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Biomedical subjects

R P Murphy

Publications and source records attributed to R P Murphy.

88 records · Page 5Linked to original sources
PubMed1982

Natural course of choroidal neovascular membranes within the foveal avascular zone in senile macular degeneration.

We divided 96 eyes (93 patients) with senile macular degeneration and choroidal neovascular membranes into two groups--those with juxtafoveal membranes (1 to 250 mu from the center of the foveal avascular zone) and those with subfoveal membranes (0 mu from the center of the zone). After an average follow-up period of 21 months, one of 38 eyes in the juxtafoveal group (3%) had improved two or more lines on the Snellen chart, three eyes (8%) had remained the same, and 34 eyes (89%) had lost two or more lines on the Snellen chart. Although 35 of the 38 eyes (92%) had had initial visual acuities of 6/30 (20/100) or better, 27 eyes (71%) had become legally blind. Of the 58 eyes in the subfoveal group, 18 (31%) had remained the same or improved and 40 (69%) had lost two or more lines on the Snellen chart; 41 (70%) had final visual acuities of 6/60 (20/20) or worse. Of the 26 eyes in the subfoveal group that had had initial visual acuities of 6/60 (20/100) or better (45%). four (15%) had stayed the same and 22 (85%) had lost two or more lines on the Snellen chart. Fourteen of the 26 eyes (54%) had final visual acuities of 6/60 (20/200) or worse. Exudative maculopathy developed in the second eye in 13% of patients who initially had unilateral choroidal neovascularization after 12 months, in 22% after 24 months, and in 29% after 36 months, using life table analysis.

Adult↗
PubMed1982

Acute retinal necrosis syndrome.

Six patients with the acute retinal necrosis (ARN) syndrome are described. Ophthalmoscopic examination demonstrated occlusion of peripheral retinal vessels and patchy areas of peripheral retinal whitening spreading rapidly over a period of weeks to markedly decreased vision. In four patients, the disease was bilateral. Histologic examination of vitrectomy specimens from three cases and one enucleated eye revealed chronic granulomatous inflammation. Extensive medical evaluations were noncontributory, with no evidence of compromised immune systems. No patient demonstrated a response to any form of therapy. The etiology is unknown.

Acute Disease↗
PubMed1982

Ventilatory failure in myasthenia gravis.

This retrospective study over the decade 1969-1978 examines the precipitating factors and outcome in thirty-one patients with myasthenia gravis who developed ventilatory failure. An unusual example of chronic alveolar hypoventilation is discussed in detail. The most favourable outcome occurred in younger patients with a hyperplastic thymus, in contrast to a poorer outlook for older patients with an atrophic gland. Eleven patients died during the period of follow up: three deaths were unrelated to myasthenia but the remaining eight were attributed directly or indirectly to it. The mortality of 36% represents a marked improvement on a 70% mortality in a similar group of patients, reported from this hospital for the years 1960-1968.

Adrenocorticotropic Hormone↗
PubMed1981

Long-term follow-up of ocular histoplasmosis treated by argon laser photocoagulation.

Sixty-eight eyes in 67 patients with a histoplasmic neovascular membrane treated with Argon laser photocoagulation between 1972 and 1978 are reviewed. Factors affecting visual outcome and causes of visual failure are discussed. Twenty of 68 eyes (nearly 30%) experienced a recurrent or new SRNVM after initially successful treatment. Final evaluation of Argon laser photocoagulation for histoplasmic neovascular membrane must await the outcome of the Macular Photocoagulation Study.

Adult↗
PubMed1979

Regression of iris neovascularization following panretinal photocoagulation.

A 57-year-old woman with proliferative diabetic retinopathy in both eyes also had iris surface neovascularization with early angle neovascularization in her right eye, which regressed completely following treatment with panretinal photocoagulation. Histopathologic examination confirmed the complete absence of abnormal vessels on the iris surface or in the iridocorneal angle of the right eye; an avascular fibrous membrane persisted on a segment of the posterior iris pigment epithelium near the pupil. There was advanced rubeosis in the untreated left eye.

Collateral Circulation↗
PubMed1979

The treatment of angle neovascularization with panretinal photocoagulation.

Thirty-two eyes in 28 patients with anterior chamber angle neovascularization were prospectively treated with panretinal photocoagulation. Of 17 eyes that had less than 270 degrees angle closure, with an intraocular pressure of less than 40 mm Hg prior to treatment, 16 showed complete disappearance of the angle neovascularization and stabilization of the peripheral anterior synechiae after treatment. None of the 15 patients who had angle closure of 270 degrees or greater, or an intraocular pressure of above 40 mm Hg, showed any significant improvement after treatment. These results suggest that panretinal photocoagulation offers a highly effective means of dealing with early and moderately advanced cases of angle neovascularization.

Adult↗
PubMed1978

Incidence and natural history of "head at risk" factors in Perthes' disease.

