Search PubMed⌕ Search

Biomedical subjects

R F Dreyer

Publications and source records attributed to R F Dreyer.

9 recordsLinked to original sources
PubMed1988

Pseudoinflammatory macular dystrophy.

We studied a family with a dominantly inherited macular dystrophy resembling Sorsby's pseudoinflammatory dystrophy. Retinal pigment epithelial atrophy and varying degrees of pigment epithelial metaplasia were prominent fundus features in this pedigree. However, findings on electro-oculography were abnormal, unlike previous findings in patients with Sorsby's dystrophy. Histopathologic study of an eye from one patient demonstrated widespread atrophy of the retina, retinal pigment epithelium, and choroid. Although the pseudoinflammatory fundus appearance is common to several macular dystrophies and some eyes with end-stage, age-related macular degeneration, abnormal electro-oculograms and a dominant inheritance pattern distinguish the dystrophy in the present pedigree from other dystrophies and age-related macular degeneration.

Aged↗
PubMed1987

Does neuroretinitis rule out multiple sclerosis?

Neuroretinitis, a form of optic neuritis, is characterized by papillitis and a stellate macular exudate, or "macular star." The star implies the presence of a disc vasculopathy and secondary leakage of lipoproteinaceous material into the macula. Demyelinating optic neuritis would not be expected to produce a secondary macular exudate. We reviewed the literature on the risk of multiple sclerosis developing in a patient after an attack of optic neuritis, and rarely found a comment on the presence of a macular star. We then reviewed two series of 40 patients who had neuroretinitis and added ten patients of our own. Signs of multiple sclerosis had not developed in the 13 patients contacted retrospectively, nor in the patients followed up prospectively. We also noted that in our patients, neuroretinitis may be accompanied by other neurologic manifestations; neuroretinitis may be bilateral and may be staggered; papillitis may present without a macular star, only to have typical exudates develop up to two weeks later; and the macular exudate may take up to 12 months to resolve. We suggest that patients who demonstrate acute papillitis with a normal macula be reevaluated within two weeks for the development of a macular star. Its presence militates strongly against the subsequent development of multiple sclerosis.

Fundus Oculi↗
PubMed1987

Relative afferent pupillary defect in eyes with retinal detachment.

Relative afferent pupillary defects were measured before and after surgery in 38 patients with unilateral rhegmatogenous retinal detachment. All 38 patients were measured preoperatively and the mean (+/- SD) pupillary defect was 1.4 +/- 0.7 log units. The afferent pupillary defect decreased in 36 of the 38 patients after successful scleral buckling operations (postoperative mean = 0.4 +/- 0.3 log units). Twenty patients had defects postoperatively of 0.3 log units or less, and seven of these had no measurable defects at all. A prediction model, using the variables of total number of peripheral quadrants detached and whether the macula was detached, yielded the following prediction equation: Relative afferent pupillary defect (log units) = 0.35 X (total quadrants) + 0.68 X macula detachment. This means that the detachment of each peripheral quadrant of retina caused about 0.35 log units of defect, whereas detachment of the macula caused 0.68 log units. The standard error of this estimate was rather large (+/- .65 log units); therefore, the size of the afferent pupillary defect can only roughly predict the extent of the retinal detachment and vice versa.

Humans↗
PubMed1984

Leber's idiopathic stellate neuroretinitis.

Twenty-nine eyes of 27 patients demonstrated the typical features of neuroretinitis with a mascular star. Historical and fluorescein angiographic features of this condition implicate a bloodborne infectious agent. It is likely that multiple agents can produce this condition, including the agent of cat-scratch fever and leptospirosis. A small subgroup may exist in whom this condition resembles anterior ischemic optic neuropathy and has a less favorable clinical course than is usual. There is evidence that this condition is not related to demyelinating disease. It is emphasized that this condition is not a maculopathy since vascular leakage in the optic nerve causes the star. Therefore, we suggest that this condition be renamed Leber's idiopathic stellate neuroretinitis.

Adolescent↗
PubMed1984

Multifocal choroiditis and panuveitis. A syndrome that mimics ocular histoplasmosis.

A review of 28 cases of multifocal choroiditis with vitreous inflammatory cells demonstrates that these patients have chorioretinal scars similar to those in the presumed ocular histoplasmosis syndrome (POHS), but they have a low incidence of positive histoplasmin skin test reactions and calcified granulomata on chest x-ray films. Anterior chamber inflammation is a frequent finding. The epidemiologic background of these patients is different from those with POHS. The subjects in this study were also different from patients with birdshot or vitiliginous choroiditis and acute posterior multifocal placoid pigment epitheliopathy. However, unilateral cases are difficult to distinguish from cases of diffuse unilateral subacute neuroretinitis. While it is possible that a subretinal nematode may have caused some of the unilateral cases in this review, multiple causative agents are likely, including an unidentified agent that causes cross reactions to histoplasmin skin tests.

Adolescent↗
PubMed1983

Ocular hypotony in myotonic dystrophy.

Ocular hypotony is a common, unexplained feature of myotonic dystrophy. Some investigators have ascribed the decrease in intraocular pressure to unusually high outflow facility. The present study demonstrates that increased outflow facility in myotonics is often artifactitious. When corrected for ocular rigidity, outflow facility is frequently normal. The present study presents indirect evidence that ocular hypotony in myotonics results from reduced aqueous production or increased uveoscleral outflow.

Humans↗
PubMed1982

Ophthalmic anatomy.

A brief review of the anatomy of the eye, the eyelid, and the lacrimal system provides reference material for the articles that follow in this issue. Pathologic changes in the normal anatomy that can help the physician diagnose an ophthalmic or systemic problem are highlighted.

Adult↗