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Biomedical subjects

R A Nozik

Publications and source records attributed to R A Nozik.

At least 19 recordsLinked to original sources
PubMed1992

Other infections of the choroid and retina. Toxoplasmosis, histoplasmosis, Lyme disease, syphilis, tuberculosis, and ocular toxocariasis.

The major clinical infectious syndromes involving the retina and choroid are discussed. Means for successful diagnosis and treatment are presented, as well as the major complications. This work emphasizes the need to identify the infectious nature of these syndromes in order to avoid the all-too-common pitfall of just treating all cases of uveitis with steroids alone.

Animals↗
PubMed1990

Lens implant surgery in pars planitis.

Intraocular lens (IOL) implantation is usually contraindicated in eyes with active inflammation, but patients with "burned-out" pars planitis also may be considered as candidates. Fifteen of 16 eyes in eight patients underwent extracapsular cataract extraction (ECCE) with posterior chamber IOL (PC IOL) implantation combined with pars plana vitrectomy for both cataracts and chronic cystoid macular edema (CME); 60% achieved visual acuity of 20/40 or better. Even with "low-grade" inflammation in these patients, however, a persistent veil of debris accumulated over the posterior and anterior surface of the IOL. One patient (patient 2) required 27 YAG procedures for two eyes, and another required 11 YAG procedures and eventual removal of the IOL. Another patient required surgical "brushing-off" of the IOL and vitrectomy. Even in eyes with "burned-out" uveitis, a continual low-grade inflammation may complicate the use of IOL implantation.

Adult↗
PubMed1985

Trimethoprim-polymyxin B ophthalmic solution in treatment of surface ocular bacterial infections.

A safety and efficacy study comparing the clinical and bacteriologic effectiveness of trimethoprim-sulfacetamide-polymyxin B-neomycin-gramicidin in a group of patients with surface ocular bacterial infections was conducted. The results demonstrated TSP to be as effective as the other solution (both clinically and bacteriologically), with fewer adverse experiences. A second study was conducted comparing TSP with trimethoprim-polymyxin B (TP) and found TP to be superior to TSP in effecting bacteriologic cures. Clinical response was similar in both groups, and the low incidence of mild adverse experiences was approximately the same. It appears that the combination of trimethoprim with polymyxin B is safe and highly efficacious, both clinically and microbiologically, for the treatment of surface ocular bacterial infections.

Adolescent↗
PubMed1983

Hyperosmolar hyperglycemic nonketotic coma. A complication of short-term systemic corticosteroid use.

Hyperosmolar hyperglycemic nonketotic coma is a serious and often lethal clinical biochemical syndrome. We report three cases of ophthalmic problems that were treated with a short course of oral corticosteroids and which resulted in the development of hyperosmolar hyperglycemic nonketotic coma. Two of these cases concerned relatively young, previously healthy patients and had fatal outcomes. The third patient, who was elderly, survived because of early detection and initiation of therapy. All three cases demonstrate that hyperosmolar hyperglycemic nonketotic coma is a serious potential complication of systemic steroidal therapy, even in a short course of treatment such as is often used in ophthalmology.

Administration, Oral↗
PubMed1982

Minocycline in experimental ocular toxoplasmosis in the rabbit.

We studied the effects of minocycline, a semisynthetic tetracycline, on experimentally induced toxoplasmic retinochoroiditis in the rabbit. In two experiments we found that this drug effectively ameliorated the clinical disease and sterilized the ocular tissues from Toxoplasma organisms. Minocycline prevented death from toxoplasmic encephalitis in 75% of the animals, whereas all the control animals died of toxoplasmic encephalitis. Minocycline appears to be a promising agent for ocular toxoplasmosis.

Animals↗
PubMed1981

Tobramycin in external eye disease: a double-masked study vs. gentamicin.

A double-masked randomized study was conducted at four centers to compare the efficacy and safety of tobramycin and gentamicin ophthalmic ointment in the treatment of superficial external eye disease. Seventy-seven patients with blepharitis and/or conjunctivitis were evaluated for safety, and 56 of the 77 individuals also qualified for evaluation of drug efficacy. After a 10 day treatment regimen, 97% of the tobramycin treated patients and 91.3% of the gentamicin treated patients were clinically cured or improved. Antibacterial effectiveness studies in the conjunctiva showed that tobramycin eradicated or controlled 87.8% of the bacterial infections vs. 77.4% for gentamicin. There was also a 9.3% adverse reaction rate with tobramycin vs. 17.6% with gentamicin. Primary symptoms consisted of erythema, injection, discomfort and itching. All adverse reactions were mild and cleared upon discontinuation of the study drug. While the trends seem to favor tobramycin, no difference was statistically significant at the p less than or equal to 0.05 level. These results indicate that tobramycin is a clinically effective and safe topical antibiotic and that it is comparable to gentamicin for topical treatment of bacterial external eye infections. It also may be better tolerated than gentamicin.

