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Biomedical subjects

H H Tessler

Publications and source records attributed to H H Tessler.

At least 19 recordsLinked to original sources
PubMed1992

High incidence of sympathetic ophthalmia after contact and noncontact neodymium:YAG cyclotherapy.

BACKGROUND: Two cases of sympathetic ophthalmia occurring after noncontact neodymium:YAG (Nd:YAG) cyclotherapy have previously been reported. In each case, the patient had undergone filtering surgery in the exciting eye. Although in each case Nd:YAG cyclotherapy was the last surgery performed, the inciting event of sympathetic ophthalmia was unclear. METHODS: The authors studied three additional patients who developed sympathetic ophthalmia after Nd:YAG cyclotherapy for glaucoma. RESULTS: Two patients developed sympathetic ophthalmia 4 months after noncontact Nd:YAG cyclotherapy, and 1 patient developed sympathetic ophthalmia 18 months after contact Nd:YAG cyclotherapy. All patients had previous cataract extractions but no filtering surgery in the exciting eye. Clinical features included chronic iridocyclitis, choroidal folds, Dalen-Fuchs nodules, and optic disc edema. Combining these cases with the two previously reported cases, the incidence of sympathetic ophthalmia at our institution thus far is 5.8% (4 of 69) and 0.67% (1 of 150) after noncontact and contact Nd:YAG cyclotherapy, respectively. CONCLUSIONS: The incidence of sympathetic ophthalmia after Nd:YAG cyclotherapy is high compared with other ocular procedures. The clinician should vigilantly monitor patients after Nd:YAG cyclotherapy and report additional cases that may have occurred at other institutions.

Aged↗
PubMed1991

Anterior granulomatous uveitis in patients with multiple sclerosis.

Granulomatous uveitis has infrequently been described as a manifestation of the autoimmune phenomena of multiple sclerosis (MS). The authors describe six cases of anterior granulomatous uveitis in patients with MS. All six patients had features of iridocyclitis and three patients had features of periphlebitis, which were suggestive of granulomatous disease. However, each patient had neurologic symptoms and signs consistent with MS and a negative laboratory workup for sarcoidosis, tuberculosis, and syphilis. Testing for MS in a subgroup of patients with granulomatous uveitis of unknown etiology and neurologic symptoms may result in a diagnosis.

Adolescent↗
PubMed1991

Clinical course of multifocal choroiditis: photographic and angiographic evidence of disease recurrence.

Multifocal choroiditis is a syndrome that simulates the presumed ocular histoplasmosis syndrome but, in addition, includes vitritis and anterior uveitis. Because of its relatively recent acceptance as a distinct clinical entity, there is little information available on the long-term natural history of this condition. We managed three cases of multifocal choroiditis with recurrent active inflammation. Two patients had new peripheral chorioretinal lesions in previously normal retina, and the other had both peripheral chorioretinal scars and new swelling of the disc.

Adult↗
PubMed1990

High-dose short-term chlorambucil for intractable sympathetic ophthalmia and Behçet's disease.

We treated five patients with intractable sympathetic ophthalmia and six patients with severe Behçet's disease by high-dose, short-term chlorambucil therapy. We used a total dose ranging from 306 mg to 4.2 g and a duration of therapy no longer than 36 weeks and in most cases less than 24 weeks. After termination of therapy all 11 patients had a sustained remission of their eye disease. Unless subretinal neovascularisation was present, all had a final visual acuity of 20/50 or better. Malignancy has not developed in any of our cases, with a follow-up ranging from 6 months to 12 years (mean, 4.5 years). Although 30- and 40-year follow-ups and larger numbers of patients may be necessary fully to realise the risks of chlorambucil, we believe that our high-dose, short-term regimen (Behçet's disease: average duration, 23 weeks; average total dose 2.2 g; sympathetic ophthalmia: average duration, 11 weeks; total average dose, 0.9 g) may be safer than previously reported chlorambucil regimens of one to two years or longer. In addition we fulfilled our aim of discontinuing all concomitant systemic corticosteroids within a relatively short time (usually six to eight weeks).

Adolescent↗
PubMed1990

Sympathetic ophthalmia and subretinal neovascularization.

We report a case of sympathetic ophthalmia with subretinal neovascularization of the macula. The subretinal neovascularization developed after penetrating trauma to the fellow eye. The occurrence of subretinal neovascularization in sympathetic ophthalmia is not surprising since disintegrative changes and breaks in Bruch's membrane have been reported in sympathetic ophthalmia. Subretinal neovascularization has also been reported in Vogt-Koyanagi-Harada syndrome, which is histopathologically similar to sympathetic ophthalmia.

Adolescent↗
PubMed1989

Twenty cases of sympathetic ophthalmia.

We reviewed the charts of 20 patients with sympathetic ophthalmia who were seen in the uveitis clinic at the Eye and Ear Infirmary within an 11-year period. Of these 20 patients 14 maintained 20/50 or better visual acuity in at least one eye. We found early enucleation to be associated with a better visual prognosis, possibly due to earlier diagnosis and faster, more aggressive therapy rather than a reduction in antigenic load. The clinical appearance of Dalen-Fuchs nodules appears to indicate a more severe stage of disease. Chlorambucil was useful in patients with severe disease. To be effective and to lessen its side effects chlorambucil was given in daily dosages that were increased weekly over a short period to achieve bone marrow suppression. After a course of chlorambucil therapy intraocular inflammation could be controlled with topical steroids alone.

