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Biomedical subjects

Tova Lifshitz

Publications and source records attributed to Tova Lifshitz.

At least 19 recordsLinked to original sources
PubMed2006

Broth culture yield vs traditional approach in the work-up of endophthalmitis.

PURPOSE: To elucidate whether the Bactec Peds Plus F broth traditionally used for culturing body fluids in pediatric departments can also be used for vitreous cultures in cases with clinically suspected endophthalmitis, and to compare yields between this method and the traditional method. DESIGN: Prospective, comparative clinical trial. METHODS: All consecutive cases with clinically suspected endophthalmitis treated in our institution between July 2003 and November 2005 were included in the study. All cases were cultured both in the Bactec Peds Plus F broth and using the traditional method. RESULTS: Thirteen cases were included in this study. The overall growth rate for the Bactec broth was 28.4% higher than the traditional method (69.2% and 53.9%, respectively, P = .48). In two cases, one of acute-onset postoperative endophthalmitis due to Streptococcus mitis and one of delayed-onset postoperative endophthalmitis attributable to Candida albicans, there was positive growth only in the Bactec broth. CONCLUSIONS: The Bactec Peds Plus F broth can be used successfully in the examination of clinically suspected endophthalmitis. The method appears to have several advantages over the traditional method: time-savings, as only one medium needs to be inoculated, transportation to the laboratory is simpler as there is no need for immediate incubation, and there is no need to maintain a supply of fresh agar media. This method is especially suitable for office settings and remote clinics, but also can be used in hospital settings, as an adjunct, to increase the growth yield.

Adolescent↗
PubMed2006

Collision sebaceous and basal cell carcinomas of the eyelid.

OBJECTIVE: To report a rare case of collision sebaceous and basal cell carcinomas of the eyelid. DESIGN: Interventional case report. METHODS: An 80-year-old woman presented with a nodular lesion at the center of the left lower eyelid. Small ulceration and madarosis were also present. RESULTS: The patient underwent excisional biopsy with frozen section control. Histopathology showed mixed sebaceous as well as basal cell carcinoma with uninvolved surgical margins. Oncologic survey did not disclose any other lesion. At 6-month follow-up, there was no evidence of recurrence, new lesions, or metastasis. CONCLUSION: Sebaceous and basal cell carcinomas can coexist in the eyelid within the same clinical lesion. Because of the potential risk of metastasis of sebaceous carcinoma, close follow-up of the patients is advisable.

Adenocarcinoma, Sebaceous↗
PubMed2006

Bilateral acute anterior uveitis as a presenting symptom of Mycoplasma pneumoniae infection.

CASE REPORT: To report a case of severe bilateral anterior uveitis associated with Mycoplasma pneumoniae without pulmonary manifestations. COMMENTS: A healthy 5-year-old girl developed severe bilateral anterior uveitis accompanied by fever, arthralgia, gastrointestinal complaints, and lethargy. Results of laboratory investigations were normal except for high levels of Mycoplasma pneumoniae antibodies. The uveitis subsided with topical application of steroids, cycloplegia, and with oral azithromycin. Although Mycoplasma pneumoniae is a rare cause of uveitis, it should be considered in patients presenting with uveitis, even with no accompanying pulmonary or other typical systemic mycoplasmal manifestations.

Acute Disease↗
PubMed2006

Diffuse benign epithelial downgrowth after cataract surgery.

CASE REPORT: We present an interventional case report of a rare occurrence of diffuse epithelial downgrowth developing after extracapsular cataract surgery and iris prolapse that was successfully treated only by excision of the membrane. A 71-year-old man underwent repositioning of an atraumatic iris prolapse 1 month after uneventful standard extracapsular cataract extraction in his right eye. Over 14 months, a white membrane was observed over almost 80% of the iris surface, reducing visual acuity. Intraocular pressure and results of fundus examination were normal. Peeling and excision of the membrane were performed. Histopathologic analysis was consistent with epithelial downgrowth. At 22 months after the epithelial downgrowth peeling, visual acuity was 6/12, there were no signs of recurrence, and intraocular pressure was normal without any treatment. COMMENTS: Provided a continuous follow-up is possible, simple excision of the membrane can be a successful treatment in selected rare cases of diffuse epithelial downgrowth.

Aged↗
PubMed2006

Panuveitis as presenting sign of chickenpox in a young child.

