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Biomedical subjects

G K Lang

Publications and source records attributed to G K Lang.

At least 145 records · Page 8Linked to original sources
PubMed1987

[Strictly focal siderosis bulbi posterior].

A 54-year-old white male with no history of trauma presented with subjective visual deterioration in the left eye. A choroidal lesion with brownish pigmentation and retinal detachment around it was found, located nasally of the optic disk. The lesion was clinically diagnosed as a malignant melanoma and the eye was therefore enucleated. Histologic examination revealed a strictly focal iron foreign body granuloma located intra- and subretinally, which had led to a localized siderosis as a result of connective-tissue encapsulation. It follows from this that an intramural iron foreign body must also be included in the differential diagnosis of malignant melanoma. The encapsulation of an iron foreign body located in the retina and choroid, with focally circumscribed ocular siderosis and glial overgrowth of the retinal defect can, in exceptional cases, justify a cautious approach toward splinters embedded in the posterior pole.

Choroid Neoplasms↗
PubMed1987

The frequency of corneal dystrophies requiring keratoplasty in Europe and the U.S.A.

A clinical and pathologic review of 1,335 corneal buttons received from 1964 to 1985 revealed 185 (13.9%) corneal dystrophies treated with keratoplasty. Fuch's endothelial dystrophy accounted for 132 (9.9%), occurring in females 80% of the time. Corneal dystrophies other than Fuchs' accounted for 53 cases (4.0%). Among the latter, the frequencies varied; 38% were granular, 30% were macular, and 19% were lattice dystrophies. The overall prevalence in series from Los Angeles and Baltimore is the same. However, there is a striking difference in the distribution of the frequencies of non-Fuchs' dystrophies. In the Erlangen series, granular dystrophy dominates (38%), while it is rare in the Baltimore series (4%); the reverse is true for lattice dystrophy (Erlangen 19%; Baltimore 37%), while macular dystrophy rates are similar.

Aged↗
PubMed1986

Clinicopathologic studies of keratoplasty eyes obtained post mortem.

Thirty eyes of 25 patients who had undergone penetrating keratoplasties were examined post mortem. Available corneal buttons and donor rims were evaluated for irregularities of the trephine margins. Of 26 eyes with clear grafts, visual acuity had been 20/80 or better in 13, worse than 20/100 in six, and was unknown in seven. In four eyes with cloudy grafts, visual acuity had been 20/400 or worse. Twenty-three eyes had had one keratoplasty and seven eyes had had two or three transplants. Microscopic examination disclosed frequent overriding wound edges with Bowman's layer incarceration in the wound in 11 eyes and Descemet's membrane incarceration in 22 eyes. Wound abnormalities were correlated with the presence and degree of astigmatism. A retrocorneal fibrous tissue layer was localized at the wound in 16 eyes, extended peripherally in 11, and extended centrally in one. Iris and vitreous incarceration in the wound occurred in 14 and eight eyes, respectively. Histopathologic features contributing to visual loss included cystoid macular edema (three eyes), senile macular degeneration (four eyes), and preretinal membranes (four eyes).

Aged↗
PubMed1985

[Accidental bilateral asymmetric ruby laser maculopathy].

A 19-year-old man sustained a bilateral coagulation of the macula caused accidentally by a ruby laser rangefinder mounted on a tank. Five days later vision was OD 0.7, OS 0.05; there was a distinct disk of coagulation of the retinal pigment epithelium with clumping of melanin granula, more in the left eye than in the right, and subretinal hemorrhage on the left. Visual improvement corresponded to the asymmetric morphologic findings: Within two months visual acuity in the right eye recovered to 1.0. In the left eye there was a temporary increase to 0.3, then permanent deterioration of vision to 0.05 OS. The macula of the left eye showed massive lipofuscein aggregation in the subretinal space. Fluorescein angiography after two months showed some hyperfluorescence, more in the left than in the right eye, but no fluorescein extravasation. The vision in the left eye is still 0.05 one year after the accident.

Accidents↗
PubMed1984

[Evaluation of infectious, inflammatory external eye diseases].

Over a period of 4 months the authors observed 240 outpatients with 302 "red eyes." Oculogenital strains of Chlamydia trachomatis were diagnosed in 12.5% of these cases. Bacterial monoinfections were found in 13.9%, coinfections in 63.9%. The remaining 9.7% included Candida sp. (4%) and Herpes I (1.4%) infections, while 4.3% remained unidentified. Allergic conjunctivitis and "dry eye" syndromes were not considered separately in this study. Specific antibiotic therapy improved the clinical condition due to "saprophytic" bacterial coinfections, indicating the pathogenic importance of this type of infection.

