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Biomedical subjects

A Rothova

Publications and source records attributed to A Rothova.

At least 55 records · Page 3Linked to original sources
PubMed1995

Presumed acquired ocular toxoplasmosis.

OBJECTIVE: To describe the clinical characteristics and laboratory findings of eight patients with focal chorioretinitis presumably caused by acquired toxoplasmosis. DESIGN: Case series. SETTING: Referral hospitals in the Netherlands. PATIENTS: Eight patients, aged 42 to 75 years, with unilateral focal chorioretinitis and laboratory evidence of a recently acquired infection with Toxoplasma gondii. MAIN OUTCOME MEASURES: Findings from ocular examination and analysis of both serum and aqueous humor samples for Toxoplasma and viral antibodies. RESULTS: All patients had unilateral focal chorioretinitis without associated old scars in the posterior pole. Patients treated with systemic or periocular corticosteroids not accompanied by antiparasitic medication showed a rapid increase of inflammation. All eight patients had Toxoplasma IgM antibodies in their serum samples, seven of whom had high Toxoplasma IgG titers. Five of eight patients had increased intraocular production of IgG antibodies against T gondii. CONCLUSION: Unilateral focal chorioretinitis in patients of any age should alert the clinician to consider acquired ocular toxoplasmosis in the differential diagnosis.

Adult↗
PubMed1995

HLA typing in congenital toxoplasmosis.

HLA-A, HLA-B, HLA-C, and HLA-D typing was performed in 47 mothers of patients suffering from ocular toxoplasmosis to investigate whether an immunogenetic predisposition exists for developing congenital toxoplasmosis in their offspring. No significant association between any HLA antigen was observed in the mothers of patients with ocular toxoplasmosis, although a total absence of the HLA-B51 antigen was found in this group. HLA-A, HLA-B, and HLA-C typing was also performed in their children (52 patients with ocular toxoplasmosis), to investigate a possible relation between the severity of ocular toxoplasmosis and an eventual immunogenetic factor. In the patients with ocular toxoplasmosis an increased frequency of the HLA-Bw62 antigen was observed in correlation with severe ocular involvement.

Disease Susceptibility↗
PubMed1995

Long term ocular and neurological involvement in severe congenital toxoplasmosis.

AIMS: This study was set up to determine the long term ocular and systemic sequelae in patients with severe congenital toxoplasmosis. METHODS: Cross sectional and retrospective study of 17 patients with severe congenital toxoplasmosis. RESULTS: In addition to chorioretinitis (100%), the most common abnormal ocular features were optic nerve atrophy (83%), visual acuity of less than 0.1 (85%), strabismus, and microphthalmos. In 50% of cases we observed iridic abnormalities and about 40% developed a cataract. Overt endocrinological disease, diagnosed in five of 15 patients, included panhypopituitarism (n = 2), gonadal failure with dwarfism (n = 1), precocious puberty with dwarfism and thyroid deficiency (n = 1), and diabetes mellitus and thyroid deficiency (n = 1). The observed endocrinological involvement was associated in all cases with obstructive hydrocephalus with a dilated third ventricle and optic nerve atrophy. CONCLUSION: The recognition of long term ocular, neurological, and endocrinological sequelae of congenital toxoplasmosis is important for medical management of these severely handicapped patients.

Adolescent↗
PubMed1995

Macular grid laser photocoagulation in uveitis.

AIMS/BACKGROUND: The aim of this study was to evaluate whether grid laser photocoagulation of the macula is beneficial in the treatment of cystoid macular oedema in patients with uveitis. METHODS: Six eyes of five patients with long standing cystoid macular oedema due to chronic uveitis were treated by grid laser photocoagulation of the macula. RESULTS: In the first weeks after treatment a temporary increase of oedema and paracentral scotomas were observed. At the long term follow up of more than 18 months in all patients, macular oedema had been reduced significantly or disappeared in all eyes treated. One eye had a significant increase in Snellen acuity, three eyes more or less stabilised, and two eyes deteriorated. CONCLUSION: The beneficial effect of laser treatment on visual acuity in patients with uveitis might be more favourable if performed at an earlier stage of the disease.

Adult↗
PubMed1994

Iris nodules in Fuchs' heterochromic uveitis.

Four black patients with Fuchs' heterochromic uveitis had multiple nodules in the iris. The iris nodules were small, transparent, and scattered across the whole surface of the iris (Busacca's nodules) but increased in density toward the pupillary border. All four patients also had nodules at the pupillary border (Koeppe's nodules). Repeated etiologic screening for systemic diseases in these patients was noncontributory. Unilateral multiple iris nodules without the formation of synechiae may be encountered as part of Fuchs' heterochromic uveitis syndrome and may be important in the identification of Fuchs' heterochromic uveitis, especially in black patients.

Adult↗
PubMed1994

Detection of intraocular antibody production to herpesviruses in acute retinal necrosis syndrome.

In order to improve the determination of the causative agent in acute retinal necrosis syndrome, we evaluated the detection of intraocular antibody production to herpesviruses in 28 patients with this disease. Intraocular antibody production was determined by calculation of the Goldmann-Witmer coefficient whereby specific antibody titers in the inflamed eye and circulation are related to the total IgG content in ocular fluid and serum. Specific antibody titers to herpesviruses and Toxoplasma were determined by the indirect immunofluorescence technique. Thirty-five patients with ocular toxoplasmosis, cataract, or proliferative vitreoretinal disorders were tested as controls. By this technique, intraocular antibody production to varicella zoster virus or herpes simplex virus could be established in 16 (57%) of the patients with the typical clinical features of acute retinal necrosis, compared to none of the controls. Of the 33 affected eyes, 21 (64%) had a visual outcome of less than 20/200. We concluded that detection of intraocular antibody production to herpesviruses may be a useful diagnostic tool in establishing the causative agents in acute retinal necrosis.

