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Biomedical subjects

H H Tessler

Publications and source records attributed to H H Tessler.

At least 55 records · Page 3Linked to original sources
PubMed1988

Fuchs' heterochromic iridocyclitis in blacks.

Fuchs' heterochromic iridocyclitis (FHI) is a frequently overlooked cause of anterior uveitis. Improper diagnosis may lead to unnecessary therapy. Dark brown irides may demonstrate heterochromia poorly. We believe that FHI may be overlooked in blacks because of a frequent lack of obvious heterochromia and the frequent presence of iris nodules. Heterochromia is not necessary for the diagnosis of FHI if other clinical features of the syndrome are present. In our series of 54 whites and 13 blacks with FHI, heterochromia occurred in 50 (92%) whites and ten (76%) blacks (nonsignificant difference). Iris nodules occurred in 11 (20%) whites and four (30%) blacks (not significant). Statistically significant differences occurred with cataract/aphakia in 41 (75%) whites and three (23%) blacks and with glaucoma in six (11%) whites and five (38%) blacks.

Age Factors↗
PubMed1988

Posterior sub-Tenon's injections of corticosteroids in uveitis patients with cystoid macular edema.

Cystoid macular edema (CME) is a major cause of visual impairment and is thought to be due to abnormal perifoveal capillary permeability. Posterior sub-Tenon's corticosteroid injections are used to improve the visual acuity in CME, although their mechanism of action is uncertain. In this study, visual acuity, blood retinal barrier (BRB) permeability, and fluorescein angiograms were recorded immediately before and one and four weeks after the administration of steroid injections. Ten patients (12 treated eyes) with CME secondary to uveitis were studied. Visual improvement, defined as an increase in at least two lines of Snellen visual acuity, was seen in half of the treated eyes. In some patients, these improvements were not directly related to changes in the BRB permeability or the amount of macular fluid. Posterior sub-Tenon's corticosteroid injections do not consistently affect blood retinal barrier permeability.

Adolescent↗
PubMed1985

Inflammatory pseudohistoplasmosis.

In patients with multifocal choroiditis, presumed ocular histoplasmosis syndrome (POHS) is often diagnosed. However, POHS typically is not associated with inflammatory activity in the ocular media. A group of patients had a pattern of multifocal choroidal spots reminiscent of POHS with active signs of inflammation in the anterior and vitreous chambers. Of the 28 patients, 43% were black. In addition to inflammation, many patients had peripapillary atrophy (39%) or diskiform macular scars (32%). Of those with diskiform scars, 33% were black. Systemically, 32% of the patients were presumed to have sarcoidosis; 29%, tuberculosis; 11%, syphilis; and 28%, no etiology. In some cases, treatment of the underlying disease resulted in improvement of the ocular findings. Inflammatory pseudohistoplasmosis syndrome appears to be a nonspecific response to a number of uveitic syndromes, including sarcoidosis, tuberculosis, and syphilis.

Adult↗
PubMed1984

Birdshot retinochoroidopathy.

Nine patients had birdshot retinochoroidopathy. Associated ophthalmologic findings included rhegmatogenous retinal detachment, rubeosis iridis, glaucoma, and a high incidence of disciform macular degeneration. Four patterns of birdshot spot distribution were noted on fundus examination. Immunologic studies showed a significantly elevated percentage of EA rosettes and an elevated C4 complement level. Electroretinograms showed b-wave amplitude reduction, with a disproportionate implicit time prolongation. The etiology of this syndrome remains unknown.

Adult↗
PubMed1983

Vitreous fluorophotometry in pars planitis.

We used vitreous fluorophotometry to supplement standard clinical techniques and fluorescein angiography to study 23 eyes in 12 patients with pars planitis. All eyes leaked abnormal amounts of fluorescein into the vitreous. The leakage was generalized in the posterior segment of the eye. In milder cases, leakage was greater posteriorly; more severe cases showed preferential leakage from the equatorial and midperipheral regions. There was no predilection for leakage in the inferior fundus. The eyes in which greater leakage occurred inferiorly tended to be those with greater overall leakage; all but one involved early cyclitic membrane formation or heavy neovascularization of the pars plana membrane. The amount of cystoid macular edema demonstrated by fluorescein angiography correlated well with vitreous fluorophotometric values, as did vitreous haze, the extent and density of the inferior membrane, and visual acuity.

Adolescent↗
PubMed1982

HLA-B27, Klebsiella pneumoniae, and the relation to acute anterior uveitis.

Acute anterior uveitis (AAU) is a disease of unknown etiology, although it is frequently associated with various autoimmune diseases. It has recently been shown in patients with ankylosing spondylitis (AS), a disease often associated with AAU, that antiserum raised against a particular isolate of Klebsiella pneumoniae would cross-react with lymphocytes possessing HLA-B27. The present study was performed to evaluate the response of lymphocytes of patients to K. pneumoniae and to determine the correlation with HLA-B27. The circulating immune complex levels in the serum of the patients were also determined for correlation with the presence of HLA-B27 antigen. We were able to demonstrate this cross-reactivity in the samples of AAU patients; however, we did find an increased immune complex level that was independent of HLA-B27 antigen. From our results, we conclude that although AAU is clinically associated with AS, the role of K. pneumoniae in these disease states remains unclear.

