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Biomedical subjects

M Snir

Publications and source records attributed to M Snir.

36 records · Page 2Linked to original sources

Aniridia: recent achievements in paediatric practice.

Aniridia is a rare panocular disorder which primarily involves not only the iris, but also the retina, optic nerve, lens and cornea. Visual acuity deteriorates as a result of nystagmus, glaucoma, cataract, corneal opacities and retinal hypoplasia. Aniridia may appear as an isolated disorder, most often familial with autosomal dominance or sporadically in association with at least 12 syndromes. Both familial isolated and Wilms tumour, bilateral sporadic aniridia, genitourinary abnormalities and mental retardation syndrome-associated aniridia have been traced to a mutation of the PAX6 gene on band 11p13. Since genetic diagnosis of this disorder is already possible, counselling affected families should be preceded by karyotype studies and linkage analysis in familial cases of isolated aniridia. In sporadic cases of isolated aniridia or WAGR syndrome, we suggest that PAX6 mutation analysis be employed.

Aniridia↗

Eyelash complications in the anterior chamber.

A 9-year-old child was admitted because of a penetrating corneal wound with a solitary eyelash in the anterior chamber. Anterior uveitis, posterior synechias, and localized anterior subcapsular cataract subsequently developed. As the latter complications did not respond to conservative treatment, the eyelash was removed surgically. The expected complications of an intraocular cilium and the surgical indications for its removal are discussed in detail.

Anterior Chamber↗

Lovastatin therapy in hypercholesterolemia: effect on fibrinogen, hemorrheologic parameters, platelet activity, and red blood cell morphology.

The effect of lovastatin therapy on blood rheology was investigated in 26 hypercholesterolemic patients. Treatment with lovastatin was associated with a significant improvement in whole blood filtration time and a tendency toward normalization in red blood cell morphology. A significant increase was observed in fibrinogen level, in ADP-induced platelet aggregation, in the percentage of "big" platelets, and in platelet count. The viscosity of whole blood and plasma and the percentage of aggregated platelets did not change significantly. The cause for these hemorrheologic changes and their role in influencing the coronary risk of lovastatin-treated hypercholesterolemic patients should be further investigated.

Adolescent↗

Lovastatin therapy in heterozygous familial hypercholesterolaemic patients: effect on blood rheology and fibrinogen levels.

Thirteen heterozygous familial hypercholesterolaemic patients were treated with lovastatin for 1 year, and were investigated for the effect on lipid profile, blood rheology and fibrinogen levels. A significant dose-dependent reduction in serum levels of total and LDL-cholesterol, Apo B and the ratio of total cholesterol to HDL-cholesterol was noted. Improvement in red blood cell filterability and an increase in fibrinogen levels were also observed. We conclude that the hypocholesterolaemic effect of lovastatin in familial hypercholesterolaemia is accompanied by changes in blood rheology. While some of these haemorheological changes may be considered beneficial, others may be regarded as unfavourable. The net effect of lovastatin therapy on the coronary risk of familial hypercholesterolaemic patients warrants further investigation.

Blood Viscosity↗

Central venous stasis retinopathy following the use of tranexamic acid.

Central venous stasis retinopathy (CVSR) was observed in two young women following the administration of oral tranexamic acid (TA) for the treatment of menorrhagia. Clinical and laboratory parameters were normal. Withdrawal of the drug and treatment with systemic steroids and fibrinolytic drugs resulted in improvement of visual acuity to 6/6. The pathogenesis of the CVSR in these cases is suggested, and the rationale of systemic treatment is discussed.

Adult↗

Postoperative refractive changes in children with congenital esotropia: a preliminary study.

A transient myopic inclination was found 2 months postoperatively in 23 children who had undergone surgery for congenital esotropia. Neither the age of the children at the time of surgery nor the length of muscle recession/resection influenced these refractive myopic changes. Early postoperative refractive correction with periodic follow-up is essential in preventing amblyopia. In 21 of the 23 children, visual acuity was 6/10 or better at last examination.

Child, Preschool↗

Visual acuity, strabismus, and amblyopia in premature babies with and without retinopathy of prematurity.

One hundred eighty-seven premature babies, 48 of whom suffered from retinopathy of prematurity (ROP), were examined. A higher incidence of strabismus was found in the group with cicatricial ROP (23% vs. 9%). Amblyopia was present in 6% of the ROP group and in only 1.4% of babies without ROP. Myopia was found in 50% of the ROP group as compared with 15% in the nonROP group. Astigmatism and anisometropia were more common in the ROP group, but hypermetropia was equally represented in both groups.

