Biomedical subjects
Publications and source records attributed to C R Kollarits.
Four members of a family had the heriditary syndrome of dominantly inherited progressive optic atrophy and congenital sensorineural deafness. Hearing evaluations revealed that two members had a potentially treatable form of deafness.
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Scleral calcifications were demonstrated roentgenographically in two patients with known hyperparathyroidism and clinically normal eyes. In one of these patients, scleral calcification was evident both on plain films and with computed tomography (CT). In the second patient, a solitary plaque of calcified sclera was visible only by CT. Histopathologic examination of the eyes of a third hyperparathyroid patient who died during surgery demonstrated calcium plaques in the posterior sclera consistent with the CT appearance of the sclera in the other patients.
Localization of intraocular and orbital foreign bodies with computerized tomography (CT) was evaluated in eight patients and an experimental model. CT examination was particularly helpful in cases with multiple similar foreign bodies and in identifying foreign bodies too radiolucent to be seen by standard skull x-rays. Limitations of CT technique included insufficient resolution to localize a foreign body immediately adjacent to the sclera as either intraocular or extraocular, and obscuration of a small foreign body by artifacts from an adjacent, larger foreign body.
A man with congenital orbital varices developed progressive ipsilateral visual loss beginning at age 62. Work-up demonstrated elevated intraocular pressure, decreased outflow facility, and mildly elevated episcleral venous pressure in the affected eye. Initiation of adequate glaucoma treatment was associated with interruption of declining visual acuity and with expansion of the constricted visual field. Medical control of coexisting glaucoma should be attempted prior to consideration of surgical intervention in any patient with visual loss and an ipsilateral orbital varix.
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A 33-year-old white man developed premature presbyopia and anisocoria as initial manifestations of acute pandysautonomia. Nine months later signs and symptoms of generalized, severe autonomic dysfunction developed, and six years later only paralysis of pupillary reactions, presbyopia, and orthostatic hypotension were unresolved. Pharmacologic testing of the pupils demonstrated no mydriasis to cocaine 4% or hydroxyamphetamine 1% and hypersensitivity to epinephrine 0.1%, methacholine 2.5%, and pilocarpine 0.0625%, suggesting the presence of sympathetic and parasympathetic, postganglionic blockage of autonomic innervation of the iris.
By in vitro incubation of rhesus monkey lenses at 37degreesC, we determined that solutions superior to intraocular irrigating solutions in common clinical use could be prepared by aspetically adding commerically available solutions of dextrose 5% in water and sodium bicarbonate to either Ringer's injection or Ringer's lactate solutions. While not as effective as glutathione-bicarbonate-Ringer's solution (G-B-R) in maintaining lens clarity, these mixtures can be prepared easily in the operating room (in contrast to G-B-r) and may improve surgical results in procedures requiring prolonged intraocular irrigation.
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The authors describe an unusual case of a serous detachment of the fovea and decreased vision with parafoveal exudates from a retinal astrocytoma with subsequent spontaneous resolution and return of central vision in a patient with tuberous sclerosis.
A new semi-automatic videopupillometer with a two-channel video integrator uses prismatic displacement of pupil images for binocular recording with a single infrared-sensitive video camera. The video integrator graphically records pupil area or diameter during testing and can reanalyze and plot information from videotape recordings of pupil responses. This new pupillometer was used to evaluate the pupil dark response in 178 eyes of 89 normal human volunteers (ages 18-75 years). The time course of pupil dilation was similar in volunteers of all ages, even though the average pupil area became progressively smaller with increasing age.
The pupil dark response and maintenance of pupil area in darkness were compared in seven narcoleptic patients and 14 age-matched normal volunteers. Onset and degree of miosis after maximal pupil dilation in darkness were similar in the two groups, although three narcoleptic patients and no normal volunteers fell asleep during the experiment. The results of this study contradict earlier suggestions that pupillography can be used to distinguish normal individuals in family studies of narcoleptic patients.