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Biomedical subjects

A M Brooks

Publications and source records attributed to A M Brooks.

At least 73 records · Page 4Linked to original sources
PubMed1989

The influence of superficial epithelial keratopathy on the corneal endothelium.

Subendothelial blebs were seen in cases of superficial keratopathy of varied etiology: superficial punctate keratopathy (42 patients); keratoconjunctivitis sicca (11 patients); epithelial basement membrane dystrophy (9 patients); mild superficial keratopathy due to exposure (9 patients), trichiasis (6 patients), or chemical contact (4 patients); and in contact-lens wearers (29 patients). The blebs were probably due to intercellular edema, separating endothelial cells from Descemet's membrane, and were reversible after resolution of the keratopathy. If the condition is chronic, changes in endothelial morphology may occur, with pleomorphism and polymegathism of the endothelial cells. These cases show that conditions which cause fine disruption of the corneal epithelium affect the integrity of the corneal endothelium. Recognition of resulting long-term changes may be important before intraocular surgery or if the cornea is to be used for grafting.

Adult↗
PubMed1989

Cyclitic glaucoma.

A series of patients is presented showing the widely variable clinical behaviour of different groups of patients who share the common features of cyclitic glaucoma. These cyclitic glaucomas may be classified: 1. Glaucomatocyclitic crises: unilateral or bilateral. This condition presents acutely, almost always in males with a strong tendency to spontaneous resolution but a liability to subsequent recurrence. Some cases are slow to resolve and may recur frequently. 2. Heterochromic cyclitis: glaucoma infrequently complicates heterochromic cyclitis and then with only a mild rise in intraocular pressure (IOP). 3. Chronic cyclitis: unilateral or bilateral. This is more common in females often presenting with a high rise in IOP which may be difficult to control medically. An insidious form of chronic cyclitis occurs in middle-aged, blue-eyed females, often with sarcoid, and is likely to progress to profound visual loss if unrecognised.

Adolescent↗
PubMed1989

A comparison of the efficacy of betaxolol and timolol in ocular hypertension with or without adrenaline.

Betaxolol hydrochloride, a selective beta 1-adrenergic blocker, is claimed to be less likely to aggravate chronic obstructive airways disease than timolol maleate, a nonselective beta-blocker. It is not clear which drug is more effective in lowering intraocular pressure (IOP) and how each acts in combination with topical adrenaline. To assess this we conducted a randomised clinical trial on ocular hypertensive patients. Both betaxolol and timolol produced a significant fall in IOP though not in all patients. No significant difference was found between betaxolol and timolol. The addition of dipivefrin gave an additional fall in some eyes only. No significant difference was found between the addition of dipivefrin and adrenaline. Some fellow eyes had a fall in IOP when dipivefrin was added to timolol. It is important to assess the response carefully in each individual eye when using betaxolol or timolol or when adding additional medication.

Adrenergic beta-Antagonists↗
PubMed1989

Specular microscopy.

Explore the source record for details and available documents.

Anterior Eye Segment↗
PubMed1989

Two cases of hereditary keratoderma with congenital glaucoma.

Two cases are reported: a father and son with a new syndrome consisting of a severe congenital glaucoma associated with a form of palmoplantar keratoderma showing features of mutilating palmoplantar keratoderma. Both the glaucoma and keratoderma may be attributed to an autosomal dominantly inherited genetic mutation of a single chromosome affecting two tissues of neural crest origin, the ectodermal tissues of the hands and feet and the cranial mesenchyme from which the tissues of the chamber angle develop. Elucidation of the precise chromosomal abnormality causing these defects may help in understanding the inheritance and aetiology of glaucoma.

Adult↗
PubMed1989

Occurrence of malignant glaucoma after laser iridotomy.

A case is described of malignant glaucoma with extreme shallowing of the anterior chamber (AC) and an abnormally high intraocular pressure (IOP) following laser iridotomy for acute angle closure glaucoma. The episode followed the use of strong miotic (pilocarpine hydrochloride 4%) and was reversed by mydriatics including phenylephrine hydrochloride. Serial estimation of anterior chamber depth is important in the management of angle closure glaucoma.

Aged↗
PubMed1989

Acute non-haemorrhagic conjunctivitis due to coxsackievirus A24.

Two cases of acute non-haemorrhagic conjunctivitis due to coxsackievirus A24 (CA24) are described. These are the first Australian isolates. The presentation was as a severe conjunctivitis in otherwise healthy adults who had not travelled outside Australia. The course was of short duration and self-limiting with no long-term sequelae. The isolates could not be neutralised by antiserum prepared against prototype CA24 but were identified by immune electron microscopy and complement fixation.

Adult↗
PubMed1989

The significance of reactions to betaxolol reported by patients.

Some patients may experience respiratory side effects on betaxolol in spite of the greater safety which is claimed for this ocular hypotensive drug compared with timolol. Six of 29 patients using betaxolol complained of wheeze or respiratory distress and five of these patients were rechallenged with betaxolol and a placebo in a double-masked clinical study, respiratory function being measured before and after each medication according to the American Thoracic Society guidelines. No patient showed any change in respiratory function either with betaxolol or the placebo. The findings further support the safety of betaxolol even in patients with respiratory disease, though some caution should be observed.

Aged↗
PubMed1989

Assessment of the corneal endothelium following keratoplasty.