Adolescent↗
PubMed1983

[Importance of the orbital collateral circulation for the origin of ischemic ophthalmopathy in stenotic diseases of the internal carotid artery].

Ischemic ophthalmopathy is the leading ocular symptom of occlusive processes of the internal carotid artery. It can be preceded by embolic symptoms as amaurosis fugax or occlusion of a branch or the main stem of the central retinal artery. Both, ophthalmologists and neurologists, should be familiar with these disturbances as they can involve important diagnostic and therapeutic consequences. Five out of six patients with an angiographically demonstrated extracranial occlusion of one internal carotid artery and a retrograde collateral circulation to the intracranial space via the external carotid and the ophthalmic arteries showed an ischemic ophthalmopathy of the ipsilateral eye. This high coincidence supports the notion that an ischemic ophthalmopathy may not be the result of the occlusive process of the internal carotid artery per se, but may be caused by ocular "steal mechanisms" due to the retrograde orbital collateral circulation.

Adult↗
PubMed1983

[Yersinia uveitis].

A 13 year-old boy was admitted with a unilateral acute fibrinous iritis accompanied by a pauciarticular arthritis which had been preceded by a febrile lower urinary tract infection. The diagnosis of a Yersinia enterocolitica infection was established by significant titers of agglutinating antibodies vs. the serotypes O-I (=0:3). The differential diagnosis of the disease included infections with salmonella, shigella, campylobacter, chlamydiae and metastatic bacterial and mycotic infections as well as rheumatic diseases. Repeated observation of Yersinia enterocolitica in our uveitis patients during the last couple of years suggests that Yersinia enterocolitica is another pathogen causing acute uveitis. The clinical significance of Yersinia enterocolitica infections in ophthalmology will have to be clarified by further specific investigations.

Acute Disease↗
PubMed1983

[Surgery of posterior polar cataract in persistent hyperplastic primary vitreous].

Between 1975 and 1982 surgery was performed on 13 eyes with posterior polar cataract and persistent hyperplastic primary vitreous (PHPV), in order to prevent loss of the eye due to the usual complications. Depending on the extent of the retrolental fibrovascular tissue, one of two possible surgical procedures was employed: (1) scissor excision through a large corneal incision in the wide-open bulb (8 eyes) in cases with a very firm, coarse and extensive retrolental membrane; (2) excision with a vitrectomy instrument, from a corneal or corneoscleral approach (5 eyes) in the "closed eye" in cases where the membrane was more circumscribed. A pars plana approach is generally contraindicated, as sensory retina often extends as far as the pars plicata. There were no serious intraoperative or postoperative complications. Prolonged local corticosteroid therapy is advisable postoperatively. In one patient, suffering from the anomaly in both eyes, there was an encouraging improvement in function to 0.6 and 0.1. The authors recommend early surgery in cases of posterior polar cataract with PHPV.

Adrenal Cortex Hormones↗
PubMed1983

[Clinical course and differential diagnosis of lentiglobus posterior (case reports of 4 children)].

Unilateral lentiglobus posterior was diagnosed in 3 boys and 1 girl between the ages of 2 months and 4 years. This anomaly of the shape of the lens was associated in three patients with a posterior polar opacity and a secondary exotrophia of the eye. The other morphological findings were normal and symmetrical as compared with the fellow eye. Three of the children underwent surgery (anterior capsulectomy, lens aspiration and planned posterior capsulectomy with anterior vitrectomy by a corneoscleral approach). The functional results following the use of continuous-wear contact lenses and alternating occlusion therapy were less disappointing than with other types of congenital unilateral cataract. The prognosis seems to be analogous to amblyopia ex anisometropia. Lentiglobus posterior may be recognized more often if the slit lamp of the operating microscope is used routinely in examination of these infants. The differential diagnosis to other anomalies of the shape of the lens and other congenital cataracts is discussed.

Child, Preschool↗
PubMed1982

[Peripheral fundus changes in subjects with healthy eyes (pilots)].

