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Biomedical subjects

Pisit Preechawat

Publications and source records attributed to Pisit Preechawat.

7 recordsLinked to original sources
PubMed2006

Orbital apex syndrome from gnathostomiasis.

A 16-year-old Thai girl presented with acute unilateral visual loss, proptosis, and ophthalmoparesis. CT demonstrated thickening and enhancement of orbital tissues including the orbital apex. A history of consumption of raw fish, together with the findings of cutaneous migratory swelling and eosinophilia, made the diagnosis of gnathostomiasis likely. Her serum was positive for Gnathostoma spinigerum using an immunoblotting technique. Parasites removed from the skin lesions revealed the typical head bulbs with 4 circumferential rows of hooklets and fine cuticular spines on their surface. Treatment with an antihelminthic and systemic corticosteroids led to resolution of orbital inflammation but left a persistent optic neuropathy marked by nerve fiber bundle visual field loss with normal visual acuity. Gnathostomiasis should be suspected in patients with an orbital apex syndrome who live or travel in an endemic area, have eaten raw fish, and develop a migratory skin rash.

Adolescent↗
PubMed2006

Four recti enlargement at orbital apex and thyroid associated optic neuropathy.

OBJECTIVE: To determine the site of muscle enlargement in thyroid-associated ophthalmopathy and optic neuropathy in Ramathibodi Hospital. MATERIAL AND METHOD: Data and images of MRI and CT of patients with thyroid-associated ophthalmopathy were retrospectively reviewed Neuro-ophthalmologic data and correlation to the imaging findings were analyzed. RESULTS: Among 19 patients with thyroid-associated ophthalmopathy, 20 imaging studies were collected. There were 4 patients with bilateral disease and crowdedness of 4 recti muscle. All of them had thyroid associated optic neuropathy. One out of 19 patients underwent two different sessions study. During her first study, right optic nerve was involved with the crowding of right optic nerve but 7 months later her left optic nerve became involved with crowding of the left optic nerve and the right 4 recti appeared smaller CONCLUSION: Four recti muscle enlargement in thyroid-associated ophthalmopathy, like four-leaf clover in coronal section of imaging study, may be an important sign of thyroid associated optic neuropathy.

Adult↗
PubMed2005

Reconstruction of contracted eye socket with amniotic membrane graft.

PURPOSE: To investigate the use of amniotic membrane graft for socket reconstruction in cases in which forniceal shortening by scar or symblepharon formation has made it difficult to successfully wear an ocular prosthesis. METHODS: A retrospective analysis of 20 contracted eye sockets that underwent forniceal reconstruction with amniotic membrane graft from 1997 to 2001. RESULTS: There were 8 male and 12 female patients, with an age range between 2 and 66 years. Duration of forniceal shortening varied from 2 months to 48 years. The operation was performed in the lower fornix in 13 eyes, upper fornix in 1 eye, and both fornices in 6 eyes. The mean follow-up period was 13.6 months. Eighty percent of cases achieved successful prosthetic fitting after surgery. Four eyes had recurrent forniceal shortening after surgery in which a prosthesis could not be properly fitted. There were no serious complications, such as infection or graft rejection. CONCLUSIONS: The use of amniotic membrane grafts can be a useful option in forniceal reconstruction with a high success rate, a low rate of complications, and without discomfort of donor sites.

Adolescent↗
PubMed2005

Retrobulbar injection of triamcinolone in thyroid associated orbitopathy.

OBJECTIVE: To identify the result of retrobulbar triamcinolone injection in patients with thyroid associated orbitopathy MATERIAL AND METHOD: Prospective noncomparative pilot study in 27 eyes of 19 patients who had been diagnosed as thyroid associated orbitopathy during October 2000 through April 2002. The patients received retrobulbar 40 mg triamcinolone treatment for each orbit weekly, totaling 4 applications. RESULTS: Three months after treatment, most of the patients demonstrated no significant change in visual acuity and visual field. Improvement of proptosis was observed in 15 eyes (56%) and stable in 10 eyes (37%). Seven patients (41%) had improvement of extraocular muscle function as demonstrated by Hess test. These results remained stable in the majority of patients at the 6 months follow up period. No systemic side effects were observed The only significant local side-effect was intraocular pressure elevation which was found in 8 eyes and responded to antiglaucoma therapy. CONCLUSION: This preliminary study demonstrated the potential benefit of retrobulbar triamcinolone injection in cases of thyroid associated orbitopathy. Long-term study in these patients is required.

Adult↗
PubMed2004

Aneurysmal third nerve palsy.

To study the clinical characteristics, treatment and outcome of patients with aneurysmal third nerve palsy. Eleven patients with isolated third nerve palsy from an intracranial aneurysm from 1998 to 2002 at Ramathibodi Hospital were reviewed retrospectively. The average age was 60 years. Ipsilateral headache and/or retroorbital pain occured in 80 percent of the patients. Ten patients had unilateral disease, whereas one patient had bilateral involvement. The most common site of aneurysm was at the origin of the posterior communicating artery. Endovascular treatment with coil embolization provided successful occlusion as well as neurosurgical clipping. Recovery of third nerve function was found in all patients but had variable degrees. Patients who received early treatment, especially within 10 days after onset of oculomotor dysfunction appeared to have the best chance of recovery. Aberrant regeneration developed in 5 cases. The commonest sign was lid retraction during adduction and downward gaze.

Adult↗