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Biomedical subjects

R Y Foos

Publications and source records attributed to R Y Foos.

At least 91 records · Page 5Linked to original sources

Vitreous cylinders.

Vitreous cylinders, a rarely discussed ophthalmologic entity, were studied in two clinical cases and in five enucleated eyes. The cylinders were found in four cases of ocular toxoplasmosis, one case of vitreous hemorrhage complicating a malignant melanoma, and one case of pars planitis and one of uveitis, both of unknown causes. Results of scanning electron microscopy in one specimen suggested that cylinders are formed by condensation of vitreous collagen fibers. We emphasize the nonspecific nature of this interesting vitreous finding.

Aged↗

Fungal endophthalmitis following intraocular lens implantation. A surgical epidemic.

Thirteen cases of fungal endophthalmitis were caused by Paecilomyces lilacinus. In all cases an intraocular lens was inserted that had been sterilized in sodium hydroxide and neutralized in sodium bicarbonate. In 12 of the 13 cases, it was absolutely determined that a manufacturer's lot 128 was the neutralizing solution used. The same fungus that caused the endophthalmitis was cultured from several of the neutralizing solutions from lot 128. Eight of the 13 eyes eventually required enucleation. Of the remaining five eyes, one eventually recovered 20/25 vision, one recovered 20/80 vision, one had light perception, and two lost light perception (one of these became phthisical). This surgically induced epidemic of fungal endophthalmitis clearly shows the major consequences of a breakdown in quality control for any substance or material used intraocularly.

Aged↗

Experimental tractional retinal detachment in rabbits. Clinical picture and histopathologic features.

A simple reproducible model for the creation of tractional retinal detachments in rabbits is presented. This model comprises retinal membranes composed of different cell types derived from ocular tissues, and eliminates the need for lengthy and expensive tissue culturing procedures. The injected cell bolus rapidly migrates to the optic disc and forms surface retinal membranes. These lead to tractional retinal detachment confined to the area of the vascular medullary rays. The rapidity and severity of the clinical process seems to be directly dependent upon the number of cells injected. Good visibility of the posterior pole is maintained throughout the course of the development of detachment. This model is acceptable for testing agents to suppress intraocular cellular proliferation. It can also serve to teach surgical techniques for the management of vitreo-retinal membranes without endangering human eyes.

Animals↗

Leukemic iris infiltration.

A 7-year-old boy with acute lymphocytic leukemia developed iris infiltration, blood-streaked hypopyon, and high intraocular pressure. A diagnostic anterior chamber paracentesis was performed, which provided a cytologic diagnosis. The aspirate was studied by both the millipore filter technique with Papanicolaou stain and a dried smear using the Wright's stain. Wright's stain provided more distinct cellular details. Irradiation of the anterior segment resulted in clearing of leukemic iris infiltration, hypopyon, and glaucoma.

Adrenal Cortex Hormones↗

Malignant melanoma. Analysis of an autopsy population.

This report analyzes 92 malignant melanoma cases from a series of 12,383 consecutive autopsies. There were 12 cases of primary ocular malignant melanoma, 76 cases of primary nonocular malignant melanoma, and 4 cases of unknown primary site. Subjects with malignant melanoma were characterized by age, sex, and race; metastatic disease patterns as well as survival periods were analyzed. In the 12 ocular malignant melanoma cases, tumor size, cell type, and survival were considered. Discussion is concerned with the distribution of primary tumor site, the location of metastatic lesions secondary to malignant melanoma, and survival in cases with primary ocular malignant melanoma.

Adolescent↗

Posterior vitreous detachment in diabetic subjects.

Posterior vitreous detachment (PVD) and vitreous synchysis were studied in autopsied diabetic subjects and compared with general autopsy population. PVD was significantly more common in diabetics, including eyes with no retinopathy. Synchysis in diabetics increased with age and with PVD, but was less than in non-diabetics for given age and PVD status. We conclude that synchysis contributes to the precocious and exaggerated PVD in diabetics, but other factors are operative.

Adult↗

Infantile cystoid maculopathy.

Three premature infants with no family history of eye disease showed bilateral cystoid maculopathy on post-mortem examination. These macular lesions are indistinguishable macroscopically from the macular lesions of sex-linked juvenile retinoschisis. Cystoid change was observed at various vertical retinal levels. The oldest child had a schisis cavity within the nerve fibre layer. All cases had reduced numbers of retinal ganglion cells and central nervous system (CNS) abnormalities. The authors believe these are the first reported cases of a cystoid macular lesion present at birth and the first description of the pathological features of a cystoid macular lesion in infants.

Central Nervous System Diseases↗

Donor eye program.

Explore the source record for details and available documents.

Academic Medical Centers↗

Orbital embryonal rhabdomyosarcoma and intracranial schwannoma.

A 39-year-old woman had a large benign intracranial schwannoma of the Gasserian ganglion. Thirty-two years previously, she had an embryonal rhabdomyosarcoma of the orbit. She had been treated by enucleation, local excision, and low-dose supplemental irradiation (1,400 rads). This is the longest survival of which we are aware following any treatment modality in such tumors. No correlation between the two tumors has been established.

