Biomedical subjects
Publications and source records attributed to D Weinberger.
The threshold sensitivity visual-field test is one of the most accurate ways to detect ocular disorders. The indications for utilization of this device in the detection and follow-up of many diseases other than glaucoma and neuro-ophthalmologic disorders can be expanded.
An unusual case of a 17-year-old woman with bilateral branch-artery occlusion is presented. A thorough clinical and laboratory investigation showed no evidence of any abnormality, which was also not found during a follow-up period of three years. The obstruction occurred in both eyes within a period of ten months. The differential diagnosis of branch-artery occlusion in the young is discussed.
This study centers on the question of whether the phenomenon of leukocyte aggregation, which is typical to inflammatory conditions, is pathogenic per se. We examined patients and laboratory animals in whom the presence of aggregated leukocytes in the peripheral blood was documented by direct visualization and where, despite the presence of aggregated leukocytes, neither the patients nor the laboratory animals showed clinical or pathological evidence for leukoembolization. Our in vitro findings about the reversibility of the phenomenon of leukocyte aggregation help to explain the above-mentioned observations as well as the well-known daily clinical experience that, despite complement activation and other aggregatory stimuli, there is no clinical or pathological evidence for leukoembolization.
Fifteen eyes of 14 patients who underwent cataract extraction surgery with or without lens implantation developed pupillary block. Six lenses were of the anterior-chamber type, two of the posterior-chamber, and four of the iris-clip Binkhorst type; three were simple aphakic eyes. Ocular hypertension was present in 12 eyes; while in three eyes, the pupillary block was detected by biomicroscopic examination. In order to relieve the block, we performed one of the following three procedures: laser (yttrium aluminum garnet (YAG), argon, or krypton) iridotomy, YAG laser photodisruption of the anterior vitreous face, or pars plana vitrectomy.
The copper vapor laser is a pulsed gas laser which emits energy in two wavelengths simultaneously: 510.6 nm (green) and 578.2 nm (yellow). Each pulse has a duration of 15 nsec, maximal energy of 3 mJ and a peak power of more than 100 kW. It is a variably high repetition rate laser, in the range between 1 kHz and more than 20 kHz. We studied its interaction with the rabbit retina, while using two different repetition rates, 4 kHz and 18 kHz. The histological analysis of the lesion produced by 4 kHz repetition rate showed undesired retinal effects, similar to those caused by other pulsed lasers. On the other hand, the histological examination of the lesion produced by the 18 kHz repetition rate showed a desired coagulation effect, limited to the outer retinal layers, and comparable to a lesion produced by a continuous wave (CW) laser.
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We present a case report of suspected retinal malignant melanoma that was followed up with a threshold sensitivity visual field test. The correlation between computerized visual fields as used in proving retinal function disabilities and other tumor-growth diagnostic tools is discussed.
A 59-year-old woman had a sectorial pigmented iris tumor in her right eye and was found to have secondary glaucoma unresponsive to medical therapy. Gonioscopy revealed a satellite tumor in the inferior chamber angle, which we suspected to be a ciliary body melanoma. Subsequently, both lesions were removed completely by superior total and inferior partial iridocyclectomy. Histologic examination disclosed a spindle cell nevus with surface plaque associated with a borderline epithelioid cell nevus. This case is an example of unexpected clinical findings that may be encountered in any iris melanocytic lesion, benign or malignant, and the consequent problems of diagnosis and management.
Between 1976 and 1980, retinopathy of prematurity (ROP) stage III (moderate) (fibrovascular proliferation) developed in 29 eyes (confluent fibrovascular proliferation of 3 clock hours in extension) of 17 preterm babies. The eyes were treated by cryopexy to the avascular retina. Analysis of the visual function and anatomic results in these eyes, five to eight years postoperatively, revealed very good visual function and only a few anatomic abnormalities. Comparison of these eyes with those of two groups of age- and birth-weight-matched preterms (one with less severe ROP, not treated by cryopexy, and the other with no ROP) showed that the degree of myopia was significantly higher in the cryotreated group. Although not statistically significant, there was a higher incidence and a greater degree of astigmatism in this study group.
A 3-year-old child, his mother, and his uncle were found to have asymptomatic distichiasis accompanied by corneal hypoaesthesia. Slit-lamp examination of the mother and her brother revealed normal corneas, but bilateral punctate epithelial staining was found in the child. In addition the child suffered from corneal erosion in his left eye due to decreased tear secretion after left occipital craniotomy and C1 laminectomy.
A relationship between the structure of the sclera and its light scattering properties is proposed. The relative optical density as a function of wavelength in the infrared was measured for three sclera and a good correlation with the predicted function was found. The angular distribution of the scattered light at 632.8 nm as well as the degree of polarisation of the scattered light at zero angle was measured for three sclera; from these results the total transmission of the sclera was determined.
Eight chronic schizophrenic patients were maintained on a diet free of gluten, cereal grains, and milk (CM-F diet) and challenged in a double-blind manner with dietary wheat gluten and placebo. While on the CM-F diet, each patient received a daily challenge of 30 g of gluten for 5 weeks and a placebo challenge for 8 weeks. No deterioration in clinical status as measured by the BPRS was noted on gluten challenge. Serum alpha 1 acid glycoprotein measurement demonstrated no evidence of inflammatory response to gluten challenge. The data suggest that sensitivity to dietary gluten is not characteristic of young chronic schizophrenic patients.
A simple clinical method for measurement of light backscatter from defined regions of the lens in vivo is described. Light scattering was quantitated in 168 lenses of 85 "normal" subjects spanning 8 decades of life. The results indicate that light scatter from the anterior capsule does not change with age. The light scatter from the anterior cortex is quite significant even in young lenses and gradually increases with age. The backscatter in the nuclear region is minimal in young eyes, increasing gradually up to the age of 40, after which it exhibits a sharp increase.
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A case of congenital glaucoma combined with pigmentary glaucoma and high myopia in a three-month-old infant is described. The pathophysiology, medical treatment, and review of the literature is discussed.
Vitreous cyst, an uncommon finding, was first described by Tansley in 1899. Since then only a few reports dealing with congenital or acquired vitreous cyst have been reported. We report the case of a 16-year-old girl with a unilateral developmental vitreous cyst combined with bilateral retinoschisis. The pathogenesis and histopathology of these phenomena remain unclear, although a few assumptions about the common pathogenesis are discussed. According to our knowledge, this is the first description of vitreous cyst and retinoschisis in the same eye.