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Biomedical subjects

L M Hamed

Publications and source records attributed to L M Hamed.

At least 37 records · Page 2Linked to original sources
PubMed1992

Ophthalmic manifestations of chronic angioedema with necrotizing vasculitis.

Anatomic features unique to periocular tissues alter the clinical appearance of angioedema, making it difficult to distinguish from cellulitis and other inflammatory conditions. Two patients had prominent periocular manifestations of chronic angioedema with necrotizing vasculitis, a systemic disease often associated with multiorgan involvement. The diagnosis was established by exclusion of other inflammatory disorders and confirmed by biopsy. The scarcity of reports in the ophthalmic literature on chronic angioedema of the eyelids may be caused by its underrecognition. The distinction between chronic angioedema and typical angioedema or urticaria is important because of differences in their diagnostic evaluation, treatment, and prognosis.

Adult↗
PubMed1992

Giant cell arteritis in the ocular ischemic syndrome.

Oculomotor nerve paresis, ocular hypotony, anterior segment ischemia, and the ocular ischemic syndrome are uncommon manifestations of giant cell arteritis. Four patients with these findings had giant cell arteritis documented by temporal artery biopsy. Cerebral angiography or ultrasonography, or both, performed in three patients, excluded hemodynamically significant stenosis of the internal carotid artery as the cause of ocular ischemia and cerebral aneurysms as the cause of oculomotor nerve paresis. Corticosteroid treatment, administered to three patients, resulted in resolution of the oculomotor deficits and the clinical signs of ocular ischemia, although the visual acuity in one patient improved from 20/400 to 20/60. Giant cell arteritis should be considered in the differential diagnosis of the ocular ischemic syndrome.

Aged↗
PubMed1992

Neuroimaging of the optic nerve after fenestration for management of pseudotumor cerebri.

The mechanisms by which optic nerve-sheath fenestration is effective remain speculative. Possibilities include surgical production of a cerebrospinal fluid filtration outlet or scarring in the subarachnoid space around the nerve in the vicinity of the fenestration site, with shifting of the pressure gradient from the nerve head to the retrobulbar portion. Two patients who underwent successful optic nerve-sheath fenestration developed a cystlike structure contiguous to the fenestration site, apparently in direct communication with the optic nerve sheaths. This was shown on magnetic resonance imaging (one patient) and orbital echography (both patients). These previously unreported observations may support the hypothesis that fenestration works by creating a filtration apparatus that controls the intravaginal pressure in the subarachnoid space surrounding the orbital segment of the optic nerve.

Adult↗
PubMed1992

Optic nerve aplasia.

Optic nerve aplasia is a rare congenital defect invariably associated with other ocular or systemic disorders. We examined a 3-year-old girl with monocular microphthalmos who had optic nerve aplasia on histopathologic examination of the eye after enucleation. Magnetic resonance imaging verified the presence of unilateral optic nerve aplasia, and demonstrated hemichiasmal hypoplasia on the affected side and bilateral optic tracts. The visually evoked cortical response revealed increased signals over the occipital cortex ipsilateral to the aplastic nerve, suggesting misdirection of axons from the temporal retina of the normal eye. The visual pathway in unilateral optic nerve aplasia may assume a primitive form of neuronal organization characterized by an increase in contralateral retinogeniculostriate projection.

Child, Preschool↗
PubMed1992

Chronic idiopathic inflammation of the retropharyngeal space presenting with sequential abducens palsies.

We describe a patient who presented with sequential, bilateral abducens palsies associated with a mass of the nasopharynx. Biopsy of the mass showed chronic non-specific inflammation and fibrosis. The diagnosis of idiopathic inflammatory pseudotumor was arrived at by exclusion of other known causes of inflammation of the retropharyngeal space. Magnetic resonance imaging suggested that injury to the sixth cranial nerves probably occurred as they traversed the dura and subarachnoid space overlying the clivus.

