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Biomedical subjects

J P Dieckert

Publications and source records attributed to J P Dieckert.

At least 19 recordsLinked to original sources
PubMed1996

Mycobacterium fortuitum endophthalmitis.

PURPOSE: The authors report the first known case of mycobacterium fortuitum endophthalmitis. METHOD: The authors use the documentation of clinical course. RESULTS: A postoperative cataract patient received a diagnosis of mycobacterium fortuitum endophthalmitis 1 month after uncomplicated cataract surgery. The endophthalmitis responded to intraocular amikacin. CONCLUSIONS: When mycobacteria are recovered from patients with endophthalmitis, amikacin should be included in the therapeutic regimen until speciation and in vitro susceptibility testing documents equally effective alternatives.

Administration, Topical↗
PubMed1996

Diabetic eye disease: a primary care perspective.

Patients with diabetes are at risk for multiple visual complications, most notably diabetic retinopathy, but also glaucoma, cataracts, optic nerve disease, and strabismus. Diabetic retinopathy is the leading cause of blindness for the majority of Americans. Microvascular damage from diabetes leads to microaneurysms, hemorrhage, exudates, and cotton-wool spots. Further progression of disease leads to new vessel growth, or neovascularization. Growth of new blood vessels can cause severe hemorrhage, scarring, and permanent visual loss. Various randomized, prospective studies have clearly shown benefit from laser therapy at specific stages of progression of retinopathy. Proper referral and close follow-up are paramount to the preservation of visual function.

Adult↗
PubMed1995

Cotton-wool spots and the early diagnosis of giant cell arteritis.

BACKGROUND: Giant cell arteritis is a common cause of severe visual loss in older individuals. Patients often present to the ophthalmologist having already lost vision in one eye. Detection of early ophthalmoscopic signs that precede irreversible visual loss in giant cell arteritis would allow preventative treatment in an otherwise frequently blinding disease. METHODS: Case presentations. RESULTS: Seven patients with mild visual symptoms and results of an ophthalmologic examination significant for cotton-wool spots were found to have giant cell arteritis. On specific questioning, six of seven patients described constitutional symptoms consistent with giant cell arteritis. Six patients had an abnormally elevated Westergren erythrocyte sedimentation rate. Temporal artery biopsy confirmed giant cell arteritis in six patients. The seventh patient received a diagnosis of polymyalgia rheumatica. Prompt treatment with corticosteroids led to preservation of vision and uneventful resolution of the cotton-wool spots in all seven patients. CONCLUSION: Cotton-wool spots are an early ophthalmoscopic finding in giant cell arteritis and can precede severe visual loss. Recognition of the significance of cotton-wool spots, use of laboratory studies, and prompt treatment may preserve vision in an otherwise frequently blinding disease.

Aged↗
PubMed1989

The ora serrata and the spiral of Tillaux. Anatomic relationship and clinical correlation.

Conventional teaching states that the spiral of Tillaux marks the location of the ora serrata. On literature review, no source for this was found. This study explores this anatomic relationship. In 20 cadaver eyes, narrow-gauge needles were placed penetrating the center of each rectus muscle insertion, and distance to the ora was measured. Insertions ranged from 2.25 mm posterior to 2.25 mm anterior to the ora, with 90% within 1 mm of it. In ten eyes, distance from the edge of insertion also was measured. Results indicate that the centers of rectus insertions, especially the lateral rectus, approximately overlie the ora, with the edges of the insertions more posterior and variable.

Eye↗
PubMed1989

Optic nerve enlargement and central retinal-artery occlusion secondary to retrobulbar anesthesia.

Optic nerve injury after retrobulbar injection of anesthetic agents may damage the optic nerve and vascular supply to the eye. We describe a case of documented orbital optic nerve injury with central artery occlusion after retrobulbar injection before cataract surgery. Early computed tomography documentation of optic nerve injury associated with retrobulbar injection is suggested to allow early consideration of optic nerve sheath decompression.

Aged↗
PubMed1989

Angioid streaks associated with abetalipoproteinemia.

Angioid streaks were observed in a 31-year-old man with abetalipoproteinemia. Angioid streaks have now been described in hereditary spherocytosis, beta thalassemia, alpha thalassemia, sickle cell anemia, and acanthocytosis secondary to abetalipoproteinemia and hypobetalipoproteinemia. The nature of the association of angioid streaks and structural defects of hemoglobin and the red blood cell is not understood.

Abetalipoproteinemia↗
PubMed1988

Delayed primary wound closure. Use to prevent implant extrusion following evisceration for endophthalmitis.

We used delayed primary wound closure in three cases of bacterial endophthalmitis to minimize the risk of implant extrusion following evisceration. In a fourth case, the wound was closed primarily, but wound dehiscence and implant extrusion occurred six weeks postoperatively, and reoperation was required. The advantages of delayed primary wound closure following evisceration of the globe for endophthalmitis include rapid removal of the intraocular abscess, continued drainage and mechanical débridement of the infected scleral pouch, and the development of granulation tissue resistant to bacterial growth at the wound margins prior to wound closure. These factors are important in reducing the risk of implant extrusion following evisceration of the globe for endophthalmitis.

Adult↗
PubMed1988

Choroidal malignant melanoma with early vitreous seeding.

