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At least 919 records · Page 51Linked to original sources
PubMed1985

[Drug treatment of inflammatory and infectious endogenous inflammations of the eye].

In many cases antibiotic treatment is indicated; steroids are not always needed. In special cases of uveitis (Behcet's syndrome, sympathetic ophthalmia, anterior uveitis in children with JRA) cytostatic treatment seems justified. Inflammations of the optic disk and nerve require very extensive diagnostic evaluation. Medical treatment is usually limited to steroids, administered systemically and locally; however, its efficacy is still a matter of debate.

Adult↗
PubMed1980

[Failures of cytostatic treatment in ophthalmology (author's transl)].

At the Department of Ophthalmology of the Univeristy of Zurich, cytostatic drugs have been used since 1962 for the treatment of various eye conditions: 16 keratoplasties, 11 cases of degenerative or proliferative eye disease, six cases of retinal vasculitis and 147 of uveitis (sympathetic ophthalmia, Behcet, chronic cyclitis, rheumatoid infantile uveitis etc. After a few rather unsatisfactory trials with methotrexate and azathioprine, a routine therapy combining cyclophosphamide and procarbazine was established. Of the 29 failures (16.1%) six were in the group of keratoplasties (37.5%!), three in cases of degenerative disease, three in the six vasculitis cases, and only 17 in the 147 cases of uveitis. The main cause of failure in corneal grafts was pre-existent vascularization, and in uveitis belated commencement of therapy. In cases where blindness threatens immunodepressors should be administered as early as possible. In the 180 cases reported here, these drugs did not produce any serious complications.

Adult↗
PubMed1977

The lifetime health-monitoring program. A practical approach to preventive medicine.

Current patterns of health care and its financing need to be improved by the incorporation of cost-effective and health-effective preventive measures. As a stimulus for further development, we propose a Lifetime Health-Monitoring Program that uses clinical and epidemiologic criteria to identify specific health goals and professional services appropriate for 10 different age groups. During infancy, for example, we recommend seven immunizations, tests to detect anemia, hemorrhagic diseases, phenylketonuria and developmental deficiencies, and routine prophylaxis of gonorrheal ophthalmia. In the age group 40 to 59, tests for hypertension, cervical, mammary, and gastrointestinal cancer, and control of obesity and smoking are in order. The cost of such preventive measures. which should not be prohibitive, must be covered by health-insurance programs, whether based on fee-for-service or capitation. The program suggested, by incorporating prevention into day-to-day care, should strengthen the patient-physician relation.

Adolescent↗
PubMed2001

Randomized trial of presumptive sexually transmitted disease therapy during pregnancy in Rakai, Uganda.

OBJECTIVE: The purpose of this study was to assess presumptive sexually transmitted disease treatment on pregnancy outcome and HIV transmission. STUDY DESIGN: In a randomized trial in Rakai District, Uganda, 2070 pregnant women received presumptive sexually transmitted disease treatment 1 time during pregnancy at varying gestations, and 1963 control mothers received iron/folate and referral for syphilis. Maternal-infant sexually transmitted disease/HIV and infant outcomes were assessed. Intent-to-treat analyses estimated adjusted rate ratios and 95% confidence intervals. RESULTS: Sexually transmitted diseases were reduced: Trichomonas vaginalis (rate ratio, 0.28; 95% CI, 0.18%-0.49%), bacterial vaginosis (rate ratio, 0.78; 95% CI, 0.69-0.87), Neisseria gonorrhoeae /Chlamydia trachomatis (rate ratio, 0.43; 95% CI, 0.27-0.68), and infant ophthalmia (rate ratio, 0.37; 95% CI, 0.20-0.70). There were reduced rates of neonatal death (rate ratio, 0.83; 95% CI, 0.71-0.97), low birth weight (rate ratio, 0.68; 95% CI, 0.53-0.86), and preterm delivery (rate ratio, 0.77; 95% CI, 0.56-1.05); but there were no effects on maternal HIV acquisition or perinatal HIV transmission. CONCLUSION: Reductions of maternal sexually transmitted disease improved pregnancy outcome but not maternal HIV acquisition or perinatal HIV transmission.

Azithromycin↗
PubMed2004

Seasonal epidemic of ocular caterpillar hair injuries in the Kangra District of India.

PURPOSE: To report a rare seasonal occurrence of ocular caterpillar hair injuries (ophthalmia nodosa) in epidemic proportions in the Kangra district of Himachal Pradesh, India. METHODS: 136 patients with pain, redness and a foreign body sensation in their eyes were examined and treated for caterpillar hair injury in a short span of 6 months. RESULTS: The pattern of corneal abrasions was very useful in indicating the presence and location of the setae. All the cases resolved with no sequelae. The intra-corneal hair remained inert on long term follow-up. CONCLUSIONS: Creating awareness about these injuries among the medical staff and the general public is necessary for proper control and management.

