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Biomedical subjects

B S Fine

Publications and source records attributed to B S Fine.

At least 37 records · Page 2Linked to original sources

The iris naevus (Cogan-Reese) syndrome: light and electron microscopic observations.

The light and electron micrscopic findings in an eye enucleated from a 38-year-old woman with iris naevus (Cogan-Reese) syndrome are presented. The clinical manifestations of this disease, namely, iridic stromal matting, iridic nodule formation, and unilateral angle-closure glaucoma, appear to be secondary to an endothelial membrane on the anterior surface of the iris. The iris naevus syndrome is now thought to represent one end of the clinical spectrum of an iridocorneal endothelial syndrome which also includes those clinical entities classified previously as Chandler's syndrome and essential iris atrophy.

Adult↗

The basement membrane exfoliation syndrome.

Previous observations suggest that "pseudoexfoliation of the lens capsule" may be a disease in which cells produce abnormal basement membrane material. Electron microscopic studies indicate that exfoliative material can be produced by cells throughout the anterior segment of the eye. This report describes abundant exfoliative material on the ciliary and iridic epithelia but not on the surface of the lens whose epithelial cells were completely necrotic. Exfoliative material also was observed in the anterior iridic stroma close to a newly formed abnormal endothelial basement membrane, suggesting that exfoliative material may be produced locally within the iris. Furthermore, typical exfoliative material, best considered a filamentous, banded basement membrane with 500-A periodicity, in the wall of a short posterior ciliary artery in the orbit indicates that the exfoliative process is not solely limited to ocular tissues. The term "basement membrane exfoliation syndrome" is proposed for this entity.

Aged↗

Proliferative endotheliopathy with iris abnormalities. The iridocorneal endothelial syndrome.

Sixteen cases of essential iris atrophy and two of iris nevus (Cogan-Reese) syndrome were reviewed retrospectively by light and electron microscopy. Varying degrees of corneal endothelial proliferation onto the trabecular meshwork and anterior iris were seen in all cases. The demonstration of an endothelial-abnormal basement membrane complex on the anterior iridic surface, deep to synechias in over half the cases, indicates that endothelialization may be primary, since it precedes the formation of anterior synechias. Pathologic and clinical evidence suggests that the iris nevus syndrome, Chandler's syndrome, and essential iris atrophy represent a continuum of clinical manifestations of a single disease process involving proliferation of the corneal endothelial and characteristic iris abnormalities; the latter may be secondary to variations in the pattern, rate, and extent of endothelial proliferation. We suggest the term "proliferative endotheliopathy" to emphasize the common pathogenetic role of corneal endothelial proliferation in all three entities (iris nevus syndrome, Chandler's syndrome, and essential iris atrophy). A more succinct alternate term is "the iridocorneal endothelial (ICE) syndrome."

Adult↗

Inheritance of Fuchs' combined dystrophy.

The inheritance pattern of Fuchs' combined corneal dystrophy is not confirmed. Published pedigrees fail to demonstrate a 50% segregation and sex ratio. They include no more than two generations of affected individuals and indicate a strong, female predilection. The pedigree we will present shows 16 affected persons in four generations. The ratio of affected to unaffected and men to women is 1:1. Penetrance is apparently 100%. Nine of the affected are under 50 years of age; four are subteen age. Light and electron micrographs of corneal tissue from three patients in three different generations are consistent with the diagnosis of Fuchs' dystrophy. Fuchs' dystrophy can therefore be established as a classic autosomal dominant pattern.

Adolescent↗

Repair and late degeneration of the primate foveola after injury by argon laser.

Each foveola of nine rhesus monkey eyes was subjected to a single, mild, calibrated exposure from an argon laser (1 to 1.4 mW for 10 to 20 min). Observations from ophthalmoscopy, fundus photography, and fluorescein angiography were correlated with light and electron microscopic studies. The ophthalmoscopic changes consisted of initial whitening and subsequent but persistent depigmentation of the foveola. Fluorescein angiography showed a pattern consistent with "window defect" of the retinal pigment epithelium (RPE). In the first 6 months after injury, the pathologic changes consisted of initial vacuolar changes of the RPE, followed by persistent hypopigmentation and slow development of membranous bodies or lipoidal degeneration in these cells. Initial alteration and subsequent incomplete reformation of cone outer segments were also noted. In animals sacrificed 3 to 4 years after injury, separation of RPE from Bruch's membrane, with production of various abnormal basement membranes and intercellular cystoid changes in the overlying retina, was observed. The morphologic observations suggest that although the mildly injured epithelial cells may recover, they may develop functional incompetence at a later date, resulting in serous detachment of RPE and foveal (macular) edema.

Animals↗

Congenital hereditary stromal dystrophy of the cornea.

Cornea from patients in two separate pedigrees showing dominant inheritance of a congenital nonprogressvie corneal clouding were examined by light and electron microscopy. The characteristic changes of abnormal corneal lamellae were widely and rather uniformly distributed throughout the stroma. The remaining corneal layers were normal. The findings are consistent with a diagnosis of congenital hereditary stromal dystrophy of the cornea, which differs greatly on both histologic and clinical grounds from the entity known as congenital hereditary endothelial dystrophy of the cornea.

Adolescent↗

Pigment epithelial windows and drusen: an animal model.

Aging rhesus monkeys, both controls and those undergoing long-term administration of investigational oral contraceptive steroids, developed widespread hyperfluorescent dots at the posterior pole. The dots were considered to represent drusen. Histologic (including electron microscopic) study showed the "drusen" in some of the animals to be almost exclusively pigment epithelial windows produced by a lipoidal degeneration of the pigment epithelial cells. The experiment provided a fortuitous model for direct correlation of clinical and histologic observations of myriad uniform, tiny, depigmented, hyperfluorescent, nonleaking spots at the level of the retinal pigment epithelium.

