Biomedical subjects
Publications and source records attributed to G H Chester.
Formal legal identification of the decomposed remains of an edentulous woman was facilitated by the postmortem recovery of an intraocular lens implant. The dimensions and dioptric power of this prosthetic lens were identical with those recorded by her ophthalmologist at the time of cataract surgery 2 years previously. On the basis of this and other circumstantial evidence, legal identification was accepted by the Coroner.
After chorioretinal biopsy in dogs, obtained without vitreous loss, accessory glial cells and fibroblasts filled the defect between cortical vitreous and bare sclera. The proliferating glial cells laid down a new basement membrane which was complete both on the internal and external aspects of the defect. After biopsy complicated by vitreous loss, however, cellular proliferation failed to re-establish complete internal and external limiting membranes, and new formed fibroblastic tissue extended into the vitreous. To our knowledge, this is the first report to describe effective regeneration of the internal limiting membrane of the retina in any species. These findings suggest that when vitreous loss can be avoided, healed chorioretinal biopsies are unlikely to lead to delayed pathological complications.
A massive dose of 7.5 g of 4,4'-diamino, diphenyl sulphone (dapsone) taken as a suicide attempt in a patient on long-term therapy for tuberculoid leprosy resulted in permanent bilateral retinal necrosis, previously unreported side effect of this drug. The patient developed a severe haemolytic anaemia, methaemoglobinaemia, and acute renal failure requiring peritoneal dialysis. It is proposed that the retinal damage was due to a combination of severe hypoxaemia and the physical effects of red cell fragmentation producing vascular occlusion in the macular and perimacular region, with consequent ischaemic necrosis.
This paper describes a simplified technique for biopsy of the retina and choroid which had been used in 5 human volunteers. The biopsy was carried out in 4 immediately before enucleation of an eye for malignant melanoma and in 1 patient who was undergoing trabeculectomy for painful glaucoma associated with retinitis pigmentosa. A combination of intravenous mannitol and transient controlled systemic hypotension, induced under general anaesthesia with intravenous sodium nitroprusside, was used in 3 cases and resulted in no vitreous loss and minimal bleeding. In the 2 cases in which hypotension was not used bleeding was a definite problem, but no vitreous loss was experienced.
In 200 cases of retinal detachment successfully treated without drainage of subretinal fluid, complete reattachment of the retina was achieved in the first post-operative week in 76% of cases. Delay in subretinal fluid absorption in the remaining 24% of cases was directly related to the duration of the retinal detachment, but was not influenced by the patients age, refractive error or the characteristics of the detachment.
A case of acute erythroleukaemia is described. The patient's RBC, which at first appeared to be a mixture of groups B and O, were shown in fact to be a mixture of normal B and very weak B.
In 200 cases of retinal detachment successfully treated without drainage of subretinal fluid complete reattachment of the retina was achieved in the first postoperative week in 76 per cent of cases. Delay in subretinal fluid absorption in the remaining 24 per cent of cases was directly related to the duration of the retinal detachment but was not influenced by the patient's age, refractive error, or the characteristics of the detachment.
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