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Biomedical subjects

R M Burde

Publications and source records attributed to R M Burde.

At least 55 records · Page 3Linked to original sources
PubMed1988

Sarcoidosis of the anterior visual pathway: successes and failures.

Four patients with progressive visual deterioration were found to have sarcoidosis involving the anterior visual pathway. They all developed chiasmal dysfunction and bilateral optic neuropathy, which responded to megadose corticosteroid therapy. When an attempt was made to withdraw the corticosteroids, the patients experienced a recrudescence of visual dysfunction and were subsequently unable to tolerate the corticosteroid dose levels necessary to maximise their visual potential. Each patient was treated with high-voltage radiation therapy, totalling up to 4500 rads. The beneficial response obtained was temporary, and immunosuppressive therapy with azathioprine or chlorambucil was instituted, preventing further deterioration.

Adrenal Cortex Hormones↗
PubMed1988

Optic nerve dysfunction in thyroid eye disease: CT.

Optic nerve dysfunction in thyroid eye disease is thought to be due to compression of the optic nerve by enlarged extraocular muscles near the orbital apex. High-resolution computed tomography (CT) scans of 78 orbits of 31 patients with thyroid eye disease were reviewed. Axial scans alone were inadequate for demonstrating compression of the optic nerve. With a coronal reformatted scan from the axial scans, a muscular index was devised and measured to reflect extraocular muscle impingement on the optic nerve. Orbits with optic nerve dysfunction had significantly higher muscular indices than those without optic nerve dysfunction, supporting the hypothesis that optic nerve dysfunction is usually secondary to compression by enlarged extraocular muscles. Muscular indices of 67% or greater in patients with optic nerve dysfunction were diagnostic of compressive optic neuropathy, while muscular indices of less than 50% appeared to exclude optic nerve compression. A single case of optic nerve dysfunction without muscular compression is also discussed.

Exophthalmos↗
PubMed1988

Abducens nerve palsy and Horner's syndrome revisited.

Sympathetic fibers destined for the eye join the abducens nerve for a short distance within the cavernous sinus; thus, a unilateral sixth nerve palsy with an ipsilateral Horner's syndrome is of significant localizing value. We report two cases of cavernous sinus lesions producing an ipsilateral abducens palsy and Horner's syndrome: one case due to an intrinsic and the other to an extrinsic lesion of the sinus region.

Abducens Nerve↗
PubMed1987

Intracranial oculomotor nerve paresis with anisocoria and pupillary parasympathetic hypersensitivity.

Three patients developed anisocoria as a result of third nerve palsies caused by intracranial lesions: two in the cavernous sinus and one in the mesencephalon. Pharmacologic testing using low concentration pilocarpine showed apparent preganglionic parasympathetic supersensitivity of the abnormal pupil. These findings are compatible with the existence of a proposed direct pathway from the midbrain to the eye, without synapse at the ciliary ganglion. Cholinergic hypersensitivity can occur, not only with postciliary ganglionic but also with preciliary ganglionic parasympathetic lesions.

Adult↗
PubMed1987

Transient postictal cortical blindness.

An 8-year-old boy with insulin-dependent diabetes mellitus and a seizure disorder demonstrated transient visual loss after severe seizure activity. The role of hypoglycemia in relation to his transient cortical blindness remains indeterminate. The nature of the cortical involvement, the rate of visual recovery, and prior reports of postictal phenomena emphasize the relatively benign nature of this condition in children.

Blindness↗
PubMed1986

Treatment of temporal arteritis with ocular involvement.

A 78-year-old white woman had catastrophic visual loss in one eye due to temporal arteritis. Despite treatment with doses of oral corticosteroids high enough to normalize the Westergren erythrocyte sedimentation rate, she experienced progressive retinal ischemia with visual loss in the second eye. The use of 1,000 mg of pulsed intravenous methylprednisolone every 12 hours restored her vision. Brief hospitalization of patients with arteritic ischemic optic neuropathy for treatment with intravenous methylprednisolone may offer a significant chance of visual recovery of the involved eye and provide optimal protection to the uninvolved eye.

