Biomedical subjects
L Y Kao
Publications and source records attributed to L Y Kao.
Ocular ischemic syndrome.
BACKGROUND: The purpose of this study was to investigate the clinical features and management of ocular ischemic syndrome (OIS) and factors influencing its development. METHODS: Ten patients (12 eyes) with OIS underwent detailed medical and ocular histories, complete ophthalmic evaluation including fluorescein angiography, internal carotid artery evaluation by duplex ultrasonography, and management. The following outcome measures were considered: visual acuity, anterior segment neovascularization, lens status, retinal and choroidal changes, and carotid artery stenosis or occlusion. RESULTS: The mean age of the patients was 63 +/- 8 years. Presenting visual symptoms included gradual (82.5%) or sudden (17.5%) onset of vision loss. At initial visit, eyes with OIS had visual acuity less than or equal to counting fingers in 50%, iris neovascularization in 58%, and neovascular glaucoma in 42%. Initially associated systemic diseases in these patients included arterial hypertension (60%), diabetes mellitus (40%), coronary artery disease (20%), previous stroke (30%) and hemodialysis (10%). Complete occlusion or severe occlusion (70-99%) of the internal carotid artery was seen in 75% on the side of OIS. Panretinal photocoagulation did not prevent OIS from progressing but vitreous hemorrhage and rubeosis iris regressed. Carotid endarterectomy had some benefit in stabilizing or improving vision in patients with OIS. CONCLUSION: OIS has a poor visual prognosis. It is imperative that the clinician be aware of the signs and symptoms of carotid disease in order to facilitate prompt diagnosis and appropriate referral, because OIS may be the presenting sign of serious ischemic cerebrovascular and ischemic heart disease.
Polytetrafluoroethylene as a wrapping material for a hydroxyapatite orbital implant.
PURPOSE: Porous coralline hydroxyapatite orbital implants have been used with great success in anophthalmic sockets. We used a substitute for donor sclera as a wrapping tissue. METHODS: Orbital implants were wrapped with polytetrafluoroethylene (PTFE) instead of homologous donor tissue in five patients after enucleation. RESULTS: The postoperative course was uneventful in three cases. Complications occurred in two cases: one with implant exposure, and one with severe implant infection leading to its eventual removal. CONCLUSIONS: PTFE is inferior to other wrapping tissue.
Diffuse infiltrating retinoblastoma: an inherited case.
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Incontinentia pigmenti: a florid case with a fluminant clinical course in a newborn.
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Unilateral congenital third cranial nerve palsy with central nervous system anomalies: report of two cases.
The third nerve palsies are not uncommon in adults and are usually the result of vascular or compressive lesions. However, they are uncommon in children and are usually congenital. Congenital oculomotor nerve palsies were generally thought to exist in isolation without associated abnormalities; however, there have been conflicting reports in the literature as to the associations of congenital oculomotor palsies. In this report, we present 2 cases of congenital third cranial nerve palsy with neurological deficits and central nervous system abnormalities. The first patient had initial presentations of inequality in pupil size, exodeviation of the affected eye, and extreme hypotropia of the contralateral eye, which was also complicated by profound neurological deficits. Magnetic resonance imaging (MRI) scans disclosed hypoplasia of the right midbrain and corpus callosum. The second patient presented with an exodeviated right eye, and pupils non-reactive to light since birth. Computed tomography scans showed ventricular dilatation and absence of the septum pellucidum, which is compatible with septo-optic dysplasia (de Morsier syndrome). The clinical courses are presented, and we also review the literature concerning congenital third cranial nerve palsy associated with central nervous system anomalies.
Congenital oculomotor palsy associated with brainstem hypoplasia.
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Advanced bilateral retinoblastoma treated conservatively with lens sparing external beam radiation therapy: report of three cases.
From 1995 through 1998, 3 children with bilateral advanced retinoblastoma were treated primarily with external beam radiation therapy; 6 eyes were irradiated with a lens sparing technique, doses varied from 5500 to 5700 cGy, and follow-up period ranged from 14 to 36 months. Recurrent tumors were found in 3 eyes, and a new growing tumor in one eye. Three eyes underwent enucleation eventually; one eye refused enucleation and finally developed optic nerve extension. The overall ocular cure rate was 2/6 (33.3%). One eye sustained visual acuity of 20/30, the other eye retained some peripheral vision; both eyes were blind in one patient. There were no deaths, metastasis, or secondary malignant tumors in our study. Advanced bilateral retinoblastoma with simultaneous radiation therapy instead of bilateral enucleation does not increase the risk of death, and more children will enjoy the benefits of retaining some vision in the affected eye through the use of this conservative therapeutic regimen.
Bilateral serous retinal detachment resembling central serous chorioretinopathy following epidural steroid injection.
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Successful treatment with cyclosporin A in a child with acquired pure amegakaryocytic thrombocytopenic purpura.
Idiopathic acquired pure amegakaryocytic thrombocytopenic purpura (APATP) in young patients (non-neonates) is a rare disorder with a variable clinical course. Cure is unusual. A 13.5-year-old boy with idiopathic APATP was treated with cyclosporin A. Apparently effective, the treatment resulted in the reappearance of marrow megakaryocytes and normalization of platelet count.
Visual loss as the initial presentation of nasopharyngeal carcinoma.
Eye symptoms and cranial nerve involvement are rather common in nasopharyngeal carcinomas, but early invasion of the optic nerve is very rare. Two cases of nasopharyngeal carcinoma that presented initially with visual loss are reported.
Anterior ischemic optic neuropathy--recurrent attacks in one eye in a bilateral case.
Subsequent involvement of the fellow eye is common in anterior ischemic optic neuropathy, but recurrent episodes in one eye are extremely rare. Our hypertensive patient had one eye attacked nine years before and two episodes in the second eye within ten days of each other. Visual-field examination revealed progressing field loss, and fluorescein angiography demonstrated an enlarged disc hypofluorescence area.
Mucocele of the sphenoid sinus with the apex orbitae syndrome.
A mucocele of the sphenoid sinus with visual impairment and headache is presented. Mucocele of the sphenoid sinus is relatively rare. The preoperative diagnosis was uncertain in this case but sphenoid sinus mucocele was considered. The transnasal surgical approach is considered to be best for treatment.