Age Factors↗

Patterned dystrophies of the retinal pigment epithelium.

Three varieties of patterned dystrophies of the retinal pigment epithelium have been described in the literature: They are reticular dystrophy, macroreticular dystrophy, and butterfly-shaped pigment dystrophy of the fovea (macula). They are all inherited and are bilateral and symmetric. Results of retinal-function tests in all three varieties were essentially normal, except for the electro-oculogram in the butterfly-shaped pigment dystrophy. We have observed within a single family one member manifesting butterfly-shaped pigment dystrophy, one member with macroreticular dystrophy, and one member with probable reticular dystrophy. Electrophysiologic studies of the retina in these patients were in accord with those already reported, except for supernormal scotopic responses in the latter two patients. This family demonstrates the linkage necessary to tie together a number of entities heretofore considered as separate.

Adult↗

Lattice corneal dystrophy. Report of an unusual case.

The clinical, histochemical, light and electron microscopic evaluation of a case of lattice corneal dystrophy, appears clinically as an atypical granular dystrophy. There is structural and histochemical differentiation of the two dystrophies. Electron microscopy is often an invaluable aid in establishing a definitive diagnosis. The possible sources of the filamentous material found in lattice corneal dystrophy are discussed. It seems that not only keratocytes, but also corneal epithelial cells, occasionally may have the ability to elaborate the abnormal material that is considered to be amyloid in nature.

Corneal Dystrophies, Hereditary↗

Meesmann's epithelial dystrophy of the cornea.

Two separate pedigrees had typical Meesmann's dystrophy of the corneal epithelium. Histologic examination of one patient from each pedigree showed two characteristic findings in corneal epithelium; the previously designated "peculiar substance" in the cells, and the vacuolated homogeneous substance mostly within the cysts. The primary disturbance probably involves the cytoplasmic ground substance that ultimately may result in complete homogenization of cells and the formation of cysts. Thickening of the epithelial basement membrane is variable and is a nonspecific response by the epithelial basal cells.

Adult↗

A histologic study of regional choroidal dystrophy.

Light and electron microscopy studies of eyes removed from an 84-year-old man after death indicated a normal optic nerve despite severe peripapillary choroidal atrophy. In the area of atrophy, the choriocapillaris, retinal pigment epithelium, and photoreceptors were absent and there was a marked decrease in choroidal arteries and veins. Bruch's membrane was intact except for several breaks in the peripapillary region. Müller cells, in the region of atrophy, produced an aberrant, thick basement membrane either in the outer layers of the neurosensory retina or directly applied to Bruch's membrane. On the basis of this study, we postulate that the primary abnormality in this disease is of the choroidal vasculature.

Aged↗

Unusual superficial variant of granular dystrophy of the cornea.

Two patients with a superficial variant of granular dystrophy of the cornea occurring primarily in nongrafted eyes developed rapid progression of clinical manifestations and visual deterioration at an early age. No other members of their family were known to be affected. A clinical diagnosis of superficial corneal dystrophy, type undetermined, was made. The histopathologic features of the corneas resembled the findings seen in Reis-Bücklers dystrophy and led to some confusion in the differential diagnosis. Electron microscopic studies in both cases unequivocally established the diagnosis of granular dystrophy.

Adolescent↗

Congenital herpes simplex virus, type 2, bilateral endophthalmitis.

A set of dizygotic twins, both born prematurely, developed herpes simplex encephalitis shortly after birth. The second twin had unilateral keratoconjunctivitis and bilateral endophthalmitis and subsequently died from disseminated herpes infection. Herpes simplex, type 2, was isolated from conjunctiva of both eyes, cerebrospinal fluid, nasopharynx and trachea. Histologic examination of the eyes reveaed bilateral endophthalmitis with a necrotizing retinitis. Intranuclear inclusion bodies were demonstrated by light microscopy in the retina, choroid and iris, and virus particles were demonstrated by electron microscopy in the retina. The other twin recovered from a much milder disseminate herpes simplex infection without apparent ocular involvement. During pregnancy, the mother had vaginitis which was suspected, but not documented, as being herpetic in origin. The father was diagnosed as having a penile infection caused by herpes simplex.

Adult↗

Effects of repeated microwave irradiations to the albino rabbit eye.

Albino rabbits were exposed to repeated microwave irradiations once daily for a month. Clinical examination was carried out for a period up to one year. No changes occurred below 300 mW./cm.2. At and above this level posterior subcapsular iridescence and posterior cortical cataracts were produced. The histologic findings in posterior subcapsular iridescence are presented. It appears that the nonprogressive posterior cortical cataracts are a result of the temperature levels generated by the microwaves in the immediate retrolental area.

Animals↗

A histologic study of calcific and noncalcific band keratopathies.

One hundred five cases previously diagnosed as band keratopathy were reexamined. We found that band keratopathy was calcific noncalcific, or mixture of both. The noncalcific band was identified as elastotic degeneration of collagen, known clinically by various alternate terms. Cases of so-called reduplication of Bowman's membrane were reexamined, and many demonstrated production of a thick basement membrane of the corneal epithelium, with or without massive calcification. Identification of calcific-band keratopathy was made by transmission electron microscopy even when the tissue had been previously decalcified.

Calcinosis↗

Electron microscopic study of human papilledema.

Papilledema associated with neoplastic invasion of the orbit in the optic disks of two patients was found and examined by light and electron microscopy. Pathologic changes in the optic nerve head and nerve included axonal degeneration and mild interstitial edema. Axonal swelling appeared to be the major factor in the overall increase in tissue volume of the optic nerve head. Vascular and perivascular glial alterations were nonspecific.

Adult↗