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Biomedical subjects

R G Weaver

Publications and source records attributed to R G Weaver.

At least 55 records · Page 3Linked to original sources

Multiple evanescent white dot syndrome.

Three patients had documented fundus changes conforming to those of the recently described multiple evanescent white dot (MEWD) syndrome. All three patients were unilaterally affected with variously sized, soft, single, and coalescent white lesions at the level of the RPE and the deep retina. Fluorescein angiography demonstrated early staining and hyperfluorescence of the white dots and delayed staining around the optic disc. Some degree of optic disc edema could be seen in all three eyes, two of which had corresponding field defects. In all three eyes, characteristic "stippling," or granularity, of the affected macula developed rapidly and vitreal cells were observed. One eye had signs of previous perivascular inflammation. ERG studies performed on one patient indicated a reduction in the a-wave and depression of the ERP, findings that correlated with the clinical observations of RPE affectation.

Adult↗

Walker-Warburg syndrome with cleft lip and cleft palate in two sibs.

Two sibs are reported with Walker-Warburg syndrome including hydrocephalus, agyria, anterior chamber dysgenesis, and encephalocele. In addition, both had cleft lip and cleft palate and intrauterine growth retardation, findings not previously noted in this condition.

Abnormalities, Multiple↗

Ophthalmic evaluation of long-term survivors of childhood acute lymphoblastic leukemia.

Thirty-four long-term survivors of childhood acute lymphoblastic leukemia (ALL) underwent comprehensive ophthalmic examinations to detect retinopathy or other ocular sequelae. Sixteen of the 34 patients received whole brain radiation (greater than or equal to 2400 rad). All 18 patients in the non-radiated group had normal eye examinations, while 4 of 16 in the radiated group had ocular abnormalities. None of the ocular abnormalities could be definitely attributed to radiation and all patients had normal visual acuity. No radiation retinopathy was found in either group.

Acute Disease↗

A new skeletal dysplasia: clinical, radiologic, and pathologic findings.

Two siblings, one male and one female, were noted to have a distinct skeletal dysplasia. The clinical and radiographic features resemble those observed in Kniest dysplasia and Rolland-Desbuquois syndrome, but important differences were noted. Specifically, these two patients have microstomia, "pursed" lips, and ectopia lentis, and their radiographs reveal no coronal clefts. Chondro-osseous features also differ from those observed in either of the other disorders. Scattered dense patches consisting of collagen fibers 10 to 30 times broader than normal are seen scattered throughout the cartilage matrix; the "Swiss cheese" appearance characteristic of Kniest dysplasia is not observed. These patients appear to have a new skeletal dysplasia, most likely inherited in an autosomal recessive fashion.

Bone Diseases, Developmental↗

Early-onset myasthenia gravis.

Signs of myasthenia gravis developed by age 3 years in 11 children. Six of these patients had persistent neonatal myasthenia gravis, a familial abnormality of neuromuscular transmission that is not immunologically mediated. Five patients had juvenile onset myasthenia gravis, an autoimmune disorder similar to myasthenia gravis in adults. Autoimmune myasthenia has rarely been recognized by age 3 years, but the presence of five cases in our series suggests that the disorder may be more common in young children than once believed. The development of anti-acetylcholine receptor antibody assays makes it easier to distinguish autoimmune myasthenia gravis from the congenital forms. This distinction is important, because the prognosis, treatment, and risk of recurrence in family members is different for each type of myasthenia.

Antibodies↗

Cavernous hemangioma of the retina, cutaneous angiomas, and intracranial vascular lesion by computed tomography and nuclear magnetic resonance imaging.

In a 32-year-old man with a right-sided retinal cavernous hemangioma and cutaneous angiomas, computed tomography and nuclear magnetic resonance imaging confirmed the presence of cerebrovascular lesions. This supports the inclusion of cavernous hemangioma of the retina in the established group of neuro-oculo-cutaneous phacomatoses.

