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Biomedical subjects

A R Pilkerton

Publications and source records attributed to A R Pilkerton.

At least 19 recordsLinked to original sources
PubMed1993

Central nervous system herpesvirus infection in systemic lupus erythematosus: diagnosis by endoretinal biopsy.

A 31-year-old woman with systemic lupus erythematosus (SLE) developed meningoencephalitis, followed by transverse myelitis. The clinical picture was otherwise not consistent with a lupus flare. Extensive diagnostic evaluation was unrevealing. Acute visual loss ensued, associated with an unusual pattern of retinitis. Endoretinal biopsy established the diagnosis of herpesvirus infection. Reinstitution of antiviral therapy, and optic nerve sheath decompression, led to resolution of neurologic deficits and partial return of vision. Our report is the first that describes a patient with SLE with herpes meningoencephalitis, transverse myelitis, and rapidly progressive outer retinal necrosis, diagnosed antemortem by endoretinal biopsy, and successfully treated with acyclovir and optic nerve fenestration.

Acyclovir↗
PubMed1993

Systemic herpetic infection diagnosed by retinal biopsy.

We describe a patient with systemic lupus erythematosus who developed myelopathy, optic neuropathy, retinopathy, and aseptic meningitis unresponsive to immunosuppressive and antimicrobial therapy. Although cultures and brain biopsy were unrevealing, a Herpes virus was suggested by retinal biopsy. The patient recovered dramatically after institution of acyclovir therapy and optic-nerve-sheath decompression. This case demonstrates that herpetic retinitis can occur in an iatrogenically suppressed host and underscores the value of tissue diagnosis.

Adult↗
PubMed1992

A new technique for repositioning and fixating a dislocated intraocular lens.

A new technique for repositioning and fixating a dislocated posterior chamber intraocular lens is described. Using pars plana vitrectomy techniques, the intraocular lens is retrieved and maintained in the plane of the ciliary sulcus. The lens haptics are sutured to the sclera in three positions to avoid recurrent dislocation or torsion of the lens. Intraocular manipulation of sharp needles is avoided. Suture knots are buried in the sclera to minimize the risk of late-onset endophthalmitis.

Aged↗
PubMed1992

Idiopathic preretinal fibrosis: a review of 237 cases.

We reviewed the charts of 223 patients (236 eyes) with idiopathic preretinal fibrosis, dividing them into two groups: those who only had been observed, and those who, after an observation period, had the membranes surgically removed. All of the patients had been followed from 6 to 120 months (mean, 29 months). Vision in the nonsurgical group slowly deteriorated and was accompanied by metamorphopsia. More rapid visual deterioration occurred in 60 eyes (25%), of which 37 (16%) required surgery. Vision in 78% of the surgical group improved, with the greatest subjective benefit considered to be subsidence of metamorphosia. Vision spontaneously improved in 2.5% of the cases.

Aged↗
PubMed1991

An alternative technique of local anesthesia for vitreoretinal surgery.

Retrobulbar anesthesia produces effective local anesthesia for ocular surgery, but significant complications have been reported with its use. To maintain its efficacy and to minimize the risks associated with the passage of a needle behind the eye, we have placed local anesthesia into sub-Tenon's space posteriorly using a blunt irrigating cannula in 100 patients undergoing vitreous or retinal procedures. Posterior Tenon's capsule is opened by blunt dissection, allowing the irrigating cannula to be passed into the posterior sub-Tenon's space for anesthetic injection. The technique was effective in 98 of 100 patients, and no morbidity was associated with its use.

Anesthesia, Local↗
PubMed1988

Rhegmatogenous retinal detachment with a pit of the optic nerve head.

A 56-year-old myope developed a retinal detachment of the macular area and the temporal quadrants in his left eye that harbored a temporally-located pit of the optic nerve head. Under anesthesia a small peripheral retinal break was identified, and the retina was reattached successfully using cryotherapy and a limited scleral buckling procedure. Peripheral retinal breaks should be searched for in myopic eyes with optic pits and retinal detachments involving peripheral retinal quadrants.

