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Biomedical subjects

J S Kelley

Publications and source records attributed to J S Kelley.

14 recordsLinked to original sources
PubMed1979

Peripheral retinal neovascularization in rheumatic fever.

During a two-year period, a 15-year-old boy had three major manifestations of rheumatic fever, ie, chorea, rash, and carditis. Following the acute carditis, peripheral retinal neovascularization appeared in the left eye. Associated transient hemiparesis suggests that emboli may account for the retinal vascular occlusion. Rheumatic fever should be considered in the medical survey of patients who have retinal new vessels of obscure origin.

Adolescent↗
PubMed1979

Retinal fluorography using oral fluorescein.

Fluorescein sodium can be administered safely by mouth. The resulting fluorograms are useful in demonstrating many retinal conditions characterized by bright late leakage, such as cystoid macular edema. Oral administration of fluorescein may be preferred in studies of children, patients with difficult veins, and in some surveys of large patient populations.

Administration, Oral↗
PubMed1979

Acute ocular leukemia.

A 71-year-old woman had a history of recent weight loss and bilateral decreased visual acuity, bilateral serous detachment, and mental depression. Fluorescein angiograms showed a myriad of retinal pigment epithelial leakage points. Despite extensive evaluation, the cause of her weight loss and ocular process remained uncertain until her death, when postmortem examination revealed leukemia infiltrates of many organs, including the choroid. After death, we correlated the clinical signs and fluorescein angiograms with the histopathologic findings. This case shows that choroidal disease may be a symptom of undetected leukemia.

Aged↗
PubMed1979

Rhegmatogenous retinal detachment with retinal telangiectasia.

A 34-year-old man with unilateral retinal telangiectasia developed a bullous retinal detachment. A horseshoe retinal tear was found at 12 o'clock. The detachment resolved with placement of an encircling scleral buckle. The prompt and permanent resolution of subretinal fluid supported our belief that this was a rhegmatogenous retinal detachment.

Adult↗
PubMed1979

Laser scotometry in drusen and pits of the optic nerve head.

Laser scotometry is an accurate means of detecting dense blind spots. A small low-energy spot is guided across the fundus from nonseeing to seeing areas. Patient responses are recorded on fundus photographys, allowing direct correlation with fundus pathology. Accuracy to less than 1 degree is feasible. All typical optic nerve drusen tested with this technique had field defects. In cases of optic nerve pits, dense scotomas correlated with the shape of visible nerve fiber defects rather than with the shape of serous retinal detachments.

Adult↗
PubMed1978

Retinal hemorrhages in subacute carbon monoxide poisoning. Exposures in homes with blocked furnace flues.

Three incidences of carbon monoxide poisoning occurred owing to defective heating systems. Twelve persons were affected; of these, three lost their lives. Because the symptoms of carbon monoxide poisoning closely resemble flu and other common illnesses, correct diagnosis was not made as promptly as it might have been. Hemorrhages were found in the nerve fiber layer of the retina in all five of the patients who had been exposed for more than 12 hours. It is our contention, therefore, that complete examination of the patient should always include ohthalmoscopy, and that the finding of retinal hemorrhages, in addition to nausea, headache, and dizziness, should aler the physician to the possibility of carbon monoxide poisoning.

Accidents, Home↗
PubMed1978

Whiplash maculopathy.

Maculopathy in three patients, caused by whiphash injury demonstrated three features that are characteristic of this subtle disturbance of the macula: a history of flexion-extension, head and neck trauma; a history of immediate mild reduction of central visual acuity in one or both eyes; and grayish swelling of the foveal zone accompanied by a small (50 to 100-mu) pit or depression in the fovea. In patients with this disturbance, the retinal opacification and the visual disturbance are transient, but the tiny depression in the retina with its whitish border is permanent.

Accidents, Traffic↗
PubMed1978

Doppler ultrasound flow detector used in temporal artery biopsy.