Adolescent↗
PubMed1989

Sympathetic ophthalmia following neodymium:YAG cyclotherapy.

Neodymium:YAG cyclotherapy has been demonstrated to lower intraocular pressure dramatically in patients with uncontrolled glaucoma, with potentially fewer side-effects than cyclocryotherapy. We report the clinical course and histopathological features of a case of sympathetic ophthalmia occurring soon after YAG cyclotherapy.

Adult↗
PubMed1988

Fuchs' heterochromic iridocyclitis in blacks.

Fuchs' heterochromic iridocyclitis (FHI) is a frequently overlooked cause of anterior uveitis. Improper diagnosis may lead to unnecessary therapy. Dark brown irides may demonstrate heterochromia poorly. We believe that FHI may be overlooked in blacks because of a frequent lack of obvious heterochromia and the frequent presence of iris nodules. Heterochromia is not necessary for the diagnosis of FHI if other clinical features of the syndrome are present. In our series of 54 whites and 13 blacks with FHI, heterochromia occurred in 50 (92%) whites and ten (76%) blacks (nonsignificant difference). Iris nodules occurred in 11 (20%) whites and four (30%) blacks (not significant). Statistically significant differences occurred with cataract/aphakia in 41 (75%) whites and three (23%) blacks and with glaucoma in six (11%) whites and five (38%) blacks.

Age Factors↗
PubMed1988

Posterior sub-Tenon's injections of corticosteroids in uveitis patients with cystoid macular edema.

Cystoid macular edema (CME) is a major cause of visual impairment and is thought to be due to abnormal perifoveal capillary permeability. Posterior sub-Tenon's corticosteroid injections are used to improve the visual acuity in CME, although their mechanism of action is uncertain. In this study, visual acuity, blood retinal barrier (BRB) permeability, and fluorescein angiograms were recorded immediately before and one and four weeks after the administration of steroid injections. Ten patients (12 treated eyes) with CME secondary to uveitis were studied. Visual improvement, defined as an increase in at least two lines of Snellen visual acuity, was seen in half of the treated eyes. In some patients, these improvements were not directly related to changes in the BRB permeability or the amount of macular fluid. Posterior sub-Tenon's corticosteroid injections do not consistently affect blood retinal barrier permeability.

Adolescent↗
PubMed1979

Bilateral cytomegalovirus panuveitis after high-dose corticosteroid therapy.

A 30-year-old previously healthy woman who recieved immunosuppressive doses of corticosteroids developed an unusual culture-proved cytomegalovirus panuveitis bilaterally. The atypical clinical course was marked by bilateral exudative detachements with minimal evidence of retinitis. Any patient receiving blood transfusions and immunosuppressive doses of corticosteroids is potentially at risk for developing ocular cytomegalovirus infection, and the clinical presentation of the ocular infection may be atypical.

Adult↗
PubMed1978

Behcet syndrome: with immunologic evaluation.

A case of Behcet syndrome with immunologic evaluation, including screening of a vulvar ulcer for IgG, IgM, IgA, and fibrinogen by direct fluorescent microscopy is presented. Attempts were made to demonstrate cellular and humoral immune responses to mucosal antigens by lymphoblast transformation in the presence of cadaver esophageal mucosal extracts and indirect immunofluorescence using autologous serum and mucosal tissue. Serial measurements of percentages of total T, active T, and B lymphocyte populations, and lymphocyte response to phytohemagglutinin (PHA) stimulation during the course of Behcet syndrome are also presented. Clinical evaluation, histology of a Behcet vulvar ulcer, and a 2-year followup with good response to chlorambucil are reviewed.

Adult↗
PubMed1976

Serum lysozyme in sarcoid uveitis.

In a study of 100 patients, the mean serum lysozyme value for patients with sarcoidosis and active uveitis was elevated, while the mean value for patients with inactive sarcoidosis and inactive uveitis was within the normal range. The mean value for patients with a clinical picture of sarcoid uveitis, but without an established diagnosis of sarcoidosis, was high. In patients with ophthalmologic findings compatible with sarcoidosis, but without radiologic, immunologic, or other clinical evidence of the disease, an elevated serum lysozyme level may be indicative of sytemic disease.

Clinical Enzyme Tests↗
PubMed1976

Intraocular lysozyme in experimental uveitis in rabbits: aqueous and vitreous assay.

We determined normal aqueous and vitreous lysozyme levels in rabbit eyes and induced experimental uveitis to record the uppermost aqueous and vitreous lysozyme levels. The normal aqueous humor of the rabbit eye contained 1.05 mug per milliliter lysozyme and the normal vitreous humor contained 0.45 mug per milliliter. After the intravitreal administration of a foreign protein, the aqueous and vitreous lysozyme levels rose within one day, reaching maximum values of 38.4 mug per milliliter and 114 mug per milliliter, respectively, at 14 days, and subsequently declining to minimal values by 28 days after injection.

Albumins↗