Twenty-eight cases of Perthes' disease were evaluated roentgenographically a minimum of 4 years after diagnosis (range, 4-17 years). The original roentgenograms were examined to see if a prognosis was possible of the final result on the basis of: (1) "head at risk" factors, or (2) Catterall's degree of epiphyseal involvement. Five "head at risk" factors more accurately predicted the course of Perthes' disease than Catterall's degree of epiphyseal involvement. The latter may change as the disease progresses. There is a definite decreasing incidence of a good radiological result with an increasing number of risk factors. The 5 risk factors are: Gage's sign; lateral subluxation; calcification lateral to the epiphysis; diffuse metaphyseal reaction and a transverse epiphyseal plate. The ability to predict the probable course of the disease and the final result should allow early institution of a more rational treatment program.

Adolescent↗
PubMedDate not supplied

Free radicals in inflammatory neurological disease: increased lipid peroxidation and haptoglobin levels in Guillain Barré syndrome.

Oxidative damage in three inflammatory neurological disorders; Guillain Barré syndrome (GBS), multiple sclerosis and aseptic meningitis, were assessed by measuring the peroxidation of lipids in body fluids. The results were compared to a control group consisting of patients with either migraine, chronic/tension headaches, benign intracranial hypertension or psychological disorders. Antioxidant status was assessed by the measurement of the extracellular proteins, haptoglobin, albumin, caeruloplasmin and transferrin. The results of the study suggested that firstly, haptoglobin levels might be a useful, easily obtainable marker to aid the diagnosis of GBS. Secondly, free radical damage may be implicated in the pathology of GBS and therefore appropriate free radical scavenging might have beneficial effects.

Adult↗
PubMedDate not supplied

The evaluation of patients with Eales' disease.

Thirty-two patients with documented Eales' disease who have been followed-up at Johns Hopkins Hospital for periods of as long as 37 years were investigated. The previously reported association of Eales' disease with tuberculoprotein hypersensitivity was confirmed in 10 of 21 patients tested. For the first time, associated vestibuloauditory dysfunction is described. The previously reported association with multiple sclerosis was not confirmed. Eales' disease is a specific vasculopathy that can affect both the retinal and vestibuloauditory circulations. Patients with suspected Eales' disease should also be examined to rule out other diseases such as diabetes, sarcoidosis, and connective tissue diseases including systemic lupus erythematosus. This can be done by obtaining such tests as fasting blood glucose, chest radiograph, erythrocyte sedimentation rate, antinuclear antibody, rheumatoid factor, and LE cell preparation. Tuberculoprotein sensitivity status should be ascertained and active tuberculosis should be ruled out. The patient should be questioned regarding hearing or balance problems, and if a history suggestive of abnormalities is elicited, referral for vestibuloauditory function testing should be made.

Adult↗
PubMedDate not supplied

Transient delay in choroidal filling after krypton red laser photocoagulation for choroidal neovascular membranes.

The authors report four patients who were treated with krypton red laser photocoagulation for neovascular membrane in the papillomacular bundle. In each patient, from 1 to 7 days following photocoagulation, there was a transient delay in filling of the choroid in a localized area beyond the treatment site. No patient suffered permanent visual loss as a result of this complication. Each patient regained normal choroidal filling (except for the treatment site) within two to four weeks. This angiographic observation may be explained by the increased uptake of the krypton red wavelength in the deep choroid.

Adult↗
PubMedDate not supplied

Clinicopathologic correlation of krypton and argon laser photocoagulation in a patient with a subfoveal choroidal neovascular membrane.

Krypton-red laser photocoagulation for choroidal neovascular membranes has been shown to produce inner retinal sparing in contrast to argon blue-green or argon-green laser photocoagulation, which causes full-thickness retinal destruction. However, previous histopathologic reports have involved only primates or humans without known macular degeneration. Clinicopathologic features of a case in which a human eye with a choroidal neovascular membrane, associated with age-related macular degeneration, was photocoagulated on four occasions with the argon-green and krypton-red lasers are presented. The results of this study confirm previous reports of the inner retinal sparing noted with krypton-red laser photocoagulation in comparison with argon blue-green or argon-green laser photocoagulation.

Aged↗
PubMedDate not supplied

Clinicopathologic features in two cases of multiple myeloma.

Multiple myeloma is a serious and fatal condition with various ocular manifestations. In two of these cases, pathologic findings included opaque ciliary body cysts, a ciliochoroidal effusion, retinal microaneurysms and hemorrhages, and detachment of both the sensory retina and the retinal pigment epithelium. In one case, a recanalized thrombus within a retrolaminar vein and direct continuity of a superonasal retinal detachment with a large pars plana cyst was observed. The proteinaceous material in the anterior chamber, ciliary body cysts, choroid and ciliary body, subretinal, and subretinal pigment epithelial areas was identified as immunoprotein using an immunoperoxidase technique.

Aneurysm↗