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Biomedical subjects

J Vander

Publications and source records attributed to J Vander.

7 recordsLinked to original sources

Intralenticular Candida species abscess in a premature infant.

PURPOSE: To report the clinical and histopathologic findings of a premature infant with severe retinopathy of prematurity complicated by the development of an intralenticular fungal abscess. METHODS: Case report and literature review. RESULTS: A markedly premature infant developed Candida septicemia at 29 weeks postconception. Over the ensuing 10 weeks, cataract and intraocular inflammation developed sequentially in each eye, as did progressive retinopathy of prematurity with tractional retinal detachment. Pars plana vitrectomy and lensectomy revealed intralenticular Candida species abscess. CONCLUSION: Progressive cataract and intraocular inflammation in a low birth weight infant may be caused by endogenous intraocular infection secondary to systemic candidiasis. Cataract secondary to retinopathy of prematurity is rare.

Abscess↗

Rhegmatogenous retinal detachments with cytomegalovirus retinitis.

The most important ocular opportunistic infection in patients with AIDS is cytomegalovirus (CMV) retinitis. Management of CMV retinitis has become complex, as the life expectancy of many patients has increased exponentially. Most retinal detachments in CMV retinitis are rhegmatogenous in nature. Because of atrophic changes in the retina and alterations in the vitreous, surgical management of these detachments leads to a stepladder approach. Options include laser demarcation, scleral buckle, and vitrectomy with silicone oil. In some patients, a combination of all three procedures may be necessary. Management in all cases should be individualized, with the realization that failure of retinal reattachment may occur.

AIDS-Related Opportunistic Infections↗

Diode laser photocoagulation for retinopathy of prematurity.

OBJECTIVE: The purpose of this study was to determine the effectiveness of laser photocoagulation in eyes with threshold retinopathy of prematurity (ROP), defined as stage 3+, zone 2, with 5 or more contiguous or 8 cumulative clock hours of extraretinal fibrovascular proliferation. METHODS: Indirect ophthalmoscopic retinal examinations were performed on 18 premature infants born between 1991 and 1993 to identify those eyes with threshold ROP. Diode laser was used to treat 31 eyes within 48 hours of diagnosis. Each patient was followed post treatment at weekly intervals until regression was starting to occur. Subsequent follow-up visits were tailored to each patient. RESULTS: During the 41 to 60 month follow-up (average 49 months, median 46 months), 27 of 31 lasered eyes (87%) demonstrated regression of the extraretinal neovascularization, and 26 (84%) had functional vision. This includes two Stage 4B eyes that were reattached with scleral buckles. Twenty-two eyes (71%) were myopic and four (13%) progressed to stage 5 retinal detachment that could not be repaired. No cataracts occurred in this group of patients. CONCLUSIONS: Although a potentially blinding disorder, threshold ROP is, in many cases, treatable with laser photocoagulation, which may be easier to administer than cryotherapy. Follow-up of patients treated with diode laser demonstrates that functional vision is attainable.

Follow-Up Studies↗