CASE REPORT: A previously healthy 2-year-old girl presented with severe panuveitis in her left eye. She developed chickenpox rash several days later. DNA particles of varicella-zoster virus (VZV) were detected by polymerase chain reaction (PCR) in the aqueous humor. No antiviral regimen was administered. The uveitis resolved completely after 1 week. COMMENTS: Patients with chickenpox should undergo a thorough ophthalmologic examination at the onset of visual symptoms. Clinicians should be aware of the rare occurrence of chickenpox when evaluating a uveitis patient. If there is suspicion of chickenpox, the clinician may consider ordering serology or PCR tests.

Chickenpox↗
PubMed2006

Lidocaine hypersensitivity after subconjunctival injection.

CASE REPORT: We report a rare case of hypersensitivity in a 63-year-old man who received subconjunctival lidocaine, cefazolin, and gentamicin for corneal abscess. Significant palpebral swelling and erythema were observed several hours after the injection. Nine months later, he received subconjunctival lidocaine, vanco-mycin, and ceftazidime for a new corneal abscess. After several hours, the eyelids were red and swollen, with mild blistering and scaling of the cheek. Two patch tests for lidocaine were negative. During follow-up, lateral tarsorrhaphy was performed under local anesthesia with lidocaine; erythema and swelling of eyelids and cheek appeared, resolving after several days. COMMENTS: Sensitivity to lidocaine can appear after subconjunctival injection. Patch tests may be negative, but the allergy suspected by the recurrence of clinical signs after rechallenge with lidocaine. Ester anesthetics can be used for local anesthesia.

Abscess↗
PubMed2006

Topiramate-induced bilateral angle-closure glaucoma.

CASE REPORT: We present an interventional case report of a rare occurrence of acute angle-closure glaucoma in a 35-year-old woman presenting 1 week after start of oral topiramate therapy for depression. Intraocular pressure measured 57 mm Hg OD and 56 mm Hg OS, and bilateral shallow anterior chamber and closed angles were observed. Ultrasound disclosed ciliochoroidal detachment, a closed angle with a forward shift of the lens, and swollen ciliary processes. Topiramate treatment was stopped. Antiglaucoma treatment was started and quickly tapered. After 5 days, examination showed deep anterior chambers and normal intraocular pressures with no medication. COMMENTS: Topiramate use can result in acute bilateral angle-closure glaucoma, which is usually reversible if the drug is discontinued. Patients starting topiramate therapy need to be informed of this potential risk.

Acute Disease↗
PubMed2006

Blastoschizomyces capitatus keratitis and melting in a corneal graft.

CASE REPORT: We present the first case, to our knowledge, of Blastoschizomyces capitatus keratitis and melting in a corneal graft. An 80-year-old man was treated for a large, severe corneal abscess and melting in the corneal graft of his right eye. Medical history was negative for hematologic disorders. Urgent penetrating keratoplasty was performed. COMMENTS: Corneal cultures grew B. capitatus. Systemic fluconazole and systemic and topical amphotericin B treatment were started. Three months after the last operation, no recurrence was observed and the graft remained clear. B. capitatus can rarely cause severe keratitis in patients even in the absence of hematologic disorders.

Aged, 80 and over↗
PubMed2006

Traumatic corneal flap dislocation one to six years after LASIK in nine eyes with a favorable outcome.

PURPOSE: To report our experience treating eye trauma after LASIK refractive surgery. METHODS: Nine eyes of eight patients (one woman and seven men) were treated for ocular trauma: blunt trauma (n=5), sharp instrument trauma (n=2,) and trauma from inflation of automobile air bags during a traffic accident (n=2). The time from LASIK varied between 3 months and 6 years. All patients were hospitalized as a result of severe decrease in visual acuity and pain. RESULTS: Seven of nine LASIK flaps had some degree of dislocation and were lifted, irrigated, and repositioned. Two flaps were edematous without dislocation. Intensive topical steroids and antibiotics were used in all patients up to 3 weeks after trauma. Three months after trauma, five eyes regained their pre-trauma visual acuity (between 20/20 and 20/40), and three eyes lost one line of best spectacle-corrected visual acuity. CONCLUSIONS: Trauma occurring several months or years after LASIK may cause flap injury. Adequate and prompt treatment usually is successful.

Adolescent↗
PubMed2006

[Ocular injuries related to Independence Day celebrations].

