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Biomedical subjects

J O'Day

Publications and source records attributed to J O'Day.

13 recordsLinked to original sources
PubMed1992

Partly reversible visual failure with methanol toxicity.

Methanol is a highly toxic substance which is used as an industrial solvent and in automotive antifreeze. If accidentally ingested blindness or death may result. The case of a young woman who developed sudden onset of visual failure following ingestion of a methanol-fortified beverage is presented. Although she failed to seek immediate medical help visual function improved. Acute changes of bilateral optic disc hyperaemia and venous engorgement were present at initial examination. She subsequently developed optic disc atrophy together with glaucomatous-like cupping of the optic discs. The aetiology of visual failure in methanol poisoning is discussed, as are the current therapeutic guidelines in the management of acute cases.

Adolescent↗
PubMed1992

Treatment of subfoveal choroidal neovascular membranes with systemic interferon-alpha 2a.

Systemic interferon-alpha has recently been reported to be useful in the treatment of choroidal neovascular membranes (CNVM) in age-related macular degeneration. To further investigate its effect we treated eight patients with subfoveal choroidal neovascular membranes of various aetiologies including idiopathic, age-related macular degeneration and myopic chorioretinal degeneration. Only one of the eight patients responded with an angiographically demonstrated decrease in the size of the CNVM; this was in a patient from the idiopathic group. Considerable side-effects were reported with marked lethargy and malaise limiting compliance with some patients. Although this is an initial report with limited patient numbers and follow-up, it does suggest a role for interferon-alpha in patients with idiopathic neovascular membranes where the retina is otherwise normal, but raises some doubt as to its efficacy in the treatment of age-related macular degeneration.

Adult↗
PubMed1991

Phenylketonuria does not cause cataracts.

In a study of 46 adults aged 28-71 years with untreated phenylketonuria (PKU) there were 3 (6.5%) with cataracts. This incidence was similar to that in the Australian population and in a control series of intellectually disabled adults. Only two of the PKU patients with cataracts could be examined by slit-lamp biomicroscopy and in both the findings suggested that the prolonged use of phenothiazines may have played a role. Slit-lamp examination of a further ten untreated PKU patients and 13 PKU adults who had been treated in childhood revealed only small lens opacities (in 40%) of a type found in 72.7% of a control group. The study provides no support for claims that PKU can cause cataracts.

Adult↗
PubMed1991

Rapid change in visual fields associated with suprasellar lymphocytic hypophysitis.

A young woman presented in the third trimester of pregnancy with a rapid onset of bitemporal hemianopia and reduced visual acuity caused by an unusual steroid responsive suprasellar tumor. A computerized tomography scan revealed a 2-cm suprasellar mass which was thought to be a tuberculum sellae meningioma. Surgery was delayed because of pregnancy. A short course of high-dose steroids was given to promote fetal lung maturity. This produced an unexpected and dramatic resolution of the field loss. As the steroid dose was reduced, the visual fields deteriorated, necessitating a craniotomy. The histology revealed lymphocytic hypophysitis, a rare but distinct clinicopathological entity affecting the anterior pituitary lobe. The significance of the suprasellar site and a possible role for the use of steroids in the preoperative management of this condition is discussed.

Adrenal Cortex Hormones↗
PubMed1991

Delayed choroidal perfusion in giant cell arteritis.

The fundus fluorescein angiograms of 13 patients with visual disturbance due to biopsy-proven giant cell arteritis (11 with anterior ischemic optic neuropathy (AION); 2 with visual obscurations only) were compared with the fluorescein angiograms from 33 patients with acute nonarteritic AION and 23 age-matched normal eyes. In all 13 patients with giant cell arteritis, the fluorescein angiograms showed a significant delay of choroidal filling time (mean 69 seconds) in comparison with either normal subjects (mean 5.8 seconds) or patients with nonarteritic AION (mean 5.5 seconds). In patients presenting with acute AION, the finding of delayed choroidal filling on fluorescein angiography should raise the index of suspicion of giant cell arteritis and lead to prompt investigation and treatment.

Acute Disease↗
PubMed1991

Intraretinal gray lesions as a sign of reversible visual loss following prolonged ophthalmic artery hypoperfusion.

A 49-year-old woman developed severe unilateral visual loss following carotid artery ligation for a carotid-cavernous fistula. The pathophysiology was presumed to be an ophthalmic artery steal caused by the fistula. This was confirmed when visual acuity was restored by a subsequent ligation of the ophthalmic artery, despite 2 weeks of profound visual loss and ocular ischemia. Superficial cotton-wool spots and deep gray intraretinal lesions developed in the retina during the period of ocular ischemia. We postulate that the deep intraretinal lesions are clinical manifestations of a zone of retinal microvascular watershed ischemia, and that their presence may be an important diagnostic guide to the presence of reversible ocular ischemia.

Blindness↗
PubMed1991

Visual outcomes of pituitary adenoma surgery. St. Vincent's Hospital 1968-1987.

Pituitary tumors are a significant cause of visual morbidity. The medical records of 45 patients with histologically verified pituitary adenoma and visual defects (fields and/or acuity) were reviewed. The patients' ages ranged from 19 to 80 years with a mean of 52.4 years. Ophthalmologists referred 76% of the patients for neurosurgical opinion. Bitemporal field defects were present in 89%. Twenty-three patients underwent transfrontal craniotomy prior to 1984, and the remaining twenty-two subsequently had transsphenoidal microsurgery. Of those eyes with abnormal visual acuity preoperatively, 74% had improvement noted postoperatively (p less than 0.001). Of those eyes with preoperatively abnormal visual fields, 68% improved (p less than 0.001). For transsphenoidal surgery the rate of improvement for fields was 81%. Preoperative visual acuity, visual field score, and patient age, were not predictive of postoperative acuity. Optic disc pallor was associated with poorer postoperative fields and acuity compared to eyes without preoperative pallor. Transsphenoidal surgery is effective treatment for visual compromise due to pituitary adenoma, and the need for early diagnosis is emphasized.

Adenoma↗
PubMed1991

An eye on systemic disease.

Vision is often threatened by a number of systemic diseases. The author details the effects of diabetes, hypertension, atheroma and collagen diseases on the eye.

Arteriosclerosis↗
PubMed1977

Retinoblastoma in Victoria.

This paper reports all cases of retinoblastoma occurring in Victoria over a 20-year period between 1956 and 1976. It suggests that the natural history of treated retinoblastoma in an Australian community, is characterized by low mortality (8.3%), but significant morbidity. The most common problem in management of unilateral cases was one of diagnosis in contrast to bilateral cases, in which the problem was one of maintaining useful vision whilst at the same time eradicating a life-threatening tumour. Suggestions are made as to how management of retinoblastoma may be further improved, and the need for an active national register is discussed.

Australia↗
PubMed1976

The hazard of the unrestrained occupant.

A review of 208 cases involving injuries sustained by vehicle occupants was extracted from the computer storage at the Highway Safety Research Institute, University of Michigan, Ann Arbor. In addition, 157 new car crashes investigated by the authors were separately analyzed. Data analysis indicates injuries are sustained by direct occupant-to-occupant contact and by one occupant forcing another into or against one or more interior car structures. All body areas can be involved in this previously unreported injury mechanism, with the upper portion of the body more susceptibel to injury. Case histories from field accident investigations document a variety of these injury mechanisms.

Accidents, Traffic↗