The corneal endothelium was assessed following penetrating keratoplasty in a series of 50 patients and eight illustrative cases are described. Assessment disclosed a wide variation in the endothelial cell count and morphology following keratoplasty. In some patients the endothelial cell count was so low and the morphology so abnormal that long-term survival of the graft was doubtful. In cases with such a low count it is very doubtful whether the graft will survive a secondary procedure such as cataract extraction or intraocular lens implantation. Some donor material may carry corneal guttae and the use of such material should be avoided. If the material is good it will withstand inflammatory episodes including graft rejection if treatment is prompt and appropriate. Satisfactory material may be obtained from elderly donors while a young donor does not guarantee suitable material. It is desirable to assess the corneal endothelium of donor material carefully before use.

Adult↗
PubMed1988

Fluorescein angiography of the iris and specular microscopy of the corneal endothelium in some cases of glaucoma secondary to chronic cyclitis.

A series is presented of middle- to old-aged female patients with gray irides and mild bilateral cyclitis accompanied by severe glaucoma with advanced cupping and field loss in the late stages. The cyclitis is accompanied by edema of the corneal endothelium, with the presence of inflammatory cells on the posterior surface of the endothelium; these changes were reversible with topical corticosteroids. There also was hypoperfusion of the iris with microneovascular changes, but these changes were not reversible. The rise in intraocular pressure (IOP) was associated with changes in the endothelial cells of the posterior cornea that may be accompanied by similar changes in the endothelium of the trabecular meshwork. A large proportion of these patients had sarcoidosis, but the more florid ocular appearances of sarcoid were not present although two patients had chorioretinal scarring. The use of topical corticosteroids was important in helping to control the elevated IOP in these cases. Recognition and treatment of the condition is important, because cupping and field loss were extreme in long-standing cases.

Adrenal Cortex Hormones↗
PubMed1988

Acute primary ischemic iris atrophy.

Five patients are described with acute primary ischemic iris atrophy with almost complete loss of the normal radial vessels of the iris and fine microneovascularization. The atrophy of the iris was marked with a thin atrophic stroma, widely dilated pupil, and extensive loss of pigment from the posterior surface of the iris. The condition is of unknown etiology but occlusion of the greater vascular circle of the iris is possible. Iris angiography showed an almost total loss of the radial vessels of the iris with some patchy microneovascularization. In recent cases, the onset was acute and all patients had a raised intraocular pressure (IOP) except one who had already undergone a drainage operation. There was an accompanying low-grade uveitis or cyclitis in the chronic stage in all cases. The condition was unilateral and the posterior segment of the eye was normal so that good visual function was possible if the accompanying cataract and glaucoma were appropriately managed.

Acute Disease↗
PubMed1988

Determination of the nature of corneal crystals by specular microscopy.

The use of the specular microscope as a noninvasive in vivo method of identifying cholesterol crystals in two cases of crystalline corneal deposits is described. This illustrates the advantage of using the specular microscope under living conditions with a much higher magnification than is obtained with the slit lamp. Attention is drawn to the wider applications of this method.

Cholesterol↗
PubMed1988

The presentation and prognosis of glaucoma in pseudoexfoliation of the lens capsule.

In a series of 519 patients with pseudoexfoliation of the lens capsule (PXF), more than half (286) presented with glaucoma, most either bilateral (61) or unilateral (157) chronic open-angle glaucoma and some acute glaucomas (65). In unilateral PXF glaucoma, the presence of PXF in the fellow eye was a serious risk factor--a raised intraocular pressure (IOP) developed in almost three quarters of these eyes and glaucoma in nearly one quarter. Because glaucoma developed in one quarter of eyes with ocular hypertension on presentation, careful treatment of this hypertension is indicated. If the IOP was not raised on presentation, it developed in only one of eight eyes, and glaucoma developed in one third of these; therefore, regular follow-up only is necessary. Acute glaucoma was usually open-angle PXF glaucoma. The response to medical treatment though good initially, usually fialed on follow-up. Although laser trabeculoplasty was often effective, usually with medical treatment, surgery was often necessary and usually successful though often with adjuvant medical treatment.

Acute Disease↗
PubMed1988

The identification of different vascular cells on the corneal endothelium by specular microscopy. I. Red blood cells and corneal endothelial changes in hyphaema secondary to contusion injury.

In order to differentiate clearly red blood cells and their relationship to the corneal endothelium, specular microscopy was performed in patients with hyphaema due to contusion injury. This enabled the clear identification of red blood cells as rounded, umbilicated or flattened spheroidal structures depending on whether they were seen side on or end on. They were seen best in the relief mode lying on the posterior endothelial surface and not infiltrating the corneal endothelium. It also disclosed the presence of subendothelial blebs one to three cells in diameter seen at the level of the corneal mosaic and not in the relief mode. These are probably due to mild oedema following the contusion injury and were distinct from the red blood cells. The corneal endothelial cell count and morphology were similar to that in the other eye when the changes resolved a week or so after the injury.

Adolescent↗
PubMed1988

The identification of different vascular cells on the corneal endothelium by specular microscopy. II. White blood cells on the corneal endothelium in keratitis.

Examination of the corneal mosaic by the direct mode of specular microscopy and of its posterior surface by the relief mode in three cases of localized keratitis with adjacent clear cornea has enabled us to identify small round white cells. Comparison with the morphology of red blood cells seen in hyphaema indicates that these small round cells are probably lymphocytes since they are fairly uniform in size, spherical but not flattened spheroids and about the same size as or a little larger than red blood cells. These cells are present on the posterior surface of the corneal endothelium but could not be seen infiltrating beneath or between the endothelial cells. They were quite distinct from larger, numerous rounded blebs two to four endothelial cells in diameter lying beneath the endothelium which have previously been described.

Adult↗