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Biomedical subjects

R Sundmacher

Publications and source records attributed to R Sundmacher.

At least 145 records · Page 8Linked to original sources
PubMed1991

[Clinical follow-up, histologic findings and therapeutic problems in a patient with bilateral ulcus rodens Mooren].

A severe, spontaneously acquired, bilateral, sight threatening Ulcus rodens Mooren of a 31 years old type I diabetic will be demonstrated in its clinical course. An improvement was achieved by a systemic immunomodulating therapy with Ciclosporin A that had to be tapered after 3 weeks due to severe side effects. The exclusive local therapy showed no effect at all. Later, the patient underwent a penetrating keratoplasty and extracapsular cataract extraction of both eyes under systemic Ciclosporin A therapy. The graft of the left eye failed due to a foudroyant bacterial infection whereas the keratoplasty of the right eye was successful up to this day despite of various complications.

Adult↗
PubMed1991

[Local prevention with interferon of "epidemic" conjunctivitis caused by a currently unidentifiable virus].

Topical Interferon application did effectively interrupt the further clinical spread of a highly contagious viral keratoconjunctivitis. A total of 130 endangered inpatients, still free from symptoms, were treated with one drop per eye daily for a period of 12 days. 123 patients stood free from any further infection. Only during the first two days after the beginning of the Interferon prophylaxis 7 inpatients showed an acute viral keratoconjunctivitis still. Obviously these patients were infected prior to the prophylactic therapy and were just in the incubation period. We conclude that Interferon eye drops (one drop per eye daily) may offer a reliable protection from exogenous viral infection. Certainly this protection comes too late if the patient's incubation period has already started.

Adenovirus Infections, Human↗
PubMed1991

[Contusion-induced traumatic aniridia].

Total aniridia occurred after a severe blow on the eyeball of a 65 year old man. The entire iris was torn off the ciliary body and escaped out of the eye through a small corneal wound. The zonular fibres were found to be intact and the posterior parts of the eye showed no traumatic changes.

Aged↗
PubMed1991

[Keratoplasty in infancy and early childhood with special reference to the auto-rotation technique].

Between January 1987 and August 1990, a total of 20 keratoplasties were performed in infants and children in the University Eye Hospital, Düsseldorf, accounting for 4% of all keratoplasties during this period. The indications included malformations of the anterior segment and central corneal opacities, mostly of herpetic or microbial etiology. The ages of the patients varied from 2 weeks to 6 years, and the cases were followed up for an average of 2 years. Five (25%) were treated with the autorotation technique. Visual acuity after surgery was satisfactory, although an irregular astigmatism was found in three cases and one child eventually had to have a contact lens fitted. In view of our encouraging results we recommend that ipsilateral rotational autokeratoplasties should be considered more often for suitable forms of central corneal opacyty, particularly for infants and children.

Child, Preschool↗
PubMed1991

[Chronic recurrent polychondritis. The spectrum of eye involvement].

Chronic relapsing polychondritis is a rare connective tissue disease of presumed autoimmunologic pathogenesis. It may involve multiple organ systems. The most characteristic signs are: relapsing inflammation of the cartilage of the outer ear, non-erosive polyarthritis, chondritis of the nasal cartilage, inflammation of different ocular tissues, inflammation of tracheal and bronchial cartilages and lesions of the inner ear. The wide range of ocular tissue involvement is discussed on the basis of two new cases with emphasis on scleritis, episcleritis, keratitis and chorioretinal involvement. Ocular disease complications that have not been published before are the massive development of subretinal stands following multiple intra- and subretinal infiltrates in the posterior pole connecting areas of chorioretinal scars. The importance of high-dose, long-term steroid therapy is stressed. In addition to steroids, immunosuppressive agents such as azathioprine and cyclophosphamide are sometimes mandatory to cope with severe multi-organ disease. Another option in very severe relapses may be plasma separation to improve the condition rapidly until drug therapy can be effective.

Adult↗
PubMed1990

Evidence for cytomegalovirus and human immunodeficiency virus infection of the retina in AIDS.

Characteristic ophthalmopathological features of retinal lesions in a patient with the acquired immunodeficiency syndrome (AIDS) are reported. In situ hybridization, immunohistochemistry and electron microscopy revealed severe unilateral cytomegalovirus (CMV) retinitis. The opposite retina which was not involved by CMV showed nonspecific signs of ischaemia in the nerve fiber layer corresponding to cotton-wool spots. Occasional cells of both retinas were positively stained by a mouse monoclonal antibody to the p24 HIV-1 antigen indicating infection of retinal cells by HIV. It is suggested that HIV may directly or indirectly damage retinal tissue and interact with opportunistic pathogens, thus leading to a variety of ocular abnormalities associated with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Preventive systemic cyclosporin A in risk keratoplasty].

