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Biomedical subjects

J B Michelson

Publications and source records attributed to J B Michelson.

At least 19 recordsLinked to original sources
PubMed1990

Lens implant surgery in pars planitis.

Intraocular lens (IOL) implantation is usually contraindicated in eyes with active inflammation, but patients with "burned-out" pars planitis also may be considered as candidates. Fifteen of 16 eyes in eight patients underwent extracapsular cataract extraction (ECCE) with posterior chamber IOL (PC IOL) implantation combined with pars plana vitrectomy for both cataracts and chronic cystoid macular edema (CME); 60% achieved visual acuity of 20/40 or better. Even with "low-grade" inflammation in these patients, however, a persistent veil of debris accumulated over the posterior and anterior surface of the IOL. One patient (patient 2) required 27 YAG procedures for two eyes, and another required 11 YAG procedures and eventual removal of the IOL. Another patient required surgical "brushing-off" of the IOL and vitrectomy. Even in eyes with "burned-out" uveitis, a continual low-grade inflammation may complicate the use of IOL implantation.

Adult↗
PubMed1990

Behçet's disease.

Explore the source record for details and available documents.

Behcet Syndrome↗
PubMed1985

Retinal angiomatosis and pancreatic cysts in von Hippel-Lindau disease: use of computed tomography scanning for diagnosis and surveillance.

Reports of the retinal and pancreatic manifestations of von Hippel-Lindau disease have been previously published. We present a case of von Hippel-Lindau disease in which computed tomography scanning was used in a new manner for diagnosis of retinal disease and for diagnosis and surveillance of pancreatic disease. We emphasize the importance of these new findings and recommend the use of yearly CT scanning of the abdomen. This replaces the previous recommendation of exploratory laparotomy in patients with pancreatic lesions. We further advocate that CT surveillance of the offspring of von Hippel-Lindau disease patients begin in the second decade, with the anticipation of curing potentially serious, blinding, or life-threatening lesions.

Adult↗
PubMed1985

Antibodies to oral mucosa in patients with ocular Behcet's disease.

A method is reported for the identification of cytoplasmic antibodies in patients with Behcet's disease and uveitis. The assay appears positive in at least 80% of patients in an American population with definite or probable Behcet's disease and 60% of patients from a Turkish population with definite Behcet's disease, with a false-positive rate of 6.5% among non-Behcet's ocular inflammatory disorders with vasculitis. When refined, this test may prove useful to the ophthalmologist in selecting out those patients with Behcet's disease from the larger group of patients with uveitis for whom no systemic etiology is identified.

Animals↗
PubMed1983

Juxtapapillary choroiditis associated with chronic meningitis due to Coccidioides immitis.

A 73-year-old man had chronic meningitis of uncertain origin. Ophthalmologic examination revealed juxtapapillary choroiditis with an associated localized serous retinal detachment. Subsequent laboratory evaluation demonstrated absent serum complement-fixing antibody titers to Coccidioides immitis, but serological examination of the CSF demonstrated an antibody titer of 1:2. The final diagnostic impression was that of chronic meningitis in association with juxtapapillary choroiditis due to C immitis.

Aged↗
PubMed1982

Vitrectomy in uveitis associated with ankylosing spondylitis.

Chronic recurrent iridocyclitis in three eyes of two patients with ankylosing spondylitis was associated with posterior spillover of inflammatory cells into the vitreous cavity. Continued inflammation resulted in significant vitreous opacification in all three eyes. After pars plana vitrectomy (two eyes) and cataract extraction with subtotal vitrectomy (one eye), visual acuity improved and stabilized in all three instances. Ocular inflammation was not appreciably exacerbated by surgical intervention. Vitreous opacification did not recur after vitrectomy, but visual improvement was limited because of chronic cystoid macular edema.

Adult↗
PubMed1982

Aspergillus endophthalmitis in a drug abuser.

In a 31-year-old man, metastatic Aspergillus endophthalmitis developed after intravenous cocaine injection. His reluctance to admit to drug abuse resulted in delay of diagnostic and curative vitrectomy. Metastatic osteomyelitis also developed, underscoring the need for careful surveillance for other systemic manifestations of fungemia. We believe this to be the first published case in which useful vision was salvaged in an eye afflicted by metastatic Aspergillus endophthalmitis.

Adult↗
PubMed1981

Ocular reticulum cell sarcoma. Presentation as retinal detachment with demonstration of monoclonal immunoglobulin light chains on the vitreous cells.

A 61-year-old man with a history of cerebral reticulum cell sarcoma-microglioma (histiocytic lymphoma) in remission was initially seen with uveitis and exudative retinal detachment. Pars plana vitreous biopsy established the diagnosis by cytologic findings and allowed the immunofluorescent demonstration of a monoclonal immunoglobulin within the vitreous cells. Direct immunofluorescent microscopy of the vitreous infiltrate may prove to be of benefit in the workup of patients with uveitis in whom malignant lymphoma must be excluded.

