Biomedical subjects

J B Mizener

Publications and source records attributed to J B Mizener.

3 recordsLinked to original sources

PubMed1997

Autoimmune retinopathy in the absence of cancer.

PURPOSE: To report the clinical and immunologic features of two patients with progressive retinal degeneration and circulating antiretinal antibodies without systemic malignancy. METHODS: Two patients were followed up for 5 to 7 years. Comprehensive medical and ophthalmic examinations and visual function testing included manual perimetry and standardized electroretinography. Patient sera were tested for antiretinal antibodies by Western blot and immunoperoxidase indirect cytochemistry techniques. RESULTS: Two patients had family history of autoimmune disease. Each had severe monocular visual loss with photopsia, a ring scotoma, and abnormal electroretinogram despite a normal-appearing ocular fundus. One had a flat electroretinogram; the other had inner retina dysfunction, with selective b wave loss and abnormal oscillatory potentials. Both patients' sera had antiretinal antibodies that specifically labeled the inner plexiform layer of donor retina by indirect immunoperoxidase testing. Neither had any sign of cancer. CONCLUSIONS: In two patients without systemic malignancy, the symptoms, perimetric findings, and normal fundus appearance resembled cancer associated retinopathy. Electroretinography and antibody findings indicating dysfunction of the inner retina are distinct from those of cancer-associated retinopathy. These two cases raise the possibility of an autoimmune mechanism for retinal degeneration that is not cancer associated. Further study is necessary to determine the role of antiretinal antibodies in these patients.

Adult↗

PubMed1997

Ocular ischemic syndrome.

PURPOSE: The purpose of the study is to investigate the clinical features and management of ocular ischemic syndrome (OIS) and factors influencing its development. INTERVENTION: The following interventions were used: detailed medical and ocular histories, complete ophthalmic evaluation including fluorescein angiography, internal carotid artery evaluation by duplex ultrasonography, and/or aortic arch angiography, management, and follow-up. MAIN OUTCOME MEASURES: The following outcome measures were considered: visual acuity, visual fields, intraocular pressure, anterior segment neovascularization and other abnormalities, lens, optic disc, retinal and choroidal changes, carotid artery stenosis or occlusion, diabetes mellitus, arterial hypertension, coronary artery disease, and cerebrovascular disease. RESULTS: Mean age of the 32 patients (39 eyes) with OIS was 68 +/- 8 years. Presenting visual symptoms included amaurosis fugax (15%) and/or gradual (28%) or sudden (41%) visual loss. At initial visit, eyes with OIS had visual acuity less than or equal to 20/400 in 64%, iris neovascularization (NV) in 87%, angle NV in 59%, intraocular pressure from 4 to 60 mmHg (median 18 mmHg), optic disc pale (40%) and/or cupped (19%) or edematous (8%), disc NV (13%), retinal NV (3%), marked retinal circulatory stasis (21%), and retinal hemorrhages (24%). Associated systemic diseases in these patients included diabetes mellitus (56%), arterial hypertension (50%), coronary artery disease (38%), and previous stroke or transient ischemic attack (31%); the incidence of diabetes, coronary artery disease, and cerebrovascular disease was much higher in patients with OIS than in the comparable general population, especially that of diabetes. Occlusion or severe stenosis (80%-99%) of the internal carotid artery was seen in 74% on the side of OIS. CONCLUSIONS: Ocular ischemic syndrome has a poor visual prognosis. However, the ophthalmologist's diagnosis may be crucial to the health of these patients, because OIS may be the presenting sign of serious cerebrovascular and ischemic heart diseases.

Aged↗

PubMed1993

Tissue plasminogen activator and Staphylococcus epidermidis endophthalmitis.

OBJECTIVE: To determine whether intraocular administration of tissue plasminogen activator (tPA) speeds clearance of inflammatory debris or prevents fibroproliferative complications in an animal model of endophthalmitis. METHODS: Aphakic rabbits were given an intraocular dose of Staphylococcus epidermidis organisms known to cause moderate inflammation and to self-sterilize. They were then randomized to receive either tPA or saline injections 2 and 3 days after inoculation. All eyes were graded by one masked clinician seven times, 1 to 28 days after infection. Vitreous samples from selected eyes were cultured. RESULTS: Treated and control eyes were found to have no significant difference in inflammatory scores. Although the eyes treated with tPA had more retinal detachments and more positive cultures than control eyes, these numbers were not statistically significant (P = .44 to .71). CONCLUSION: Fibrinolysis with intraocular tPA does not accelerate clearance of inflammation nor decrease fibroproliferative complications in this animal model of endophthalmitis.

Animals↗