Biomedical subjects

J L Elfervig

Publications and source records attributed to J L Elfervig.

4 recordsLinked to original sources

PubMed2001

Pattern visual evoked potential in the diagnosis of functional visual loss.

OBJECTIVE: To study the pattern visual evoked potential (P-VEP) in the diagnosis of functional visual loss. STUDY DESIGN: Retrospective study of observational case series. PARTICIPANTS: Seventy-two subjects whose best corrected visual acuity (VA) was 20/50 or worse, with or without visual field defect, and whose visual abnormalities could not be explained by the findings of ophthalmologic and neurologic examination were included in this study. MAIN OUTCOME MEASURES: To compare the P-VEP estimated acuity to the initial subjective VA and to the best-performed VA. RESULTS: Seventy-two subjects with functional visual loss had normal P-VEPs. The initial subjective VA was 20/50 in 9 subjects and < or =20/200 in 42 subjects. After clinical examination and reassurance, the best-performed VA was > or =20/50 in 53 subjects and < or =20/200 in 8 subjects. The discrepancy between the P-VEP estimated acuity and the best-performed VA was less than 3 lines of Snellen acuity in 63 of 72 (87.5%) subjects and more than 4 lines in 6 subjects. These six subjects were three women with loss of vision of unknown origin and three men with injury-related visual loss. CONCLUSIONS: P-VEP has the advantage of objectively predicting VA and is a useful test in the diagnosis of functional visual loss.

Adolescent↗

PubMed1998

Long-term follow-up of Stargardt's disease and fundus flavimaculatus.

OBJECTIVE: To understand better the shared characteristics of Stargardt's macular dystrophy (SMD) and fundus flavimaculatus (FF) by reviewing the clinical morphologic and retinal function changes in a large group of affected patients. DESIGN: The study design was a retrospective case review. PARTICIPANTS: Fifty-two patients with SMD and 48 patients with FF were observed from 1 to 22 years. INTERVENTION: Visual acuity (VA), visual fields (VFs), fundus photographs (FPs), fluorescein angiography (FA), electro-oculography (EOG), and electroretinography (ERG) were studied at various intervals. MAIN OUTCOME MEASURES: Changes of VA, VF, FP, FA, EOG ratio, and ERG amplitudes and implicit time at different periods in patients with SMD and patients with FF were measured. RESULTS: Visual acuity decreased gradually in both the SMD and FF groups, and once the 20/200 level was reached, little further change occurred. The yellowish flecks associated with these entities faded with time, and areas of retinal pigment epithelial (RPE) and choriocapillary atrophy developed. In advanced longstanding disease, retinal vessel attenuation and peripheral pigmentary changes were noted. Ninety-four percent of patients with FF were noted to have macular dystrophy at their last visit. Patients who had only central lesions did not have peripheral lesions develop. Intrafamilial variation in the funduscopic pattern was shown in four families. The EOG ratio was abnormal in 2.6% of the patients with SMD and in 48.6% of the patients with FF. An abnormal scotopic ERG was noted in 21.1% of the patients with FF and in none of the patients with SMD. The photopic ERG was abnormal in 32.4% of the patients with FF and in 5.4% of the patients with SMD. In patients with FF, a statistical dependence was noted between the duration of the disease and the ERG results, but no such correlation was seen in the SMD group. CONCLUSIONS: Morphologic changes and retinal function deterioration are more severe in patients with FF than in patients with SMD. The duration of the disease has a greater effect on patients with FF than on patients with SMD. These clinical morphologic and physiologic data may be used to supplement laboratory molecular biologic studies and aid in the further classification of these entities.

Adolescent↗

PubMed1998

Retinal detachment.

A retinal detachment is often traumatic and shocking to patients once they become aware of the condition. Nurses have the unique opportunity to assist these patients in accepting and in coping with this potential serious vision loss through understanding, education, rehabilitation, and ocular safety.

Humans↗

PubMed1981

Endogenous cryptococcal endophthalmitis.

We have described a case of Cryptococcus neoformans endophthalmitis, especially rare in the absence of simultaneous CNS involvement. The key to management appears to lie in early diagnosis, which is difficult because there are multiple causes of uveitis; clinical examination will not establish the specific cause. If clinical improvement is not apparent after several days of nonspecific therapy and other studies have failed to yield a diagnosis, appropriate stains and cultures of vitreal aspirate should be done for fungi and other organisms. Amphotericin B plus 5-fluorocytosine is the treatment of choice, possibly with intravitreal instillation of amphotericin B and vitrectomy.

Amphotericin B↗