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Biomedical subjects

C Y Lowder

Publications and source records attributed to C Y Lowder.

52 records · Page 3Linked to original sources
PubMed1991

Varicella-zoster virus retinitis in patients with the acquired immunodeficiency syndrome.

We examined five patients infected with the human immunodeficiency virus who developed a rapidly progressive necrotizing retinitis characterized by early patchy choroidal and deep retinal lesions and late diffuse thickening of the retina. In all but one case, the retinitis began in the posterior pole with little or no clinical evidence of vasculitis. All five patients had relentless progression of disease and were left with atrophic and necrotic retinae, pale optic-nerve heads, and narrowed vasculature. None of the patients developed aqueous or vitreal inflammation or retinal detachment. Clinical and laboratory evidence suggested that varicella-zoster virus was the causal agent in all five cases. First, the onset of retinitis in four cases either succeeded or was coincident with an eruption of dermatomal zoster. Second, varicella-zoster virus was cultured from the two chorioretinal specimens and varicella-zoster virus antigen was detected in the vitreal aspirate from one case. Third, by means of immunocytochemistry, varicella-zoster virus antigen was found in the outer retinae of both enucleation specimens. Fourth, viral capsids with the size and shape of herpesviridae were found in the outer retinae of both enucleation specimens. The clinical features observed in this study are distinct from those described for the acute retinal necrosis syndrome and appear to constitute a new and highly characteristic pattern of varicella-zoster virus-induced disease.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Acute multifocal inner retinitis.

Two patients developed acute changes in vision two to four weeks after a febrile illness. On ophthalmic examination, each patient had bilateral vitreitis without anterior segment inflammation and multiple, bilateral, round, yellow-white inner retinal lesions that were located in the posterior pole and midperiphery. Laboratory tests did not contribute to a diagnosis. Symptomatic visual loss was caused by neuroretinitis and serous retinal detachment in one patient and by an occluded branch retinal artery in the other. The multifocal retinal lesions resolved gradually without treatment over several months with minimal or no residual retinal changes. Acute multifocal inner retinal lesions may be associated with a preceding nonspecific viral illness and may cause a sudden change in vision if associated with neuroretinitis, serous retinal detachment, or retinal vessel occlusion. We have termed this constellation of ophthalmic findings acute multifocal inner retinitis.

Acute Disease↗
PubMed1991

Posterior segment manifestations of inflammatory bowel disease.

Thirteen patients with inflammatory bowel disease and posterior segment disease were subject to a retrospective review. Eight patients had Crohn's disease and five had ulcerative colitis. In six patients, the inflammatory bowel disease was active when ocular inflammation occurred. Patients had one or more posterior segment findings that included serous retinal detachment (8), choroidal infiltrates (6), retrobulbar neuritis (1), papillitis (1), retinal pigment epithelium disturbance (1), and choroidal folds (1). Posterior segment disease responded to systemic and periocular corticosteroids in 9 of 13 cases. Four patients whose disease relapsed after corticosteroid therapy was suspended responded to bowel resection. Ophthalmologists should be aware of the wide spectrum of posterior segment abnormalities associated with inflammatory bowel disease that may require and respond to anti-inflammatory agents.

Adolescent↗
PubMed1991

Corneal microsporidiosis in a patient with AIDS.

Microsporidia are obligate intracellular protozoan parasites that are becoming increasingly recognized as opportunistic pathogens in patients with AIDS. They have been associated with enteritis, hepatitis, and peritonitis and recently keratoconjunctivitis. Gram stain demonstrates the presence of these organisms on light microscopic sections. The specific diagnostic features that distinguish microsporidia from other small nonspore-forming organisms are best demonstrated by electron microscopy, which is also used to characterize the members of Microsporea. In this study, salient histopathologic features of microsporidia in corneal epithelium obtained from an HIV-seropositive individual who developed AIDS are illustrated and discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Presumed Pneumocystis carinii choroiditis. Unifocal presentation, regression with intravenous pentamidine, and choroiditis recurrence.

Pneumocystis carinii choroiditis is a well-documented but rare infection that has been described as a bilateral, multifocal process. Treatment efficacy has not been well established. In this report, three cases of presumed P. carinii choroiditis that developed during aerosolized pentamidine therapy for the prophylaxis of P. carinii pneumonia are described. All patients had unilateral choroiditis, and two patients were first observed to have unifocal choroiditis. In all patients, choroidal lesions decreased in size with intravenous pentamidine treatment. Choroiditis exacerbated in the two unifocal cases after the frequency of maintenance intravenous pentamidine therapy was decreased. P. carinii choroiditis may appear as a unifocal, unilateral lesion that may represent an earlier stage of infection than previously described. Intravenous pentamidine therapy appears to control P. carinii choroiditis but may need to be continued to prevent exacerbation. Patients receiving prophylactic aerosolized pentamidine therapy are not protected against extrapulmonary disease, and presumed P. carinii choroiditis may serve as a marker for disseminated infection.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Benign osteoblastoma of the orbit.

Benign osteoblastoma is a rare, solitary, vascular, osteoid-producing tumor that is rich in osteoblasts. This is the first report of a case of osteoblastoma of the orbit not contiguous with a sinus cavity.

