Biomedical subjects

Nitza Goldenberg-Cohen

Publications and source records attributed to Nitza Goldenberg-Cohen.

11 recordsLinked to original sources

PubMed2006

Retinal nerve fiber layer thickness in amblyopic eyes.

PURPOSE: To compare the peripapillary retinal nerve fiber layer (RNFL) thickness of sound and amblyopic eyes. DESIGN: Prospective observational case series. METHODS SETTING: Institutional. STUDY POPULATION: Patients with unilateral strabismic, anisometropic, or combined amblyopia. OBSERVATION: Fast RNFL analysis with ocular coherence tomography (OCT) of sound and amblyopic eyes. MEASURE: Mean RNFL thickness. RESULTS: For the 17 patients (mean age 10.7 years) in whom both eyes were imaged, the mean thickness of the sound eye was 109.2 microm (median 112.7) and of the amblyopic eye was 104.2 microm (median 105.0), and the average difference (sound eye less amblyopic eye) was 5.0 microm (median 3.0) (95% confidence interval -2.3, 12.2, P = .17). The sound eye was 10 microm or more thicker than the amblyopic eye in four patients; the amblyopic eye was 10 microm or more thicker than the sound eye in one patient; and the difference was within 10 microm in 12 patients. Test-retest data were obtained for 23 pairs of sound eyes and 21 pairs of amblyopic eyes, with 75% of the test-retest pairs within 7%. CONCLUSIONS: We found a small, but not clinically significant, difference in nerve fiber layer (NFL) thickness between amblyopic and sound eyes. Reliability was excellent, with most eyes testing within 7% of the first test.

Adolescent↗

PubMed2005

Ocular injury in children from exploding microwaved eggs.

PURPOSE: To report an ocular injury caused by exploding microwave-cooked eggs. DESIGN: Case reports. METHODS: Two children exposed to exploding microwaved eggs were examined for facial burns and ocular trauma. RESULTS: One patient sustained mild corneal epithelial damage in both eyes and eyelid burn, which were treated conservatively. The other, injured in the same event, had symblepharon and moderate keratopathy requiring intensive lysis. CONCLUSIONS: Physicians should be alerted to the potential risk of vision-threatening ocular injury from exploding microwaved foods, and the public should be educated not to cook eggs in microwave ovens.

Blast Injuries↗

PubMed2005

Postoperative adjustable surgery of the superior oblique tendon.

PURPOSE: To describe a surgical procedure for loosening or tightening the superior oblique (SO) tendon that enables bedside adjustment following the surgery, with surgical outcome reported. METHODS: A permanent suture separates the two cut ends of the SO tendon, with a sliding noose for adjustment. The noose is accessed by having the patient look up or straight ahead, not down, during adjustment at the bedside. Records of 17 patients who underwent this surgery between June 2000 and January 2003 were reviewed and analyzed for outcome. RESULTS: Seventeen patients, 18 eyes, mean age 43.7 years (range 5.9 to 71 years) had SO surgery with postoperatively adjustable sutures. Twelve eyes of 11 patients had a loosening procedure, and six eyes had a tightening procedure. Seven of the patients had had precious eye muscle surgery, four having had previous surgery on the same SO tendon. All but one patient returned for the follow-up examination, ranging from 1.5 to 7 months postoperatively. Torsional imbalances in 12 patients improved in all but two. In four patients with a preoperative A pattern, the A pattern improved from 16 PD to 0 PD on average. In eight patients with vertical misalignment in straight ahead gaze who had no other cyclovertical muscle surgery simultaneously, the mean reduction was 7 PD. All patients except one had improvement in preoperative symptoms. CONCLUSION: Both loosening and tightening procedures can be performed successfully using a postoperative adjustment technique for the SO tendon.

Adolescent↗

PubMed2005

Oligodendrocyte dysfunction after induction of experimental anterior optic nerve ischemia.

PURPOSE: The early response and survival of oligodendrocytes after axonal stroke and their potential contribution to neuronal survival in vivo have not been adequately addressed. The purpose of this study was to investigate the changes occurring in the retina and optic nerve (ON) in anterior ischemic optic neuropathy (AION), using a c-fos transgenic mouse model. METHODS: A new mouse model of AION (rodent AION) was developed to evaluate the in vivo stress response of oligodendrocytes and retinal ganglion cells (RGCs) in a transgenic mouse strain, using the immediate early stress-response gene c-fos, RT-QPCR technology, immunohistochemistry, and electron microscopy. Confocal microscopy was used with cell-specific antibodies to characterize the timing of cells responding to rAION. The TUNEL assay detected cells undergoing apoptosis. Ultrastructural changes were analyzed by electron microscopy. RESULTS: In rAION, oligodendrocytes rapidly respond in vivo to ischemic ON damage, with c-fos activation as an early detectable event. Early evidence of progressive oligodendrocyte stress, is followed by demyelination, wallerian degeneration of the ON, and oligodendrocyte and RGC death far from the primary lesion. CONCLUSIONS: After rAION induction oligodendrocytes, as well as RGCs, undergo progressive stress, with dysfunction and apoptosis. The findings lead to a proposal that progressive retrograde oligodendrocyte stress, away from the primary lesion, is an important factor after ischemic optic neuropathy. Postinduction demyelination must be addressed for effective neuroprotection of ischemic and hypoxic white matter.