Humans↗
PubMed1982

Vitreous fluorophotometry in three models of experimental diabetes mellitus.

Fluorophotometry was performed on rats eight to ten days after they were made diabetic with streptozotocin (85 mg/kg), alloxan (50 mg/kg), or pancreatectomy. When compared with normal control animals, no significant differences in aqueous or vitreous fluorescein levels were noted in any of the diabetic models studied. We did note significant depressions of plasma fluorescein levels in pancreatectomized and streptozotocin-treated rats. We normalized our data for these plasma differences by calculating the ratios of aqueous and vitreous fluorescein to plasma fluorescein levels (RA and RV). Both RA and RV were significantly elevated in streptozotocin-induced diabetes; RV alone was elevated following pancreatectomy, while no change in either ratio was apparent in diabetes induced with alloxan. Treatment of streptozotocin-diabetic rats with cortisol for one week caused plasma fluorescein levels and RV to return toward normal, although RA remained elevated. We are cautious in assigning any meaning to changes in RA and RV, especially in view of the paucity of information on the behavior of fluorescein in the blood.

Alloxan↗
PubMed1980

Cilioretinal circulation and branch arterial occlusion associated with preretinal arterial loops.

Three patients had occlusion of preretinal loops and associated branch arterial occlusion. On fluorescein angiography all three eyes showed extensive cilioretinal circulation and that the occluded preretinal loops were part of the cilioretinal vascular anomaly. This supports the hypothesis that one form of preretinal arterial loop is associated with a malformation of the cilioretinal circulation.

Adolescent↗
PubMed1980

The effects of iodate and iodoacetate on the retinal adhesion.

Sodium iodate and sodium iodoacetate were employed as biological probes to evaluate component forces contributing to the strength of retinal adhesion to the retinal pigment epithelium (RPE). Iodate treatment produced a rapid reduction in the strength of adhesion, which was complete within 1 hr without evidence of concurrent structural change. The adhesive strength reduction produced by iodoacetate required 8 to 12 hr, corresponding to the appearance of early structural changes in the photoreceptor outer segments, although delayed metabolic disturbances in the RPE might also have been involved. The study suggests that metabolic activity in the RPE may account for a portion of the strength of adhesion and that structural changes in the photoreceptor outer segments may also contribute to the forces of adhesion.

Adhesiveness↗
PubMed1979

Experimental vitreous fibroplasia following perforating ocular injuries.

Biochemical data and histopathologic observations were made on an experimental model of vitreous fibroplasia in the rabbit eye, with comparisons between the change in vitreous collagen concentration and histologic characteristics 7, 14, and 30 days after injury. Prior to two weeks after injury there is a relatively small amount of new vitreous collagen formed, associated with an inflammatory and vascular reaction. At four weeks there is a marked increase in new vitreous collagen and dense fibrous sheets are noted. Vitreous hemorrhage accelerates collagen formation, and methylprednisolone sodium succinate does not decrease vitreous fibrosis. Our results suggest that the optimum time for vitrectomy, under the conditions of this experiment, is two weeks after primary repair. The efficacy of steroids in retarding vitreous fibroplasia is not supported.

Animals↗
PubMed1975

Retinal adhesion in light- and dark-adapted rabbits.

The effects of pigmentation and light exposure on retinal adhesion in rabbits have been investigated in a complete factorial experiment. Ocular pigmentation did not significantly influence retinal adhesion. A significant difference in retinal adhesive forces was found between light and dark adaptation. The force required to detach the retina from the retinal pigment epithelium was 20 per cent greater in light-adapted eyes than in dark-adapted eyes. These observations suggest that the positional change of rhodopsin molecules in the outer segment disk membranes occurring with light exposure and the resultant alteration in interdisk electrostatic forces may play an important role in retinal adhesion.

Adaptation, Ocular↗