Over a period of one year in 1980 2451 pilots between 25 and 41 years of age and 674 pilot recruits between 18 and 24 years of age were examined ophthalmologically. All the subjects tested had a visual acuity of 20/20 or better. Of this population, 16% wore glasses with refractive powers ranging up to +4.0 to -1.5 D. Fundus examination revealed microaneurysms in 8%, chorioretinal scars in 6%, paving-stones in 5%, pigmented nevi of the choroid in 4.2% and hypertrophies of the retinal pigment epithelium in 1.3%. White without pressure was seen in 11%. The incidence of formations predisposing to retinal breaks (lattice degeneration and snail tracks 9.1%, round retinal holes 1.5%) was comparable to that of other populations examined by other authors.

Adolescent↗
PubMedDate not supplied

[Orbital myopathy in metastatic malignant paraganglioma: a paraneoplastic syndrome?].

BACKGROUND: Several disease entities of the orbit are known which display an autoimmunological pathogenesis. Among these disease entities the thyroid-related immune orbitopathy and the idiopathic orbital inflammatory syndrome (orbital pseudotumor). The pathogenesis of these diseases is not well understood; however, an autoimmune inflammatory reaction histologically characterized by a chronic inflammatory cell infiltrate has been suggested. One care of orbital pseudotumor presumably of paraneoplastic origin occurring in a patient with a non-Hodgkin's lymphoma has been reported. We report a patient with a metastatic paraganglioma and a proptosis secondary to enlargement of all extraocular muscles. CASE REPORT: A 52-year-old woman presented with a recent decline in visual clarity of her left eye and diplopia. Two years ago, the diagnosis of a hormonally inactive paraganglioma has been made. Ophthalmologic examination displayed a lagophthalmos caused by a right-sided facial paralysis secondary to a cerebral metastasis and a bilateral enlargement of all extraocular muscles. Curative therapy for the paraganglioma was not available. Palliative therapy as well as a high-dose corticosteroid therapy for the orbitopathy was refused by the patient. The patient died 18 months later. DISCUSSION: Our patient developed orbital changes similar to thyroid-related immune orbitopathy; however, there was no dysfunction of the thyroid. We believe that the orbital changes were a paraneoplastic immune reaction caused by the metastatic paraganglioma. We recommend that in patients who do not conform to the prototypical profile of well-known orbital disease entities should undergo further testing to exclude a remote neoplasm.

Autoimmune Diseases↗
PubMedDate not supplied

[Oncocytoma of the conjunctiva].

A 72-year-old woman presented with a lesion in her right eye, which had developed over 2 years. The cherry red lesion was located in the bulbar conjunctiva in the area of the plica semilunaris. Ophthalmologic examination was otherwise normal. Differential diagnosis included a pyogenic granuloma and a hemangioma. Excision of the tumor was performed. Histological examination revealed solid nests and cords of polyhedral cells exhibiting abundant, finely granular acidophilic cytoplasm and round to oval paracentral nuclei usually containing a single prominent nucleolus. The diagnosis of oncocytoma was established. Ocular oncocytomas are rare neoplasms and are mostly found in the caruncle. A location in the bulbar conjunctiva is extremely rare and only two reports are found in the literature with both of these located in the plica semilunaris.

Adenoma, Oxyphilic↗
PubMedDate not supplied

Value of positron emission tomography in the diagnosis of malignant ocular tumors.

PURPOSE: To address the question whether positron emission tomography (PET) can identify malignant ocular tumors. METHODS: In patients with ocular tumors, PET was performed using the incorporation of the glucose analogue (18)F-2-fluoro-2-deoxy-D-glucose. The diagnosis of the ocular lesions was based on conventional diagnostic procedures including histologic examination. RESULTS: Nineteen patients with a mean age of 62.8 +/- 14.2 years were included in this study. Nine patients with a mean age of 62.9 +/- 13.1 years displayed the presence of a malignant tumor including metastatic lesions (4), malignant melanomas (4) and squamous cell carcinoma (1). Additionally, 10 patients with a mean age of 62.8 +/- 15.9 years with benign lesions were studied. There was a statistically significant difference (p = 0.012) in tumor height and tumor volume, but not in tumor diameter between benign and malignant lesions. The smallest PET positive lesion measured 7 x 3 mm. PET was positive in 7 out of 9 malignant lesions and negative in all 10 benign lesions, i.e. there was no false-positive and two false-negative results. The two false-negative tumors represented malignant melanomas of the choroid. Additionally, results of the PET examination were independent of tumor size. CONCLUSION: PET seems to be of limited value for the diagnosis of malignant melanoma of the choroid, i.e. a negative result does not exclude a malignant process.

Adult↗