Search PubMed⌕ Search

Biomedical subjects

H H Tessler

Publications and source records attributed to H H Tessler.

At least 37 records · Page 2Linked to original sources
PubMed1993

Elevated serum sialic acid in idiopathic acute iridocyclitis.

We measured the serum levels of sialic acid in 12 patients with idiopathic acute iridocyclitis and 18 normal controls. Sialic acid levels were significantly elevated in the patients with idiopathic acute iridocyclitis. Since animal studies have shown that intraocular inflammation alone cannot elevate serum level of sialic acid, the result of our study suggest that idiopathic acute iridocyclitis may be a multiorgan disease with systemic effects.

Acute Disease↗
PubMed1993

Iris crystals in chronic iridocyclitis.

Iris crystals in three patients with idiopathic iridocyclitis, Fuchs' heterochromic iridocyclitis, and iridocyclitis associated with systemic pseudolymphoma are described. Two patients had iris crystals in one eye, and the other patient had bilateral involvement. The number of iris crystals in each eye ranged from one to multiple crystals. Iris crystals were minute and refractile and glistened with light; they have previously been reported to be Russell bodies and to be associated with hypergammaglobulinaemia. However, two of the patients, who underwent serum protein electrophoresis, did not demonstrate hypergammaglobulinaemia.

Adult↗
PubMed1993

Preliminary study of a new intraocular method in the diagnosis and treatment of Propionibacterium acnes endophthalmitis following cataract extraction.

Late endophthalmitis, due to Propionibacterium acnes, developed in three patients following uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens (PC-IOL) insertion. Cultures from the capsular bag yielded P. acnes in all three. With topical anesthesia and through an anterior chamber paracentesis, culture specimens were taken from and clindamycin irrigated into the capsular bag. Filtered 100% oxygen was introduced into the anterior chamber in two; the third also received an injection of gentamicin and dexamethasone into the capsular bag. After treatment, two patients received oral antibiotics; one received hyperbaric oxygen therapy. Visual acuity was improved and inflammation reduced in all three. However, after treatment, ocular toxic effects due to clindamycin were suspected in one. This approach offers several clear advantages, including topical anesthesia, outpatient management, elimination of the need for vitrectomy, and retention of the intraocular lens (IOL).

Aged↗
PubMed1993

Mitomycin as adjunct therapy in correcting iatrogenic punctal stenosis.

A 52-year-old woman developed persistent epiphora in her left eye after undergoing occlusion of the left puncta. Two attempts to reopen the puncta with a one-snip procedure and placement of punctal silicone plugs failed. The epiphora resolved and the puncta remained patent after the patient underwent a third one-snip procedure, supplemented with topical mitomycin during and after surgery.

Administration, Topical↗
PubMed1993

Computed tomography and magnetic resonance imaging in the diagnosis of posterior scleritis.

The clinical records of 14 patients with posterior scleritis were reviewed to compare the diagnostic potential of computed tomography (CT) and magnetic resonance imaging (MRI) in this condition. None of these patients had evidence of collagen vascular or other systemic diseases. Done 13 times on 11 patients, CT was diagnostic for posterior scleritis in six patients on seven occasions. We used MRI six times in five patients, and it was not diagnostic for posterior scleritis in any patient. Thus, CT appeared to be more sensitive than MRI in the diagnosis of posterior scleritis. The CT results appeared comparable to ultrasonographic findings (obtained eight times in six patients) in the diagnosis of posterior scleritis. Both CT and MRI, however, detected signs of orbital pseudotumor in six and three patients, respectively. These findings support the concept that posterior scleritis and orbital pseudotumor may represent a continuum of the same disease process.

Adolescent↗
PubMed1993

Quadruple therapy for ocular toxoplasmosis.

Between Dec. 1, 1973, and May 30, 1989, 36 patients (37 eyes) with ocular toxoplasmosis seen at a uveitis clinic received quadruple therapy (pyrimethamine, trisulfapyrimidines, clindamycin and prednisone). The criteria for quadruple therapy were active lesions involving or threatening the macula or the optic disc, or a visual acuity of 20/70 or worse due to vitreous opacification caused by active inflammation. All but four of the cases showed improved vision. A total of 54% of the cases responded favourably within 2 weeks after the start of treatment, and 81% responded within 3 weeks. Patients took pyrimethamine for 1 to 2 weeks and received trisulfapyrimidines and clindamycin for 3 weeks, with a tapering course of orally given prednisone. The only complication was skin rash secondary to trisulfapyrimidine therapy, in four cases. None of the patients manifested diarrhea, pseudomembranous colitis or bone marrow suppression. The length of follow-up ranged from 1 month to 15.5 years. There were seven recurrences in five patients, five of which responded to a second course of quadruple therapy.

Adolescent↗
PubMed1992

High incidence of sympathetic ophthalmia after contact and noncontact neodymium:YAG cyclotherapy.

