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Biomedical subjects

M T Miller

Publications and source records attributed to M T Miller.

At least 19 recordsLinked to original sources
PubMed1992

Refractive evaluation in thalidomide embryopathy.

To evaluate the ocular findings associated with thalidomide embryopathy, we examined 86 of 100 Swedes who had a proven correlation between birth defects and the mother's intake of thalidomide during pregnancy. Cycloplegic refraction, keratometry, and axial length measurements were performed. The subjects were divided into four groups according to their physical malformations, giving a time frame for when in gestation the insult occurred (the sensitive phase for thalidomide is 20-36 days after conception). The results indicate a trend toward shorter and longer axial lengths, high refractive errors, and corneal astigmatism in thalidomide embryopathy compared to controls, and in addition there was a tendency for those anomalies to occur in the group with the earliest thalidomide-induced defects. It is suggested that thalidomide disturbs the growth and shape of the eye and that this effect is exerted early in its teratogenic period.

Abnormalities, Drug-Induced↗
PubMed1992

Ocular teratology. Observations, speculations, questions, principles reaffirmed.

Teratology is most simply defined as "the study of environmental agents which disturb development". A more comprehensive definition is "the study of causes, mechanisms, and manifestations of developmental deviation, structural or functional." Teratology has several important purposes. Obviously, the most important is to protect future generations by identifying environmental agents that cause malformations. In this sphere, ophthalmologists are generally not the primary detectors. One notable exception is when Gregg, in 1941, recognised that an increase in congenital cataracts was due to a viral agent and brought rubella embryopathy to the attention of the medical community. Another pertinent reason for teratology is that it gives us insights into normal development. As Harvey said with such flair, "nature is nowhere accustomed more openly to display her secret mysteries than in cases where she shows tracings of her workings apart from the beaten path".

Ethanol↗
PubMed1992

The study of malformations "by the company they keep".

Our study of individuals with thalidomide embryopathy reaffirms many of the principles of clinical teratology concerning sensitivity of developing structures and specificity of action. It also highlights important features of ocular teratology that differ from those of other organ systems. Because malformations of the eye and associated structures do not significantly threaten the survival of the embryo, fetus, or neonate, any variation in prevalence in older individuals is not due to the nature of the ocular malformation but may be significantly modified by "the company they keep," the systemic malformations occurring at the same time as the original insult, whether it be an environmental, a genetic, or a local disturbance. Additionally, the presence of clusters of malformations caused by a teratogen at a specific time supports the concept of a common pathogenic mechanism and provides suggested avenues for further research into the cause of these malformations.

Abnormalities, Drug-Induced↗
PubMed1989

Magnetic resonance imaging of pituitary stalk hypoplasia. A discrete midline anomaly associated with endocrine abnormalities in septo-optic dysplasia.

Septo-optic dysplasia describes optic nerve hypoplasia in association with endocrine disturbances and/or midline brain malformations. Magnetic resonance imaging of the brain was used to study two patients with optic nerve hypoplasia, endocrine abnormalities, and normal midline brain anatomy on prior computed tomographic scan. The magnetic resonance imaging scans showed normal midline brain anatomy except for failure to visualize the pituitary stalk, a structure that magnetic resonance imaging has shown to be 100% sensitive in imaging in our normal controls. We propose that our two patients have endocrine abnormalities due to the discrete anomaly of pituitary stalk hypoplasia.

Child, Preschool↗
PubMed1988

Simulated superior oblique tendon sheath syndrome.

Three patients with simulated Brown's superior oblique tendon sheath syndrome are presented. With the use of computed tomographic (CT) findings, the site of the pathology could be demonstrated. In all three patients, there were definite abnormal findings in the anterior sheath of the reflected tendon of the superior oblique. The abnormal findings in one case were confirmed at the time of surgery. Therapy in two of the cases was determined by the abnormal findings on the CT scan.

Adolescent↗
PubMed1987

Amniotic bands as a cause of ocular anomalies.

We examined nine patients with amniotic band syndrome who had systemic and ocular pathologic deformities. The most common ocular malformations were congenital corneal leukomas or acquired corneal opacities secondary to exposure and eyelid colobomas. The eyelid defects appeared to be extensions of facial clefts in these patients and were often located adjacent to the corneal opacities. Other anomalies included microphthalmos, strabismus, and hypertelorism. One patient had the typical peripheral and facial stigmata of the amniotic band syndrome in association with a coloboma of the left iris and retina.

Abnormalities, Multiple↗
PubMed1987

Computed tomography scanning in the evaluation of ocular motility disorders.

Ocular muscle disturbances (strabismus) are common disorders affecting two to four per cent of the population. Until recently, CT and MRI have not been used extensively in the diagnosis of congenital and acquired conditions causing strabismus. In this article the value of these scanning techniques in terms of more appropriate therapeutic intervention and further insight into the pathophysiology of these conditions is detailed.

