Reis-Bücklers dystrophy: a study of eight cases.
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Adult↗
Biomedical subjects
H D Perry
Publications and source records attributed to H D Perry.
Factors related to corneal epithelial complications after closed vitrectomy in diabetics.
In a series of 30 vitrectomy patients, postoperative corneal complications developed in 14 (47%). Thirteen (92%) of the 14 patients with complications were diabetic. Other factors that were positively correlated with the development of corneal complications included decreased corneal sensitivity, intraoperative lensectomy, and intraoperative epithelial debridement. The corneal complications involved the epithelium in 11 (78%) of the 14 complicated cases, with involvement of the endothelium (as manifested by stromal edema) in five (35%) cases. The diabetic human corneal epithelium contains considerable levels of sorbitol and fructose, which indicates the probable presence of the sorbitol pathway. As in the lens, this pathway may lead to osmotic changes that make the diabetic corneal epithelium more vulnerable to damage intraoperatively. Postoperatively, reepithelialization is delayed because of a probable failure of adhesion of cells to the underlying basement membrane.
Cornea↗
Schirmer test after topical anesthesia and the tear meniscus height in normal eyes.
The height of the inferior tear meniscus was measured in 86 normal eyes. A value greater than 0.1 mm was obtained in 93% of the eyes that were studied. However, attempts to correlate meniscus height with subsequent Schirmer test results showed that these measurements varied randomly. Schirmer tests that were conducted on 265 eyes without instillation of 0.5% proparacaine hydrochloride and on 466 eyes with proparacaine showed that topical anesthesia reduced mean test values by 40%. When proparacaine was used prior to testing, no decrease in tear production with advancing age was demonstrated, nor were results significantly different in males and females. Schirmer test values, ranging from 0 to 3 mm, were obtained in 15% of the normal volunteers when the test was performed after instillation of topical anesthesia and after blotting of the tear lake from the inferior cul-de-sac.
Adult↗
Iris involvement in granulocytic sarcoma.
A 6-year-old boy with a diagnosis of acute myeoblastic leukemia in remission developed iris infiltration accompanied by uveitis, hypopyon, and vitreous hemorrhage, which was initially unilateral, later becoming bilateral. Pathologically, the eyes showed leukemic infiltrates in the conjunctiva, episclera, sclera, ciliary body, trabecular meshwork, canal of Schlemm, choroid, vitreous, and the iris. Leder stain studies showed positive esterase activity, indicating granulocytic sarcoma. Granulocytic sarcoma may appear intraocularly as iris nodules. These iris nodules may be the initial manifestation of granulocytic leukemia.
Antineoplastic Agents↗
Oversize corneal donor grafts in penetrating keratoplasty.
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Aged↗
Reversible blindness in optic neuritis associated with influenza vaccination.
A patient is reported in whom bilateral optic neuritis developed following an influenza vaccination. From complete blindness (absence of light perception) in one eye, the patient's vision returned to normal following steroid treatment.
Blindness↗
Sustained release of BCNU for the treatment of intraocular malignancies in animal models.
Sustained release of 1,3-bis(2)chloroethyl)-1-nitrosourea (BCNU) via an episcleral implanted silicone device was used to treat Brown-Pearce epithelioma in the anterior chamber of rabbit eyes. One group of test eyes received BCNU dissolved in sesame oil; a second group received BCNU in pure ethanol. Control eyes received only the diluent, sesame oil or pure ethanol. The effectiveness of the various dosages and diluents was compared by clinical observation, by weight of the enucleated eyes, and by histopathologic examination. Sustained release of BCNU via an episcleral implanted silicone device delayed the growth of Brown-Pearce epithelioma in rabbit eyes of both test groups. The most effective action resulted from administration of BCNU in pure ethanol.
Animals↗
An illuminated grid for macular testing.
The status of the macula should be included in the preoperative evaluation of patients about to undergo keratoplasty or cataract extraction. Frequently, corneal opacities or cataracts preclude visualization of macular details. In such cases, the Amsler grid is useful in assessing macular function. This study evaluated 15 patients with opaque media. In 13 patients, the opacity was too dense to allow the patient to see the Amsler grid. However, all 13 patients could see the illuminated version of the grid. Of the three abnormal responses detected by the use of the illuminated grid, two were caused by macular pathology and one by amblyopia.
Adult↗
Cysticercosis of the eyelid.
A 14-year-old girl had a four-month history of a painless, enlarging mass in the right upper eyelid. Histopathologic examination revealed the cystic mass to be Cysticercus cellulosae, the larval form of Taenia solium. This patient had been in Vietnam and Laos several years previously and, while there, developed a flu-like syndrome. Despite the fact that she was asymptomatic for the two years preceding her clinical examination, the histopathologic diagnosis of C cellulosae prompted an extensive medical and neurologic work-up to rule out the possibility that the patient harbored the adult tapeworm or other larval forms. Fortunately, the results of this survey were negative.
Adolescent↗
Corneal complications after closed vitrectomy through the pars plana.
A retrospective study of 150 patients who underwent closed vitrectomy through the pars plana evaluated the incidence and character of postoperative corneal complications. Corneal changes developed in 43% of patients. Thirty patients had significant corneal complications, half of which resolved with treatment. Fourteen patients had complications that necessitated corneal surgery or resulted in loss of useful vision. Diabetic patients were at greatest risk for corneal problems, particularly postoperative epithelial defects. Intraoperative lensectomy was the only other factor that increased the corneal complication rate. The importance of early recognition and therapy for corneal changes after vitrectomy becomes apparent.
Corneal Diseases↗
Corneal donor material selection.