Adult↗

Monocular elevation paresis caused by an ipsilateral lesion.

A 52-year-old woman presented with a paresis of elevation of the right eye, equally severe in abduction and adduction (monocular elevation paresis). CT demonstrated a small, right-sided tumor of the mesodiencephalic junction. Monocular elevation paresis has been attributed to lesions of the contralateral pretectum, although proof has been lacking. Now, with documentation of an ipsilateral brainstem etiology, we can postulate a lesion affecting the upgaze efferents from the ipsilateral rostral interstitial nucleus of the medial longitudinal fasciculus.

Brain Neoplasms↗

Drusen-associated visual field defects and hemorrhages.

Retinal hemorrhages and visual field defects can occur as complications of optic nerve drusen. The visual defects of optic drusen are of three types: (1) concentric constriction of the field, (2) enlargement of the blind spot, and (3) nerve fiber bundle defects. Retinal hemorrhages also fall into three categories: (1) splinter hemorrhages overlying the disk, (2) vitreous hemorrhages, and (3) subretinal hemorrhages. The unusual disk vasculature associated with drusen is probably responsible for the retinal hemorrhages and may be the primary defect in the pathogenesis of drusen. Altered axoplasmic transport and abnormal axonal calcium metabolism have also been thought to be significant in the pathogenesis of drusen.

Adult↗

Federal grant support to general practice residency programs in dentistry: results of two years of funding.

The Health Professions Educational Assistance Act of 1976 (P.L. 94-484) authorized federal grant support to general practice residency programs. This paper reports the results of two years of funding under this authority. In this period, 46 institutions received grants totalling $7.8 million for the purpose of enlarging enrollments, hiring faculty and support staff, improving facilities, and related purposes. Three hundred eighty-six residents were enrolled in grant-supported programs; 118 of these residents received federal financial assistance. Dental departments in hospitals located in the eastern part of the country were the major recipients of these grants. Additional information related to program and trainee data, sponsorship of programs, developmental stage of programs, geographic location of programs, and funding by budget category is presented.

Academic Medical Centers↗

Ophthalmomyiasis interna posterior. Subretinal tracks and intraocular larvae.

Only seven cases of identifiable intraocular botfly larva infestation have been reported in North America--five since 1969. Two additional cases, both from the same institution, are documented here. The offending maggot or larva was visible in both instances. The findings in each case were diagnostically and morphologically striking. The characteristic funduscopic finding of subretinal tracks, along with the appearance of the larva--encysted in one patient and free-floating in the other-deserves emphasis, since this condition is not always benign and may not be as rare as previously assumed.

Adolescent↗

Ophthalmic findings in dural arteriovenous shunts.

Five cases of dural carotid arteriovenous shunts in the region of the cavernous sinus are reported. Discussion of the specific carotid angiographic features stresses the pathophysiologic characteristics of these shunts in relation to the ophthalmic findings. In all cases, the meningohypophyseal artery was involved as the sole or predominant source of the afferent arterial supply, and the degree of proptosis, epibulbar congestion and secondary glaucoma correlated with retrograde filling of the superior ophthalmic vein from the cavernous sinus. The ophthalmologist's early recognition of this entity as a "spontaneous" pathologic occurrence is important, since he is intimately involved in its diagnosis and long-term management.

Aged↗

Presumed choroidal naevi and sensory retinal detachment.

Two cases of choroidal naevus in patients with presenting complaints of blurred central vision and subsequent findings of abnormal retinal pigment epithelium (RPE) overlying the pigmented choroidal lesion are presented. Fluoroangiographic evidence of sensory retinal elevation in these areas is provided. Both cases were treated with low-intensity argon laser photocoagulation, with return of central vision without complication. The diagnostic importance of morphologically altered RPE, particularly lipofuscin pigment, overlying such choroidal tumours is stressed. A significant period of follow-up in each case is documented photographically.

Adult↗