Animals↗

PubMed2005

T1799A BRAF mutations in conjunctival melanocytic lesions.

PURPOSE: To gain a better understanding of the molecular events leading to the development of conjunctival melanocytic lesions and conjunctival melanoma, this study was conducted to investigate the presence of T1799A BRAF oncogenic mutation in these lesions. METHODS: Forty-eight surgically excised conjunctival melanocytic lesions from 48 patients were examined for the presence of the BRAF T1799A mutation. Twenty-eight lesions were conjunctival nevi, of which 20 were excised from children younger than 18 years. Fifteen lesions were conjunctival primary acquired melanosis (PAM; 11 without atypia and 4 with atypia) and five were conjunctival melanomas. To detect the BRAF T1799A mutation, both a newly developed kit (Mutector; TrimGen, Sparks, MD) and direct DNA sequence analysis of exon 15 after PCR amplification were used. RESULTS: The T1799A BRAF mutation was identified in 14 of 28 (50%) conjunctival nevi analyzed, but in none of the 15 conjunctival PAMs, with and without atypia. The T1799A BRAF mutation was identified in two of the five (40%) conjunctival melanomas. There was no difference in the BRAF mutation detected in conjunctival nevi in children or adults, as the BRAF mutation was detected in 50%. CONCLUSIONS: The results showed that conjunctival nevi, similar to skin nevi, have a high frequency of oncogenic BRAF mutations. Furthermore, the results suggest that the oncogenic event leading to BRAF mutations affect only conjunctival nevi and not conjunctival PAM. The clinical significance of these observations remains to be determined.

Adolescent↗

PubMed2004

Plasma ghrelin levels are normal in obese patients with idiopathic intracranial hypertension (pseudotumor cerebri).

PURPOSE: Idiopathic intracranial hypertension (IIH) occurs predominantly in young, obese women. Weight loss may alleviate symptoms of IIH yet may be difficult to achieve. Ghrelin, a gastric hormone, is involved in normal body weight and appetite regulation. Its levels are elevated in syndromes of overeating and decline in simple obesity. We postulated that fasting plasma ghrelin levels are elevated in IIH patients and that the typical postprandial decline in plasma ghrelin may not occur. DESIGN: Prospective, observational case-control study. METHODS: Prospective study. SETTING: University hospital and clinic. STUDY POPULATION: Sixty-five patients with a diagnosis of IIH and 25 obese control patients (screened for IIH symptoms). Patients with intracranial abnormalities or a history of gastric surgery were excluded. OBSERVATION PROCEDURE: Fasting plasma ghrelin, leptin, and insulin levels were assessed between 8 am and 10 am. Subjects were fed a standard breakfast, and postprandial ghrelin levels were measured 30 minutes later. RESULTS: Fasting plasma ghrelin levels negatively correlated with body mass index in both IIH subjects (r = -.48) and controls; leptin showed a positive correlation with body mass index in both IIH (r =.59) and controls. Levels were not significantly different between the groups. Postprandial ghrelin declined by 71 +/- 31 (95% CI) pg/ml in the IIH group and 71 +/- 35 (95% CI) pg/ml in the control group. CONCLUSION: Plasma ghrelin levels, both fasting and postprandial, do not differ between IIH patients and obese controls. Obese IIH patients should be encouraged to lose weight and referred for medical weight loss management to maximize their chances of alleviating their symptoms.

Adult↗

PubMed2004

Traumatic optic neuropathy in children and adolescents.

PURPOSE: Retrospective review to describe the features and visual outcome of traumatic optic neuropathy (TON) in children and adolescents. METHODS: Interventional and observational case series of children <18 years with TON. RESULTS: Forty children, 24 boys and 16 girls, were identified with 43 affected eyes. The mean age was 11.6 years (range, 2 to 18). The most common causes were motor vehicle accidents (62%) and sports injuries (22%). The trauma was blunt in 78% of cases and penetrating in 22%. Visual acuity at presentation for 27 patients whose visual acuity could be assessed ranged from no light perception to 20/80. Interventions included corticosteroids (n = 18), decompression of the optic canal (n = 3), and optic sheath nerve fenestration (n = 1). Visual outcome for 22 children with at least 1 month of follow-up was no light perception in 10 (45%), < 20/200 in 7(32%), 20/200 to < 20/80 in 1(4%), and > or = 20/80 in 4 (18%). There was no difference in the rate or degree of improvement between treated and untreated patients. CONCLUSION: TON in children is caused by mechanisms similar to those that cause TON in adults. The severity of visual loss as well as the rate and degree of improvement are also similar. Our data do not indicate that treatment improves visual outcome.