BACKGROUND: Each year, following Israel's Independence Day celebrations, patients are referred to the Soroka University Medical Center as a result of ocular injuries from items such as artificial snow spray, fireworks, plastic hammers and stick-lights (plastic tubes filled with fluorescent liquid). This study aims to describe and characterize the ocular injuries that are directly related to the use of these devices. PATIENTS AND METHODS: The files of all patients who were referred to the Department of Ophthalmology in the Soroka University Medical Center, between the years 1998 and 2005, during the period of Israel's Independence Day, were screened. If a patient sustained an injury from a device used during the celebration, then data relating to the age, sex, injured eye, diagnosis, the device that caused the injury and treatment were collected. RESULTS: A total of 437 patients were included in this study; fifty-two patients had suffered an ocular injury directly due to a celebration device. The patients' mean age was 17.6 years; 61.5% of the patients were male. The three most common ocular injuries were corneal erosions, conjuctival erosions, and superficial punctate keratitis (38.5%, 28.9%, and 23.0%, respectively). Other injuries included corneal and conjuctival foreign bodies, traumatic iritis, elevated intraocular pressure, and subconjuctival hemorrhage. The devices responsible for most of the injuries were artificial snow spray and fireworks. Ocular injuries from stick-light liquid, plastic hammers, and balloon explosions were seen as well. Almost all patients (96.1%) required medical treatment. Patients injured by celebration devices accounted for 27.9% of all patients seen during this period in our Ophthalmology Department; after several years, the rate approached 40%. CONCLUSION: Strict enforcement of rules and legislation regarding the use of celebration devices must be upheld. The public's awareness of the harm that these devices can cause should be strengthened.

Eye Injuries↗
PubMed2006

[Eye involvement in rheumatoid arthritis in children and adults].

Rheumatoid arthritis (RA) and juvenile rheumatoid arthritis (JRA) are systemic autoimmune diseases characterized by synovitis and a wide range of extraarticular manifestations. Ocular involvement occurs frequently in both diseases and it may affect all layers of the eyes. This review summarizes the clinical manifestations, the diagnostic tools and the therapeutic modalities of the various ocular features of patients with juvenile and adult rheumatoid arthritis.

Adult↗
PubMed2005

Artisan phakic intraocular lens for correcting high myopia.

OBJECTIVES: To evaluate the safety indexes and efficacy of Artisan phakic intraocular lens (IOL) for the correction of high myopia. METHODS: Retrospective interventional case series reports. Thirty-one eyes (22 patients) with myopia from -5.25 to -19.00 diopters underwent implantation of an Artisan phakic IOL. Follow-up examinations were performed at 1 day, 1 week, 1 month, and 3 months. The following parameters were recorded: manifest refraction, slit-lamp examination, applanation tonometry, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), complications or adverse reactions. The primary variable was the refractive outcome at 3 months. Secondary variables were change in BSCVA, and efficacy and safety indexes. RESULTS: At 3 months, mean spherical equivalent was -0.50 +/- 0.36 diopters (range, -1.25 - plano). In 29 eyes (93.5%) UCVA was 6/12 or better; the other three eyes had UCVA of 6/15. The difference between preoperative and 1 week postoperative BSCVA was not statistically significant (p = 0.25). Comparison of BSCVA at 1 week and at 1 month was statistically significant (p = 0.05); this difference was even more significant at 3 months (p = 0.01). The BSCVA remained the same or improved for all the eyes. BSCVA for 20 eyes (64.5%) had improved one or more lines in visual acuity. Mean endothelial cell loss at 3 months was 3.96%. CONCLUSION: The Artisan lens is a safe, predictable, and efficacious method to correct high myopia. Postoperative gain in BSCVA was achieved for the majority of eyes. Future study to assess safety indexes and risk of complications is required with long-term follow-up.

Adult↗
PubMed2005

Rapid spontaneous resolution of vitreomacular traction syndrome documented by optical coherence tomography.

A 48-year-old woman presented with a 2-week history of metamorphopsia and reduced vision in her left eye. Visual acuity was 20/30 OS. Slit lamp biomicroscopy fundus evaluation revealed a dull foveal reflex. Optical coherence tomography (OCT) showed attachment of the posterior hyaloid to the macula and significant macular elevation. One month after presentation, visual complaints disappeared. OCT revealed complete posterior vitreous detachment and normal foveal thickness. Although rare, rapid spontaneous resolution of vitreomacular traction syndrome can occur. OCT is a helpful diagnostic tool for following these patients.