Adolescent↗
PubMedDate not supplied

Vogt-Koyanagi-Harada disease.

Vogt-Koyanagi-Harada disease (VKH) is a multisystem autoimmune disorder principally affecting pigmented tissues in the ocular, auditory, integumentary and central nervous systems. Patients are typically 20 to 50 years old and have no history of either surgical or accidental ocular trauma. Pigmented races are more commonly affected. Depending on revised diagnostic criteria, the disease is classified as complete, incomplete or probable based on the presence of extraocular findings (neurological, auditory and integumentary). The clinical course of VKH is divided into four phases: prodromal (mimics a viral infection), uveitic (bilateral diffuse uveitis with papillitis and exudative retinal detachment), convalescent (tissue depigmentation), and chronic recurrent (recurrent uveitis and ocular complications). The pathogenesis of VKH is thought to be related to an aberrant T cell-mediated immune response directed against self-antigens found on melanocytes. VKH has been linked to human leukocyte antigen DR4 (HLA-DR4) and HLA-Dw53, with strongest associated risk for HLA-DRB1*0405 haplotype. The diagnosis of VKH is clinical, and differential includes sympathetic ophthalmia, sarcoidosis, primary intraocular B-cell lymphoma, posterior scleritis, and uveal effusion syndrome. Treatment is typically initiated with high-dose oral corticosteroids, but other immunomondulatory agents (most oftentimes cyclosporine) may be needed for non-responsive patients or when corticosteroid side-effects are not tolerated. Visual prognosis is generally good with prompt diagnosis and aggressive immunomodulatory treatment.

Diagnosis, Differential↗
PubMed1996

Melanocyte lysis by cytotoxic T lymphocytes recognizing the MART-1 melanoma antigen in HLA-A2 patients with Vogt-Koyanagi-Harada disease.

The MART-1/Melan-A melanoma antigen recognized by the majority of HLA-A2-restricted tumor-infiltrating lymphocytes is a self antigen expressed on melanocytes and the retina. We have investigated whether Vogt-Koyanagi-Harada (VKH) disease and sympathetic ophthalmia (SO), systemic inflammatory disorders affecting various organs containing melanocytes, are autoimmune diseases directed toward the MART-1 antigen. In two of three patients with VKH disease and one patient with SO, CD8(+) T cell clones (TCC) form intraocular fluid of HLA-A2(+) patients lysed T2 cells when pulsed with a HLA-A2-binding MART-1 peptide, but not a HLA-A2-binding pMel-17 or tyrosinase peptide, in a HLA-A2-restricted manner. In addition, Th, TCC recognizing a HLA-A2-binding MART-1 peptide were also established from peripheral blood mononuclear cells of a patient with VKH disease. In contrast, either CD4(+) TCC from these patients or CD8(+) TCC from the intraocular fluid of HLA-A2(+) patients with uveitis associated with Behcet's disease or HTLV-1 uveitis did not show this cytotoxicity. The results demonstrate that the MART-1 peptide-specific cytotoxic T lymphocytes lyse melanocytes in the eye of patients with VKH disease or SO, suggesting that these diseases are autoimmune diseases directed toward the MART-1 antigen in HLA-A2(+) patients.

Antigens, Neoplasm↗
PubMed1985

Update on enucleation and evisceration surgery.

The best operative results with fewest complications after enucleation surgery can be achieved by following basic principles, some of which are those of conservative tissue excision, using spherical implants placed behind Tenon's capsule into the muscle cone and avoiding surgical techniques that overlap the extraocular muscles (especially the superior rectus) over the front of the implant. The presence of an intraocular tumor demands that an enucleation be done. When the possible development of sympathetic ophthalmia is not present, the surgeon should consider doing an evisceration because of the cosmetic and motility advantages. Mention is made of some developments in enucleation surgery, such as the scleral cap reinforcement, the "baseball" implant technique using donor sclera, the use of liquid nitrogen to freeze intraocular tumors before removal of the eye, the dermis-fat orbital graft, and the use of two spherical orbital implants instead of one.

Eye Enucleation↗
PubMed1991

Caterpillar-induced keratitis.

Caterpillar hairs are responsible for a well-described though infrequent form of ocular trauma and disease sometimes referred to under the term ophthalmia nodosa. Four patients with this condition are presented with a review of the pathology and treatment guidelines.

Adolescent↗
PubMed1999

Outcome of vitreoretinal surgery and penetrating keratoplasty using temporary keratoprosthesis.

