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Biomedical subjects

J W Sassani

Publications and source records attributed to J W Sassani.

At least 19 recordsLinked to original sources
PubMed1997

Herpes simplex blepharoconjunctivitis presenting as complete acquired ankyloblepharon.

PURPOSE: A 90-year-old woman was referred to us with a 1-month history of progressively worsening blepharoconjunctivitis. She had a complete acquired ankyloblepharon of the right lids, which resulted in the appearance of a right upper lid abscess on computed tomography. METHODS: Blepharotomy with separation and debridement of the lid margins was performed. RESULTS: Cultures were positive only for herpes simplex virus, type II. CONCLUSIONS: Herpes simplex blepharoconjunctivitis may take many clinical forms. Our patient's severe manifestations led to the clinical and radiologic appearance of preseptal cellulitis with a right upper lid abscess.

Aged↗
PubMed1996

Timolol hemihydrate vs timolol maleate to treat ocular hypertension and open-angle glaucoma.

PURPOSE: We compared the therapeutic efficacy and safety of timolol hemihydrate to timolol maleate in patients with ocular hypertension and chronic open-angle glaucoma. METHODS: We conducted this three-month study as a multicentered, masked, parallel group comparison. Both the 0.25% and 0.5% concentrations were evaluated against similar concentrations of timolol maleate. Dosing was twice daily. An open-label, nine-month study followed the masked portion of the protocol, in which all patients received either 0.25% or 0.5% timolol hemihydrate. A total of 371 patients were included in both the 0.25% and 0.5% studies. RESULTS: We found statistically similar intraocular pressures with both the 0.25% (18.3 and 18.6 mm Hg for the hemihydrate and maleate groups, respectively) and 0.5% (19.9 and 19.5 mm Hg for the hemihydrate and maleate groups, respectively) concentrations of timolol hemihydrate and timolol maleate after three months of masked treatment. Likewise, peak intraocular effect at two hours after taking the medication was statistically similar between medicines at both concentrations. Likewise, both ocular and systemic safety were similar between the maleate and hemihydrate preparations at both concentrations. In the nine-month open-label protocol, therapeutic efficacy (19.9 and 19.1 mm Hg for the 0.25% and 0.5% concentrations, respectively) and safety of timolol hemihydrate were similar to effect and safety of the three-month protocol. CONCLUSIONS: This study suggests that timolol hemihydrate had an ocular hypotensive efficacy and safety profile statistically equivalent to that of timolol maleate for up to three months of therapy. Timolol hemihydrate showed efficacy and safety similar to that observed within the first three months, for up to one year of therapy.

Adolescent↗
PubMed1995

Conserved expression of the opioid growth factor, [Met5]enkephalin, and the zeta (zeta) opioid receptor in vertebrate cornea.

In addition to neuromodulation, endogenous opioids serve as growth factors. The naturally occurring opioid peptide, [Met5]enkephalin, termed opioid growth factor (OGF), has been found to be a potent and tonic inhibitor of processes related to growth and renewal, particularly cell proliferation. OGF mediates its actions through the zeta (zeta) opioid receptor. In order to determine if OGF and/or the zeta receptor are present in human corneal epithelium, immunocytochemistry was utilized. Immunoreactivity with regard to OGF and to the zeta receptor could be detected in the cortical cytoplasm of both basal and suprabasal epithelial cells, but was not associated with the cell nucleus. Investigation of the ubiquity of OGF and zeta receptor in the vertebrate cornea showed that both elements are present in a wide variety of classes of the phylum Chordata, including mammalia, aves, reptilia, amphibia, and osteichthyes. These results suggest that an endogenous opioid system related to growth may have originated as early as 300 million years ago, and that the function of this system in cellular renewal and homeostasis is a requirement of the vertebrate corneal epithelium.

Adult↗
PubMed1995

A history of low vision and blind rehabilitation in the United States.

The author presents a history of services for the blind and those with low vision in the United States focusing on the areas of orientation and mobility, and rehabilitation teaching. The controversies involving the development of these specialties are discussed. Emphasis is placed on the role of Father Thomas Carroll in the establishment of low vision and blind services for the military and veterans administrations. Published data regarding the past role of ophthalmologists in obtaining low vision services for patients is reviewed. The opportunity for a more active role for ophthalmologic involvement in the rehabilitation of the low vision and blind patient is discussed.

Blindness↗
PubMed1995

Opioid growth factor modulates corneal epithelial outgrowth in tissue culture.

