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Biomedical subjects

R H Osher

Publications and source records attributed to R H Osher.

44 records · Page 3Linked to original sources
PubMed1979

Pupillary and visual field evaluation in patients with melanocytoma of the optic disc.

Twenty patients with melanocytoma of the optic disc underwent Goldmann perimetry and pupillary evaluation. Two patients (10%) had normal visual fields. Three (15%) had minimal blind spot enlargement. Fifteen patients (75%) had a greatly enlarged blind spot, of which ten had concomitant nerve fiber bundle field defects. These consisted of a nasal step in two cases (10%), relative nerve fiber bundle defects in four cases (20%), and an absolute arcuate defect in four cases (20%). The blind spot enlargement relates to the pigmented tumor extended beyond the disc boundary, thereby shading the peripapillary retina. The nerve fiber bundle defects result from injury to the visual axons passing through the nerve head, although the mechanism is uncertain. A Marcus Gunn pupillary sign produced by the melanocytoma was found in six patients (30%), all of whom had a substantial relative or absolute nerve fiber bundle defect.

Adolescent↗
PubMed1979

Amaurosis fugax associated with SC hemoglobinopathy and lupus erythematosus.

A 23-year-old woman with SC hemoglobinopathy and systemic lupus erythematosus had recurrent amaurosis fugax in her right eye. Extraordinary retinal vascular events were observed and photographed during the amaurotic attacks. Prednisone therapy halted the attacks. We believe a focal lupus vasculopathy involving the central retinal artery caused the amaurosis fugax.

Adult↗
PubMed1979

Clinical and follow-up studies of melanocytomas of the optic disc.

Forty patients with melanocytoma of the optic disc were evaluated to determine their clinical variations and behavior. Follow-up examination of 1 to 19 years was obtained in 27 patients. Of the 27 lesions, four (15%) showed a slight increase in size, and one tumor (4%) decreased in size. The remaining 22 tumors (81%) have not yet demonstrated ophthalmoscopic changes. In spite of occasional growth, the melanocytoma is a benign tumor that requires no treatment.

Adolescent↗
PubMed1979

Myasthenic "oculomotor" palsy.

A patient is described who presented with an abrupt onset of diplopia in association with a drooping lid. The motility pattern was consistent with a pupil sparing oculomotor nerve palsy. In addition, the behavior of the palpebral fissure was characteristic of aberrant regeneration. Intravenous Tensilon resulted in a prompt elevation of the lid and improvement in eye movements. The differential diagnosis of a pupil sparing third nerve palsy should include myasthenia gravis.

Adult↗
PubMed1978

Axial myopia. A neglected cause of proptosis.

Ten patients who had unilateral proptosis ranging from 2.5 to 4.0 mm were found to have axial myopia confirmed by ultrasonography and, in one case, by computerized tomography. The historical features emphasized include an acquired painless bulging eye, amblyopia, and a stable visual acuity. Noteworthy features on ophthalmologic examination include a difference in visual acuity and refraction between the two eyes, a difference in the lenses on inspection of the patient's glasses, and an ipsillateral myopic fundus. Careful history taking, examination, ultrasonographic evaluation, and inspection of old photographs will separate this group of patients and avoid unnecessary endocrine studies, angiography, and costly neuroradiologic investigations. Finally, it must be recognized that coexisting disease must be evaluated as if the proptosis did not exist.

Adolescent↗
PubMed1978

Neuro-ophthalmological complications of enlargement of the third ventricle.

A wide variety of visual sensory and ocular motor problems may occur as a direct result of enlargement of the third ventricle. Four patients are described with optic nerve dysfunction, partial third nerve palsy, proptosis, and Sylvian aqueduct syndrome all resulting from an enlarged third ventricle. The pathogenetic mechanisms are discussed.

Adolescent↗
PubMed1975

Ocular myasthenia gravis and Hashimoto's thyroiditis.

Two patients had ocular myasthenia gravis coexistent with Hashimoto's thyroiditis. A 37-year-old woman presented with diplopia and displayed a head tremor and thyroid enlargement. Thyroid function tests showed an elevated thyroid stimulating hormone (TSH). A quantitative Tensilon test yeilded a "perverse" response and a needle biopsy indicated Hashimoto's disease. A 26-year-old woman presented with diplopia and subsequently developed blepharoptosis and thyroid enlargement. Examination revealed Cogan's eyelid twitch sign, a paradoxical quantitative Tensilon test, and laboratory studies revealed normal thyroid function tests. Treatment was directed at each disease entity separately. Ocular myasthenia gravis was managed with an anticholinesterase agent in combination with oral corticosteroids that provided additional control. Suppressive therapy with desiccated thyroid hormone reduced the size of the thyroid gland, diminished the signs and symptoms of hypothyroidism, and lowered the levels of TSH, possibly decreasing the risk of thyroid carcinoma. Both patients showed gratifying responses to therapy.

Adult↗