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Biomedical subjects

H W Skalka

Publications and source records attributed to H W Skalka.

14 recordsLinked to original sources

Hereditary pigmented paravenous retinochoroidal atrophy.

A father and son with pigmented paravenous retinochoroidal atrophy demonstrated the classical fundus appearance of bilateral sharply circumscribed patches of retinochoroidal atrophy and pigmentation along the retinal veins. Our patients, and the preponderance of males in previously reported cases of this disease, suggest the possibility of Y-chromosome mediated male-to-male transmission. Electrophysiologic findings in our patients included elevated dark-adaptation thresholds, slightly reduced electroretinographic amplitudes, slightly prolonged a- and b-wave implicit times, and (in Case 1) abnormal electro-oculographic ratios. These findings indicate a diffuse tapetoretinal degeneration, and suggest that pigmented paravenous retinochoroidal atrophy is another incomplete form of retinitis pigmentosa.

Adolescent

Asymmetric retinitis pigmentosa, luetic retinopathy and the question of unilateral retinitis pigmentosa.

A seropositive patient with the fundus appearance of monocular luetic retinopathy is presented. Electrophysiologically, this patient shows a late-onset form of progressive tapetoretinal degeneration (retinitis pigmentosa) presenting in an extremely asymmetric manner. The differential diagnosis of luetic and other inflammatory retinopathies vs. tapetoretinal degenerations is briefly discussed. Features distinguishing unilateral retinitis pigmentosa from bilateral tapetoretinal degenerations are reviewed, and the existence of unilateral retinitis pigmentosa as a genetic entity is questioned. Prolongation of ERG- a- and b-wave implicit times is characteristic of the tapetoretinal degenerations, and normal implicit times in the fellow eye are suggested as an additional criterion for the diagnosis of unilateral retinitis pigmentosa.

Dark Adaptation

"Congenital" hematic cyst of the orbit.

A case of true hematic cyst of the orbit in a 10-year-old girl, apparently resulting from birth trauma, is presented. Ultrasonic and clinical features believed to aid the examiner in correctly diagnosing such a lesion are presented. While apparently unique among reported cases, "congenital" hematic cysts of the orbit undoubtedly occur occasionally and the possibility of this entity should be considered in appropriate circumstances.

Birth Injuries

Ultrasonically-aided percutaneous orbital aspiration.

Ultrasonography is the most effective diagnostic modality for locating and delimiting cystic orbital lesions, and may often provide an accurate tissue diagnosis. A case is presented demonstrating the ability of ultrasonography to aid in the percutaneous aspiration of selected orbital cystic lesions.

Adolescent

Association of presenile cataracts with heterozygosity for galactosaemic states and with riboflavin deficiency.

Red cells and the lens of the eye are non-nucleated cells; moreover, they have metabolic similarities. Cataracts develop in childhood in homozygotes for galactosaemic abnormalities, which can be detected by biochemical measurements in red blood-cells. It has not been determined whether heterozygotes for these defects are at greater risk for cataract development later in life. Similarly, riboflavin deficiecy for which the erythrocyte is a sensitive indicator, has been associated with cataracts in animals. Red-cell studies were carried out in 22 patients, aged under 50, with cataracts. Heterozygosity for galactokinase deficiency was detected in 5 patients, for galactose-uridyl transferase in 2, and evidence of an erythrocytic deficiency of riboflavin in 8. Even when Black subjects were excluded from analysis because of their high incidence of polymorphism for galactokinase, these findings are significantly different from those expected from population surveys and suggest that many patients with presenile cataracts have a biochemical abnormality which can be detected by examination of red blood-cells and which may be corrected by dietary restrictions or supplements.

Adolescent

Perineural optic nerve changes in endocrine orbitopathy.

A-scan ultrasonographic measurements of the differences between nerve and dural diameters of the retrobulbar optic nerve were made in 55 eyes of 30 patients with endocrine orbitopathy. This measurement was found to be enlarged in all cases. Extraocular muscle thickness measurements were also made ultrasonically in these eyes, and the degree of intervaginal distension was found to increase with increasing extraocular muscle involvement. These findings were consistent whether the patients were hyperthyroid, hypothyroid, or euthyroid clinically, and the findings occurred in the absence of any detectable functional optic nerve compromise. The cause of this subdural perineural enlargement remains unknown.

Adult

Neural and dural optic nerve measurements with A-scan ultrasonography.

Ultrasonography has been shown to be of great value in studying drusen, cupping, and elevation of the optic disk, as well as mass lesions of the orbital optic nerve. We have found A-scan ultrasonography to be an accurate and simple method of measuring both the diameter of the retrobulbar optic nerve and the size of the subdural perineural space. We have found the intervaginal space of the retrobulbar optic nerve to be uniformly enlarged in papilledema, optic nerve lesions, and endocrine orbitopathy.

Humans

Recurrent hemorrhage in traumatic hyphema.

A retrospective review of hospital records reveals that over 90% of recurrent bleeds in traumatic hyphema occur at night. It is postulated that rapid eye movement (REM) sleep, with its displays of saccadic virtuosity, is the major reason for the nocturnal prevalence of such recurrent hyphemas. Theoretical considerations suggesting a more rational therapy of traumatic hyphema are presented and clinical trials are suggested.

Adolescent

Ultrasonic diagnosis of posterior lens rupture.

A case of ultrasonically-diagnosed posterior lens capsule rupture, confirmed at surgery, is presented. The A-scan and contact B-scan findings enabling the diagnosis to be made are presented. The ability to make such a preoperative determination allows for the planning of more rational therapy, and should help improve the final visual results in such cases.

Adult

Ultrasonography in foreign body detection and localization.

The relative advantages and disadvantages of radiographic and ultrasonic studies in foreign body detection and localization are discussed. The value of ultrasonography in finding radiolucent orbital foreign bodies and its clear superiority in the localization of foreign bodies with respect to the walls of the eye is demonstrated by several examples. The information concerning the state of the lens, vitreous, and retina in such traumatized eyes which is obtained by ultrasonography represents a very important additional benefit of such study.

Eye Foreign Bodies

Macular cysts and holes.

The ocular findings in an eight-year-old Negro male with unilateral axial myopia and bilateral macular cysts and holes are presented. Normal psychophysical, electrophysiologic, and angiographic findings were noted despite obvious anatomic changes. The constellation of observed findings in this patient appears to be unique.

Amblyopia