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Biomedical subjects

J T Ernest

Publications and source records attributed to J T Ernest.

At least 19 recordsLinked to original sources
PubMed1992

Ocular toxicity of prednisone in pediatric patients with inflammatory bowel disease.

We performed ocular examinations on 58 corticosteroid-treated pediatric patients with inflammatory bowel disease (IBD) and on 58 age-matched controls. Posterior subcapsular cataracts (PSC) were detected in 12 of the 58 treated patients (20.7%) and in none of the controls. The difference in mean intraocular pressure (IOP) between the treated patients (15.89 +/- 4.11 mm Hg) and control subjects (13.63 +/- 2.35 mm Hg) was significant statistically (P < 0.001). Twenty-one patients (36.2%) were characterized as "IOP responders" (IOP > or = 20 mm Hg, change in IOP > or = 6 mm Hg between visits, or a difference in IOP > or = 6 mm Hg between the two eyes). Formation of PSC was not correlated significantly (P > 0.05) with the total dose of prednisone, duration of treatment, average daily dose, or number of days on high doses (> or = 25 mg). Raised IOP was correlated (P = 0.005) only with average daily dose (12.4 +/- 10.9 mg/day; range, 0-47 mg/day) 30 days before examination. When the dose of corticosteroid was reduced to < 10 mg/day, 2 patients manifested regression of PSC, and 12 IOP responders showed a decrease in IOP to within 2 SD of the mean control IOP. Only 3 of the 58 treated patients (5.2%) manifested both PSC and raised IOP. A significant inverse correlation (P = 0.02) was established between IOP at first examination and formation of PSC. We propose that the mechanisms for steroid-induced lens opacities and raised IOP do not share the same genetic basis. Because 52% of these children developed either PSC or raised IOP with prednisone therapy, we advocate careful ophthalmologic monitoring of pediatric patients receiving corticosteroids for IBD or any other condition.

Adolescent↗
PubMed1979

Immune-complex deposition in the eye in systemic lupus erythematosus.

A patient with systemic lupus erythematosus (SLE) and lupus retinopathy showed resolution of subretinal edema documented with fluorescein angiography. Subsequently at autopsy, immunofluorescence studies disclosed ocular deposition of immunoglobulins in the vascular layer of choroid capillaries and basement membranes of ciliary processes and bulbar conjunctivas. To our knowledge, these findings represent the first reported documentation of probable immune-complex ocular vasculitis in lupus retinopathy using immunofluorescent techniques, and they support the hypothesis that lupus retinopathy is caused by immune complex deposition as are other manifestations of SLE.

Adolescent↗
PubMed1979

Vitreous body oxygen tension following experimental branch retinal vein obstruction.

We obstructed either temporal or nasal superior and inferior retinal veins on one eye of rhesus monkeys with xenon photocoagulation. This resulted in large areas of nonperfused retina adjacent to normal retina in the same eye. Intraretinal neovascularization (new vessels in the retina) developed following the absorption of retinal hemorrhage and edema. We used microelectrodes to measure and compare vitreous body oxygen tensions over the nonperfused and over the normal retinal areas. There was no significant difference between the oxygen tension measurements in the same eye.

Animals↗
PubMed1978

Visual function in acute posterior multifocal placoid pigment epitheliopathy.

We examined a 19-year-old woman with acute posterior multifocal placoid pigment epitheliopathy one week after she noted blurring of central vision. Her corrected visual acuity was R.E.: 6/7.5 (20/25), and L.E.: 6/12 (20/40). The visual fields showed 10-degree pericentral scotomas. A color vision defect and an abnormal Stiles-Crawford effect were present. Dark adaptation showed a delayed time course, with normal final thresholds. The electro-oculogram was subnormal, suggesting widespread abnormality of the retinal pigment epithelium. Active lesions resolved within three weeks, but fluorescein angiography showed characteristic widespread residual changes. Within three weeks, she had normal visual acuity and a normal electro-oculogram. Other tests of visual function showed recovery with a slower time course. By one year, the visual fields, color matching, Stiles-Crawford effect, and dark adaptation were almost normal. Analysis of the color-matching data and Stiles-Crawford effect indicated that the abnormalities of macular function were caused by an underlying lesion of the pigment epithelium and photoreceptors. This caused a physical distortion of the photoreceptor layer and metabolic disfunction of the photoreceptors.

Adult↗
PubMed1978

Transscleral electroretinography.

