Search PubMed⌕ Search

Biomedical subjects

U Rehany

Publications and source records attributed to U Rehany.

At least 37 records · Page 2Linked to original sources
PubMed1999

Diagnosis of chlamydial infection by direct enzyme-linked immunoassay and polymerase chain reaction in patients with acute follicular conjunctivitis.

BACKGROUND: Acute follicular conjunctivitis is a clinical diagnosis common to multiple etiologies, of which chlamydial infection requires specific antibiotic treatment. PURPOSE: This prospective study was designed to evaluate Chlamydia trachomatis as the cause of acute follicular conjunctivitis by two sensitive tests: direct enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR). METHODS: Conjunctival scrapings from patients presented with untreated acute follicular conjunctivitis were examined by ELISA and PCR, and patients were followed up for prolongation of the disease course. RESULTS: All 36 consecutive patients presented with acute follicular conjunctivitis were negative for Chlamydia trachomatis by ELISA and PCR. None of the patients had a prolonged course of more than 4 weeks or required treatment with systemic antibiotics as would be expected from chlamydial infection. CONCLUSIONS: Chlamydia trachomatis was probably not responsible for the acute follicular conjunctivitis in this series, and ELISA and PCR may not be cost effective for evaluation of acute follicular conjunctivitis due to chlamydial infection. Further evaluation of the cost effectiveness of these tests is required in chronic follicular conjunctivitis.

Acute Disease↗
PubMed1999

Aggressive systematic treatment for central retinal artery occlusion.

PURPOSE: To report the efficacy of an aggressive systematic regimen for the treatment of acute nonarteritic central retinal artery occlusion (CRAO). METHODS: Eleven patients who had unilateral CRAO with symptoms of fewer than 48 hours' duration were treated with an aggressive stepwise systematic regimen until retinal circulation improved or until all the treatment steps were performed. Five patients with unilateral CRAO and symptoms of fewer than 48 hours' duration were treated in the same institution in an arbitrary nonsystematic manner. The therapeutic steps of the aggressive treatment included ocular massage, sublingual isosorbide dinitrate, intravenous acetazolamide, intravenous mannitol or oral glycerol, anterior chamber paracentesis, intravenous methylprednisolone followed by streptokinase, and retrobulbar tolazoline. After each step, retinal flow was evaluated by three-mirror contact lens. The nonsystematic treatment was arbitrary and included one or several of the above. Visual acuity and complete eye examination data were recorded before and after treatment. RESULTS: Visual acuity and retinal arterial supply were improved in eight (73%) of the 11 patients treated in the stepwise systematic manner. All eight patients in whom visual acuity improved had symptoms for fewer than 12 hours, and the presumed cause was either platelet-derived or cholesterol embolus from atheroma or the patients had glaucoma. Patients in whom visual acuity did not improve had CRAO that was attributed to calcified emboli or primary antiphospholipid antibody syndrome and had symptoms more than 12 hours before treatment. Visual acuity did not improve in all five patients with the nonsystematic treatment regardless of the presumed cause or duration of the occlusion. The success of the treatment in the systematic treatment group was statistically significantly better compared with the outcome of the nonsystematic treated group (Fischer exact test, P = .01). CONCLUSIONS: In the treatment of CRAO, an aggressive systematic regimen including medical and mechanical means may reestablish retinal circulation and improve visual outcome. The cause of arterial occlusion, the nature of occlusive emboli, and the duration of retinal ischemia may determine the visual outcome, but a larger series is warranted to verify the effectiveness of the treatment and the prognostic factors.

Acetazolamide↗
PubMed1999

Iridocorneal melanoma associated with type 1 neurofibromatosis: a clinicopathologic study.

OBJECTIVE: A clinicopathologic study of an iridocorneal melanoma associated with type 1 (peripheral) neurofibromatosis is presented. DESIGN: Case report with clinicopathologic correlation. PARTICIPANT: A 32-year-old white woman with type 1 neurofibromatosis presented with long-standing blindness of her right eye due to diffuse intrastromal brown corneal discoloration. INTERVENTION: The patient underwent penetrating keratoplasty and the corneal button was inspected. RESULTS: Histopathologic evaluation of the corneal button after penetrating keratoplasty revealed an intrastromal mixed-type malignant melanoma, which stained positively with HMB-45 and S-100 protein and spared the corneal epithelium and limbus. The corneal graft remained transparent, with best-corrected visual acuity of 20/30. Twenty-two months after surgery, the tumor involved the anterior chamber angle and the iris. Three years later, it caused refractory glaucoma necessitating enucleation. The iris tumor did not extend beyond the iris-lens diaphragm and showed the same cytologic features as the corneal stromal tumor. CONCLUSION: To our best knowledge, this is the first report of iridocorneal melanoma associated with peripheral neurofibromatosis. The location of the tumor in the deep corneal stroma, without initial macroscopic involvement of the angle or iris, may suggest that the corneal portion of the tumor may have developed "in situ" rather than as an extension of iris melanoma. The common origin of melanoma cells and Schwann cells from the neural crest and the proliferation of the Schwann cells in neurofibromatosis provides additional support for this hypothesis.

