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Biomedical subjects

H E Killer

Publications and source records attributed to H E Killer.

At least 19 recordsLinked to original sources
PubMed2001

Acute asymmetric upper nasal quandrantanopsia caused by a chiasmal colloid cyst in a patient with multiple sclerosis and bilateral retrobulbar neuritis.

PURPOSE: To report a patient with multiple sclerosis and a history of sequential bilateral retrobulbar neuritis, who developed new onset of highly asymmetric upper quadrantanopsia. DESIGN: Interventional case report. METHOD: A 36-year-old woman with multiple sclerosis and bilateral retrobulbar neuritis developed an acute asymmetric upper nasal quadrantanopsia. RESULTS: Magnetic resonance imaging of the brain revealed a cyst that caused chiasmal compression and bilateral visual field defects. CONCLUSION: New onset of bilateral visual field defects in a patient with diagnosed multiple sclerosis is likely to be caused by a new attack of the demyelinating disease. In this case, a newly diagnosed chiasmal colloid cyst was the cause of visual field defects.

Acute Disease↗
PubMed2001

Unilateral papilledema caused by a fronto-temporo-parietal arachnoid cyst.

PURPOSE: To report a case of unilateral papilledema caused by an arachnoid cyst. METHODS: Interventional case report. RESULTS: A 36-year-old woman presented with unilateral papilledema in the left eye. Magnetic resonance imaging (MRI) of the brain demonstrated a large fronto-temporo-parietal arachnoid cyst in the left hemisphere. The papilledema resolved after placement of a cysto-peritoneal shunt that drained the cerebrospinal fluid directly from the arachnoid cyst into the peritoneum. CONCLUSION: Papilledema caused by increased intracranial pressure is usually bilateral; unilateral papilledema is possible under special anatomical circumstances.

Adult↗
PubMed1999

Significant immediate and long-term reduction of astigmatism after lateral rectus recession in divergent Duane's syndrome.

Duane's syndrome is associated with anisometropia and amblyopia. We encountered 1 patient with right divergent Duane's syndrome (type 2 according to Huber's classification) with high astigmatism of the right eye and a head turn. In order to improve the head turn and thereby avoid eccentric gaze through the glasses, the right lateral rectus muscle was recessed by 7.75 mm. Postoperatively, the amount of astigmatism was reduced by 1.5 dpt with no change of the axis. This change of refraction remained stable over a follow-up time of 18 months.

Astigmatism↗
PubMed1999

Lymphatic capillaries in the meninges of the human optic nerve.

OBJECTIVE: Although many anatomical studies of the orbit and the optic nerve have been performed, lymphatic capillaries in the dura of the human optic nerve have never been reported. This study was performed to determine whether or not lymphatic capillaries are present in the dura of the human optic nerve. MATERIALS AND METHODS: This postmortem study was carried out in seven subjects without ocular disease. The subjects were obtained no later than 6 hours after death, following qualified consent for autopsy. The dura of the human optic nerve was studied with light microscopy, scanning electron microscopy, and transmission electron microscopy. In some cases, india ink was injected into the subarachnoid space as a marker. RESULTS: Lymphatic capillaries in the dura of the human optic nerve were morphologically demonstrated with histological criteria (fenestrated endothelium, lack of a basal membrane, and absence of blood cells in the lumen of the vessels). The highest concentration of lymphatic capillaries was found in the bulbar part of the dura behind the ocular globe. Using light microscopy and transmission electron microscopy, ink was seen within the lumen of the lymphatic capillaries. The dura itself was not stained with the marker. CONCLUSION: The presence of lymphatic capillaries in the dura of the human optic nerve was demonstrated with light microscopy, transmission electron microscopy, and scanning electron microscopy.

Cadaver↗
PubMed1998

Corneal penetration of diclofenac from a fixed combination of diclofenac-gentamicin eyedrops.

PURPOSE: To establish the corneal penetration of diclofenac in the presence of gentamicin in patients having cataract surgery. SETTING: Kantonsspital Augenklinik, Aarau, and Hôpital Jules Gonin, Lausanne, Switzerland. METHODS: Eligible patients having cataract surgery (39 women, 30 men) were treated with 4 drops of diclofenac 0.1%-gentamicin 0.3% (Voltamicin) instilled at 20 minute intervals. Paracentesis was performed 15, 30, or 60 minutes after the last instillation, and a sample of aqueous humor was collected for analysis of diclofenac by high-performance liquid chromatography. Blood samples of some patients were obtained before surgery for analysis. RESULTS: Mean diclofenac levels (+/- SD) in the aqueous humor 15, 30, and 60 minutes after the last instillation were 72 +/- 84, 108 +/- 87, and 201 +/- 116 ng/mL (= 682 nMol/L), respectively. Diclofenac remained below the limit of detection (5 ng/mL) in all samples of blood serum. In general, local tolerance was good; no side effects were reported. Comparison of the data with published results of topically instilled diclofenac 0.1% suggests that the concentration of diclofenac in the aqueous humor achieved with 4 instillations of the combination product is similar to that achieved with 8 instillations of diclofenac 0.1% (Voltaren Ophtha) alone. CONCLUSIONS: Drug levels of diclofenac in the aqueous humor well above IC-50 for cyclo-oxygenase were achieved with the regimen applied. No inhibitory effect by the gentamicin or vehicle was observed. Comparison of these data with published results of Voltaren Ophtha implies a 2-fold better penetration of diclofenac with the diclofenac-gentamicin combination.

