis and review prior cases in the literature. Fulminant clinical presentations and poor visual outcomes are the rule, but a combined aggressive medical and surgical approach may conserve vision.