Abducens Nerve↗
PubMed1992

Suprasellar tumors of maldevelopmental origin in Klinefelter's syndrome. A report of two cases.

Patients with Klinefelter's syndrome may have a predisposition for the development of neoplasia, particularly extragonadal germ-cell tumors, but a suprasellar location is rarely reported. The clinical and neuroradiologic features in two patients with Klinefelter's syndrome and dysmorphic suprasellar masses of maldevelopmental origin (presumably lipomas or lipodermoids) are described. One patient had bilateral optic atrophy and decreased vision. To our knowledge, only one similar case (a suprasellar hamartoma) has been previously reported in association with Klinefelter's syndrome.

Brain Neoplasms↗
PubMed1992

Levator-sparing nuclear oculomotor palsy. Clinical and magnetic resonance imaging findings.

Two patients with diplopia presented with unilateral oculomotor palsy, defective elevation of the contralateral eye, and sparing of the levator palpebrae muscle. In each case, magnetic resonance imaging disclosed an infarction of the oculomotor nuclear complex in the mesencephalon. This clinical neuroradiological correlation is consistent with Warwick's scheme pertaining to the neuroanatomy of the oculomotor nuclear complex and demonstrates the utility of MRI in diagnosing ocular motility disorders of brainstem origin.

Aged↗
PubMed1992

Reduction of postoperative adhesions secondary to strabismus surgery in rabbits.

The efficacy of tissue coating with sodium hyaluronate solution or oxidized regenerated cellulose (Interceed) sleeves in reducing the occurrence and severity of postoperative adhesions following strabismus surgery was tested in rabbits in vivo and compared with the efficacy in this regard of treatment with balanced salt solution. The use of Interceed sleeves significantly increased formation of postoperative adhesions, but coating with sodium hyaluronate solution prior to and during surgery significantly reduced such formation.

Animals↗
PubMed1991

Congenital optic tract syndrome.

We describe two patients with complete homonymous hemianopia who were unaware of their visual field defects. The clinical impression of an optic tract syndrome was confirmed by magnetic resonance imaging, which showed absence of the corresponding tract in each case. The pathogenesis of congenital absence of the optic tract is unclear but it could represent either a primary failure of development or secondary atrophy due to focal injury during the perinatal period.

Adult↗
PubMed1991

Inferior rectus muscle contracture syndrome after retrobulbar anesthesia.

Ipsilateral hypotropia with restricted elevation is an increasingly recognized strabismic entity resulting from injury to the inferior rectus muscle after local retrobulbar anesthesia. Eight patients with this disorder are described. Computed tomography of the orbit in three patients demonstrated isolated segmental enlargement of the retrobulbar portion of the inferior rectus muscle; the findings of magnetic resonance imaging in one patient was most compatible with fibrosis. Four patients underwent strabismus surgery consisting of adjustable recession of the affected inferior rectus muscle; all recovered single binocular vision in the functional fields of gaze postoperatively. Surgical exploration of the ipsilateral inferior rectus muscle demonstrated normal anatomy in the peribulbar portion of the muscle.

Aged↗
PubMed1991

Associated neurologic and ophthalmologic findings in congenital oculomotor nerve palsy.

Unlike acquired oculomotor nerve palsy in childhood, the congenital form is usually considered to be an isolated disorder, not associated with other neurologic or systemic disease. In a series of 14 patients with this diagnosis, 10 had associated neurologic disorders. Clinical-neuroradiologic correlation identified the brainstem as the site of the lesion in some patients. The ipsilateral pupil was involved in 12 patients and was miotic with a trace or no reaction to light on the side of the palsy in 8 of the 12 patients. In two of these eight patients, the pupil was documented to be dilated and fixed in early infancy and subsequently became miotic at several months of age, concurrent with emergence of other signs of aberrant reinnervation. Pupillary miosis as a result of aberrant reinnervation appears to be much more frequent after congenital than acquired pupillary-involving oculomotor palsy. Four patients showed better visual acuity in the paretic eye, an unexpected finding. The paretic eye appeared to have a fixational advantage if the patient had nystagmus, presumably due to asymmetric dampening of the nystagmus. Significant anisometropia and astigmatic errors in the paretic eye were present in essentially all patients.