Aged↗
PubMed1996

[Retrobulbar neuritis--diagnosis and differential diagnosis].

The American multicenter study 'A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis' (5) showed how a retrobulbar neuritis should not be treated, Oral steroids (1 mg per kilogram of body weight per day) are not only ineffective but also associated with a higher rate of recurrences compared to high dose i.v. methylprednisolone. In the light of this study, 'low-dose' steroid therapy for retrobulbar neuritis is contraindicated. High-dose methylprednisolone speeds up recovery of the visual function and lowers the recurrence rate two years after treatment; however, this protective effect could not be demonstrated after three years. These recommendations are valid only for primary demyelinating retrobulbar neuritis. Other less common optic neuropathies, such as these of microvascular origin, respond to 'low-dose' steroids; therefore, the diagnosis of primary demyelinating retrobulbar neuritis must be made with caution as a diagnosis of exclusion. This paper discusses a number of important optic neuropathies and gives recommendations for investigations. Compressive optic neuropathies and chiasmal disease will not be covered here.

Central Nervous System Diseases↗
PubMed1996

[Differential diagnostic considerations on retrobulbar neuritis].

Retrobulbar neuritis is a frequent diagnosis in patients (age groups 20-40 years), who complain about acute monocular loss of vision, accompanied by painful eye movements. The clinical course with recovery over about six weeks and the possibility of additional neurological dysfunction in the following years confirm the diagnosis of primarily demyelinating disease. Beside the typical retrobulbar neuritis, there is a group of vascular optic nerve disorders as well as Leber's optic neuropathy that need to be differentiated from primary demyelinating retrobulbar neuritis. Compressive optic neuropathies, unilateral chiasm disorders and infiltrative optic neuropathies will not be considered in this paper, because of their subacute presentation.

Adult↗
PubMed1993

[Acute amaurosis in EPH gestosis].

For more than one hundred years ophthalmologists have been interested in the occurrence of acute blindness in patients with toxemia of pregnancy. In addition to general symptoms of toxemia of pregnancy there are specific symptoms and findings in the visual and cortical pathways. Acute blindness during toxemias of pregnancy can be divided into transient-ocular or cortical, as well as permanent, mostly of ocular origin. There are diverse causes of this pathological condition.

Blindness↗
PubMed1992

[Pseudotumor cerebri, clinical parameters and therapeutic modalities].

Pseudotumor cerebri is a central nervous disorder with elevated intracranial pressure that is most common among young obese women. It presents with headache, transient visual obscurations and loss of central vision. Papilledema and visual field defects are frequent. Acetazolamid can be used for treatment. If medical treatment is not successful, optic nerve sheath decompression is recommended. Three patients were treated medically and there were treated surgically. Both methods stabilized or improved visual fields and central vision.

Acetazolamide↗
PubMed1990

[Vision disorders in normal eye status].

The origin of unusual visual phenomena is usually located in the brain or in the brainstem. They appear with normal ophthalmologic findings. Neurologic and ophthalmologic knowledge is needed for a localizing diagnosis and neuro-imaging is most often required. Selected cases of peripherally to centrally located lesions are presented.

Adolescent↗
PubMed1990

Natural history of radiation-induced brachial plexopathy compared with surgically treated patients.

Twelve patients who developed radiation-induced brachial plexopathy (RIBP) after receiving radiation therapy for breast carcinoma (7 patients) or Hodgkin's lymphoma (5 patients) were followed for 12 or more years, with a mean follow-up time of 20 years. Tingling and numbness of the fingers as well as weakness of the hand or arm were the most prominent presenting symptoms of RIBP. Whereas pain in most patients evolved only later in the course, it became a predominant feature in only 2. In 8 of the 12 patients, the plexopathy was surgically treated, either by neurolysis only or by neurolysis plus omental grafting in order to stop progression or paresis and/or pain. In 8 patients, including 6 of the operated group, there was slow and steady progression of RIBP over time, with the final outcome being almost complete paralysis of the arm (2 patients) or severe sensorimotor paresis rendering the hand useless (6 patients). In only 4 patients, including 2 of the non-operated group, was there absence of progression and stabilization of the paresis with only slight functional loss of the affected arm in 3 patients and severe palsy in 1. None of the 12 patients had any clear long-lasting improvement of their sensorimotor impairment. It is concluded from this study that RIBP, irrespective of surgery (neurolysis and/or omentum transplant), left two-thirds of the patients with severe or total paresis of the arm. However, the almost complete relief of severe pain (6 of 8 patients), both immediately and in follow-up patients treated with neurolysis and/or omental transplant, indicates that surgical treatment has a beneficial effect on pain relief.

Adult↗
PubMedDate not supplied

Bilateral non-arteritic anterior ischemic optic neuropathy in a patient with autoimmune thrombocytopenia.

PURPOSE: To describe a patient with bilateral non-arteritic anterior ischemic optic neuropathy (NAION) and idiopathic autoimmune thrombocytopenia (ITP) with an extremely low platelet count. METHOD: Case report. RESULTS: Remarkably good recovery of visual acuity. CONCLUSIONS: Bilateral non-arteritic anterior ischemic optic neuropathy can develop in the presence of a very low platelet count.

Aged↗