We studied the electroretinogram in normal patients, patients with opacities of the anterior segment, and patients with vitreous hemorrage, using a high-intensity light stimulus delivered either through the sclera or through the pupil. We found the response obtained with transscleral stimulation a consistent indicator of gross retinal function. Since the stimulus entered the eye through the sclera, it provided a method for studying the retinal responses independent of opaque or translucent media.

Corneal Opacity↗
PubMed1977

The effect of photocoagulation on the choroidal vasculature and retinal oxygen tension.

Light microscopy and latex-pigment injection of rhesus monkey eyes studied at varying times after retinal laser and xenon photocoagulation of varying intensity showed that the choriocapillaris was obliterated by a wide range of intensities but that the choroidal arteries and veins remained open. Retinal oxygen tensions acutely increased over the lesion but later subsided to normal. Multiple treatment sessions several days apart may reduce the risk of hemorrhage associated with hypermia secondary to photocoagulation.

Animals↗
PubMed1977

The effect of systolic hypertension on rhesus monkey eyes after ocular sympathectomy.

Systolic hypertension was induced in rhesus monkeys by obstructing the thoracic aorta and by ocular sympathectomy obtained with the retrobulbar injection of 6-hydroxydopamine. During the late phase of fluorescein angiography, fluorescein leaked from the choroidal circulation into the retina. The retinal vessels did not leak fluorescein. The effect was not permanent since fluorescein did not leak into the retina after the blood pressure returned to normal.

Animals↗
PubMed1977

Chorioretinopathy in a case of systemic lupus erythematosus.

A 19-year-old woman with systemic lupus erythematosus had choroidal fluorescein leakage into discreet areas of subretinal fluid. The findings were abolished with corticosteroids. A choroidal vasculitis was suggested by mononuclear infiltration and immunofluorescent demonstration of immunoglobulin.

Adrenal Cortex Hormones↗
PubMed1977

The effect of mannitol infusion on retinal function and oxygen tension.

Mannitol administered intravenously in rhesus monkeys resulted in a temporary recovery of the visual evoked response (VER) after its decrease due to elevation of the intraocular pressure. Mannitol infusion caused an immediate, albeit transitory, increase in retinal oxygen tension. These changes were independent of the ocular hypotensive effect of mannitol, and we conclude that the drug is a far better agent for the treatment of acute glaucoma than heretofore believed.

Animals↗
PubMed1977

Electro-oculography in infants.

To record the electro-oculogram in infants without using general anesthesia and passive globe rotation, we used the static vestibular reflex in which compensatory eye movements occur in response to angular rotation of the semicircular canal. To produce these eye movements, we placed the infant in a supine position in his mother's arms in a rocking chair and, while he nursed from a bottle, directed his attention to a distracting stimulus. We recorded the electro-oculogram during rocking under conditions of light and dark adaptation. We used the electro-oculograms to calculate the conventional light-to-dark amplitude ratio.

Electrooculography↗
PubMed1976

Bilateral optic nerve hypoplasia in a pup.

A 6-week-old Beagle failed to respond to visual stimulation. Examination revealed fixed dilated pupils and hypoplasia of both optic disks. Results of electroretinography were normal. Radiography of the skull revealed small optic nerve foramina. Histologically, the outer layers of the retinas were normal, the retinal ganglion cells were scarce, and the nerve fiber layers, optic nerves, and optic chiasm were hypoplastic.

Animals↗
PubMed1976

Submacular choroidal circulation.

A neoprene latex and pigment mixture was injected into the choroidal blood vessels of human cadaver eyes. When peripheral resistence was normal, a single arteriole filled a single lobule of the choriocapillaris drained by mulitple surrounding venules. The choridal veins interconnected and an increase in the peripheral resistance caused by elevation of the venous pressure resulted in filling of contiguous lobules in a retrograde manner through the venules that normally drain them.

Aged↗
PubMed1976

Diffuse congenital hemangiomatosis with infantile glaucoma.

A white male infant was born with multiple hemangiomas of the skin and mucous membrane. At 7 months of age he exhibited the signs and symptoms of infantile glaucoma in each eye, but goniotomy was not possible because of vascularity in the angles. Cyclocryotherapy was used on multiple occasions to control intraocular pressure until a goniotomy could be done safely in one eye. The other eye has had good control of intraocular pressure without operation.

Ciliary Body↗