In addition to neuromodulation, endogenous opioid peptides serve as growth factors. To determine involvement of opioids in the homeostatic renewal and repair of the corneal epithelium, epithelial outgrowths from 3-mm explants of rabbit cornea were investigated. Blockade of opioid-receptor interaction by the potent opioid antagonist naltrexone (NTX) for 7 days significantly increased the extent of outgrowths and the number and labeling index (DNA synthesis) of epithelial cells, relative to control levels. Outgrowths exposed to the opioid growth factor (OGF) [Met5]enkephalin for 7 days were subnormal in extent and labeling index and displayed alterations in architectural pattern. The effects of OGF on epithelial outgrowth were blocked by concomitant exposure to the opioid antagonist naloxone; naloxone alone had no effect on growth at the concentration utilized. NTX and OGF were active in both serum-containing and serum-free cultures. Immunocytochemical investigations showed that both OGF and its opioid receptor zeta (zeta) were present in epithelial cells growing in control media. The results indicate that an endogenous opioid peptide and its receptor are present in mammalian corneal epithelium and serve to modulate cell proliferation, migration, and organization.

Animals↗
PubMed1994

Disciform choroidal melanoma.

BACKGROUND: The clinical and histopathologic findings in a hemorrhagic lesion involving the right macula of a 77-year-old man are presented. Clinical and fluorescein angiographic evaluation of the lesion led to a diagnosis of subretinal neovascular membrane secondary to age-related macular degeneration (AMD). The membrane was judged to be amenable to surgical excision and was excised. METHODS: Histopathologic and immunohistochemical studies were performed on the excised tissue. RESULTS: The lesion was a small, epithelioid cell choroidal melanoma. CONCLUSIONS: Newer surgical techniques for AMD may tend to preclude watchful waiting in the diagnosis of unusual hemorrhagic lesions in the macula, thereby increasing the importance of histopathologic examination of any tissue removed during such procedures.

Aged↗
PubMed1993

Choroidal nonperfusion in giant cell arteritis.

A 68-year-old man had visual loss secondary to isolated choroidal nonperfusion as a clinical manifestation of giant cell arteritis. Ophthalmoscopy disclosed scattered yellow-white lesions at the level of the retinal pigment epithelium in the posterior pole of the right eye. Intravenous fluorescein angiography demonstrated marked delay in choroidal filling of the macula in the right eye. There was no ophthalmoscopic or angiographic evidence of anterior ischemic optic neuropathy or central retinal artery occlusion. After approximately 72 hours of intravenous corticosteroid therapy, the patient's visual acuity improved and repeat intravenous fluorescein angiography showed normal choroidal circulation. Isolated choroidal ischemia is a potential cause of reversible visual loss in patients with giant cell arteritis.

Aged↗
PubMed1993

Phenotypic variation in combined granular-lattice (Avellino) corneal dystrophy.

OBJECTIVE: To describe the phenotypic variation exhibited by members of families with combined granular-lattice (Avellino) corneal dystrophy. SETTING: We examined 40 patients (age range, 12 to 85 years) from six unrelated families with Avellino corneal dystrophy. This included the first individuals to ever be examined near the presumed site of origin in Italy. In addition, one family was the first to trace its origins to Germany rather than to Italy. We studied the phenotypic expression of the disease in the cornea, visual acuities, subjective complaints, complications, treatment, and histologic condition of these individuals. RESULTS: The granular stromal lesions reach their mature quantity and size early in life, and appear as either gray and crumb-shaped deposits or superficial with an annular and planar distribution. The lattice component appears gradually, beginning and maturing later in life. The phenotypic variation within families was found to be substantial. Widely variable proportions of lattice and granular changes were found within single sibships. Visual acuities ranged from 20/20 to 20/400. Recurrent corneal erosions were present but infrequent. Subjective complaints included glare and decreased night vision. Penetrating keratoplasty was required in one individual to restore vision. Histopathologic examination revealed typical amyloid and granular deposits. Granular deposits were found replacing Bowman's membrane and extending to the corneal surface. These deposits probably represent the cause of recurrent erosions. CONCLUSIONS: Combined granular and lattice corneal dystrophy may present with substantial phenotypic variation. The disease can be found in individuals who trace their ancestry to both Italy and Germany, a wider geographic distribution than previously proposed.

Adolescent↗
PubMed1993

Simultaneous bilateral malignant glaucoma following laser iridotomy.

A case of bilateral malignant glaucoma is described in a 50-year-old white woman 4 weeks after successful bilateral laser iridotomy for angle-closure glaucoma. The malignant glaucoma may have been precipitated by systemic hydrochlorothiazide therapy. The condition was worsened by pilocarpine; however, atropine and cyclopentolate opened the angle and deepened the anterior chamber, resulting in resolution of the malignant glaucoma. The clinician must be alert to the possibility of malignant glaucoma following laser iridotomy for angle-closure glaucoma.

Atropine↗
PubMed1993

Effect of intermittent versus continuous patient monitoring on reliability indices during automated perimetry.