Accidents, Traffic↗

PubMed2004

Noninvasive neuroimaging of basilar artery dolichoectasia in a patient with an isolated abducens nerve paresis.

PURPOSE: To describe the neuroimaging findings in a patient with an isolated abducens nerve palsy caused by a dolichoectatic basilar artery. DESIGN: Retrospective case report. METHODS: A 65-year-old man presented with a 3-year history of gradually worsening horizontal double vision. He subsequently underwent magnetic resonance imaging, magnetic resonance angiography, and computed tomographic angiography. RESULTS: Neuroimaging revealed dolichoectasia of the basilar artery. The enlarged, tortuous vessel appeared to be compressing the subarachnoid portion of the nerve at its exit from the brainstem. CONCLUSION: Noninvasive neuroimaging studies are sufficient to establish a diagnosis of basilar artery dolichoectasia in patients with isolated cranial neuropathies.

Abducens Nerve Diseases↗

PubMed2003

Lack of BRAF mutation in primary uveal melanoma.

PURPOSE: BRAF T1796A activating mutations have been found in a high proportion of cutaneous melanomas, cutaneous nevi, and papillary thyroid carcinoma and in a small fraction of other cancers. This study was designed to investigate the incidence of BRAF T1796A mutation in uveal melanoma. METHODS: Twenty-nine formalin-fixed, paraffin-embedded posterior uveal melanomas were included in the study. DNA was extracted from the paraffin sections followed by PCR amplification of exon 15 and detection of the common BRAF missense mutation (T-->A transversion at nucleotide 1796) using restriction enzyme analysis. RESULTS: Although positive cutaneous melanoma control cell lines harbored the T1796A BRAF mutation, none of the 29 uveal melanomas harbored the mutation. CONCLUSIONS: These data suggest that BRAF T1796A activating mutation is not common in primary uveal melanoma. These findings are in accord with known differences in tumorigenesis between uveal and cutaneous melanomas.

DNA Mutational Analysis↗

PubMedDate not supplied

Inflammatory reaction in acute retinal artery occlusion: cytokine levels in aqueous humor and serum.

PURPOSE: To investigate the role of inflammation in acute retinal artery occlusion (RAO). METHODS: Levels of interleukin (IL)-6, IL-8, and tumor necrosis factor alpha (TNF-alpha) were measured in serum (n = 14) and aqueous humor (AqH) (n = 8) samples from patients with RAO. Findings were compared with 24 age- and disease-matched patients, 10 healthy subjects (serum), and 16 patients undergoing cataract surgery (AqH). RESULTS: Patients who arrived early (within 4-6 hours of occlusion) had higher serum IL-8 and IL-6 levels than controls; the IL-6 level in the AqH was lower than that of controls, while the IL-8 level was higher. In seven patients for whom both serum and AqH samples were available, serum IL-6 levels were higher than their corresponding AqH levels in most patients arriving within 10 hours of occlusion, and AqH IL-8 levels were higher than the corresponding serum levels in all but one. TNF-alpha levels were consistently higher in the serum than in the AqH at all time points. CONCLUSIONS: Serum IL-8 and IL-6 and AqH IL-8 are elevated immediately following acute RAO. The early local suppression of IL-6 may be related to ocular immune mechanisms.

Acute Disease↗

PubMedDate not supplied

Cyclocryotherapy versus transscleral diode laser cyclophotocoagulation for uncontrolled intraocular pressure.

BACKGROUND AND OBJECTIVE: To compare the use of cyclocryotherapy and diode laser cyclophotocoagulation for the treatment of uncontrolled intraocular pressure. PATIENTS AND METHODS: Seventy consecutive patients (70 eyes) treated for high, unresponsive intraocular pressure during a 4-year period with cyclocryotherapy (n = 38) or diode laser cyclophotocoagulation (n = 32) with a follow-up period of at least 3 months (mean follow-up = 15.7 months) were compared for intraocular pressure, visual acuity, and complication rate. RESULTS: Mean intraocular pressure was reduced from 40.9 +/- 11.9 to 20.5 +/- 10.3 mm Hg in the cyclocryotherapy group, and from 35.9 +/- 9.3 to 21.3 +/- 10.7 mm Hg in the cyclophotocoagulation group. Intraocular pressure was controlled in 60.5% and 62.5% of eyes, respectively. Deterioration in visual acuity occurred in 31.5% of the cyclocryotherapy group and 37.5% of the cyclophotocoagulation group. Severe visual loss to no light perception was noted in 6 eyes and 2 eyes, respectively, and phthisis bulbi in 2 eyes in the cyclocryotherapy group (5.2%) and 1 eye in the cyclophotocoagulation group (3.1%). CONCLUSIONS: Cyclocryotherapy and diode laser cyclophotocoagulation are equally effective in decreasing intraocular pressure in patients with persistent uncontrolled glaucoma, with a lower rate of complications associated with diode laser cyclophotocoagulation.

Adult↗