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Biomedical subjects

K Ramaesh

Publications and source records attributed to K Ramaesh.

27 records · Page 2Linked to original sources

Perfluorodecalin-induced intravitreal inflammation.

OBJECTIVE: To report an unusual case of intravitreal inflammation in a human eye caused by the presence of residual perfluorodecalin in a case of giant retinal tear and retinal detachment. METHODS: The posterior capsule of the lens, which was infiltrated with deposits, was collected during surgery. The specimen was stained with hematoxylin and eosin, with periodic acid-Schiff, and for melanin. Part of it was examined with electron microscopy. Immunohistochemical staining was performed to demonstrate CD68 antigens, cytokeratin, and glial fibrillary acid protein. RESULTS: Vacuolated macrophages and retinal pigment epithelial cells infiltrated the posterior capsule. Electron microscopy showed the presence of membrane-lined vacuoles within the macrophages. A monolayer of epithelial cells covered the cellular infiltration. CONCLUSION: Residual perfluorodecalin can induce an intraocular chronic macrophage response.

Adult↗

Corneal epithelial toxic effects and inflammatory response to perfluorocarbon liquid.

We report an unusual case of corneal epithelial toxic effects associated with perfluorocarbon liquids (PFCLs). The clinical and histopathologic findings are described. An elderly man underwent vitreoretinal surgery for a complicated retinal detachment. Perfluorodecalin was used to repair the retina. It was left in situ for 8 weeks and removed via the pars plana. One month after removal of heavy liquids the patient developed a nonhealing corneal epithelial defect associated with limbitis. Perfluorodecalin was found under the superior conjunctiva. A conjunctival biopsy revealed the presence of vacuoles in the conjunctival stroma surrounded by an inflammatory response that consisted of lymphocytes, macrophages, and giant cells. On surgical removal of the PFCL from the subconjunctival space, the epithelial defect healed. The histopathologic and clinical evidence suggest that the inflammatory response and corneal epithelial ulceration were caused by the prolonged presence of PFCL in the subconjunctival space. To the best of our knowledge, PFCLs have not previously been reported to cause corneal epithelial defects or incite an inflammatory response in the human eye.

Aged↗

Intraocular metastases of cutaneous malignant melanoma: a case report and review of the literature.

Cutaneous malignant melanoma metastatic to the eye is rare but has been documented. The usual presentation is after the diagnosis of disseminated metastases. A 40-year-old Caucasian man presented with floaters and hazy vision due to ocular metastasis. He developed painful intractable rubeotic glaucoma leading to enucleation. Histopathological examination confirmed anterior segment tumour adherent to the iris that was consistent histopathologically with the primary cutaneous melanoma.

Adult↗

Effect of bile acids on fibroblast proliferation and viability.

PURPOSE: To examine the in vitro effects of bile acids and salts on the viability, growth and morphology of human Tenon's capsule fibroblasts. METHODS: Human Tenon's capsule fibroblasts were grown from explants in culture and used between passages 3 and 5. Fibroblasts (n = 3) were treated in triplicate with deoxycholic acid (DA), sodium deoxycholate (NaD) and cholic acid (CA) at concentrations between 50 microM and 1 mM. Cell viability and growth were assessed with trypan blue staining and haemocytometer counting, and a colorimetric (MTT) assay. Morphology was assessed with light microscopy and cresyl violet staining. RESULTS: A dose-dependent decrease in viability was observed following bile acid treatment (24 and 48 h) where the effects of DA > NaD > CA. The LD50 values at 48 h for DA, NaD and CA were 300 microM, 400 microM and 720 microM respectively. Cell growth following bile acid treatment was reduced compared with controls. Fibroblasts treated with bile acids displayed a loss of normal spindle-shaped morphology and multiple processes, some with varicosities, extended from many cells. These changes were dose-dependent, and at higher concentrations cells became detached and were non-viable (trypan-blue-positive). Extensive cell death was observed in cultures treated with DA 400 microM, NaD 500 microM and CA 800 microM. CONCLUSIONS: Lower doses of bile acids and salts reduced in vitro fibroblast growth associated with morphological changes; higher doses induced fibroblast cytotoxicity. These observations suggest that bile acids and salts, in particular DA, may be useful in regulating wound fibrosis following trabeculectomy surgery.

Adolescent↗

Congenital corneal anesthesia.

Congenital corneal anesthesia is a rare clinical entity that poses a diagnostic dilemma, particularly in the pediatric age group. The sensory deficit may be confined to the cornea, or extend to other divisions of the trigeminal nerve. The sensory deficit may occur as an isolated abnormality, as part of a complex neurological syndrome, or it may occur in association with multiple somatic abnormalities and congenital insensitivity to pain. This condition usually presents between the ages of 8 to 12 months. Poor vision, photophobia, conjunctival injection, and corneal ulceration in the absence of pain and distress in a child should alert the clinician to the possibility of anesthetic cornea. In the early stages of presentation, punctuate keratopathy is the main feature, which may progress to non-healing persistent corneal epithelial defects. This stage may progress to acute corneal lysis and perforation. In most patients, conservative approaches such as copious lubrication, prevention of self-harm and cautious use of bandage contact lenses are effective in preventing progressive corneal damage. Tarsorrhapy is effective in promoting epithelial healing and permanent lateral tarsorraphy may prevent further development of epithelial defects. Amniotic membrane graft may be considered in order to improve epithelial healing. Corneal grafts carry a poor prognosis. Accurate initial diagnosis, evaluation, and proper management are paramount to prevent visual loss due to long-term complications of corneal anesthesia. This review of the literature outlines the problems and approaches in diagnosis, evaluation, and management of this rare condition.

Cornea↗

Retinal vein occlusion in lymphomatoid papulosis.

PURPOSE: To describe an unusual patient who presented with hemi-retinal vein occlusion and lymphomatoid papulosis (LyP). METHODS: Clinicopathological case study. RESULTS: A 42 year old female patient presented with blurring of vision in her left eye and a nodular eruption of the skin involving arms, face and torso. She also complained of a non-itchy, blotchy rash on the arms, face and torso lasting for period of three months. Ocular examination showed a left superior hemi-retinal vein occlusion. The nodules resolved spontaneously over a period of two-three weeks leaving a faint scar. Hematological and systemic evaluation for auto-immune disorders, hypercoagulability, systemic malignancy and lymphoma were negative. A biopsy of the skin nodule was performed which showed infiltration of lymphoid blast cells which were CD30 positive. Based on the clinicopathological features a diagnosis of lymphomatoid papulosis (LyP) was made. CONCLUSIONS: Clinical and pathological features of this patient may suggest the retinal vein occlusion may be secondary to LyP.

Adult↗