Child, Preschool↗
PubMed1984

Uveitis. A review.

Uveitis is the term used to describe most intraocular inflammations. The classification of uveitis into anterior, posterior and diffuse is based on the physical appearance of an inflamed eye. Diagnosis is usually on the basis of a thorough history, a review of systems to uncover any systemic diseases known to be associated with uveitis and a complete eye examination. We review the most common types of uveitis, the pertinent laboratory investigations and different therapeutic aspects.

Arthritis, Juvenile↗
PubMed1981

Macular and paramacular detachment of the neurosensory retina associated with systemic diseases.

We have reviewed 168 cases of angiographically proved SRD of the macular region of unknown etiology that were seen at The Cleveland Clinic Foundation. Thirty-seven percent of these patients had documented coincident systemic diseases. Of that group, patients with autoimmune disease appeared to have ocular symptoms during the active phase of the systemic illness. Nine cases are reported characterizing the coincidence of exacerbation of systemic disease with recurrent serous detachment of the neurosensory retina. It is our hypothesis that in patients with autoimmune disease, the choroiditis is secondary to the damage caused by immune complexes. Thus, in these patients, SRD was a manifestation of the systemic illness.

Adult↗
PubMedDate not supplied

Systemic diseases associated with intermediate uveitis.

BACKGROUND: Intermediate uveitis is characterized by vitreal inflammation with associated inflammation of the vitreous base and peripheral anterior retina and choroid. It may be found as an isolated and idiopathic condition or in association with systemic disorders such as multiple sclerosis and sarcoidosis. OBJECTIVE: To identify the clinical features of intermediate uveitis and assess its association with systemic diseases. METHODS: Retrospective study of 83 patients presenting with intermediate uveitis between 1970 and 1991. RESULTS: Evidence of systemic disorders was found in 26 of 83 patients (31.3%). Of these 26 patients, 10 had presumed sarcoidosis, 6 had multiple sclerosis, 2 had isolated optic neuritis, 2 had inflammatory bowel disease, 4 had isolated thyroid abnormalities, and 2 had histories suggestive of Epstein-Barr virus infection. Associated ocular findings included cystoid macular edema, peripheral retinal perivascular sheathing, cataracts, posterior vitreous detachment, fine keratic precipitates, preretinal macular fibrosis, retinal tears, retinal detachment, and optic disc edema. CONCLUSIONS: Patients with intermediate uveitis may have associated systemic diseases and should have careful follow-up with regular systemic evaluation.

Adolescent↗
PubMedDate not supplied

An unusual ocular manifestation of discoid lupus erythematosus.

BACKGROUND: Discoid lupus erythematosus is a chronic skin disease characterized by well-demarcated papules and plaques. Mucous membrane changes are common; however, conjunctival involvement is unusual. We report a case of unilateral, chronic, isolated discoid lupus erythematosus of the conjunctiva. OBSERVATIONS: A 32-year-old man presented for evaluation of chronic conjunctivitis of the right eye that had persisted for 9 years. A biopsy of the bulbar conjunctiva revealed a mixed mononuclear cellular infiltrate distributed along the epithelial basement membrane zone and around the stromal blood vessels. Immunohistopathologic examination revealed a diffuse, granular pattern of fluorescence corresponding to immunoglobulins and complement components along the epithelial basement membrane zone and in the walls of the stromal blood vessels. Electron microscopy demonstrated changes in the epithelial basal lamina consistent with discoid lupus erythematosus, including areas that were multilayered. Immunoelectron microscopy identified sub-basal lamina deposits of immunoglobulin G. CONCLUSIONS: Discoid lupus erythematosus should be a suspected cause of chronic conjunctival inflammation; the diagnosis is substantiated by immunopathologic and ultrastructural studies.

Adult↗
PubMedDate not supplied

Corneal microsporidioses: characterization and identification.

Two ocular infectious disorders attributed to Microsporidia have been observed. They differ in that one infection involves the corneal stroma leading to corneal ulceration and suppurative keratitis whereas the other infection involves the conjunctival and corneal epithelium. The corneal stromal infection is caused by a binucleated oval spore that is Nosema-like in character. The conjunctival and corneal epithelial infection occurs in HIV-sero-positive individuals and is caused by a spore containing a single nucleus that is a member of the genus Encephalitozoon. Characteristics of these genera and the above-mentioned infections are presented.

Adult↗
PubMedDate not supplied

Giant papillary conjunctivitis associated with rigid gas permeable contact lenses.

Giant papillary conjunctivitis (GPC) is an external ocular inflammatory disorder associated with contact lens wear. GPC seems to occur less frequently with hard than with soft contact lens wear. The management of soft contact lens related GPC has included refitting with hard lenses, specifically the newer rigid gas permeable (RGP) lenses. We retrospectively studied 14 RGP lens wearers in whom GPC developed. Three patients had had GPC associated with soft contact lens wear and had been fitted with RGP lenses in an effort to restore contact lens tolerance. The interval of time between the initiation of RGP lens wear and the onset of GPC was inversely related to the lens oxygen transmissibility (DK value). Ophthalmologists should be aware of the association between GPC and rigid gas permeable lens wear.

Adolescent↗