Adolescent↗
PubMed1991

Strabismus presenting after cataract surgery.

Strabismus presenting after cataract surgery is etiologically related to a heterogenous group of disorders. Clinical data from 63 patients so affected revealed four broad etiologic categories: 1) pre-existing disorders that preceded the cataract surgery, but were rendered asymptomatic by the occluding cataract (e.g., thyroid eye disease, cranial nerve palsy, myasthenia); 2) disorders precipitated by prolonged occlusion by a cataract (e.g., sensory deviations, decompensation of heterophorias, and central disruption of binocular vision); 3) disorders resulting from surgical trauma to extraocular muscles and orbital soft tissues. Traumatic injury to the inferior rectus muscle secondary to retrobulbar anesthesia injection, a specific subset, is postulated to result from a Volkmann's type ischemic contracture, a well-known osseofascial compartment syndrome occurring in peripheral skeletal muscles. 4) Disorders related to resulting aphakia/pseudophakia and associated optical aberrations (e.g.; anisophoria, ocular dominance reversal, and color/brightness disparity). The diagnostic and therapeutic implications of these findings are discussed.

Adult↗
PubMed1989

Optic neuropathy in uremia.

We examined three patients who developed optic neuropathies while undergoing chronic hemodialysis. One patient developed severe bilateral deterioration of vision, but recovered totally four weeks after discontinuing deferoxamine chelation therapy. Another patient had bilateral visual loss associated with chronic papilledema of idiopathic increased intracranial pressure. A third showed atypically severe consecutive anterior ischemic optic neuropathy. The latter two patients showed little improvement with high-dose intravenous methylprednisolone therapy combined with more vigorous hemodialysis. These cases, in addition to those previously described, underscore the heterogeneity of optic nerve disease in patients with uremia.

Adult↗
PubMed1989

The spectrum of optic nerve disease in human immunodeficiency virus infection.

We studied four patients with HIV-associated optic neuropathies. One had syphilitic optic perineuritis, which responded promptly and completely to penicillin therapy. The second had cytomegalovirus papillitis and visual acuity subsequently deteriorated to no light perception. The third showed varicella zoster optic neuritis, which improved after intravenous acyclovir treatment. The fourth patient developed cryptococcal retrobulbar neuritis and died shortly thereafter. Optic neuropathy was among the initial symptoms of HIV infection in two of the four cases.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Pseudotumor cerebri induced by danazol.

Intracranial hypertension with papilledema occurred in two patients receiving danazol therapy for either cyclic neutropenia or immune hemolytic anemia. Results of clinical, laboratory, and neuroradiologic studies showed no apparent cause for the condition in Case 1 and the papilledema resolved one month after discontinuing danazol. Carotid angiography in Case 2 demonstrated cerebral venous sinus thrombosis; the papilledema showed gradual improvement after cessation of danazol. An additional seven cases of pseudotumor cerebri presumed secondary to danazol therapy have been reported to the Food and Drug Administration. The papilledema resolved in all seven cases soon after discontinuing danazol. A drug-induced complication should be suspected, and alternative therapy sought, in patients who develop intracranial hypertension associated with administration of danazol.

Adult↗
PubMed1989

Acute macular neuroretinopathy and multiple evanescent white dot syndrome occurring in the same patients.

A young woman developed acute macular neuroretinopathy in one eye and five years later developed the multiple evanescent white dot syndrome in the same eye. Another young woman developed unilateral multiple evanescent white dot syndrome and central macular lesions typical of acute macular neuroretinopathy that appeared soon after the peripheral macular and juxtapapillary white lesions resolved. The findings in these two patients suggest that these two relatively rare syndromes may have pathogenetic and etiologic features in common.

Adult↗