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Biomedical subjects

A A Bialasiewicz

Publications and source records attributed to A A Bialasiewicz.

At least 55 records · Page 3Linked to original sources

[Rhegmatogenous retinal detachment in atrophia gyrata: pars plana vitrectomy with silicone oil instillation].

BACKGROUND: Gyrate atrophy is a form of choroidal dystrophia characterized by a genetic defect of the mitochondrial matrix enzyme ornithine ketoacidoaminotransferase on chromosome 10. Apart from rare myopathic problems, cases of choroidal, iridal atrophy, complicated subcapsular cataract, optic atrophy, macular edema, reticular retinoschisis, vasculitis and perivasculitis could be observed so far. To our knowledge, rheumatogenous retinal detachment has been described before. We present a 34-year-old female subject with a retinal detachment of the right eye over 3 quadrants with 3 small round foramina in the area 10 to 11 o'clock. PATIENTS: Concentric defects of the visual field had been known since the age of 4; the patient was slightly myopic. At the age of 31, the patient had undergone cataract extraction with implantation of posterior chamber lenses in both eyes. The ophthalmological examination revealed large areas of choroidal atrophia in both eyes. A determination of visual acuity resulted in hand movements in the right eye and 0.1 in the left eye. The ERG was extinguished. RESULTS: The retina could be fully reattached by pars plana vitrectomy and instillation of silicone oil. At the same time, we performed an excision of secondary cataract. On demission, the visual acuity of the right eye was finger counting. Because a brother of the patient had also suffering from a progressive choroidal atrophy since his childhood, an autosomal recessive disease was suspected. The only abnormality detected was strongly elevated plasma levels of ornithin (7.5 to 14 mg/dl, compared to levels of 0.6 to 2.0 in controls). Urinary excretion of ornithin was also strongly increased. DISCUSSION: To our knowledge there was no previous description of a case of atrophia gyrata in association with rhegmatogenous retinal detachment after intraocular surgery. As the pigment epithelium is missing, intraoperative endolaser-coagulation would be useless. For this reason, and since a tendency for reattachment is lacking consistent with one of the characteristics of this disease, the only approach to this case is intraocular tamponade with silicone oil.

Adult↗

Corneal and external disorders and refractive surgery.

A review of disorders of the anterior segment of the eye may show new avenues of research as well as clinical perspectives arising from recently accumulated data. It will have to select new theoretical and clinical findings, which may most probably be apt to survive the test of time, thus providing a long-standing stimulus in science. This body of scientific work in corneal and external disorders may be divided into infectious and noninfectious entities as well as refractive and tectonic or structural problems. In this review, we will focus on the inflammatory implications of anterior segment ocular disease, and mention some evolving diagnostic features and new treatment modalities, as well as opinions on refractive surgery complicated by inflammation.

Animals↗

Plasma sterilization of selected ophthalmic instruments for combined intraocular surgery.

Plasma sterilization is a nontoxic fast procedure for thermolabile and thermostable microsurgical instruments. We report data on the microbicidal effectiveness for daily routine surgical instruments like steel scissors, trephination devices, microstripper and Vitro-Cat as well as irrigation/aspiration instruments. When these instruments were cleaned from blood and saline, and when H2O2 intensifiers (adapters) were applied where necessary plasma sterilization proved to be a microbiologically safe procedure with legally adequate reduction factors of > 6 log.

Bacillus↗

[Subretinal manifestations as the chief findings in parasitic diseases in germany].

The most frequent intraocular manifestations of parasitoses in Germany and world-wide are retinochoroidal lesions of Toxoplasma gondii; worms are less frequent. In reports of four cases it is shown that demographic data, biomicroscopical hallmarks and the fecal wet-mounts are the most important parameters for a presumptive diagnosis, if no intraocular material can be isolated. The patients in this series lack systemic features and changes in the blood differential, probably due to the adequate alimentary state and lack of reinfestations.

Adult↗

[Intraocular inflammation 1993 (endophthalmitis)].

Despite several recently published optimistic reports on successful therapeutic regimens of postoperative endophthalmitis caused by coagulase-negative staphylococci this intraocular disease still represents a preeminent danger for ocular vision and the integrity of the globe. In this survey critical analyses of studies concerning infectious as well as the non-infectious intraocular inflammations have been reviewed. The demand for an initiation of "metastudies" seems appropriate in order to evaluate the many controversial data collections concerning the incidence, diagnosis and results of therapeutic interventions of postoperative endophthalmitis.

Endophthalmitis↗

[Ocular chlamydia infections in Munsterland. A clinical study of 409 patients].

We evaluated demographic data, McCoy cell cultures from conjunctival smears and chlamydia-specific IgG and IgA serum antibody titers in 409 patients (194 men and 212 women) suffering from (kerato)conjunctivitis of presumed bacterial etiology in 1988-1992. Overall, 105 patients were positive in culture and/or serology tests (78 in McCoy cell cultures, 45 in serology tests). In 33 patients (31%) corneal involvement was epithelial (5), subepithelial (13), phlyctenular (7) and/or took the form of pannus vasculosus (12). The incidence and severity of corneal signs correlated with the duration of the (kerato)conjunctivitis. Nasolacrimal duct complications were documented in 16 patients with a duration of illness exceeding 6 months. Some 33% of cases were recorded in May and June, a further 26% from November to January. The age groups primarily affected were: females 20-30 years (25%), males 30-40 years (25%). The highest number of new cases was registered in 1990.