Adult↗
PubMed1994

Blindness from uveitis in a hospital population in Sierra Leone.

A retrospective study was conducted to assess the causes of blindness and visual impairment in patients who visited an eye hospital in Sierra Leone, West Africa, in 1989 and 1992. These data were compared with figures from 1981. Throughout the years, senile cataract was the major cause of blindness, followed by uveitis (including onchocerciasis). Uveitis remained the second most important cause of blindness in this population, despite the significant decrease in blindness from onchocerciasis (from 30% in 1981 to 15% in 1992). An increasing number of patients with uveitis from non-onchocercal origin was observed: almost 10% of the blindness found in 1992 was due to uveitis of non-onchocercal origin. A reduction in visual handicap in patients with non-onchocercal uveitis could be achieved if local hospitals could obtain more accurate diagnoses in these patients.

Age Distribution↗
PubMed1993

Long-term effects of ceftriaxone treatment on intraocular Lyme borreliosis.

Twelve patients with intraocular Lyme borreliosis suffering from vitreitis were treated with ceftriaxone intravenously. Eight patients had definitive Lyme borreliosis, and tentative diagnosis was made in four patients. After treatment with ceftriaxone, all 12 patients were followed up for more than one year. Vitreitis diminished in all patients and visual acuity improved in six patients. The best results were achieved in patients with definitive Lyme borreliosis.

Adult↗
PubMed1993

Therapy for ocular toxoplasmosis.

We conducted a prospective multicenter study of the efficacy of current therapeutic strategies for ocular toxoplasmosis in 149 patients. Treatment consisted of the following three triple-drug combinations: group 1, pyrimethamine, sulfadiazine, and corticosteroids; group 2, clindamycin, sulfadiazine, and corticosteroids; and group 3, trimethoprim, sulfamethoxazole and corticosteroids. Patients with peripheral retinal lesions were not treated systemically. No difference in the duration of inflammatory activity was observed between treated and untreated patients (P = .5). The most important factor predicting the duration of inflammatory activity was the size of the retinal lesion itself, independent of the treatment (P < .001). We found a reduction in size of the retinal inflammatory lesion for 49% of the pyrimethamine-treated patients (17 of 35) compared to 20% of the untreated patients (eight of 41) (P < .01). However, the most frequent occurrence of side effects was also associated with pyrimethamine medication (26%, nine of 35). The mean recurrence rate after three years of follow-up was 49% for all patients (60 of 122 patients), with no differences between treated and untreated patients (P = .6).

Adult↗
PubMed1993

Birdshot chorioretinopathy and Lyme borreliosis.

Two patients in whom ocular Lyme disease was suspected and who had antibodies to Borrelia burgdorferi developed birdshot chorioretinopathy and carried the HLA-A29 antigen. In a series of 11 patients with birdshot chorioretinopathy who carried the HLA-A29 antigen, three patients had antibodies against B. burgdorferi as determined by either immunofluorescence assay, enzyme-linked immunosorbent assay, Western blot analysis, or a combination of these tests. Further studies will be necessary to evaluate whether this is a false-positive reaction or whether B. burgdorferi has a causative role in the pathogenesis of birdshot chorioretinopathy.

Blotting, Western↗
PubMed1993

Fundus pathology in neurosarcoidosis.

We describe the ocular symptomatology in 6 patients with neurosarcoidosis. All patients suffered from uveitis posterior or panuveitis. Ophthalmoscopy revealed multifocal chorioretinic lesions, periphlebitis, severe papilledema or an isolated chorioretinic process. The similarity with birdshot chorioretinopathy is described. Nuclear magnetic resonance imaging, computer assisted tomography and visual field examination can all contribute to the determination of neurological involvement in sarcoidosis.

Adolescent↗
PubMed1993

Does autoimmunity to S-antigen play a role in Fuchs' heterochromic cyclitis?

Autoimmunity directed against retinal or choroidal antigens has been suggested to play a role in the chorioretinal lesions observed in patients with Fuchs' heterochromic cyclitis. This hypothesis was addressed and patients with Fuchs' heterochromic cyclitis were tested for cellular immunity (migration inhibitory factor assay) against human retinal S-antigen. A significantly higher percentage of patients with Fuchs' heterochromic cyclitis had a positive cellular autoimmune response to S-antigen than healthy controls and other patients with anterior uveitis. This finding is remarkable since Fuchs' heterochromic cyclitis is generally classified as an anterior uveitis and patients with Fuchs' heterochromic cyclitis without chorioretinal lesions also had a positive test. In view of these results and a sensitisation against a corneal antigen reported earlier in Fuchs' heterochromic cyclitis, it is suggested that a chronic low grade grade anterior uveitis or chorioretinitis of unknown origin may cause the release of potent autoantigens in these patients.

Adult↗
PubMed1993

Uveitis and Lyme borreliosis.

In a retrospective study 56 consecutive patients with uveitis of unknown origin and 56 consecutive patients suffering from uveitis of established aetiology were investigated. The purpose of this study was to determine the frequency of positive serological tests for Lyme borreliosis among patients with uveitis and to relate laboratory data to clinical findings. The antibody titre for Borrelia burgdorferi was determined by two assays: the indirect immunofluorescence assay and the enzyme linked immunosorbent assay. A positive result according to one or both assays was found for eight patients with uveitis of unknown aetiology (14%) and three patients with uveitis of established cause (5%). On clinical examination, none of the patients fulfilled the CDC criteria for diagnosis of Lyme borreliosis.

Antibodies, Bacterial↗