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Biomedical subjects

R D Brod

Publications and source records attributed to R D Brod.

31 records · Page 2Linked to original sources
PubMed1990

Endogenous Candida endophthalmitis. Management without intravenous amphotericin B.

Eight consecutive cases of culture-proven endogenous Candida endophthalmitis (ECE) were managed between 1980 and 1988. All patients were treated with vitrectomy and injection of intravitreal amphotericin B. Blood cultures were negative in all patients, although Candida albicans was cultured from a foot ulcer in one patient. No systemic therapy was used in three patients, three patients received oral ketoconazole, and two patients received oral flucytosine postoperatively. Intravenous amphotericin B was not used because of lack of evidence of disseminated candidiasis and the systemic toxicity associated with its use. The ECE responded favorably to treatment in all cases. Final vision was better in patients with a shorter interval between onset of symptoms and initiation of antifungal therapy. Posttreatment visual acuities were: four eyes greater than or equal to 20/50, two eyes at 20/80 to 20/200, and two eyes less than 5/200. This series showed that ECE without evidence of disseminated disease can be treated successfully with vitrectomy and intravitreal amphotericin B.

Adult↗
PubMed1990

Management options for retinal detachment in the presence of a posteriorly dislocated intraocular lens.

Six consecutive cases of retinal detachment occurring in the presence of a posteriorly dislocated intraocular lens were managed between 1978 and 1988. In three cases, a standard scleral buckling procedure was performed with successful retinal reattachment, leaving the dislocated implant in the inferior formed vitreous. In two cases, the implant was removed through the pars plana at the time of pars plana vitrectomy, fluid/gas exchange, and scleral buckling procedure. In the remaining case, the intraocular lens was repositioned with scleral fixation sutures after pars plana vitrectomy, fluid/gas exchange, and scleral buckling. All cases achieved and maintained retinal reattachment with visual improvement. Recommendations for management are discussed.

Adult↗
PubMed1989

The site of operating microscope light-induced injury on the human retina.

We determined the site of the focal illumination from the Zeiss OPMI-6 operating microscope on the retina of the phakic and aphakic human cadaver eye by directly observing the illuminating element image on the posterior scleral surface of the globe. With the eye straight ahead and the operating microscope level, the focal oval area of retinal illumination was located superior to the foveola in both the phakic and aphakic eye. Tilting the operating microscope 10 degrees toward the surgeon displaced the entire illuminating element image 0.50 mm below the foveola in the phakic eye and 0.25 mm below the foveola in the aphakic eye. Rotating the eye inferiorly 10 degrees displaced the entire illuminating element image 1.0 mm below the foveola in the phakic eye and 1.25 mm below the foveola in the aphakic eye. Centering the field of view superiorly (viewing the superior limbus) paradoxically displaced the illuminating element image inferiorly, resulting in central foveal illumination. Foveal light exposure was avoided in most eye positions by tilting the microscope at least 10 degrees toward the surgeon.

Aphakia↗
PubMed1989

Transient central retinal artery occlusion and contralateral amaurosis after retrobulbar anesthetic injection.

A transient, ipsilateral central retinal artery occlusion and contralateral amaurosis developed following retrobulbar injection of 2% lidocaine and 0.75% bupivacaine. A computerized tomography scan obtained 1 1/2 hours following the injection demonstrated an air bubble within the ipsilateral optic nerve sheath. This case further supports the view that intranerve sheath injection can cause these two complications associated with retrobulbar anesthesia.

Aged↗
PubMed1987

A model for predicting the site of paraxial retinal lesions secondary to "coaxial" operating microscope illumination systems.

We measured a 15 +/- 2-mm displacement of the illuminating element of the coaxial operating microscope from the true optical center of the microscope. We further calculated the displacement of the image of the illuminating element of the operating microscope on the retina of the simplified schematic eye and found that the "coaxial" operating microscope would focus the light between 1.3 and 1.8 mm superior to the fovea of the eye, depending on the theoretical refractive status of the simplified eye. Actual measurements on a simulated retina (35-mm camera) confirmed the calculated displacements. The deviation varied with eye tilt and microscope position. We also found that the maneuvers commonly used by anterior segment surgeons of tilting the microscope and rotating the eye downward tended to displace the image of the illuminating element closer to the fovea, increasing the chance for symptomatic retinal damage. A combination of such maneuvers may reduce the potential for clinically significant retinal phototoxicity by displacing the light further inferior to the fovea.

Humans↗
PubMed1987

Diagnosis of neuronal ceroid lipofuscinosis by ultrastructural examination of peripheral blood lymphocytes.

A 7-year-old child with a history of seizures, psychomotor regression, and progressive visual loss was found to have juvenile type neuronal ceroid lipofuscinosis on the basis of characteristic ophthalmoscopic and electroretinographic findings. Although transmission electron micrographs of two separate skin biopsy specimens were normal, peripheral blood lymphocytes were vacuolated and demonstrated, by ultrastructural examination, characteristic "fingerprint profiles" confirming the diagnosis. Peripheral blood lymphocytes from the patient's mother, who had an acquired seizure disorder, demonstrated vacuolated lymphocytes with membranous formations and osmophilic granular bodies, as revealed by electron microscopy. Examination of peripheral blood lymphocytes can be a sensitive diagnostic test in suspected neuronal ceroid lipofuscinosis and may be useful in identifying carriers or family members in the early clinical stages of the disease.

Child↗