Adult↗

Coronal adenomas.

The incidence and morphologic features of coronal adenomas, benign epithelial tumors of the ciliary processes, were studied in 500 autopsy cases. Macroscopically, coronal adenomas are white, globular, often cystic in appearance, of limited growth potential, and found only on the ciliary processes. Microscopically, they contain convoluted sheets or tubes of nonpigmented epithelium, between which are found varying amounts of amorphous eosinophilic, PAS-positive, extracellular material. Coronal adenomas were present in 153 (31%) of 500 cases, were bilateral in 23 (15%), and were thus present in 176 (18%) of the 1,000 eyes examined. Two clinically important complications of coronal adenomas were found, sectoral cataracts and misdiagnosis as iris tumor.

Adenoma↗

Opticociliary veins in a primary optic nerve sheath meningioma.

A 59-year-old man developed painless visual loss in his left eye over a one-year period, with rapid progression to blindness over three months. Ocular examination of the left eye revealed proptosis, marked optic disk pallor, dilated retinal veins, and congeries of vessels at the disk margin (opticociliary veins). His right eye was unremarkable. Fluorescein angiography and histopathologic examination confirmed the presence of opticociliary veins communicating between branches of the central retinal vein and the adjacent choroidal vasculature. Primary orbital optic nerve meningioma associated with opticociliary veins was diagnosed.

Cranial Nerve Neoplasms↗

Myelinated retinal nerve fibers associated with ipsilateral myopia, amblyopia, and strabismus.

Four patients had extensive unilateral myelinated nerve fibers associated with ipsilateral myopia, amblyopia, and strabismus. Their profound visual impairment, exotropia, and the early age onset of symptoms indicated that the amblyopia may have been organically caused. Prognosis is poor for even partial correction but good results have been obtained with intense therapy that includes full correction of the refractive error in each eye and extraocular muscle surgery if cosmetically necessary. In patients with axial myopia, images of a similar size will be produced by placing a lens of the correct power at the spectacle plane. In younger patients, a contact lens should not be used to correct the refractive error because it creates an undesirable anisometropia. Younger patients who have parafoveal fixation and no strabismus respond best to amblyopia therapy.

Adolescent↗

Metastatic tapioca iris melanoma.

A case of metastatic tapioca melanoma of the iris in a 12-year-old girl is reported. The patient had heterochromia, a red painful eye, and was treated for iritis with secondary glaucoma. In the course of 5 months iris lesions with the clinical appearance of tapioca pudding developed, and biopsy disclosed a melanoma. The eye was immediately enucleated, and pathological examination showed a melanoma with predominantly epithelioid-type cells which had infiltrated the angle, the posterior chamber, and the surgical wounds. Conjunctival extension was noted 10 months after enucleation, and regional lymph node metastases were found 4 months later. Previously reported cases are reviewed and compared with the present case.

Child↗

Retinal holes.

Holes of the peripheral retina, defined as full-thickness breaks of trophic origin with no associated flap or free operculum, were found in 136 (2.4%) eyes from 2,800 autopsied subjects. Primary retinal holes (those with no indication of a proximal causative lesion and with no lattice degeneration in either eye) occurred in only eight of the 5,600 eyes studied; all were unilateral, single, less than 0.25 disk diameter in size, within the basal zone, and in eyes from elderly subjects. Secondary holes were found in 128 (2.3%) of eyes and of these, lattice degeneration was the most common cause (103). Other lesions complicated by hole formation included zonular traction tufts (10), chorioretinitis (9), meridional folds (3), and pavingstone degeneration (2). Retinal holes in surgically aphakic eyes did not differ qualitatively or quantitatively from those in age-matched phakic eyes.

Adult↗

Vitreoretinal juncture over retinal vessels.

Previous studies have attributed changes in the retinal surface over or adjacent to large superficial retinal vessels to a variety of conditions, the most common being 'anomalous vitreoretinal attachments.' The fundamental nature of the lesions and their pathogenesis, however, has remained controversial. The present study was undertaken to categorize the ultrastructural alterations of the vitreoretinal juncture over retinal vessels in the posterior fundus of man, and to clarify the relationship of these fundamental changes to clinically significant lesions in this region. Results show no difference in vitreoretinal, or more specifically vitreolaminar attachments over vessels when compared with adjacent regions. The cause of the more significant anomalies, notably surface breaks and their sequelae, is apparently multifactorial and related to a sequence of events. Initially three events predispose to or cause small surface breaks: developmental thinning of the inner limiting lamina; subsurface retinal degeneration; and transmigrating macrophages. These small surface breaks, when complicated by vitreous incarceration or by simple epiretinal membrane formation, can during posterior vitreous detachment cause peeling of the retinal surface, and the resulting large surface breaks may in turn provoke more complex proliferative lesions of the vitreoretinal juncture.

Adult↗