Systemic cyclosporin A prophylaxis was applied in 18 high-risk corneal transplants. Immunoreactions occurred in three cases. They correlated with too low serum level of cyclosporin A. Two of them could be reversed by an increase of cyclosporin A dosage in combination with an intensive corticosteroid therapy. Four corneal transplants failed from persistent severe basic disease. Eleven corneal transplants remained clear during the follow-up (5-33 months). A constant trough cyclosporin A serum level of 100-120 ng/ml has been shown to exert efficient immunomodulating effects. We currently judge a postoperative prophylaxis period of 6 to 12 months with cyclosporin A to be sufficient in most high-risk cases.

Administration, Oral↗
PubMed1990

[Keratoplasty. Progress and distant goals].

Rapid practical progress in perforating keratoplasty has been achieved in the prophylaxis and therapy of immune reactions and herpes recurrences, as well as in intraocular lenses and eye banks. In other areas like normal transplant optics, normally surviving transplant endothelium and epithelium, the recurrence of epithelial dystrophies and the functional equivalence of lamellar transplants, progress has been limited and will presumably be slow despite all efforts.

Combined Modality Therapy↗
PubMed1989

[The significance of herpesviridae in ophthalmology].

Herpesviruses are the most common causes of infection-related loss of vision or blindness in our part of the world. A better understanding of the underlying pathophysiology, together with major pharmaceutical advances have led to medical and surgical therapy which enables us to preserve or restore useful vision in most patients.

Eye Infections, Viral↗
PubMed1989

Primary intracerebral malignant lymphoma presenting with ophthalmological symptoms: bioptical and autoptical case study.

A case of primary malignant lymphoma of the brain with preceding first unilateral, then bilateral uveitis and retinochorioiditis is presented. The diagnosis was established on brain biopsy material using immuno-histochemical methods. The autopsy disclosed a polymorphous immunocytoma with bilateral brain involvement including structures of the posterior optic pathways. Clinical and pathogenetic implications regarding this "oculo-cerebral type" of malignant lymphoma, which has been only seldom reported in the literature are discussed.

Brain Neoplasms↗
PubMed1989

Topical BVDU plus low-dosage steroids in the treatment of chronic relapsing zoster keratouveitis. A pilot study.

A therapeutic trial with topical bromovinyldeoxyuridine (BVDU) plus low-dosage steroids was conducted in five patients with chronic zoster keratouveitis, who had previously received topical acyclovir (ACV) and steroids. In all cases, BVDU (plus steroids) was found to be superior to ACV (plus steroids). Yet BVDU was not able to keep the patients from having chronic relapsing varicella-zoster keratouveitis. This can probably be explained by pathophysiological reasons, i.e., the persistence and low-grade multiplication of the varicella-zoster virus in peripheral eye tissues during the chronic carrier stage. It is possible that this chronic carrier status could be obviated by vigorous antiviral treatment during the acute phase of the illness.

Administration, Topical↗
PubMed1989

[Bacteriologic and serologic studies].

With many infectious eye diseases, the practising ophthalmologist is faced by the question as to whether a serologic or microbiologic work-up pays off in terms of greater diagnostic or therapeutic efficiency. A critical appraisal indicates that on average, they are relatively insignificant, and so some time and money could probably be saved. Important exceptions to the rule are discussed separately.

Antibodies↗
PubMed1988

[Electroretinography in AIDS retinopathy and AIDS cytomegalovirus retinitis with ganciclovir therapy].

Electroretinographic (ERG) investigations were performed in three AIDS patients. The first had cotton wool-like spots in both eyes (AIDS "retinopathy"). The second presented with the same changes in his right eye and an acute cytomegalovirus (CMV) in his left eye. In the third patient signs of healed peripheral retinochoroiditis were found. In CMV retinitis the retinal damage demonstrated by ERG correlated well with the ophthalmoscopic findings. As the ERG improved concurrently with Ganciclovir therapy, retinal function can be monitored by means of ERG controls. In the cases of AIDS "retinopathy" with only a few cotton wool-like spots and with healed peripheral retinochoroiditis, pronounced changes in the ERG were seen regularly; these were most probably caused by ischemia of the inner retinal layers.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Clinical aspects of herpetic eye diseases.

Diagnosis and treatment of herpes simplex virus eye diseases has benefitted from a vast amount of clinical and experimental studies. In this short presentation reference can only be made to some fields, which may illustrate--pars pro toto--the progress achieved during the last years. Clinico-virological correlation studies have led to a better understanding and classification of different typical clinical pictures, especially those affecting the structures of the anterior chamber: endotheliitis trabeculitis, and focal serous iritis. Antiherpetic drugs have become available which do not only penetrate the cornea in sufficient amounts but can also be used systemically. This will lead to a new role of steroids in the treatment of intraocular herpetic diseases. The combination of high-titer human interferon eye drops with a basic therapy of topical antiviral agents has considerably improved therapeutic results in dendritic keratitis.

Adrenal Cortex Hormones↗