Age Factors↗

Retinal manifestations of thrombotic thrombocytopenic purpura (TTP) following use of contraceptive treatment.

An 18-year old woman, suffering from thrombotic thrombocytopenic purpura (TTP) disease after taking an oral contraceptive, developed bilateral retinal elevations in the posterior pole with Elschnig spot formation without visual acuity impairment. Clinical and laboratory evaluation combined with intensive medical and surgical therapy (splenectomy) caused regression of the ocular and general findings. We believe that the ocular pathologic findings in this clinical case are due to injury in the choroidal vasculature and the pe layer as a manifestation of the TTP disease.

Adolescent↗

An unusual extraocular muscle anomaly in a patient with Crouzon's disease.

A 29-year-old female suffering from Crouzon's disease was admitted to hospital with retinal detachment in the right eye. At operation agenesis of 4 extraocular muscles (superior and inferior recti and obliquus) was found, together with abnormal insertion of the 2 horizontal muscles. The same extraocular muscular abnormalities were found in the left eye. We suggest here a new surgical treatment in such cases and discuss the reasons for the limitation of ocular motility in such cases.

Adult↗

Bilateral maculopathy simulating 'cherry-red spot' in a patient with Crohn's disease.

A 23-year-old man suffering from Crohn's disease developed a bilateral maculopathy simulating 'cherry-red spot' with vision impairment and normal electroretinogram during total parenteral hyperalimentation, when copper and zinc serum levels were considerably decreased. The maculopathy rapidly subsided after cessation of the parenteral hyperalimentation and the addition of cooper and zinc. The cause of this maculopathy may be ocular involvement as part of the systemic disease owing to storage of the supplementary free amines and intravenous lipids, and the deficiency of zinc and copper.

Adult↗

Retinopathy of prematurity and surfactant treatment.

PURPOSE: Surfactant therapy in premature infants has reduced the severity of respiratory distress syndrome (RDS), thus leading to a reduction in mortality. However, the anticipated effect of surfactant therapy on the incidence and severity of retinopathy of prematurity (ROP) is ambiguous. The acute rise in PaO2 and the increased survival of low-birth-weight infants may augment the risk of ROP, whereas their improved health and respiratory status may lower it. METHODS: We reviewed the findings of sequential ophthalmologic examinations performed in our neonatal intensive care unit. Premature infants of gestational age under 32 weeks and weighing less than 1500 g at birth who received surfactant treatment were compared with a group of historical controls consisting of premature infants of the same mean birth weight and gestational age who did not get this supplement. RESULTS: ROP was present in 13 (65%) of the 20 surfactant-treated babies, and threshold disease was noted in six (30%). In the historical control group, 20 (77%) of 25 infants had ROP, of whom 10 (40%) were treated for threshold disease. These differences were not statistically significant. CONCLUSION: Surfactant therapy was not associated with an increased incidence of ROP in our series.

Age of Onset↗

Mitomycin C and 5-fluorouracil antimetabolite therapy for pediatric glaucoma filtration surgery.

PURPOSE: To evaluate the efficacy and safety of augmented trabeculectomy with 5-fluorouracil (5-FU) and mitomycin C (MMC) compared to 5-FU only for the treatment of pediatric glaucoma. PATIENTS AND METHODS: In a prospective randomized clinical trial, 8 children (12 eyes) with pediatric glaucoma, either congenital or secondary to: lens aspiration, Sturge-Weber syndrome, or steroids underwent augmented trabeculectomy. Six patients (8 eyes) underwent augmented trabeculectomy with 5-FU plus MMC and 2 patients (4 eyes) underwent augmented trabeculectomy with 5-FU only. MAIN OUTCOME MEASURES: Between-group comparison of postoperative parameters: change in intraocular pressure (IOP), dependence on antiglaucoma medication, number of 5-FU injections, cup-disc ratio, corneal diameter, drug-induced complications. RESULTS: In the 5-FU/MMC group, 7/8 eyes showed good control of postoperative IOP (9-16 mm Hg), which was independent of antiglaucoma therapy; only 2 injections of 5-FU were needed. By contrast, in the 5-FU group, no control of the postoperative IOP (21-23 mm Hg) was achieved in 4/4 eyes, and these patients remained dependent on antiglaucoma medication; up to 6 injections of 5-FU were used. There was no deterioration in the cup-disc ratio or the corneal diameter in either group. Results were maintained on follow-up (23-27 months). No significant drug-induced complications were noted. CONCLUSION: Augmented trabeculectomy with adjunctive 5-FU/MMC may be an option for the control of pediatric glaucoma in patients with a poor surgical prognosis.

Alkylating Agents↗