Biomedical subjects
Publications and source records attributed to L Joffe.
A 74-year-old woman had a saccular dilatation, presumably of the central retinal vein, on the optic nerve head. The lesion caused no symptoms, and over a four-month period showed (vidence of thrombosis and stagnation within it. The lesion caused no interference with either the arterial or venous circulation of the retina. We advised no treatment and continue to observe the patient.
An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.
One thousand black African and 380 white Caucasian patients over the age of 50 were examined for evidence of age-related macular changes, namely, drusen, pigment epithelial atrophy, and disciform macular degeneration. Drusen and pigment epithelial changes were found to occur twice as commonly in Caucasians as in Africans; there was a much greater difference in the prevalence of disciform macular degeneration between the 2 groups. The cause of the differences remains unexplained.
A case of keratoconus in a patient with probable type IV Ehlers-Danlos syndrome is described. We believe this to be the first such case reported. The patient has undergone successful corneal grafting.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Forty-one children with a clinical diagnosis of Kawasaki syndrome had a pediatric ophthalmologic examination performed at a mean time of 8.6 days after onset of fever. Twenty-seven of 41 patients (66%) had evidence of anterior uveitis by slit lamp examination. Bilateral involvement was noted in 25 of 27 patients (97%). Punctate keratitis was evident in 5 of 41 patients (12%). Three of these five had coexisting uveitis. The incidence of anterior uveitis in patients examined during the first week of their illness was 83% (20 of 24 patients), compared to an incidence of 41% (7 of 17) in patients first examined greater than 1 week after onset of disease (P = 0.004). There was no difference in the uveitis, vs. the non-uveitis groups with respect to age, sex, race or subsequent aneurysm formation as a complication of their Kawasaki syndrome. The mean erythrocyte sedimentation rate was not different in the two groups. Anterior uveitis is a common finding early in the course of Kawasaki syndrome. Slit lamp examination may be a helpful clinical tool in identifying patients with Kawasaki syndrome, and uveitis should be considered for inclusion in the Centers for Disease Control case definition of Kawasaki syndrome.
Four patients with retinal wrinkling and epiretinal membrane formation presented with a unique clinical syndrome consisting of comitant, small angle hyperdeviations with intractable vertical diplopia, and unstable single vision with a failure to respond to conventional prism therapy. The pathophysiology underlying this presentation appears to be the establishment of a rivalry between central and peripheral fusional mechanisms due to mechanical macular distortion.
Orbital rhabdomyosarcoma presenting as a localized, epibulbar mass is unusual, but common enough for the clinician to be aware of it. Although there has been a recent trend toward simple biopsy followed by irradiation and chemotherapy, cases presenting in this manner may sometimes be managed by total excision with preservation of the globe, follwed by irradiation and chemotherapy. A case of such an epibulbar rhabdomyosarcoma is presented as an illustrative example.