PURPOSE: This prospective, randomized study was undertaken to determine the effect of intermittent versus continuous patient monitoring on reliability indices (fixation losses, false-positive errors, and false-negative errors) during automated static perimetry. METHODS: A practice Humphrey Program C30-2 visual field was administered to 169 subjects (mean age +/- standard deviation, 56 +/- 18 years) for 1.5 minutes, during which time trained technicians continuously monitored all subjects and assessed patient fixation as noted on the eye monitor. The computer-generated reliability indices during the 1.5 minute practice test were recorded. After completion of the practice test, the 169 eyes were randomized to either intermittent or continuous monitor for the permanent C30-2 test. During intermittent monitoring, the technician returned periodically to the examination room to assess the subject's performance. For continuous monitoring, the technician continually assessed the subject's performance while remaining in the examination room throughout the test duration. RESULTS: The mean number of visits per visual field test during intermittent monitoring was 4.0, and mean test duration was 15.8 minutes. There was no difference in the mean deviation, pattern standard deviation, and short-term fluctuation (P = 0.85, 0.98, and 0.41, respectively) of the visual fields for intermittent and continuous monitoring, suggesting similar diffuse depression and localized defects in the visual fields for each group. The mean fixation losses (6.9%), false-positive errors (1.8%), and false-negative errors (5.8%) for the intermittently monitored group were not different from the mean fixation losses (7.8%), false-positive errors, (3.1%) and false-negative errors (5.0%) for the continuously monitored group (P = 0.40, 0.24, and 0.36, respectively). CONCLUSION: Although recommended, continuous monitoring does not appear necessary for all patients undergoing automated perimetry. Error-free reliability indices combined with the technician's judgment of patient reliability during the first 1.5 minutes of C30-2 testing may be a guideline for choosing intermittent monitoring.

Adult↗
PubMed1993

Histopathology of argon laser peripheral iridoplasty.

We report the light and electron microscopic findings from two eyes treated with argon laser peripheral iridoplasty (ALPI) for bilateral angle-closure glaucoma. The patient, a 45-year-old man, died from complications of acquired immunodeficiency syndrome 16 days following ALPI. Ocular pathologic findings included contraction furrow formation and proliferation of fibroblast-like cells, accompanied by collagen deposition on the iris surface, denaturation of stromal collagen, and coagulative necrosis of blood vessels within the anterior two thirds of the iris stroma. These findings suggest that heat shrinkage of collagen may be responsible for the short-term response to ALPI, and that contraction of the fibroblastic membrane may be responsible for its long-term effects. Additionally, the presence of coagulative necrosis of iris blood vessels suggests that overt treatment may result in iris necrosis. To our knowledge this is the first report of the histopathology of ALPI.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Renal cell carcinoma metastatic to the orbit: a clinicopathologic report.

Renal cell carcinoma (RCC) is a tumor of middle-aged men that metastasizes to the lung, liver, and bone. Few cases of RCC metastatic to the orbit have been reported. When this tumor spreads to the orbit, the orbital metastasis is likely to be the first indication of the cancer. We report the case of a 53-year-old man with widespread metastatic RCC whose first sign of disease was a metastatic orbital tumor. External and ocular examination and computed tomographic and histopathologic findings are described. The clinical characteristics, treatment, and prognosis of metastatic RCC are discussed.

Carcinoma, Renal Cell↗
PubMed1992

Traumatic intraconal hematic cyst of the orbit.

A 35-year-old man with a history of repeated previous facial injuries presented with acute onset of a right orbital mass less than 2 weeks after blunt trauma to the right eye. Orbital B-scan ultrasonography and computed tomography showed an intraconal cystic lesion. The tumor was excised via lateral orbitotomy. Pathologic evaluation demonstrated a hematic cyst containing fresh blood. The presence of hemosiderin in the cyst wall suggested recent bleeding in a preexisting orbital hemorrhagic lesion. Patients with hematic cysts of the orbit usually present with a subperiosteal mass months to years after trauma.

Adult↗
PubMed1992

Keratoconus and bilateral lattice-granular corneal dystrophies.

The occurrence of lattice and granular corneal dystrophies in the same eye has been reported in individuals who trace their families to the province of Avellino in Italy. We present the first histopathologic report of keratoconus and bilateral lattice-granular corneal dystrophies occurring in the same patient. This individual's family also originated in Avellino, Italy.

Aged↗
PubMed1991

Late bleb-related endophthalmitis after trabeculectomy with adjunctive 5-fluorouracil.

The incidence of late-onset bleb-related endophthalmitis was evaluated retrospectively in 229 consecutive trabeculectomies performed with adjunctive 5-fluorouracil (5-FU) therapy. Mean follow-up was 23.7 +/- 16.3 months (range, 3 to 60 months). Thirteen eyes (5.7%) of 11 patients developed bleb-related endophthalmitis an average of 25.9 +/- 17.4 months (range, 5 to 58 months) after surgery. Infection occurred in 9 of 96 (9.4%) procedures performed from below and in 4 of 133 (3.0%) procedures performed superiorly (P = 0.05, Fisher's exact test). The relative risk of bleb-related endophthalmitis in trabeculectomy from below versus above is 4.0 after adjustment for age and sex (95% confidence interval = 1.1, 14.8). Trabeculectomy with adjunctive 5-FU performed from below carries an increased risk of late bleb-related infection. The incidence of late bleb-related endophthalmitis after 5-FU trabeculectomy appears to be higher than that for trabeculectomy without adjunctive 5-FU injections.

Adolescent↗