Female↗
PubMed2005

COL11A2 mutation associated with autosomal recessive Weissenbacher-Zweymuller syndrome: molecular and clinical overlap with otospondylomegaepiphyseal dysplasia (OSMED).

Autosomal recessive Weissenbacher-Zweymuller syndrome (WZS) is a skeletal dysplasia characterized by rhizomelic dwarfism and severe hearing loss. Mutations in the COL11A2 gene have been implicated in causing the autosomal dominant form of this syndrome as well as non-ocular Stickler syndrome and the autosomal recessive syndrome otospondylomegaepiphyseal dysplasia (OSMED). In a consanguineous Bedouin tribe living in Southern Israel, five individuals affected by autosomal recessive WZS were available for genetic analysis. Homozygosity of a mutation in the COL11A2 gene was found in all affected individuals. This finding lends molecular support to the clinical notion that autosomal recessive WZS and OSMED are a single entity.

Abnormalities, Multiple↗
PubMed2005

Isolated congenital histiocytosis in the palpebral conjunctiva in a newborn.

PURPOSE: To report a rare case of congenital histiocytosis in a newborn without skin involvement. DESIGN: Interventional case-report. METHODS: A full-term baby presented with a mass over the palpebral conjunctiva of his left upper lid. Ophthalmic examination was otherwise normal, and the baby was healthy. There were no skin lesions. RESULTS: The lesion was completely removed surgically. Pathologic examination demonstrated a cellular infiltrate composed of eosinophils and histiocytes. Immunohistochemistry disclosed positive stain for protein S-100 and CD1 antigenic determinant. Pediatric oncology evaluation was completely normal. Eighteen months after presentation, the patient remained healthy without recurrence of the lesion. CONCLUSIONS: Rare cases of congenital histiocytosis can present as a solitary lesion over the palpebral conjunctiva, without skin or systemic involvement.

Antigens, CD1↗
PubMed2005

Is the tono-pen accurate for measuring intraocular pressure in young children with congenital glaucoma?

PURPOSE: We sought to compare intraocular pressure (IOP) measurements by Perkins tonometer and Tono-Pen in young children with primary congenital glaucoma (PCG). METHODS: This was a retrospective comparative case series. We reviewed the clinical records of all children with primary congenital glaucoma who underwent examinations under general anesthesia at Soroka University Medical Center between January 1999 and July 2002. Our main outcome measures were IOP with Perkins hand-held tonometer and Tono-Pen tonometer. RESULTS: A total of 28 eyes of 16 children were examined under general anesthesia. The mean IOP was 18 +/- 6 mm Hg with the Perkins tonometer and 22 +/- 8 mm Hg with the Tono-Pen. In 18 eyes, IOP was less than 21 mm Hg with the Perkins tonometer; these eyes had already undergone surgical procedures. The other 10 eyes with IOP greater than 21 mm Hg with the Perkins tonometer underwent surgery at the end of the examination under anesthesia. In eyes with IOP greater than 16 mm Hg (Group A, n = 18), a significant difference (P < 0.001) was found between the Perkins and Tono-Pen measurements, even although the values were strongly correlated (r = 0.60). In contrast, in eyes with IOP less than 16 mm Hg (Group B, n = 10) no statistically significant difference (P = 0.28) and good correlation (r = 0.78) were obtained. A difference of 5.8 +/- 3.8 mm Hg and 0.6 +/- 1.7 mm Hg between Perkins and Tono-Pen readings, respectively, was found in Groups A and B. CONCLUSIONS: Tono-Pen readings disagree with Perkins tonometer measurements for measuring IOP in children with PCG who present with IOP greater than 16 mm Hg and tends to overestimate IOP. A further study with a similar population is necessary to confirm these results.

Glaucoma↗
PubMed2005

Secondary artisan phakic intraocular lens for correction of progressive high myopia in a pseudophakic child.

An 8-week-old infant underwent unilateral cataract extraction and posterior chamber intraocular lens implantation for total cataract in the left eye. After surgery, a residual progressive myopic error was observed, ranging from -4.5 diopters (D) 6 months after the operation to -14.0 D at the age of 3 years. Because of parental noncompliance for contact lens and spectacles use, secondary implantation of Artisan phakic IOL of -14.0 D power was performed. No intra- or postoperative complications were observed. Nine months after this second operation, myopia diminished to -3.25 D.

Disease Progression↗