PubMed Health⌕ Search

Biomedical subjects

T M Topping

Publications and source records attributed to T M Topping.

32 records · Page 2Linked to original sources
PubMed1986

Treatment of intraocular lymphoma with high-dose Ara-C.

Ocular lymphoma is an uncommon clinical entity with a propensity for intracranial extension. Palliation has been reported following radiotherapy, but the ultimate prognosis is poor, and significant treatment-related morbidity is common. Recent pharmacokinetic studies have suggested that sustained therapeutic drug concentrations are achievable in cerebrospinal fluid after systemic administration of high-dose cytosine arabinoside (Ara-C). These data led the authors to attempt treatment of a case of recurrent ocular lymphoma with high-dose Ara-C. Therapeutic drug levels were documented in intraocular fluids, and prolonged objective regression of tumor was seen. Systemic high-dose Ara-C deserves consideration for the treatment of ocular lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

Ultrastructural studies of cornea, iris and lens in a case of siderosis bulbi.

Transmission electron microscopy studies of cornea, iris and lens from a case of ocular siderosis due to a retained intraocular foreign body (IOFB) and vitreous hemorrhage are presented. We observed widespread degeneration of lens epithelium, iris stromal cells and iris pigment epithelium associated with intra- and extracellular siderosomes. A direct relationship was found between the degree of cell degeneration and the number of intracellular siderosomes in lens epithelium. This is contrary to findings in other siderotic tissues which show intracellular iron deposition to be associated with increased ability to detoxify iron. The cornea showed siderosomes only within keratocytes, and there was no evidence of a relationship between siderosome accumulation and cell degeneration. The literature on ultrastructural studies of ocular siderosis is reviewed and the current theory of the mechanism of chronic iron toxicity is discussed.

Adult↗
PubMed1984

Posttraumatic endophthalmitis.

Nineteen consecutive cases of culture-proved posttraumatic endophthalmitis occurred. Over an eight-year period, 19 (7.4%) of 257 patients with penetrating trauma had endophthalmitis develop, and 19 (31.1%) of 61 cases of endophthalmitis were due to trauma. Eleven (10.7%) of 103 patients with intraocular foreign bodies had endophthalmitis develop. Final visual acuity was 20/200 or better in eight (42.1%) of 19 and 20/30 or better in five (26.3%) of 19 cases of posttraumatic endophthalmitis. Organisms cultured were similar to those in the other types of endophthalmitis, except that Bacillus species were seen only in posttraumatic endophthalmitis (five [26.3%] of 19). Virulent organisms or retinal breaks or detachments seen at the time of primary repair indicated poor prognoses.

Adolescent↗
PubMed1982

Surgical results in ocular trauma involving the posterior segment.

Of 106 eyes with trauma involving the posterior segment, 12 could not be repaired, 74 were treated with vitrectomy, and 20 without vitrectomy. Fifty-five eyes (52%) achieved functional success (defined as a final visual acuity of 6/30 [20/100] or better or as a postoperative improvement in visual acuity from light perception or worse to 6/240 [5/200] or better), 16 (15%) attained anatomic success (attached retinas and generally clear media) but were functional failures, and 35 (33%) were both anatomic and functional failures. The prognosis was better in cases with intraocular foreign bodies and worse in cases with retinal detachments, marked vitreous hemorrhage, and large scleral lacerations. Traumatic involvements of the lens did not appear to affect the prognosis. Prophylactic scleral buckling appeared to lessen the incidence of postoperative retinal detachment. The eyes that underwent vitrectomy within 14 days of the injury had a better final visual outcome than those that underwent later vitrectomy.

Adolescent↗
PubMed1982

Traumatic wound dehiscence following penetrating keratoplasty.

Four young male patients with keratoconus had traumatic dehiscence of the surgical wound after penetrating keratoplasty. Two were rendered aphakic by the trauma, and in one patient the lens was dislocated posteriorly. In each case the dehiscence was repaired by resuturing the original corneal graft. Despite marked corneal oedema in the immediate postoperative period all four grafts deturgesced and subsequently cleared. The follow-up has been a minimum of 23 months. We recommend therefore primary resuturing of traumatic wound dehiscence after keratoplasty, anterior vitrectomy if the lens dislodged, and prophylactic antibiotics postoperatively. The clearing of the initially oedematous grafts in each case illustrates the resilience of the corneal endothelium.