Anti-Bacterial Agents↗
PubMed1979

Clindamycin in chronic toxoplasmosis. Effect of periocular injections on recoverability of organisms from healed lesions in the rabbit eye.

Bilateral toxoplasmic retinochoroiditic scars were induced in 21 rabbits. Eleven rabbits were treated with clindamycin phosphate and ten rabbits received parallel injections of normal saline solution. All injections were made into Tenon's space. Toxoplasma organisms could be recovered from tissue suspensions of retina and choroid of four (18%) of the clindamycin-treated eyes, compared with recovery from 12(60%) of the 20 control eyes. There were significantly fewer Toxoplasma cysts in the hematoxylin-eosin-stained sections of the treated eyes than in similar sections of the untreated control eyes.

Animals↗
PubMed1979

Experimental endophthalmitis treated with an implantable osmotic minipump.

A rabbit model of endophthalmitis was used to test the efficacy of an osmotic minipump delivery system as compared to standard intravitreal injection of the antibiotic, Staphylococcus aureus was inoculated into the vitreous cavity, and elimination of microorganisms was compared with use of intravitreal administration of 100 micrograms of gentamicin sulfate by either single pars plana injection or the continuous four-day administration of drugs to the vitreous via pars plana tubing connected to the minipump implanted subcutaneously near the rabbit's ear.

Animals↗
PubMed1979

The microbial flora in extended-wear soft contact-lens wearers.

Of 857 cultures of material collected from the eyelids, conjunctivae, and contact lenses of 51 extended-wear soft-contact-lens wearers, 44 (5%) grew potential pathogens. The aphakic patients wearing contact lenses had fewer recoverable pathogens (24 of 295 or 8%) than a group of preoperative cataract patients (63 of 295 or 21%). On five occasions, positive cultures accompanied clinical symptoms, and on three occasions, repeated cultures grew the same potential pathogen.

Aphakia, Postcataract↗
PubMed1976

Orbital rim fat atrophy after repository periocular corticosteroid injection.

A 29-year-old white woman with acute recurrent nongranulomatous iridocyclitis of undetermined cause was treated with a retrobulbar injection of depocorticosteroid (Kenalog) through the inferior eyelid. This resulted in rapid clearing of the uveitis, but she developed subcutaneous and inferior orbital fat atrophy. This atrophy persisted during the 1 1/2 years of observation.

Adipose Tissue↗
PubMed1976

Immunosuppressive treatment of uveitis.

Ten out of 31 cases of severe corticosteroid-resistant uveitis showed a good clinical response to systemic chlorambucil therapy. Cases of Behcet's syndrome, sympathetic ophthalmia, chronic cyclitis, and rheumatoid sclerouveitis seem to be in the most favorable categories to be considered for cytotoxic-immunosuppressive therapy.

Chlorambucil↗
PubMed1975

Effect of immunization with attenuated Mycobacterium bovis on experimental toxoplasmic retinochoroiditis.

Administration of attenuated Mycobacterium bovis (Bacillus Calmette-Guérin or BCG) provides nonspecific resistance to a variety of microbial infections and tumors. This is associated with a state of augmented immunologic responsiveness. Mustering defenses against intracellular parasites, such as Toxoplasma gondii, presents a special problem that can be met only by measures that alter the intracellular environment. Our study was designed to evaluate the effect of prior immunization of rabbits with BCG on experimental toxoplasmic retinochoroiditis. One group of rabbits was immunized by the intravenous administration of BCG, another group by the retrobulbar injection of BCG, and a third group, unvaccinated, served as a control. Intravenous immunization provided significant protection against Toxoplasma organisms injected into the suprachoroidal space. In the immunized rabbits, the onset of Toxoplasma retinochoroiditis was delayed and the severity of the disease reduced. Although Toxoplasma was isolated from the chorioretinal tissues of both BCG-immunized and control rabbits, Toxoplasma antibody was not (with one exception) detected in the sera of BCG-immunized rabbits. While vaccination by the retrobulbar route produced little or no effect, intravenous administration of BCG provided nonspecific resistance to Toxoplasma retinochoroiditis in rabbits.

Animals↗