Histologic study of eyes used as donor material for corneal transplant revealed one instance of massive leukemic infiltration with leukemic keratic precipitates on the fellow eye. In another eye, microabscesses composed of acute and chronic inflammatory cells containing Crytococcus neoformans were present. In a third patient metastatic anaplastic cells were present in the choroid. We think donor eyes are absolutely unacceptable if death was caused by any chronic neurologic disorder, unless clearly secondary to trauma. Eyes from patients with septecimia, hepatitis, jaundice and any evidence of any active viral infection, syphilis, and positive serology are also unacceptable. Extreme caution should be used in selecting eyes of patients with ocular or systemic malignancy, long-term diseases, particularly if immunosuppressive agents were used, where a history of eye disease exists, including corneal disease or dystrophy, iritis, absolute glaucoma or acute glaucoma, and eyes with a history of previous intraocular surgery.
Bacterial Infections↗
Direct delivery of anticancer agents: experimental treatment of intraocular malignancy.
Two anticancer agents, one lipophilic, 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU), and one hydrophilic, 5-(3,3-dimethyl-1-triazeno) imidazol-4-carboxamide (DTIC), were used to treat Brown-Pearce epithelioma in the anterior chamber of rabbit eyes. The BCNU test animals were divided into three groups: one treated by direct injection of the drug into the subconjuntival space or the anterior chamber, the second by both direct injections and intravenous administration, and the third by intravenous injection alone. The DTIC test animals were treated with only local injection into the subconjunctival space or anterior chamber. Dosage, delivery system, and effectiveness were compared following clinical observation and histopathologic examination. Direct delivery of BCNU or DTIC in subconjuntival space or anterior chamber delayed the growth of Brown-Pearce epithelioma in rabbit eye. The effectiveness of this treatment was significnatly enhanced by combining direct injection with systemic administration of a lower dose of BCNU.
Animals↗
Hemorrhage from isolated aneurysm of a retinal artery: report of two cases simulating malignant melanoma.
Isolated retinal arterial aneurysms or macroaneurysms of the retinal arteries may be the cause of hemorrhage in the retina or vitreous. Two cases are reported in which hemorrhages from isolated retinal arterial aneurysms clinically simulated malignant melanoma of the choroid. Previous studies of lesions simulating malignant melanoma of the uvea have shown that vitreous and retinal hemorrhage may easily mislead the clinician. It is stressed that careful prolonged observation does not materially decrease the patient's chance for survival if he does have a malignant melanoma and may prevent an unnecessary enucleation.
Aged↗
Chorioretinitis sclopetaria: choroidal and retinal concussion injury from a bullet.
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Adult↗
Cilioretinal artery occlusion associated with oral contraceptives.
Visual acuity in a 17-year-old girl who took norethindrone with mestranol (Ortho-Novum) for eight months decreased to 6/9 (20/30) in the left eye. Ophthalmoscopically, retinal edema was temporal to the disk and white plaques were in each of two branches of cilioretinal artery. A superior centrocecal scotoma corresponding to the area of edema was present. After the patient discontinued use of the drug, visual acuity improved to 6/6 (20/20).
Adolescent↗
Clinical and histopathologic observations in severe Vogt-Koyanagi-Harada syndrome.
Vogt-Koyanagi (V-K) syndrome is a severe anterior uveitis associated with alopecia, vitiligo, poliosis, and dysacousia. Harada's disease (HD) is primarily a posterior uveitis accompanied by signs of meningeal irritation and abnormalities of the cerebrospinal fluid. The overlapping of clinical manifestations between the two justified considering them as part of a spectrum of one disease (V-K-H). In a clinicopathologic study of nine cases four patients (three with V-K syndrome and one with V-K-H syndrome) histopathologically displayed a granulomatous uveitis. Five patients (two with V-K syndrome and three with HD) showed a nongranulomatous uveitis. We emphasized this latter finding, since in the past the diagnosis of this syndrome has been discarded both clinically and histopathologically because of the absence of a granulomatous uveitis. We established the clinical and histopathologic differences between V-K-H and sympathetic ophthalmia. The designation "uveomeningoencephalitic syndrome" stresses the key features of V-K-H, namely the uveal involvement and signs of meningeal irritation (that is, headaches, personality changes, and cerebrospinal fluid alterations).
Adult↗
Fluorescein pattern of the choriocapillaris in the neonatal rhesus monkey.
Seven neonatal rhesus monkeys were studied by serial fundus photography and fluorescein angiography at weekly intervals during the first 12 weeks of life. The neonatal rhesus showed little pigmentation of the fundus during the first six weeks of life. The fluorescein angiograms showed a definite sequential as well as segmental filling pattern at the level of the choriocapillaris. This filling pattern was based on individual units called lobules. In addition there was a segmental flow in the macula; that is, the nasal macula filled before the temporal macula.
Animals↗
Malignant melanoma of the choroid associated with spontaneous expulsive choroidal hemorrhage.
A 79-year-old man initially had a perforated corneal ulcer of his blind right eye. The next day a spontaneous expulsive choroidal hemorrhage occurred just before scheduled enucleation. Histopathologic examination of the enucleated eye revealed a severe necrosis of several posterior ciliary arteries in the expulsive choroidal hemorrhage, as well as a large occult spindle B malignant melanoma of the choroid. The necrosis of the posterior ciliary arteries may have been the cause of the choroidal hemorrhage. The finding of an occult malignant melanoma may be more than a chance occurrence of two unrelated events, inasmuch as both are associated with necrosis of the posterior ciliary arteries.
Aged↗