Biomedical subjects
H W Climenhaga
Publications and source records attributed to H W Climenhaga.
Autosomal dominant keratitis: a possible aniridia variant.
OBJECTIVE: To describe the findings in a family with hereditary keratitis. DESIGN: Case series. SETTING: Eye genetics clinic at a university-affiliated hospital in Edmonton. PATIENTS: Fifteen affected members, nine female and six male, of a four-generation family with hereditary keratitis. RESULTS: The pattern of transmission was consistent with autosomal dominant inheritance. The disorder was characterized by the presence of a circumferential band of opacification and vascularization at the level of Bowman's membrane adjacent to the limbus. Progression toward the central cornea occurred in some instances. Penetrating keratoplasty was performed in certain cases when the visual axis was involved and the acuity deteriorated. Histopathological studies confirmed the inflammatory nature and the anterior stromal localization of the keratitis. Thirteen of the affected members in whom a detailed fundus examination was possible had macular hypoplasia. Several had abnormalities of the iris, including iris stromal defects and ectropion uveae. CONCLUSIONS: The presence of macular hypoplasia in association with the iris and corneal changes suggests that autosomal dominant keratitis is likely a variant of aniridia.
Adjustable sutures: experimental assessment of final muscle position.
The likelihood of forward "creep" of muscles recessed with the use of adjustable loops of suture in the correction of strabismus was investigated. Twelve orthotropic dogs underwent both regular and loop recessions of the lateral and medial rectus muscles; the data for two of the dogs were excluded because of loss of muscles. Three months later it was found that in the majority of cases the recessed muscles had minimally advanced from the position of surgical placement. Although the type of recession made little difference to the results, the mean forward creep was much greater for the medial rectus muscles (1.55 +/- 0.68 mm [p less than 0.01] and 2.00 +/- 2.44 mm [p = 0.09] for those undergoing regular and loop recessions respectively) than for the lateral rectus muscles (0.35 +/- 0.58 mm and 0.60 +/- 0.62 mm respectively). During the operations the amount of contraction of the medial rectus muscle had been noted to vary. It is likely that in some instances the tension on the suture loops was insufficient to hold them taut, and the muscles therefore adhered to the sclera at variable sites. Hence, adequate intrinsic muscle tone may be important for predictable clinical results of loop recession.