Adult↗
PubMed1980

Cystoid macular edema after retinal detachment surgery.

One hundred eyes in 98 patients were studied by fluorescein angiography and stereo color photography six weeks after successful scleral buckling surgery. Twenty-five percent of 67 phakic eyes and 40% of 33 aphakic eyes demonstrated cystoid macular edema. Older phakic patients were at significantly greater risk to develop cystoid macular edema than younger phakic patients. Seventeen percent of successfully repaired eyes demonstrated distortion of the macula by preretinal membranes; 16 of these 17 eyes showed leakage of fluorescein dye into the surrounding retina sometimes also causing cystoid edema. Either cystoid macular edema or macular distortion was present in 38% of the phakic eyes and 64% of the phakic eyes after successful retinal detachment surgery.

Edema↗
PubMed1979

Experimental double-perforating injury of the posterior segment in rabbit eyes: the natural history of intraocular proliferation.

A reproducible model of double perforating injury of the posterior segment of the rabbit eye was developed. Immediately after injury, a viterous condensation was visible between wounds. The scleral exit wound was sealed by fibroblastic proliferation of probable episcleral origin by the fourth day and the entrance similarly by the seventh day. Cellular proliferations originating in the wounds crossed the vitreous cavity following the vitreous injury tract or condensed vitreous to the disc or to the vitreous base. The earliest intraocular proliferations, composed of spindle-shaped, fibroblast-like cells, were seen at day 4. Occasional pigment epithelia were present in and on these proliferations. Other proliferations occurred directly on the retinal surface adjacent to the wounds. The transvitreous proliferations employed the vitreous as a scaffold, while the surface proliferations used the retinal surface for contact guidance.

Animals↗
PubMed1979

Vitrectomy for injury: the effect on intraocular proliferation following perforation of the posterior segment of the rabbit eye.

Perforating injuries were produced in the posterior segments of rabbit eyes. A control group had no surgery; a second group underwent closed vitrectomy immediately after injury; and a third group had closed vitrectomy delayed two weeks following injury. The eyes were then observed for four weeks. Transvitreal proliferation, which was found in each of the control eyes, was effectively prevented in the eyes that underwent immediate vitrectomy. Established transvitreal proliferation was removed and its recurrence prevented by delayed vitrectomy. These results establish the principle that vitreous acts as a scaffold for proliferation. Removal of the vitreous eliminates the structures along which proliferation can occur and thus effectively prevents transvitreal proliferation. Early removal of vitreous in severely injured eyes with vitreous damage is recommended.

Animals↗
PubMed1978

Proliferations in the vitreous cavity after perforating injuries. A histopathological study.

Histologic specimens from 32 human eyes that had been enucleated at different intervals after servere injuries were studied. Following the rules of general wound repair, intraocular proliferations start two to four days after the injury and may be massively developed within one week after injury. Their cell composition and extent are related to the site and extent of tissue damage and the amount of hemorrhage. The findings support the recommendation of a primary vitreous repair in severely injured eyes.

Adolescent↗
PubMedDate not supplied

Uveal lymphoid neoplasia: a clinical-pathologic correlation and review of the early form.

We report three cases of uveal lymphoid neoplasia that were diagnosed early in their course. One case exhibited a posterior form, presenting with progressive hyperopia from a serous-macular detachment and choroidal involvement along with retrobulbar involvement. This patient was treated with proton beam irradiation. Two cases displayed an anterior form, with fixed fleshy epibulbar masses resembling salmon patches, and choroidal involvement. The histologic findings from biopsy of these anterior masses are presented. One of these patients was treated with complete excision of the mass and double freeze-thaw cryotherapy of the scleral bed, and the other patient was treated with conventional photon beam irradiation. The clinical features of uveal lymphoid neoplasia in its early form are discussed. Evaluation and treatment strategies for these early forms of uveal lymphoid neoplasia are reviewed.

Aged↗