Biomedical subjects
Publications and source records attributed to I Nawratzki.
Fifteen patients with juvenile macular degeneration fitted with low-vision aids were followed up for a period of two to three years. About 80% of the patients equipped with visual aids used their devices successfully. It appears that in Stargardt's disease, low-vision aids are more useful than in other maculopathies.
Abnormalities in the zinc and copper metabolism have been described in some pigmentary retinopathies. In these eye disorders changes in the Retinal Pigment Epithelium are a common finding. Albinism is a manifestation of a metabolic disorder with abnormalities of pigment formation which also occurs in this mentioned retinal layer. Recently, we described abnormalities in the metabolism of these metals in black albino patients. In them, elevated values of ceruloplasmin were found. In the present study we performed a similar work among Caucasians. When both the Caucasian albino and control groups were compared, no statistical difference in the ceruloplasmin, serum zinc and copper and their concentration in urine was present. However, in 7 patients of the Caucasian albino group the serum zinc was distinctly elevated. The mean concentration of ceruloplasmin was high as well. No definitive correlation in regard to the positivity or negativity of tyrosinase was observed. Our findings may support our previous observations regarding albinism as a possible primary abnormality of zinc and copper metabolism.
A ten-year-old autistic boy with high myopia and very poor vision presented a bilateral anomaly of the disc, diagnosed as morning glory syndrome. Further investigation showed an absence of the corpus callosum and probably herniation of an encephalocele into the third ventricle. The association of bilateral morning glory syndrome and very low visual acuity in both eyes with a midline brain lesion and autism has not been previously described.
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Clinical data of 6 cases of cortical blindness in infancy were analyzed. The underlying brain damage was a result of hypoxic events occurring in the pre- or perinatal period, or shortly after birth. The long-term follow-up of the children showed that some visual recovery occurred but capacity of recognition remained impaired. Early diagnosis of this entity and adequate education will help the visual and psychomotor development of the child.
We evaluated the refraction of 198 children born prematurely with birth-weights of 2,000 g or less, without any ocular disease. Between the ages of 6 months to 3 1/2 years these children had a mild hypermetropia. The refractive error did not change between the ages of 6 months and 3 1/2 years. The refraction of the prematurely born children was similar to that found in children born at full term.
Transposition of vertical muscles for residual tropia was performed: nasal displacement for exotropia and temporal displacement for esotropia. Five millimeter equal displacement of superior and inferior recti corrected 10 to 14 prism diopter while equal displacement of 7 to 8 mm resulted in correction of 25 prism diopter. Special indications of this procedure may be: (1) residual tropia in cases with severe intractable ambylopia or pathology in one eye where patient and surgeon may be reluctant to operate on the sound eye, or (2) residual tropias of the alternating type in patients who underwent operations in all horizontal muscles of both eyes.
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Penalization therapy for strabismic amblyopia is indicated in the group over six years of age. Good visual acuity of 6/12 or better was achieved and maintained at least for two years in 74% of the 38 cases reported. Deep amblyopia of 6/60 or less is no contraindication to treatment, success being achieved in 50% of this group. It seems that previous occlusion treatment diminishes the rate of success. Close supervision during the treatment is mandatory to assure the desired use of the amblyopic eye.
Sixteen patients with ocular criteria of Leber congenital amaurosis (LCA) were studied. Neurological examination was normal in 11 of 16 patients. The electroencephalogram was normal in six of eight patients, while two had nonspecific theta slowing. Computerized tomography of the brain was normal in two of five; hypoplasia of the cerebellar vermis was seen in one, and mild to moderate ventriculomegaly was seen in two of five. Six patients underwent the verbal subtests of the Wechsler Intelligence Scale and a detailed battery of neuropsychological tests. Subtests dependent on early environmental influences were most severely affected, while culture-free subtests showed average or well above average performance. These results strongly support the hypothesis that children with LCA may be capable of normal cognitive functioning, although they perform poorly on standard IQ tests. This is related to their early environmental and sensory deprivation, rather than to a primary central nervous system dysfunction.
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