Adult↗
PubMed1999

Congenital unilateral buphthalmos in Walker-Warburg syndrome: a clinicopathological study.

BACKGROUND AND PURPOSE: Walker-Warburg syndrome is a congenital autosomal recessive oculocerebral disorder characterised by hydrocephalus, brain agyria, microphthalmos and retinal dysplasia with or without meningoencephalocele. We describe an unusual finding of congenital unilateral glaucoma and buphthalmos in one eye and microphthalmos in the fellow eye of two neonates with Walker-Warburg syndrome. PATIENTS: Two neonates with Walker-Warburg syndrome and unusual findings of buphthalmos in one eye and a microphthalmic fellow eye are presented. RESULTS: Histological examination of the buphthalmic eyes revealed the presence of mesenchymal tissue in the anterior angle covered by endothelium. No anterior chamber angle was identified in the microphthalmic fellow eye and the iris was adherent to the corneal periphery. CONCLUSIONS: Congenital buphthalmos may also appear in Walker-Warburg syndrome. The buphthalmos may result from later embryonal ocular developmental arrest than that of the microphthalmic eye.

Abnormalities, Multiple↗
PubMed1998

Ocular trauma following penetrating keratoplasty: incidence, outcome, and postoperative recommendations.

BACKGROUND: The surgical wound after penetrating keratoplasty is more vulnerable to contusive trauma than the intact cornea. OBJECTIVES: To assess the incidence of ocular trauma following penetrating keratoplasty, and to evaluate its causative factors, management, and visual outcome. SETTING: Tertiary referral facility in a fairly closed population. METHODS: Retrospective study assessing ocular injuries of all 559 patients who underwent penetrating keratoplasty in the center between September 1986 and March 1993. RESULTS: Fourteen (2.5%) of 559 patients who underwent penetrating keratoplasty, over a period of 78 months, suffered surgical wound dehiscence because of contusive ocular trauma. The mean age of the patients (30.6 years) was significantly lower (P<.001) than that of the total number of patients who received transplants (49 years). The interval between transplantation and trauma ranged from 2 weeks to 2 years (mean interval, 6.7 months). In 11 of the 14 patients the trauma occurred prior to removal of sutures. Globe rupture occurred at the donor-recipient interface in all of the patients, accompanied by vitreous and lens loss in 8 patients (57%). In 2 patients (14%) trauma included disruption of retinal tissue resulting in poor visual outcome. The trauma occurred most often at home (in 7 patients). After follow-up periods of 1 to 6 years (mean, 29 months), the corrected visual acuity ranged from 20/120 to 20/20 in 12 patients (86%). CONCLUSIONS: Ocular injury following penetrating keratoplasty is not a rare event. Since corneal graft wound is vulnerable to ocular trauma, we recommend the constant use of protective eyewear and periodically instruct the patients on the long-term vulnerability of the graft wound. Patients should be repeatedly cautioned against high-risk environments and strenuous activity.

Adolescent↗
PubMed1998

Implantation of glaucoma drainage implant tube into the ciliary sulcus in patients with corneal transplants.

The placement of glaucoma drainage implants may be complicated by tube-corneal touch and endothelial decompensation, particularly after corneal transplantation. We describe an innovative surgical approach to glaucoma drainage implant procedures that may decrease such complications. The approach involves placement of the shunt tube into the ciliary sulcus. This approach may serve as an alternative to anterior chamber angle or pars plana implant placement in pseudophakic or aphakic eyes with refractory glaucoma and a high risk for corneal decompensation.

Adult↗
PubMed1998

Sneddon's syndrome: neuro-ophthalmologic manifestations in a possible autosomal recessive pattern.

Sneddon's syndrome is a rare neurodermatologic disorder that is manifested by multiple cerebrovascular accidents and livedo reticularis. The authors describe two siblings from one family with Sneddon's syndrome, suggesting autosomal recessive inheritance. The propositus presented with internuclear ophthalmoplegia and ophthalmic artery occlusion. These manifestations as well as the autosomal recessive inheritance have not yet been reported in Sneddon's syndrome.

Adolescent↗
PubMed1997

Solitary extranodal anaplastic large cell lymphoma, Ki-1+, of the eyelid.

PURPOSE: To report a rare case of solitary anaplastic large cell lymphoma, Ki-1+, of the eyelid. METHOD: Case report. A firm ulcerated mass of the lower eyelid in a 10-year-old boy was the initial and only sign of anaplastic large cell lymphoma. RESULTS: A local excision of the mass was performed. Histologic examination disclosed large lymphoid anaplastic cells that reacted positively for T-cell markers and CD30 antigen. CONCLUSION: A solitary eyelid mass can be an initial sign of anaplastic large cell lymphoma in children.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Lenticular astigmatism after penetrating eye injury.