BACKGROUND: Two cases of sympathetic ophthalmia occurring after noncontact neodymium:YAG (Nd:YAG) cyclotherapy have previously been reported. In each case, the patient had undergone filtering surgery in the exciting eye. Although in each case Nd:YAG cyclotherapy was the last surgery performed, the inciting event of sympathetic ophthalmia was unclear. METHODS: The authors studied three additional patients who developed sympathetic ophthalmia after Nd:YAG cyclotherapy for glaucoma. RESULTS: Two patients developed sympathetic ophthalmia 4 months after noncontact Nd:YAG cyclotherapy, and 1 patient developed sympathetic ophthalmia 18 months after contact Nd:YAG cyclotherapy. All patients had previous cataract extractions but no filtering surgery in the exciting eye. Clinical features included chronic iridocyclitis, choroidal folds, Dalen-Fuchs nodules, and optic disc edema. Combining these cases with the two previously reported cases, the incidence of sympathetic ophthalmia at our institution thus far is 5.8% (4 of 69) and 0.67% (1 of 150) after noncontact and contact Nd:YAG cyclotherapy, respectively. CONCLUSIONS: The incidence of sympathetic ophthalmia after Nd:YAG cyclotherapy is high compared with other ocular procedures. The clinician should vigilantly monitor patients after Nd:YAG cyclotherapy and report additional cases that may have occurred at other institutions.

Aged↗
PubMed1991

Anterior granulomatous uveitis in patients with multiple sclerosis.

Granulomatous uveitis has infrequently been described as a manifestation of the autoimmune phenomena of multiple sclerosis (MS). The authors describe six cases of anterior granulomatous uveitis in patients with MS. All six patients had features of iridocyclitis and three patients had features of periphlebitis, which were suggestive of granulomatous disease. However, each patient had neurologic symptoms and signs consistent with MS and a negative laboratory workup for sarcoidosis, tuberculosis, and syphilis. Testing for MS in a subgroup of patients with granulomatous uveitis of unknown etiology and neurologic symptoms may result in a diagnosis.

Adolescent↗
PubMed1991

Clinical course of multifocal choroiditis: photographic and angiographic evidence of disease recurrence.

Multifocal choroiditis is a syndrome that simulates the presumed ocular histoplasmosis syndrome but, in addition, includes vitritis and anterior uveitis. Because of its relatively recent acceptance as a distinct clinical entity, there is little information available on the long-term natural history of this condition. We managed three cases of multifocal choroiditis with recurrent active inflammation. Two patients had new peripheral chorioretinal lesions in previously normal retina, and the other had both peripheral chorioretinal scars and new swelling of the disc.

Adult↗
PubMed1990

High-dose short-term chlorambucil for intractable sympathetic ophthalmia and Behçet's disease.

We treated five patients with intractable sympathetic ophthalmia and six patients with severe Behçet's disease by high-dose, short-term chlorambucil therapy. We used a total dose ranging from 306 mg to 4.2 g and a duration of therapy no longer than 36 weeks and in most cases less than 24 weeks. After termination of therapy all 11 patients had a sustained remission of their eye disease. Unless subretinal neovascularisation was present, all had a final visual acuity of 20/50 or better. Malignancy has not developed in any of our cases, with a follow-up ranging from 6 months to 12 years (mean, 4.5 years). Although 30- and 40-year follow-ups and larger numbers of patients may be necessary fully to realise the risks of chlorambucil, we believe that our high-dose, short-term regimen (Behçet's disease: average duration, 23 weeks; average total dose 2.2 g; sympathetic ophthalmia: average duration, 11 weeks; total average dose, 0.9 g) may be safer than previously reported chlorambucil regimens of one to two years or longer. In addition we fulfilled our aim of discontinuing all concomitant systemic corticosteroids within a relatively short time (usually six to eight weeks).

Adolescent↗
PubMed1990

Sympathetic ophthalmia and subretinal neovascularization.

We report a case of sympathetic ophthalmia with subretinal neovascularization of the macula. The subretinal neovascularization developed after penetrating trauma to the fellow eye. The occurrence of subretinal neovascularization in sympathetic ophthalmia is not surprising since disintegrative changes and breaks in Bruch's membrane have been reported in sympathetic ophthalmia. Subretinal neovascularization has also been reported in Vogt-Koyanagi-Harada syndrome, which is histopathologically similar to sympathetic ophthalmia.

Adolescent↗
PubMed1989

Twenty cases of sympathetic ophthalmia.

We reviewed the charts of 20 patients with sympathetic ophthalmia who were seen in the uveitis clinic at the Eye and Ear Infirmary within an 11-year period. Of these 20 patients 14 maintained 20/50 or better visual acuity in at least one eye. We found early enucleation to be associated with a better visual prognosis, possibly due to earlier diagnosis and faster, more aggressive therapy rather than a reduction in antigenic load. The clinical appearance of Dalen-Fuchs nodules appears to indicate a more severe stage of disease. Chlorambucil was useful in patients with severe disease. To be effective and to lessen its side effects chlorambucil was given in daily dosages that were increased weekly over a short period to achieve bone marrow suppression. After a course of chlorambucil therapy intraocular inflammation could be controlled with topical steroids alone.

Adolescent↗
PubMed1989

Sympathetic ophthalmia following neodymium:YAG cyclotherapy.

Neodymium:YAG cyclotherapy has been demonstrated to lower intraocular pressure dramatically in patients with uncontrolled glaucoma, with potentially fewer side-effects than cyclocryotherapy. We report the clinical course and histopathological features of a case of sympathetic ophthalmia occurring soon after YAG cyclotherapy.

Adult↗