Biomedical subjects
W L Broughton
Publications and source records attributed to W L Broughton.
Bilateral retinal detachment following cytomegalovirus retinitis.
Bilateral retinal detachments developed in a renal allograft patient several months after the onset of cytomegalovirus retinitis. Laser photocoagulation was used to limit the posterior extent of one detachment until the detachment was surgically repaired. The thinned, atrophic retina that results from the necrotizing retinitis makes localization of retinal holes difficult and, in this case, contributed to the initial impression that these detachments were nonrhegmatogenous in origin.
A clinicopathologic study of 56 cases of intraocular medulloepitheliomas.
A clinicopathologic and follow-up study of 56 intraocular medulloepitheliomas in the Registry of Ophthalmic Pathology revealed a mean age of five years at the time of definitive diagnosis, most patients having had a delay in surgical therapy of more than one year after onset of signs or symptoms. Histologic evidence of malignancy was observed in 37 tumors, and follow-up studies revealed four patients to have died of metastatic disease. Heteroplastic elements (brain tissue, cartilage, or rhabdomyoblasts) were observed in four benign and 17 malignant tumors; these 21 were designated teratoid medulloepitheliomas. The most important prognostic feature was extraocular extension, observed in ten cases. All four of the known tumor deaths were preceded by clinically obvious orbital spread. In four additional cases with orbital involvement the patients were lost to follow-up. We concluded, therefore, that the prognosis is worse than the results of this study would indicate, especially among those cases observed to habe extraocular extension.
Nonpulsatile exophthalmos in carotid-cavernous sinus fistula.
An unusual case of carotid artery-cavernous sinus fistula with pulseless exophthalmos is presented in a two and one-half year old child. Though exophthalmos and increased episcleral venous distention were present, the ophthalmic artery pressure was not significantly altered as determined by ocular pneumoplethysmography. Consequently there was no evidence of hypoxic sequelae which frequently occur with this arteriovenous shunt. The combined use of arteriography and ocular pneumoplethysmography is advocated for determining and characterizing the presence of significant intracranial arteriovenous disease.