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Biomedical subjects

M Tariq Bhatti

Publications and source records attributed to M Tariq Bhatti.

12 recordsLinked to original sources
PubMed2003

High- and low-risk profiles for the development of multiple sclerosis within 10 years after optic neuritis: experience of the optic neuritis treatment trial.

OBJECTIVE: To identify factors associated with a high and low risk of developing multiple sclerosis after an initial episode of optic neuritis. METHODS: Three hundred eighty-eight patients who experienced acute optic neuritis between July 1, 1988, and June 30, 1991, were followed up prospectively for the development of multiple sclerosis. Consenting patients were reassessed after 10 to 13 years. RESULTS: The 10-year risk of multiple sclerosis was 38% (95% confidence interval, 33%-43%). Patients (160) who had 1 or more typical lesions on the baseline magnetic resonance imaging (MRI) scan of the brain had a 56% risk; those with no lesions (191) had a 22% risk (P<.001, log rank test). Among the patients who had no lesions on MRI, male gender and optic disc swelling were associated with a lower risk of multiple sclerosis, as was the presence of the following atypical features for optic neuritis: no light perception vision; absence of pain; and ophthalmoscopic findings of severe optic disc edema, peripapillary hemorrhages, or retinal exudates. CONCLUSIONS: The 10-year risk of multiple sclerosis following an initial episode of acute optic neuritis is significantly higher if there is a single brain MRI lesion; higher numbers of lesions do not appreciably increase that risk. However, even when brain lesions are seen on MRI, more than 40% of the patients will not develop clinical multiple sclerosis after 10 years. In the absence of MRI lesions, certain demographic and clinical features seem to predict a very low likelihood of developing multiple sclerosis. This natural history information is a critical input for estimating a patient's 10-year multiple sclerosis risk and for weighing the benefit of initiating prophylactic treatment at the time of optic neuritis or other initial demyelinating events in the central nervous system.

Acute Disease↗
PubMed2003

Visual loss and ophthalmoplegia after shoulder surgery.

IMPLICATIONS: Ophthalmic complications can occur after a variety of non-ocular surgery. The etiology of postoperative visual loss and eye movement dysfunction is complex and multifactorial. In many cases, more than one perioperative factor may be associated with an adverse ophthalmic outcome.

Adult↗
PubMed2003

Peripheral third cranial nerve enhancement in multiple sclerosis.

Cranial nerve III dysfunction in multiple sclerosis (MS) is uncommon. Seven cases of isolated cranial nerve III paresis associated with MS have been reported in the English-language literature. MR imaging was obtained in five cases demonstrating lesions within the midbrain. We present the detailed clinical and MR imaging findings of a young woman with MS and an isolated, painful pupil involving complete left cranial nerve III palsy. Initial MR imaging showed isolated enhancement of the cisternal portion of the cranial nerve III, suggesting that peripheral nervous system involvement may develop as part of the disease process in some patients with MS.

Adult↗
PubMed2002

PRK-pTK as a treatment for a patient with Thygeson's superficial punctate keratopathy.

PURPOSE: This article reports a case in which Thygeson's superficial punctate keratopathy was treated with photorefractive keratectomy (PRK) combined with phototherapeutic keratectomy (PTK). METHODS: A 20-year-old white woman in good health who had a 2-year history of Thygeson's superficial punctate keratopathy in both eyes was evaluated for refractive surgery to treat myopia. The patient had experienced multiple recurrences of the Thygeson's during the preceding 2-year period. Previous treatment had consisted of topical steroids with good response to therapy but recurrences once the topical therapy was stopped. After discussing different options, the patient underwent uncomplicated PRK-PTK for treatment of her myopia, and her postoperative course was uneventful. RESULTS: Eight months after undergoing PRK-PTK, the patient has excellent uncorrected visual acuity (20/20 in both eyes) and has experienced no recurrences of Thygeson's superficial punctate keratopathy. CONCLUSIONS: Successful treatment of Thygeson's superficial punctate keratopathy in a patient with a low myopia may be achieved with the use of combined PRK-PTK procedures.

