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Biomedical subjects

H M Lambert

Publications and source records attributed to H M Lambert.

48 records · Page 3Linked to original sources

Choroidal malignant melanoma with early vitreous seeding.

Primary choroidal malignant melanoma with extension through the overlying retina is a rarely reported entity, and to our knowledge actual seeding of the vitreous has never been reported. The pathologic findings in a 41-year-old woman who presented with a large amelanotic subretinal mass near the optic disc of the right eye are discussed. Fundus examination preoperatively revealed a concentration of discrete, fleshy, oval to round, vitreous bodies of varying size, limited to the area overlying the mass. Histopathology of this tumor revealed a spindle cell posterior choroidal melanoma with marked atrophy of the overlying retina. At the apex, the retina was discontinuous and melanoma cells extended into the overlying vitreous. Some of the cells surrounded asteroid bodies overlying the tumor, altering their clinical appearance. This behavior, while only involving a small fraction of the tumor cells, may imply a more aggressive tumor.

Adult↗

Linear nevus sebaceous syndrome.

The linear nevus sebaceous syndrome is a rare disorder first described in 1962 in two cases by Feuerstein and Mims. As originally described, it consisted of the triad of the characteristic midline facial linear nevus sebaceous of Jadassohn, seizures, and mental retardation. The authors have followed a patient with this syndrome from birth to age 8 and although he does demonstrate several neurologic and ocular abnormalities, he enjoys normal intelligence and has never suffered seizures. The features of this syndrome and several new ocular findings demonstrated in this case are described. Based on our long-term follow-up of this patient and our review of the reported cases to date, the authors suggest that the triad for this disorder should be changed to include the midline facial linear nevus sebaceous of Jadassohn, neurologic abnormalities which may, but not necessarily, include seizures and mental retardation, and ophthalmologic abnormalities.

Arachnoid↗

Air travel and intraocular gas.

The safety of air travel for persons with intraocular gas after ocular surgery has been in question since the mid 1970s, when the use of intraocular gases after vitrectomy became widespread. After vitrectomy, air-fluid exchange was performed on six Rhesus monkeys. During simulated air travel in an altitude chamber, intraocular pressure rose an average of 42 mmHg with intraocular air volumes as small as 0.25 cc. Hypotony was observed after return to ground level in all cases. Transient central retinal artery occlusion and pupillary block was observed. Patient safety and comfort is endangered during air travel with very small volumes of intraocular gas.

Aircraft↗

Recurrent proliferations in macular pucker, diabetic retinopathy, and retrolental fibroplasialike disease after vitrectomy.

The clinical and ultrastructural details of recurrent epiretinal and transvitreal membranes from patients with macular pucker, diabetes mellitus, and a retrolental fibroplasialike disease are presented. The membranes were characterized ultrastructurally by the presence of reactive glia and moderate amounts of collagen in the extracellular matrix. Many of the cells in the recurrent membranes showed myofibroblastlike differentiation. Recurrence of transvitreal membranes in a previously vitrectomized eye may be explained by spontaneous detachment of contracting epiretinal membranes.

Adult↗

Intraocular foreign body from a nylon line grass trimmer.

Nylon line grass trimmers are commonplace in America's lawn armamentarium. As their number has increased, so has the potential for ocular injury from objects thrown from these tools. A patient of ours was injured by an intraocular piece of nylon line thrown from one of these tools. The patient required removal of the foreign body, lensectomy, and anterior vitrectomy to rehabilitate her eye. This report again demonstrates the need for eye protection when using any type of lawn equipment. We think manufacturers of these products should label them to show that eye protection is necessary for the safe use of these tools.

Accidents, Home↗

Autosomal dominant preretinal vascular loops.

Preretinal vascular loops are a congenital malformation usually occurring in otherwise normal fundi. These anomalies consist of vessels, most commonly arteries, that spiral into the vitreous and return to the otherwise normal retinal vascular system. The authors present two members of a family with preretinal vascular loops and two members with other vascular anomalies. The inheritance pattern in this group is autosomal dominant.

Adult↗

Perfluoro-N-octane (PFO) in the repair of complicated retinal detachments due to severe proliferative diabetic retinopathy.

PURPOSE: To report our experience with perfluoro-N-octane (PFO) in the surgical management of complicated retinal detachments due to proliferative diabetic retinopathy. METHODS: Retrospective review of 18 consecutive eyes of 18 patients with tractional or combined tractional and rhegmatogenous retinal detachments due to severe proliferative diabetic retinopathy managed by pars plana vitrectomy and the intraoperative use of PFO. Preoperative characteristics, intraoperative findings and procedures and postoperative results were recorded. RESULTS: The mean preoperative acuity was 2/200 (range, 20/25 to light perception). The mean final visual acuity was 4/200 (range, 20/20 to no light perception). With a mean follow-up of 6 months, there was an 89% anatomic reattachment rate at the last visit and visual acuity was stable or improved in 72% of eyes. CONCLUSIONS: In our experience, PFO is a helpful surgical adjunct in the anatomic reattachment of tractional or combined tractional and rhegmatogenous diabetic retinal detachments. Visual acuity was stabilized or improved in the majority of eyes.

Adult↗

Tissue plasminogen activator in the surgical excision of subfoveal choroidal neovascular membranes.

We investigated the use of tissue plasminogen activator (t-PA) as an adjunct to the surgical removal of subfoveal choroidal neovascular membranes. t-PA in a concentration of 6 micrograms/0.1 cc dissolved the fibrin rim surrounding recent subfoveal membranes but was less effective on more mature lesions. t-PA may be a useful intraoperative tool to limit the damage to surrounding structures during the surgical excision of recent subfoveal choroidal neovascular membranes with surrounding fibrin rims.

Adult↗