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Biomedical subjects

J C van Meurs

Publications and source records attributed to J C van Meurs.

27 records · Page 2Linked to original sources
PubMed1991

Analysis of local antibody production in the vitreous humor of patients with severe uveitis.

We analyzed the local antibody production in vitreous humor samples collected during vitrectomy in patients with severe vision-threatening uveitis. In 24 patients, paired serum and undiluted vitreous humor samples were collected and tested for antibodies against Toxoplasma gondii, herpes simplex virus, varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, and Toxocara canis. Total IgG and the Goldmann-Witmer coefficient were determined. The initial diagnosis of ocular toxoplasmosis could be confirmed in six of the seven patients. The seventh patient showed a local antibody production against herpes simplex virus. One of the three patients with chronic panuveitis at initial diagnosis showed a local antibody production against T. gondii. These last two findings resulted in a change in medical treatment. Analysis of local antibody production in vitreous humor samples is a valuable diagnostic tool.

Animals↗
PubMed1991

Choroidal filling patterns in sickle cell patients.

Two choroidal occlusion syndromes are recognized: the triangular syndrome after ciliary artery occlusions, and the multifocal lesions associated with choroidal arteriolar occlusions. Both syndromes have been described in sickle cell patients. We compared early venous phase fluorescein angiograms of 51 Hb SS or Hb SC patients and 15 age and race matched controls, to test whether geographic early filling defects of the choriocapillaris might be more common in these rheologically impaired patients. We found no difference in occurrence of these filling defects between the two groups, and conclude that choriocapillaris filling defects in the early venous phase only are not pathological.

Adolescent↗
PubMed1991

Ocular findings in sickle cell patients on Curaçao.

We examined about half the estimated number (based on gene frequency) of sickle cell patients on the island of Curaçao. This study may represent one of the most comprehensive and a selective cross-sectional surveys available. Studying 81 Hb SS and 97 Hb SC patients, we were able to confirm the correlation between iris atrophy and proliferative sickle retinopathy (PSR), the correlation between Hb SC and proliferative sickle retinopathy (PSR) and the major role of PSR in blindness in sickle cell patients. In Hb SC patients over the age of 18 PSR occurred in 50%, leading to vitreous hemorrhage in 18% and to retinal detachment in 8%. We found a frequency of blindness in one eye (fingers counting or less) of 4% in the entire sickle population, and 6% among Hb SC patients. Bilateral blindness was rare: one Hb SS patient, due to cortical blindness. The relatively frequent occurrence of severe complications in a narrowly defined population should stimulate our efforts to prevent these from occurring.

Adolescent↗
PubMed1991

Retinal folds through the macula.

In a series of 137 consecutive conventional primary retinal detachment repairs we postoperatively found retinal folds through the macula in four cases (2.8%). All four patients had presented with an acute, bullous, superior detachment, and had been treated with an encircling band, drainage of subretinal fluid, injection of an air/gas mixture, cryocoagulation, and a radial buckle to close the largest retinal tear. Redundant retina (created by the encircling band and possibly by stretching in the bullous detachment) became folded either by compression by the gas-bubble in the recumbent patient, or by a steam roller action of the bubble when the patient sat up. In acute bullous detachments, we try to avoid this complication by using an air/gas bubble which is not greater than necessary to tampon the retinal break, and by positioning the patient in such a way that residual subretinal fluid is pressed away from the posterior pole.

Follow-Up Studies↗
PubMed1991

Relationship between peripheral vascular closure and proliferative retinopathy in sickle cell disease.

In a study involving 97 patients with hemoglobin SC sickle cell disease (Hb SC) and 87 subjects with hemoglobin SS sickle cell disease (Hb SS) on the island of Curaçao, we found a higher incidence of peripheral retinal vascular closure and proliferative retinopathy in the former as compared with the latter. Examination of composite fluorescein angiograms obtained from 15 Hb SS and 36 Hb SC patients, whose mean and median age were the same and in whom more advanced stages of sickle retinopathy were equally represented, revealed statistically significantly smaller measurements of perfused retina (indicative of larger areas of non-perfusion) in Hb SC patients as compared with Hb SS patients (P = 0.002, P = 0.014) as well as in subjects exhibiting neovascularization as compared with those who did not (P = 0.022, P = 0.004). This suggests that a vaso-occlusive tendency in the retina is greater in individuals with Hb SC than in those with Hb SS; the more extensive ischemic areas provide a stimulus for neovascularization, explaining the higher prevalence of proliferative retinopathy in the former patients as compared with the latter.

Adult↗
PubMed1990

[Vision-threatening eye manifestations in patients with sickle cell disease on Curaçao].

Prospectively we performed an ophthalmological examination in 81 Hb SS and 97 Hb SC patients on the island of Curaçao, about half the estimated number of patients, based on gene frequency. These patients had not been selected on ophthalmological symptoms. Proliferative retinopathy was present in 2% of the Hb SS patients, and in 50% of the Hb SC patients (71% among those over 18 years old). The frequency of severe visual loss (counting fingers or less) in one eye due to sickle cell disease in Hb SS patients was 1% (one patient, both eyes), and in Hb SC patients 6% (6 patients, 6 eyes). Bilateral blindness was rare: one Hb SS patient had cortical blindness. Visual loss in Hb SC patients (of which four eyes with loss of light perception) was caused by proliferative retinopathy, with its complications like vitreous haemorrhage and retinal detachment. Although the effectiveness of prophylactic laser treatment remains to be established, it would appear prudent to have an eye examination performed regularly in Hb SC patients older than 20 years.

Adult↗
PubMed1990

Clearance rate of macrophages from the vitreous in rabbits.

Macrophages are usually present in epiretinal membranes from eyes with proliferative vitreoretinopathy (PVR). Information on the kinetics of macrophages in the eye may be of help in identifying their role in this disease. To determine the half-life of macrophages in the vitreous, peritoneal macrophages were labeled by allowing them to phagocytose 141Cerium (gamma-emitter) labeled microspheres, and were then injected into the vitreous of the same rabbit from which they were obtained. The animals were sacrificed at various times post-injection and the radioactivity remaining in the vitreous was measured. Using this procedure, the half-life was found to be 4.8 days.

Animals↗
PubMedDate not supplied

Posterior segment eye-surgery in day care?

Day care is generally accepted in anterior segment eye-surgery. In the Rotterdam Eye Hospital this option was also considered for posterior segment surgery. We were interested in the opinion of patients on this matter and therefore asked patients, who were admitted for posterior segment eye-surgery, to answer a questionnaire. The major question was: 'If your physician had given his permission, do you think it would have been possible for you to go home on the evening after surgery?'. Other questions evaluated problems in organising assistance at home and transportation to the out-patient clinic as well as circumstances after the operation, such as pain, nausea, dizziness and anxiety. Eighty-one out of 87 patients responded: 56% answered 'eye' and 44% 'no' to the major question. Relating the answer to the major question to medical data and to answers to the other questions, we found organizational problems at home and anxiety to have a statistical significant relation with a negative answer. Clinical factors like age, American Society of Anesthesiologists (ASA)-class, diabetes mellitus (including insulin-dependant), type of anesthesia, time of the day the surgery was finished, duration of surgery, pain, nausea or dizziness were not significantly related. The number of patients involved in this study, however, is too small to draw conclusions on specific subgroups of patients.

Adolescent↗