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Biomedical subjects

W B Phillips

Publications and source records attributed to W B Phillips.

7 recordsLinked to original sources
PubMed1994

Postoperative endophthalmitis in association with diabetes mellitus.

BACKGROUND: Endophthalmitis continues to be a potentially devasting complication of ocular surgery, despite advances in microsurgical technique and infection-preventing measures. Patients with diabetes have altered immunity at various levels and may be more susceptible to infection after ocular surgery. The authors evaluate the associations between diabetes mellitus and postoperative endophthalmitis. METHODS: The records of 162 consecutive patients treated over a 5-year period for endophthalmitis occurring within 2 weeks of ocular surgery were retrospectively reviewed. RESULTS: Twenty-one percent of this consecutive series of patients with endophthalmitis after surgery had diabetes mellitus. Both the diabetic and nondiabetic groups were similar with respect to age, type of primary surgery, duration from surgery to onset of symptoms, presenting visual acuity, and management of endophthalmitis. Seventy-nine percent of the patients with diabetes and 68% of those without diabetes had culture-proven endophthalmitis. Staphylococcus was responsible for 74% and 71% of the culture-positive cases, respectively. The patients with diabetes were more likely to have endophthalmitis secondary to a gram-negative organism (P < 0.001) than those without diabetes (18.5% versus 5.7%). Visual outcome was worse in the diabetic group, although this may be related to preoperative visual status. CONCLUSIONS: Twenty-one percent of this consecutive series of patients with endophthalmitis after surgery had diabetes mellitus. The patients with diabetes mellitus were more likely to have endophthalmitis caused by gram-negative organisms and appear to have a poorer visual prognosis after treatment for endophthalmitis.

Adult↗
PubMed1994

Late onset endophthalmitis associated with filtering blebs.

A consecutive series of 71 cases of late onset endophthalmitis (defined as onset of symptoms at least 2 weeks after surgery) were reviewed to determine the association of this entity with glaucoma surgery filtering blebs and to identify any predisposing factors. Sixteen cases were associated with filtering blebs and two with inadvertent blebs following cataract surgery. Onset of endophthalmitis ranged from 24 days to 20 years after surgery (mean, 6.9 years). Possible contributing factors included trauma, vitreous wicks, and bleb leak. Twelve cases were culture-positive, with 5 cases of Staphylococcus epidermidis; 2, Staphylococcus aureus; 4, Streptococcus; and 1, Pseudomonas. There were no cases of Hemophilus. The more virulent organisms were generally associated with a poor visual outcome. The organisms recovered in this series were similar to those found in postoperative endophthalmitis not associated with filtering blebs.

Adult↗
PubMed1993

Pars planitis presenting with vitreous hemorrhage.

A 31-year-old woman complained of a sudden, painless decrease in vision of the right eye. Ophthalmic examination demonstrated a vitreous hemorrhage in the right eye secondary to peripheral neovascularization. The left eye demonstrated findings consistent with pars planitis. Before this episode, vision was good in both eyes. Although rare, vitreous hemorrhage can occur in the setting of pars planitis and may be a presenting symptom. Pars planitis should be considered in the differential diagnosis of young patients with vitreous hemorrhage.

Adult↗
PubMed1992

Nocardia choroidal abscess.

Nocardia is a Gram positive, aerobic, filamentous branching micro-organism that rarely causes human infection. When infection does occur it usually takes the form of a subcutaneous abscess or a pneumonia-like illness. We describe a case of a patient with chronic lymphocytic leukaemia who developed painless loss of vision in the right eye secondary to a choroidal abscess after a prolonged course of treatment on several immunosuppressive agents. The patient also complained of right shoulder pain that was unresponsive to conventional therapy, and had been admitted and treated for several episodes of 'pneumonia'. A diagnostic transvitreal fine-needle aspiration biopsy of the ocular lesion was performed which demonstrated Nocardia asteroides. This allowed for appropriate antibiotic therapy to be instituted early in the course of the infection and prompted the systemic work-up which also demonstrated central nervous system and arthropic nocardial infection.

Abscess↗
PubMedDate not supplied

Ocular manifestations of diabetes mellitus (continuing education credit).

1. Within 15 to 20 years of being diagnosed as having diabetes mellitus, 90% of patients will have some degree of diabetic retinopathy and 25% will have proliferative diabetic retinopathy. 2. The majority of the cases of blindness from diabetic retinopathy could be prevented or significantly delayed by timely and appropriate management of diabetic retinopathy. 3. Until a cure for diabetes mellitus is discovered, all patients with diabetes mellitus should receive ophthalmic evaluation soon after the diagnosis is made.

Diabetes Mellitus, Type 1↗