Primary choroidal malignant melanoma with extension through the overlying retina is a rarely reported entity, and to our knowledge actual seeding of the vitreous has never been reported. The pathologic findings in a 41-year-old woman who presented with a large amelanotic subretinal mass near the optic disc of the right eye are discussed. Fundus examination preoperatively revealed a concentration of discrete, fleshy, oval to round, vitreous bodies of varying size, limited to the area overlying the mass. Histopathology of this tumor revealed a spindle cell posterior choroidal melanoma with marked atrophy of the overlying retina. At the apex, the retina was discontinuous and melanoma cells extended into the overlying vitreous. Some of the cells surrounded asteroid bodies overlying the tumor, altering their clinical appearance. This behavior, while only involving a small fraction of the tumor cells, may imply a more aggressive tumor.

Adult↗
PubMed1988

Central serous chorioretinopathy in U.S. Air Force aviators: a review.

Idiopathic central serous chorioretinopathy (ICSC) is an uncommon disease with the potential to cause loss of visual acuity, decreased color vision, and decreased depth perception. These visual changes may become permanent and require removal of aviators from flight status. This study reviews 55 eyes of 47 USAF aviators with ICSC examined at the United States Air Force School of Aerospace Medicine (USAFSAM), Brooks AFB, TX. Clinical and aeromedical findings, both on initial and on follow-up ophthalmic examination were studied. Ninety-seven percent of aviators otherwise medically qualified were ultimately returned to flight status. Overall, 51% had recurrent episodes, 17% had bilateral disease, and 13% underwent laser photocoagulation. Visual acuity correlated with active disease, and there was a trend toward poor stereopsis and diminished color vision with worsening visual acuity. Eighty-six percent attained a final visual acuity of 20/20 or better. On final examination, 90% had normal stereopsis, 87% had normal color vision, and 49% had a normal central visual field. Eyes with recurrent disease tended to have degraded final visual acuity, stereopsis, color vision, and central visual field. The visual and aeromedical prognosis from a single attack of ICSC is generally favorable, but repeated attacks can lead to a significant decrease in visual functions that may jeopardize flying status.

Adult↗
PubMed1987

Linear nevus sebaceous syndrome.

The linear nevus sebaceous syndrome is a rare disorder first described in 1962 in two cases by Feuerstein and Mims. As originally described, it consisted of the triad of the characteristic midline facial linear nevus sebaceous of Jadassohn, seizures, and mental retardation. The authors have followed a patient with this syndrome from birth to age 8 and although he does demonstrate several neurologic and ocular abnormalities, he enjoys normal intelligence and has never suffered seizures. The features of this syndrome and several new ocular findings demonstrated in this case are described. Based on our long-term follow-up of this patient and our review of the reported cases to date, the authors suggest that the triad for this disorder should be changed to include the midline facial linear nevus sebaceous of Jadassohn, neurologic abnormalities which may, but not necessarily, include seizures and mental retardation, and ophthalmologic abnormalities.

Arachnoid↗
PubMed1986

Air travel and intraocular gas.

The safety of air travel for persons with intraocular gas after ocular surgery has been in question since the mid 1970s, when the use of intraocular gases after vitrectomy became widespread. After vitrectomy, air-fluid exchange was performed on six Rhesus monkeys. During simulated air travel in an altitude chamber, intraocular pressure rose an average of 42 mmHg with intraocular air volumes as small as 0.25 cc. Hypotony was observed after return to ground level in all cases. Transient central retinal artery occlusion and pupillary block was observed. Patient safety and comfort is endangered during air travel with very small volumes of intraocular gas.

Aircraft↗
PubMed1985

Norrie's disease: a study of two families.

Norrie's disease, or congenital progressive oculo-acoustico-cerebral degeneration, is a rare X-linked recessive syndrome of retinal malformation, deafness, and mental retardation and/or deterioration. The natural history of the disorder in two families with five affected males, four living and one deceased, is described. The histopathology of two patients, one from each family, is reported. Differential diagnosis, treatment, and genetic counseling are discussed.

Adolescent↗
PubMed1983

Optic nerve pit and baring of the circumlinear vessel.

The concept of a circumlinear vessel (CLV) of the ophtic disc was recently introduced into the opthalmic literature, and baring of the CLV was suggested as a sign of acquired disc injury, especially from glaucoma. In a review of fundus photographs of 27 eyes with optic nerve pits, only one eye was found in which the CLV was bared. This observation supports the concept that baring of the CLV is a sign of acquired disc change.

Adolescent↗
PubMed1983

Contact lenses for laser applications.

Contact lenses for anterior and posterior segment laser applications are described. Commercially available lenses are classified according to design, application, manufacturer and cost.

Contact Lenses↗
PubMed1982

Prostatic carcinoma metastatic to choroid.

Metastatic prostatic carcinoma of the choroid became clinically undetectable after orchidectomy and oestrogen administration. The choroidal tumour rapidly regressed over a 2-month period and clinically disappeared, with restoration of 6/6 vision from 6/60 and return of visual field. This dramatic response and lack of complications make hormonal manipulation the preferred mode of initial therapy in prostatic carcinoma metastatic to the choroid.

Adenocarcinoma↗