Adult↗
PubMed2002

Ocular manifestations of electrical injury: a case report and review of the literature.

PURPOSE: To report a case of electrical shock resulting in multiple ocular manifestations, including anisocoria, acute bilateral iritis, bilateral cataracts, and macular cyst formation, and to provide a review of the literature on electrically induced ocular injuries. METHODS: Case report and review of the literature. RESULTS: The case presented demonstrates a sequential occurrence of anisocoria, bilateral cataract formation, iritis, and macular cyst formation, with resolution following medical and surgical treatment. CONCLUSIONS: Electrically induced injuries can have many ocular manifestations that may occur simultaneously or sequentially, occasionally occurring later than the inciting event. The most common ocular finding is cataract formation.

Adult↗
PubMed2002

Primary antiphospholipid syndrome presenting with a branch retinal artery occlusion in a 15-year-old boy.

Acute vascular events are rare in the pediatric population, but there is an association with the presence of antiphospholipid antibodies. When there is no other underlying medical disorder, this is referred to as primary antiphospholipid syndrome. We present a case of a 15-year-old boy who developed an acute superior branch retinal artery occlusion. Complete evaluation revealed significant elevations in antiphospholipid antibodies. To our knowledge, there are no cases in children of primary antiphospholipid syndrome presenting with this clinical manifestation.

Adolescent↗
PubMedDate not supplied

A red eye and then a really red eye.

A 90-year-old woman presented with a 4-week history of a presumed infectious conjunctivitis resistant to topical antibiotic medications. Examination revealed tortuous, dilated conjunctival vessels in the right eye, retinal hemorrhages, and an orbital bruit suggestive of a carotid-cavernous sinus fistula (CCF). While awaiting a magnetic resonance imaging study, she returned to the clinic the next day with a painful, swollen right eye and an intraocular pressure of 69 mm Hg. A cerebral arteriogram confirmed a direct CCF. Because of the tortuosity of the systemic vascular anatomy, a right carotid artery cut-down with balloon occlusion was performed with successful closure of the fistula and prompt resolution of the orbital congestion. This case illustrates the spectrum of subtle to conspicuous ocular manifestations that can be seen in patients with CCF and its potential to present as an emergency. CCF should be included in the differential diagnosis of an "atypical" red eye. Recognition of arteriolized conjunctival vessels and auscultation of an orbital bruit raises the possibility of a CCF, requiring prompt diagnostic studies.

Aged↗
PubMedDate not supplied

Double trouble.

A 78-year-old woman presented with vertical double vision. The Bielschowsky-Parks' three-step test suggested a left inferior rectus muscle paresis. Diagnostic testing confirmed the diagnosis of myasthenia gravis. Despite treatment with pyridostigmine bromide (mestinon) the diplopia persisted. She refused corticosteroid treatment and sought a second opinion, resulting in three unsuccessful strabismus surgeries to correct her ocular misalignment. The evaluation and management of ocular myasthenia gravis is reviewed and the appropriate timing of strabismus surgery is discussed.

Aged↗
PubMedDate not supplied

Ophthalmic complications of endoscopic sinus surgery.

The intimate anatomical relationship between the orbit and the paranasal sinuses places the orbit and its contents at risk of harm from primary pathologic processes of the sinuses. In the absence of ophthalmic signs or symptoms, ophthalmologists are not routinely involved in the management of patients with sinus disease. Occasionally, some patients may develop ophthalmic complaints after surgical intervention. The orbit, optic nerve, extraocular muscles, and lacrimal drainage system are susceptible to injury during endoscopic sinus surgery. The risk of injury is related to the skill of the sinus surgeon, history of previous surgery, extent and severity of disease, and anatomic variation. Furthermore, recent advances in endoscopic sinus surgery, in particular the use of powered cutting instruments, has resulted in a novel mechanism of injury to the ocular structures.

Endoscopy↗