Biomedical subjects
Publications and source records attributed to P J Maris.
Four patients developed giant conjunctival cysts following scleral buckling for retinal detachment. Histologically these cysts showed a core of fibrous tissue lined by stratified, non-keratinizing epithelium and with goblet cells. They probably arose from inadvertent implantation of epithelium during surgery. In three cases the cysts were surgically excised without recurrence. Alternate modes of therapy are discussed.
A 25-year-old white man presented with acute multiple sclerosis manifested by right blindness, difficulty urinating, and paresthesias and weakness of both legs. Retinal examination revealed a distal occlusion of the descending branch of the superior temporal arteriole leading to an area of retinal ischemia of the right eye. The optic disc was edematous, and there were focal areas of periphlebitis. All retinal signs resolved in three weeks, and the only abnormality that persisted was a pale right optic disc. The finding of small arteriolar disease is unusual and may represent another possible pathogenetic mechanism in multiple sclerosis.
Two cases of retinal detachment are presented in which significant scleral ruptures occurred at the time of scleral buckling surgery. Retinal reattachment was achieved and scleral ruptures successfully closed utilizing standard scleral buckling elements. Long-term follow-up of both cases failed to disclose any significant ocular complications occurring at the rupture site. Intraoperative management and techniques recommended for the avoidance of this complication are discussed.
Two patients with a heretofore undescribed unilateral choristomatous malformation of the intracranial optic nerve and chiasm underwent craniotomy for partial resection of the optic nerve in the belief that the tumor was either a glioma or a meningioma. Visual acuity in the affected eye was reduced to 20/200 in one patient and to finger counting in the other. Chiasmal involvement in the first case was associated with a superotemporal field defect in the opposite eye. Ophthalmoscopy disclosed atrophic nerve heads in both affected eyes. Heteroplastic masses of smooth muscle and adipose tissue replaced most of the resected optic nerve in each case.
Two hundred consecutive primary rhegmatogenous retinal detachments repaired with Silastic sponge implants were evaluated. A primary reattachment rate of 94% and an overall reattachment rate of 95% were achieved. Two of the successful repairs became detached after six months giving a redetachment rate of approximately 1%. Eight of the 12 failures were due to massive periretinal proliferation (MPP) (overall incidence of MPP = 4%). To date, only one Silastic sponge has had to be removed because of late infection. No cases of extrusion or erosion occurred. We recommend this procedure as safe and effective.
A 62-year-old woman known to have tuberous sclerosis had an ususual peripapillary retinal elevation in her left eye. The patient had no specific ocular symptoms and we considered the diagnosis of papilledema secondary to increased intracranial pressure. Retinal angiography established that she had a peripapillary exophytic retinal angioma associated with an epipapillary astrocytic hamartoma in this eye.