A doppler ultrasound flow detector can be helpful in performing a temporal artery biopsy. The anatomical location of the arteries can be traced on each side of the patient's head during the preoperative stage, and the flow pattern can be compared with the findings on simple palpation. Selection of a vessel for biopsy may thus be influenced. The detector can also be used under sterile conditions to locate the artery when the injection of local anesthesia has made palpation more difficult, thereby facilitating dissection of an adequate specimen.

Biopsy↗
PubMed1978

Correlation of clinicopathologic findings in a patient. Congenital night blindness, branch retinal vein occlusion, cilioretinal artery, drusen of the optic nerve head, and intraretinal pigmented lesion.

The ocular clinicopathologic features of this unique patient were congenital stationary night blindness, drusen of the optic nerve head, cilioretinal artery, intraretinal pigmented lesion, and branch retinal vein occlusion. Photocoagulation therapy led to total disappearance of the neovascular tissue, clinically and histopathologically. Histopathologic examination showed an occluded branch vein associated with a sclerotic retinal arteriole. Peripheral to the site of venous occlusion, inner ischemic retinal atrophy was present. The normal complement of rod and cone photoreceptors supports the view that the night blindness in this case was an abnormality in the neural transmission and not on a morphological basis. The pigmented intraretinal lesion proved to be a localized area of retinal and choroidal neovascularization with anastomosis and secondary retinal pigment epithelial hyperplasia. This lesion was identical to Fuchs' dot of myopia but out patient was hyperopic.

Argon↗
PubMed1978

Use of the argon aiming beam in visual function testing.

The aiming beam of the argon laser photocoagulator can be a useful tool in visual function testing. Applied with the slit lamp delivery system and fundus contact lens, it clearly documents the size of the blind spot surrounding the optic nerve head and the normal area of nonfunctional retina in the periphery. The size of pathologic field defects can be recorded on fundus photographs or retinal drawings by an observer. Safety precautions must be taken to protect all patients from excessive laser energy.

Argon↗
PubMed1977

Recurrence of macular corneal dystrophy after lamellar keratoplasty.

A 20-year-old man required bilateral lamellar keratoplasties for macular corneal dystrophy. Histochemical proof of macular corneal dystrophy was demonstrated in both of the excised lamellar corneal buttons. Eleven years later, the patient underwent a penetrating kiratoplasty in his left eye. Light microscopic, histochemical, and electron microscopic study of the excised button disclosed characteristic features of macular corneal dystrophy in the donor cornea. Recurrence of macular corneal dystrophy in a corneal graft appeared to be the result of replacement of the donor keratocytes by genetically defective host cells.

Adult↗
PubMed1977

Fluorescein angiography: techniques and toxicity.

Fluorescein angiography is a safe, well-standardized procedure for establishing fundus abnormalities. It facilitates documentation of the finest detail of the fundus, allows estimation of the blood flow through the retina, and permits the doctor to evaluate the integrity of the retinal vessels. When there is good communication between doctor and patient, and between doctor and photographer, it is an especially useful procedure.

Emergency Medical Services↗
PubMed1977

The management of choroidal tumors.

TWe have outlined a systematic approach to the management of choroidal lesions which might appear to be choroidal melanoma: 1. When a solid, elevated mass is suspected of being a malignancy, first complete a thorough examination of both eyes, including a detailed history. Arrange for a general medical evaluation to detect sources of metastatic lesions or early metastases from the eye. 2. Eliminate the possibility of flat choroidal lesions by slit-lamp and indirect ophthalmoscopic examination. These are considered benign and can be followed at routine intervals with simple sketches or color fundus photographs. Fluorescein angiography is not essential, but can confirm the benign appearance and help in following overlying secondary changes such as pigment epithelial defects. 3. Rule out serous or cystic lesions by the use of slit lamp and fundus contact lens, and indirect ophthalmoscope with transillumination. Fluorescein angiography again can help confirm the benign nature of these lesions, but the serial fundus examinations are definitive in 99 percent cases. 4. Document the appearance of the lesion with drawings, stereo-photographs, and stereo angiography. Follow the evolution of the lesion with these modalities for a sufficient time to be certain of the diagnosis. 5. Follow lesions in the peripapillary area with particular care.

Choroid Neoplasms↗