Brain Neoplasms↗
PubMed1980

Subretinal neovascular membrane and disciform scar in Behçet's disease.

A 33-year-old woman with a three-year history of aphthous ulceration of the mouth, vaginal ulceration, and erythema nodosum, also had a subretinal neovascular membrane in the left eye. She showed antibodies to guinea pig lip epithelium by indirect immunofluorescence. Thus, Behçet's disease must also be considered in the differential diagnosis of subretinal neovascular membrane in young patients, especially when antibodies to oral mucosa can be shown.

Adult↗
PubMed1979

Experimental endophthalmitis treated with an implantable osmotic minipump.

A rabbit model of endophthalmitis was used to test the efficacy of an osmotic minipump delivery system as compared to standard intravitreal injection of the antibiotic, Staphylococcus aureus was inoculated into the vitreous cavity, and elimination of microorganisms was compared with use of intravitreal administration of 100 micrograms of gentamicin sulfate by either single pars plana injection or the continuous four-day administration of drugs to the vitreous via pars plana tubing connected to the minipump implanted subcutaneously near the rabbit's ear.

Animals↗
PubMed1979

Possible foreign body granuloma of the retina associated with intravenous cocaine addiction.

A 27-year-old man who was a heroin addict had light flashes in front of the right eye and a hemicentral scotoma immediately after intravenous cocaine. The initial ophthalmoscopic appearance was of a white foreign body lying over the papillomacular bundle of the retina in the right eye. This ophthalmoscopic finding was consistent with intraocular talc, cornstarch, or lactose, common diluting agents that are present in intravenous injections of heroin, cocaine, or methylphenidate hydrochloride, and are known to cause systemic embolic phenomena in chronic drug abusers. This glistening crystal on the surface of the retina changed and evolved into a noninfectious but inflammatory organization of retinal granuloma, in which the foreign body crystal could still be visualized at the apex of the lesion. The anterior and posterior segments of the eye remained free of inflammatory signs throughout the course of the organization of the retinal granuloma.

Adult↗
PubMed1979

Lepromatous iridocyclitis diagnosed by anterior chamber paracentesis.

A 34-year-old man with a three-month history of intraocular inflammation after ocular trauma with a fir branch, had an acute unilateral fulminant iridocyclitis. The iris had a thick, gray, cheesy membrane composed of nodular lepromata. The patient denied a history of Hansen's disease, despite the dermatologic and facial features that suggested the diagnosis. Anterior chamber paracentesis and scleral nodule biopsy demonstrated Mycobacterium lepra. The iridocyclitis resolved after treatment with dapsone, corticosteroids, and rifampin.

Adult↗
PubMed1979

Clinical conditions mistaken for metastatic cancer to the choroid.

Thirteen patients who were referred to the Oncology Unit with the diagnosis of metastatic cancer to the choroid were studied and found to have other conditions. All of the patients were female. Nine of the 13 had a history of systemic cancer of which 6 were breast cancer. Five patients were currently being treated with chemotherapeutic agents for their systemic cancer. Three of the 13 patients had bilateral fundus lesions. The most common diagnostic entities confused with metastatic disease were either inflammatory or hemorrhagic lesions of the retina. The preceding history of cancer in the patient with a puzzling fundus lesion may predispose the referring ophthalmologist to suggest a diagnosis of metastatic cancer to the choroid.

Adult↗
PubMed1979

Uveal melanoma occurring as a fourth primary malignancy: case report.

A patient developed 4 separate malignancies over a 26 year period, the last of which was a primary choroidal melanoma. She demonstrated that despite previous malignancies, suspicious lesions should never be dismissed as being metastatic in origin, but should be thoroughly evaluated and treated accordingly.

Adenocarcinoma↗
PubMed1978

Subretinal fluid examination of LDH, PGI, and CEA in a case of metastatic bronchogenic carcinoma of the choroid.

A 58-year-old white male with a history of bronchogenic carcinoma presented with a total retinal detachment overlying a choroidal metastasis. His main tumor burden had been extirpated by pneumonectomy followed by radiation therapy four months prior to admission. With the development of a painful, glaucomatous eye, unresponsive to conventional therapy, enucleation was performed. Histologic examination of the enucleated globe revealed a metastatic tumor to the choroid, consistent with primary bronchogenic carcinoma. Aqueous humor and plasma examination revealed elevated ratios (Aqueous humor:Plasma) of lactate dehydrogenase (LDH) and phosphoglucose isomerase (PGI). Furthermore, subretinal fluid examination demonstrated concentrations of LDH and PGI higher than aqueous humor. While the level of carcinoembryonic antigen (CEA) in the plasma was normal (less than 2.5 ng/ml) following pneumonectomy, it was 121 ng/ml in the subretinal fluid. This would suggest that a choroidal lesion alone, in the absence of a clinically detectable primary tumor, is insufficient to elevate the plasma CEA.

Aqueous Humor↗