Lenticular astigmatism of 5.00 diopters developed after penetrating injury in the eye of a 16-year-old boy. Full visual acuity, refraction, and crystalline lens clarity remained stable for more than 2 years. The high astigmatism, in conjunction with a spherical cornea and posterior lens capsule striae, indicates the lenticular origin of the astigmatism.

Adolescent↗
PubMed1996

A donor corneal patch graft for an incompetent scleral flap following trabeculectomy.

Prolonged postoperative hypotony may complicate filtration surgery, especially in conjunction with mitomycin-C. Incompetence of the scleral flap is one of the etiologic factors of hypotony. A persistent leak from an incompetent or traumatized scleral flap may necessitate surgical intervention, including patching techniques. To the best of the authors' knowledge, the following is the first report on using a partial-thickness corneal allograft as a patch for an incompetent and leaking scleral flap.

Aged↗
PubMed1995

Corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus in children.

BACKGROUND: The onset of keratoconus usually coincides with adolescence, and may be associated with vernal conjunctivitis or other atopic conditions. In patients with vernal conjunctivitis, acute hydrops may be the presenting sign of keratoconus in preadolescence. METHODS: Review of ophthalmic clinical manifestations of three children with presenting symptoms and signs of acute corneal hydrops associated with vernal conjunctivitis. RESULTS: Three children, 5 to 11 years of age, presented with corneal hydrops associated with mild vernal conjunctivitis. In two of these children, vernal conjunctivitis was asymptomatic, and in one child the signs of vernal conjunctivitis appeared after the occurrence of hydrops. No other factors, including mechanical factors such as eye rubbing, were found to be related. CONCLUSIONS: The association of vernal conjunctivitis with keratoconus may contribute to the early occurrence of hydrops. Corneal hydrops in children may, therefore, indicate coexisting vernal conjunctivitis.

Child↗
PubMed1994

Clostridium bifermentans panophthalmitis after penetrating eye injury.

BACKGROUND: Intraocular and orbital anaerobic infections usually result from penetrating eye injuries with soil-contaminated foreign bodies. The outcome of these infections almost always has been loss of the globe, despite appropriate antibiotic and surgical treatment. The most prevalent etiologic microbe of anaerobic panophthalmitis is Clostridium perfringens. CASE REPORT: To the authors' knowledge, this is the first report of panophthalmitis caused by Clostridium bifermentans after penetrating eye injury. The patient had severe signs and symptoms of intraocular and orbital infection, with early total loss of visual function. Parenteral and intravitreal therapy with penicillin and clindamycin, administered according to antibiotic sensitivity studies of cultures from the anterior chamber and vitreous, did not restore vision. CONCLUSIONS: Due to the early devastating outcome, penetrating eye injuries with soil-contaminated foreign bodies should be regarded as being at high risk for clostridial infection and should be treated promptly with vitrectomy and antibiotic therapy for aerobic and anaerobic infection.

Adolescent↗
PubMed1994

Suppression of corneal allograft rejection by systemic cyclosporine-A in heavily vascularized rabbit corneas following alkali burns.

Immunologic rejection is the main cause of corneal graft failure, especially in vascularized corneal beds. The purpose of this study was to investigate the effect of systemic Cyclosporine-A (CsA) on the survival of corneal allografts in heavily vascularized rabbit corneal beds, following alkali burn. Heavy corneal vascularization was induced in one eye of 20 rabbits by alkali burn. Forty-five days later, penetrating keratoplasty was performed in all the heavily vascularized corneas. Twenty-five mg/kg/day of CsA was intramuscularly administered to 10 rabbits for 30 days. The other 10 rabbits were treated with the solvent without CsA and were used as a matched control group. The results show a significant difference in corneal allograft survival between the two groups. All corneal grafts in the untreated group were intensely rejected and vascularized within 3 weeks. Nine of the 10 corneal transplants, in the CsA-treated group, remained transparent without signs of immunologic rejection for > 180 days. In one corneal transplant, minor signs of rejection occurred. We suggest that CsA, when given systemically, is a potent drug in the prevention of immunologic rejection in high-risk corneal transplantations, such as allografts, in heavily vascularized corneas following alkali burn.

Animals↗
PubMed1984

In vitro incorporation of proline into keratoconic human corneas.

Corneal buttons were obtained from four young adults with advanced keratoconus following perforating keratoplasty. The corneal buttons were incubated in organ culture media containing 3H-proline. Autoradiographs of corneal sections showed that the incorporation of the radioisotope was significantly higher in all layers of the kerotoconic corneas than that found in the normal controls, indicating an increased protein biosynthesis in the former. It is suggested that in spite of the found increased synthetic activity, slow destruction and thinning of the cornea in keratoconus might occur as the result of inadequate compensation for tissue loss due to increased collagenolytic activity in the disease.

Adult↗