PURPOSE: The use of a temporary keratoprosthesis has allowed earlier surgical intervention in eyes with coexisting vitreoretinal and corneal disease. We analyzed our experience with this type of surgery. METHODS: We retrospectively reviewed charts of patients in whom a temporary keratoprosthesis was used between 1987 and 1998. Analysis was focused on ocular history, indications for surgery, visual acuity (VA), intraocular pressure, anatomic results, and complications. RESULTS: A temporary keratoprosthesis was used in 31 eyes, 22 (71.0%) of which were for trauma-related indications. In 6 (19.4%) of the operated eyes, the fellow eye also had severely reduced VA. Retinal detachments were present in 30 (96.8%) eyes; most had evident proliferative vitreoretinopathy. Twelve (38.7%) eyes had vitreous hemorrhage, and 20 (64.5%) had corneal scars. Improvement in VA was seen initially in 45.1% of patients, and 51.6% maintained equal or better VA at their final visit as compared with before surgery. The common documented reasons for poor final VA were recurrent retinal detachments deemed inoperable (32.3%), phthisis (22.6%), and optic atrophy or macular scar (16.1%). Corneal grafts remained clear in 41.9%. Nine patients had further surgery. The most significant complication was one case of sympathetic ophthalmia. CONCLUSIONS: Combined vitreoretinal and corneal surgery using temporary keratoprostheses has been used in our institution to treat eyes with extreme abnormalities. Outcomes were less favorable than some reported in the literature, probably because of the severity of disease for which temporary keratoprostheses were reserved. Although results are probably better than the natural course of the disease, patients should be informed of realistic expectations for improvement and potential complications when offered this option.

Adolescent↗
PubMedDate not supplied

Gonococcal conjunctivitis in a four-month-old infant.

Classic neonatal gonococcal ophthalmia usually manifests during the first week of life with a purulent ocular discharge accompanied by periorbital edema and erythema. This case report describes a 4-month-old child with chronic but minimal ocular discharge and intermittent mild conjunctival infection who proved to be infected with Neisseria gonorrhoeae. This experience emphasizes the need for the physician to evaluate for gonococcal infection any child with conjunctivitis.

Conjunctivitis↗
PubMed1992

Ocular and systemic determination of IL-1 beta and tumour necrosis factor in a patient with ocular inflammation.

Cytokines such as interleukin-1 beta (IL-1 beta) and tumour necrosis factor (TNF) may play an important role in ocular inflammation. We studied a patient with clinical features of sympathetic ophthalmia secondary to previous penetrating ocular injuries, and compared the ocular and systemic levels of IL-1 beta and TNF to control serum, and correlated these findings to histopathological sections of the patient's eye. Histology showed the presence of a diffuse chronic inflammatory infiltrate within the choroid and in a perivascular distribution in the retina. The significantly elevated ocular and systemic levels of IL-1 beta and TNF suggest that there is not only a localized ocular response but a systemic response as well. The presence of IL-1 beta TNF may play a role in the pathogenesis of ocular inflammation once the blood ocular barrier has been breached and ocular antigens have been exposed to the systemic immune system.

Endophthalmitis↗
PubMed1986

Chlamydial infections in infancy.

Non-gonococcal ophthalmia neonatorum was the first recognized manifestation of sexually transmitted chlamydial infection and for many years it was thought to be the only manifestation in infants born to infected mothers. In the 20 years since techniques for isolation of Chlamydia trachomatis in cell culture were described, many important effects of chlamydial infection, including afebrile pneumonia in infants, have been established. Prospective studies have determined the incidence of chlamydial infection in pregnant women and the risk of transmission of infection to their infants. They have shown that these are among the commonest perinatal infections. It is estimated that at least 1% of infants in this community have chlamydial conjunctivitis and up to 5/1000 will develop pneumonia. Chlamydial infections are characterized by a subacute onset and, without appropriate treatment, a prolonged course. Although they are rarely fatal, symptoms are sometimes severe and there may be long-term sequelae. The recent development of rapid and relatively inexpensive methods for direct detection of chlamydiae in clinical specimens will facilitate the diagnosis and treatment of infections in infants.

Chlamydia Infections↗
PubMed1998

Diode laser cyclophotocoagulation: dose-standardized therapy in end-stage glaucoma.