Antigen-Antibody Complex↗
PubMed1981

Humoral and cellular immunity studies in patients with Vogt-Koyanagi-Harada syndrome and pars planitis.

We performed a comprehensive immunologic assessment of 17 patients with Vogt-Koyanagi-Harada syndrome (VKH) and nine with pars planitis (PP). Several variations in humoral and cellular immunity were found when the patients were compared with normal controls. Elevated serum IgD levels, positive results from various autoimmune profile assays, and deviations from normal levels of viral antibody titers were noted in both groups of patients. However, only some VKH patients had elevated beta 2 microglobulin, total complement level and E-active and EA rosette counts. HLA haplotype typing revealed no distinct correlation between patients when compared with a normal population.

Antibodies, Viral↗
PubMed1980

Anterior segment ischemia in Fuchs' heterochromic cyclitis.

Six consecutive patients with early Fuchs' heterochromic cyclitis (FHC) were examined with anterior segment 10% fluorescein sodium angiography. Anterior segment perfusion defects and iris vasculature leakage were seen in all patients. Chronic anterior segment ischemia may be an integral feature of FHC, which predisposes these eyes to rubeosis and, in some cases, to neovascular glaucoma.

Adolescent↗
PubMed1980

Vogt-Koyanagi-Harada syndrome.

We studied 20 patients with Vogt-Koyanagi-Harada syndrome. They represented 3.7% of referred patients with uveitis. American Indian ancestry appears to be the link to Oriental racial type. Five patients had a forme fruste retinal detachment. After extensive treatment with corticosteroids, detachments flattened within an average of two to three months. Anterior inflammation continued to persist chronically. Seven of our patients had retinal vasculitis. Pregnancy had a beneficial effect on disease activity. Those patients with diabetes mellitus and sickle cell hemoglobin did not have an adverse effect. Visual outcome was good; of 20 patients, 16 had visual ascuity of 6/21 (20/70) in at least one eye.

Adolescent↗
PubMed1979

Bilateral cytomegalovirus panuveitis after high-dose corticosteroid therapy.

A 30-year-old previously healthy woman who recieved immunosuppressive doses of corticosteroids developed an unusual culture-proved cytomegalovirus panuveitis bilaterally. The atypical clinical course was marked by bilateral exudative detachements with minimal evidence of retinitis. Any patient receiving blood transfusions and immunosuppressive doses of corticosteroids is potentially at risk for developing ocular cytomegalovirus infection, and the clinical presentation of the ocular infection may be atypical.

Adult↗
PubMed1978

Behcet syndrome: with immunologic evaluation.

A case of Behcet syndrome with immunologic evaluation, including screening of a vulvar ulcer for IgG, IgM, IgA, and fibrinogen by direct fluorescent microscopy is presented. Attempts were made to demonstrate cellular and humoral immune responses to mucosal antigens by lymphoblast transformation in the presence of cadaver esophageal mucosal extracts and indirect immunofluorescence using autologous serum and mucosal tissue. Serial measurements of percentages of total T, active T, and B lymphocyte populations, and lymphocyte response to phytohemagglutinin (PHA) stimulation during the course of Behcet syndrome are also presented. Clinical evaluation, histology of a Behcet vulvar ulcer, and a 2-year followup with good response to chlorambucil are reviewed.

Adult↗
PubMed1976

Serum lysozyme in sarcoid uveitis.

In a study of 100 patients, the mean serum lysozyme value for patients with sarcoidosis and active uveitis was elevated, while the mean value for patients with inactive sarcoidosis and inactive uveitis was within the normal range. The mean value for patients with a clinical picture of sarcoid uveitis, but without an established diagnosis of sarcoidosis, was high. In patients with ophthalmologic findings compatible with sarcoidosis, but without radiologic, immunologic, or other clinical evidence of the disease, an elevated serum lysozyme level may be indicative of sytemic disease.

Clinical Enzyme Tests↗
PubMed1976

Intraocular lysozyme in experimental uveitis in rabbits: aqueous and vitreous assay.

We determined normal aqueous and vitreous lysozyme levels in rabbit eyes and induced experimental uveitis to record the uppermost aqueous and vitreous lysozyme levels. The normal aqueous humor of the rabbit eye contained 1.05 mug per milliliter lysozyme and the normal vitreous humor contained 0.45 mug per milliliter. After the intravitreal administration of a foreign protein, the aqueous and vitreous lysozyme levels rose within one day, reaching maximum values of 38.4 mug per milliliter and 114 mug per milliliter, respectively, at 14 days, and subsequently declining to minimal values by 28 days after injection.

Albumins↗