Adolescent↗

[Syngeneic transplantation of nasal mucosa and azathioprine medication for therapy of cicatricial ocular mucous membrane pemphigoid. Study of 9 patients with 11 eyes].

Nine patients (11 eyes) with ocular cicatricial pemphigoid were treated with systemic azathioprine and a syngeneic nasal mucosa transplant from the inferior turbinate. Follow-up was 8-26 months (average 15 months). Grafting was successful in all cases. Treatment ameliorated the symptoms of pain in all patients and double vision in one. In 2 eyes in which simultaneous pannus resection had been performed, neither pannus nor corneal vascularization recurred. Late complications were recurrences with symblephara in two cases when azathioprine was stopped; in one patient with a serpiginous ulcer tectonic penetrating keratoplasty à chaud had to be performed; and in another a trophic ulcer was healed with a therapeutic contact lens.

Aged↗

[Optical rehabilitation by tectonic anterior segment reconstruction].

BACKGROUND: The potential benefits of anterior segment surgery to achieve visual rehabilitation in severely compromised eyes subsequent to infectious complications in the anterior segment remain a subject of controversy. PATIENTS AND METHODS: Anterior segment reconstructive surgery was performed on twelve patients (12 eyes) with infectious adherent leukoma and extensively damaged intraocular structures. Nine patients (nine eyes) were followed up over a period of two years (20-26 months) and three over a period of nine months (8-11 months). RESULTS: Simultaneous and consecutive surgical interventions including corneal grafting, anterior chamber reconstruction and posterior chamber lens implantation combined with antimicrobial and antiviral prophylaxis as well as corticosteroid treatment resulted in visual recovery in nine eyes, and in four in a visual acuity of 0.4 or better (reading VA). CONCLUSIONS: Surgery for optic reasons due to infectious adherent leukoma does not seem to be completely unsuccessful with respect to the low complication rate despite proven retrocorneal membranes in this study.

Adult↗

Coxsackievirus B3-associated panuveitis.

A 29-year-old woman suffered from headaches, diarrhoea, and high grade fever followed by a unilateral retinal vasculitis, papillitis, and chorioretinitis. Abnormal electrocardiographic findings and antibody titre dynamics strongly suggested a coxsackievirus B3 infection. With respect to prior observations on coxsackievirus B group associated uveitis this viral infection may be considered in patients with well defined extraocular manifestations and uveitis.

Adult↗

[Incidence of postoperative bacterial infections after planned intraocular interventions].

Between August 1982 and August 1984 3059 intraocular operations were performed with topical prophylactic antibiotics. Results of conjunctival cultures did not influence the surgical schedule. 8179 intraocular operations were performed between September 1984 and August 1988. An intraocular operation was postponed until conjunctival cultures were negative using topical antibiotics administered at hourly intervals. The rate of postoperative intraocular infections decreased significantly (p less than 0.0001) from 21 (0.69%) of 3059 during the first to 9 (0.11%) of 8179 intraocular operations during the second observation period. In the first period 11 vitrectomies and 2 enucleations due to bacterial endophthalmitis had to be performed. In the second period 2 vitrectomies and no enucleations were necessary (p less than 0.0001). Our results indicate, that decontamination of the conjunctiva may be an import factor for the prevention of postoperative endophthalmitis following elective intraocular surgery.

Adult↗

[Unilateral chronic granulomatous blepharitis as a leading symptom of Oriental cutaneous leishmaniasis in Germany. Giesma stain as rapid diagnosis and initial description of systemic therapy with gamma-interferon].

Nine months after leaving the Lebanon, a four-year-old immigrant boy presented with a 5 months history of blepharitis. The lesion remained therapy-resistant for aminoglycoside antibiotics. Six months later, the patient presented with an indolent granulomatous necrotizing purulent blepharitis and follicular conjunctivitis. Diagnosis was made by Giemsa stain and histopathology, which revealed amastigotes in macrophages consistent with the diagnosis of oriental cutaneous leishmaniasis. Therapy with systemic recombinant gamma Interferon, which is described for the first time in this disease entity, resulted in a successful primary healing of the cutaneous lesion. Self-healing epithelial keratitis was the only side-effect observed. Ophthalmologists in Germany should be aware of the differential diagnosis of oriental cutaneous Leishmaniasis in patients suffering from chronic granulomatous lid lesions of patients from countries endemic/epidemic for Leishmaniasis. Laboratory diagnosis is simple. Insights into the immunology of infection have made possible novel therapeutic avenues using gamma-Interferon being effective without serve side-effects and allowing for a good primary healing of the cutaneous lesions.

Biopsy↗