Aged↗
PubMed1986

Topographic analysis of Horner's syndrome.

Horner's syndrome or oculosympathetic paralysis is not an uncommon finding in patients with head and neck neoplasms. While in most cases the syndrome is easily established at the bedside, it can be confirmed and topographically defined as a central, preganglionic, or postganglionic lesion through sequential pharmacologic testing. The importance of such localization lies in differentiating neoplasia vs. a benign condition as the cause of the syndrome. Such variants as congenital Horner's, an alternating Horner's, and a pseudo-Horner's syndrome are discussed in regard to their differential features.

Cocaine↗
PubMed1985

Cryptogenic oculomotor nerve palsies in children.

We examined two cases of isolated, acquired, unremitting oculomotor palsies in children. The results of systemic, neurologic, and neuroradiologic investigations were normal. Both children were observed for more than two years and showed no additional signs or symptoms. Acquired isolated oculomotor palsies in some cases are not necessarily a harbinger of serious disease.

Child↗
PubMed1985

Stereoacuity in patients with optic nerve disease.

Twenty-eight patients were given the Titmus stereoacuity test (TST). Seventeen patients had documented optic nerve disease, and 11 had no known optic nerve disease. Thirteen of 17 patients (76%) with known optic nerve disease failed to achieve their expected TST scores, while only three of 11 (27%) of the patients without optic nerve disease fell into this category. Patients with reduced visual acuity secondary to optic nerve disease showed a disproportionately greater reduction in their TST scores than would be expected, based on Snellen's visual acuities.

Adult↗
PubMed1985

Transient monocular obscuration--?amaurosis fugax: a case report.

A 73-year-old white man with pseudophakia experienced repeated bouts of transient visual loss associated with erythropsia and colour desaturation. A diagnosis of atheromatous carotid vascular disease was considered, prompting carotid angiography, during which time the patient experienced transient aphasia. Subsequent examination during an episode of visual loss showed that a spontaneous anterior chamber haemorrhage was the cause of the visual complaints.

Aged↗
PubMed1985

The role of cerebral cortex in the generation of voluntary saccades: a positron emission tomographic study.

The purpose of this study was to define the location and behavior of cerebral structures within the normal human brain that participate in the generation of voluntary saccadic eye movements. Changes in regional cerebral blood flow (rCBF) during task performance were assumed to reflect like changes in regional neuronal activity induced by the task. The locations of all rCBF changes were described in stereotaxic coordinates. Cerebral blood flow (CBF) was measured with positron emission tomography (PET) and bolus intravenous injection of H2(15)O. The use of H2(15)O with PET allowed six, seven-slice measurements of brain blood flow to be made in rapid sequence for each subject, without removing the subject from the tomograph between scans. Nine paid normal volunteers were studied. The paradigm included three saccadic eye-movement (SEM) conditions, one finger-movement condition and two control conditions (initial and final). The three SEM conditions allowed comparisons to be drawn between targeted versus untargeted SEMs, auditorily cued versus visually cued SEMs, and stochastic versus rhythmic SEMs. All tasks were simple and deterministic in that each movement exactly mirrored the preceding movement: finger flexion then extension, saccade-left then saccade-right. Saccadic eye movements were associated with rCBF increases within the frontal eye fields, the supplementary motor area, and the cerebellum. Finger movements were associated with rCBF changes within the sensorimotor hand areas, the supplementary motor area, and the cerebellum. The frontal eye fields were discrete cortical regions consistently active during the generation of voluntary SEMs and uninfluenced by target presence, type of cue, or task complexity, indicating a predominantly motor function. The supplementary motor area (SMA) was consistently active during all motor tasks and was uninfluenced by the degree of task complexity or stochasticity. A role for SMA in establishing "motor set" during both simple and complex motor tasks is suggested. An anterior-posterior somatotopy was found for SMA-eye (anterior) versus SMA-hand (posterior). Lateral occipital visual association cortex activation was present only during targeted saccadic conditions.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