Eye Diseases↗
PubMed1987

Dynamic computed tomography and its application to ophthalmology.

In this review of 31 patients, dynamic CT is discussed as a valuable tool in the study of the dynamics of blood flow in patients with unexplained visual problems that may be related to ischemic optic neuropathy. Dynamic CT scans are obtained by rapid-sequence CT imaging during and following a rapid bolus injection of intravenous contrast medium. It demonstrates the initial passage of contrast material through the area of interest, thus giving a true picture of the degree of vascularity and the dynamics of blood flow.

Diagnosis, Differential↗
PubMed1979

A comparison between meptazinol and omnopon in the relief of postoperative pain.

In a random double-blind trial, meptazinol 100 mg, a new hexahydro-azepine derivative, was found to be comparable to Omnopon (papaveretum) 20 mg when given intramuscularly for the control of pain in 50 cases after hysterectomy. The onset of analgesia was rapid and the effect lasted for about 3 hours. Cardiovascular and respiratory systems remained stable. No significant difference as regards sedation and nausea was noticed between the two groups.

Adult↗
PubMedDate not supplied

Absence of the superior rectus muscle in Apert's syndrome.

A patient with classical Apert's syndrome is discussed along with the finding of absent superior rectus muscle. This anomaly may be more common than thought, especially in relation to craniofacial anomalies. A review of Apert's syndrome and superior rectus agenesis is presented.

Acrocephalosyndactylia↗
PubMedDate not supplied

Unusual variant of familial aniridia.

A woman and her two children had apparent dominantly inherited ocular abnormalities including aniridia, ptosis, nystagmus, corneal pannus, persistent pupillary membrane, lenticular opacities, and foveal hypoplasia. A broad spectrum of iris abnormalities was observed: the daughter had aniridia with persistent pupillary membrane strands traversing the anterior lens capsule; the iris of the mother and son had a velvety surface with no detailed crypts, but did have some persistent pupillary membrane tags extending from the collarette. All three family members had moderately severe bilateral ptosis, pendular nystagmus, corneal pannus, and visual acuity of 20/200. Several systemic abnormalities also were noted, including obesity and mental retardation in the two children, and alopecia, cardiac abnormalities, and frequent spontaneous abortion in the mother. Family history indicated that the children's maternal grandmother also had similar ocular findings. We believe that this constellation of findings represents a rare, apparently dominant, variant of aniridia.

Adult↗
PubMedDate not supplied

Progressive hemifacial atrophy (Parry-Romberg disease).

Hemifacial atrophy (Parry-Romberg syndrome) is characterized by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissue and fat. The onset is usually in the first two decades. Ophthalmic involvement is common; the most frequent abnormality is progressive endophthalmos with subsequent changes in the palpebral fissure. Pupillary disturbances, heterochromia, uveitis, and restrictive strabismus have also been frequently reported. We describe six cases that manifest a wide spectrum of ocular and systemic findings. They are noteworthy in that all exhibit pigmentary disturbances of the ocular fundus, a finding rarely reported. Another unusual ocular manifestation in one patient was an acquired partial third nerve palsy on the unaffected side.

Adolescent↗
PubMedDate not supplied

Möbius and Möbius-like syndromes (TTV-OFM, OMLH).

There exists a spectrum of syndromes characterized by cranial nerve palsies, limb anomalies, and craniofacial malformations. Criteria based on type and severity of limb anomaly or presence or absence of cranial nerve palsy may alter the syndrome nomenclature due to a selection bias but do not appear to benefit syndrome delineation to any extent. Patients with seventh nerve palsy and abduction weakness are usually diagnosed as having Möbius syndrome by ophthalmologists. The observed ocular motility findings range from primarily abduction deficiencies to patients who have a Duane or gaze palsy pattern of horizontal movements. Some cases previously described as "sixth nerve and partial third" may better fall into one of the latter groups, since an isolated adduction deficit as a manifestation of third nerve involvement is rare. The presence of clinical appearance of Duane syndrome in these Möbius-type patients raises the possibility of abnormal innervation of the lateral rectus as an explanation of some patterns of motility observed.

Abducens Nerve↗
PubMedDate not supplied

Necrotizing scleritis following strabismus surgery for thyroid ophthalmopathy.

Necrotizing scleritis with inflammation of the right eye developed after bilateral eye muscle surgery for thyroid ophthalmopathy. Debilitating pain, delay in onset, and involvement of the sclera distinguish this condition from anterior segment ischemia. The surgery may have acted as a nonspecific trigger in an eye at risk for scleritis. Necrotizing scleritis has occurred infrequently after other types of eye surgery but, to our knowledge, has not been previously reported as a complication of eye muscle surgery.

Aged↗