Biomedical subjects
Publications and source records attributed to K R Diddie.
Two patients underwent vitrectomy with the use of intraocular gas. In one patient the cornea decompensated because of lens-cornea contact and in the second patient a surgical technique devised to protect the cornea from lens contact was used successfully. The technique consisted of injecting a smaller gas bubble into the anterior chamber before the instillation of the posterior chamber gas.
We used new applications for a pars plana infusion cannula in three patients with retinal and choroidal detachments. Because the cannula maintained intraocular volume and form, it was helpful in treatment bullous retinal detachment and choroidal detachment.
We measured skin reactions serum antibody, and lymphocyte stimulation to Histoplasma antigens in a series of patients with presumed ocular histoplasmosis syndrome and in controls. The most sensitive test, lymphocyte stimulation to H. capsulatum sonicate, also correlated with severity of the disease. Lymphocyte stimulation to Histoplasma may be a useful adjunct to the monitoring of presumed ocular histoplasmosis syndrome.
A 33-year-old woman with Hodgkin's disease developed a painless progressive loss of vision in both eyes. Despite an ophthalmoscopic appearance of white-yellow retinal necrosis and retinal hemorrhage similar to that described with Hodgkin's disease, no sign of the disorder was found at autopsy. Instead, widespread evidence of Herpesviridae family virus infection was present in several organs, including the retinas. Opportunistic infection, including herpes simplex and cytomegalovirus, should be considered when retinitis complicates Hodgkin's disease.
A patient with systemic lupus erythematosus (SLE) and lupus retinopathy showed resolution of subretinal edema documented with fluorescein angiography. Subsequently at autopsy, immunofluorescence studies disclosed ocular deposition of immunoglobulins in the vascular layer of choroid capillaries and basement membranes of ciliary processes and bulbar conjunctivas. To our knowledge, these findings represent the first reported documentation of probable immune-complex ocular vasculitis in lupus retinopathy using immunofluorescent techniques, and they support the hypothesis that lupus retinopathy is caused by immune complex deposition as are other manifestations of SLE.
Color matching and Stiles-Crawford effect measurement were performed in 3 patients with central serous choroidopathy, 2 normal and 1 deuteranomalous trichromats. The color matches in the affected eye of each patient were displaced to red and could be explained by the hypothesis that the visual photopigments are in reduced optical density due to receptor disorientation caused by serous elevation of the sensory retina. The Stiles-Crawford effects of the affected eyes was abnormal confirming the hypothesis of receptor disorientation. The type III color defect accompanied by pseudo-protanomaly ascribable to receptor disorientation as occurs in central serous choroidopathy may be differentiated from the type III defect without pseudo-protanomaly.
Light microscopy and latex-pigment injection of rhesus monkey eyes studied at varying times after retinal laser and xenon photocoagulation of varying intensity showed that the choriocapillaris was obliterated by a wide range of intensities but that the choroidal arteries and veins remained open. Retinal oxygen tensions acutely increased over the lesion but later subsided to normal. Multiple treatment sessions several days apart may reduce the risk of hemorrhage associated with hypermia secondary to photocoagulation.
A 9-year-old boy, the product of a consanguineous marriage, had visual acuity of 6/60, pendular nystagmus, and a bull's-eye type of macular atrophy. A sensorineural deafness was present. The photopic electroretinogram was extinguished; the electro-oculogram was normal. There was associated mental retardation and failure of inhibition of the pituitary gland by high levels of circulating thyroid hormone. Two older siblings although not examined, had similar endocrine abnormalities. Non-involvement of three half-siblings suggested autosomal recessive inheritance.
A 19-year-old woman with systemic lupus erythematosus had choroidal fluorescein leakage into discreet areas of subretinal fluid. The findings were abolished with corticosteroids. A choroidal vasculitis was suggested by mononuclear infiltration and immunofluorescent demonstration of immunoglobulin.
Hyphema was created in ten albino rabbits and removed within an hour by the Douvas Rotoextractor. All the blood was gone from each eye within 48 hours and there was no evidence of damage to iris, cornea or lens after six weeks. One patient underwent Douvas Rotoextractor removal of a hyphema that was causing increased intraocular pressure and corneal staining. Three months postoperatively, vision was 6/7.5 and intraocular pressure was controlled.