BACKGROUND: Ciliary body ablation in end-stage glaucoma has been widely performed with cryotherapy and neodymium:yttrium aluminium garnet (Nd:YAG) laser, both techniques frequently involving considerable pain and postoperative inflammation, with an unpredictable final intraocular pressure (IOP) and a significant risk of phthisis. Diode laser cyclophotocoagulation (cyclodiode laser) has recently been introduced in an attempt to avoid some of these problems. METHODS: Thirty patients with uncontrolled IOP and advanced glaucoma were divided on clinical grounds into two groups and were treated with either a half or a full standardized dose of laser (40 x 1500 mW for 1500 ms) and monitored for IOP control, visual acuity, postoperative inflammation and phthisis. Success of IOP control was defined as IOP < 22 mmHg or a decrease in IOP of > 30%; preservation of visual acuity or control of pain in blind eyes was also assessed. RESULTS: A sustained lowering of IOP was achieved in 90% of patients, with a mean follow up of 10.4 months. For the full treatment cases (group A), mean (+/-SD) pre-operative and postoperative IOP was 49.4 +/- 11.2 and 25.8 +/- 17.7 mmHg, respectively (a 48% reduction); 55% of patients achieved IOP < 22 mmHg and 68% gained an IOP reduction of > 30%. For the half-treatment cases (group B). the mean pre-operative and postoperative IOP was 29.4 +/- 4.3 and 18.9 +/- 5.7 mmHg, respectively (a 36% reduction); 63% of patients achieved IOP < 22 mmHg and 50% gained an IOP reduction of > 30%. Neovascular glaucoma was present in 60% of patients; the full-treatment subgroup of these patients achieved a mean lowering of IOP of 58%. Of 22 sighted eyes, 11 (50%) recorded no change in vision; seven (32%) eyes lost and four (18%) eyes gained vision; pain control was achieved in six of eight blind eyes (75%). There was no significant postoperative inflammation, one case of hypotony and no suggestion to date of sympathetic ophthalmia. CONCLUSION: Diode laser cyclophotocoagulation appears to be simple, safe and is frequently successful in the control of IOP in end-stage glaucoma. Optimum dosage parameters remain to be determined.

Aged↗
PubMed2005

Intravitreal triamcinolone acetonide for treatment of intraocular oedematous and neovascular diseases.

Intravitreal triamcinolone acetonide (IVTA) has increasingly been applied as treatment for various intraocular neovascular and oedematous diseases. Comparing the various diseases with respect to effect and side-effects of the treatment, the best response in terms of gain in visual acuity (VA) has been achieved for intraretinal oedematous diseases such as diffuse diabetic macular oedema, branch retinal vein occlusion, central retinal vein occlusion and pseudophakic cystoid macular oedema. In eyes with various types of non-infectious uveitis, including acute or chronic sympathetic ophthalmia and Adamantiadis-Behcet's disease, VA increased and the degree of intraocular inflammation decreased. Some studies have suggested that intravitreal triamcinolone may be useful as angiostatic therapy in eyes with iris neovascularization and proliferative ischaemic retinopathies. Intravitreal triamcinolone may possibly be helpful as adjunct therapy for exudative age-related macular degeneration (AMD), particularly in combination with photodynamic therapy. In eyes with chronic, therapy-resistant ocular hypotony, intravitreal triamcinolone can induce an increase in intraocular pressure (IOP) and may stabilize the eye. The complications of intravitreal triamcinolone therapy include: secondary ocular hypertension in about 40% of the eyes injected; medically uncontrollable high IOP leading to antiglaucomatous surgery in about 1-2% of the eyes; posterior subcapsular cataract and nuclear cataract leading to cataract surgery in about 15-20% of elderly patients within 1 year of injection; postoperative infectious endophthalmitis occurring at a rate of about one per 1000; non-infectious endophthalmitis, perhaps due to a reaction to the solvent agent, and pseudo-endophthalmitis with triamcinolone acetonide crystals appearing in the anterior chamber. Intravitreal triamcinolone injection can be combined with other intraocular surgeries, including cataract surgery, particularly in eyes with iris neovascularization. Cataract surgery performed some months after the injection does not show a markedly elevated complication rate. The injection may be repeated if the resultant benefits decrease after the initial IVTA injection. In non-vitrectomized eyes, the duration of the effect and side-effects of a single intravitreal injection of triamcinolone is about 6-9 months for a dosage of about 20 mg, and about 2-4 months for a dosage of 4 mg. So far, it has remained unclear whether the solvent agent should be removed, and if so, how.

Choroidal Neovascularization↗
PubMed1989

The prevalence of bacteriuria among high risk neonates in Nigeria.

Among the 446 high risk neonates studied for significant bacteriuria and pyuria in the neonatal wards of the Obafemi Awolowo University teaching hospital Complex, Ile-Ife, 7.6% and 5.8% were positive for significant bacteriuria and pyuria respectively, while none of the 81 infants in the control group were positive. Males and females were similarly affected and there was no seasonal variation in the prevalence of pyuria or bacteriuria. It is noteworthy that 25 (96%) of the 26 pyuria neonates also had bacteriuria emphazising the significance of pyuria as a possible screening method for urinary tract infections in neonates. The clinical problems in the neonates studied included prematurity, low birthweight, neonatal jaundice, fever, CNS symptoms, ophthalmia neonatorum, prolonged rupture of the membranes (PROM), respiratory distress, septic cord/skin, diarrhoea, vomiting and feeding problems. Only prematurity and low birthweight were significantly associated with bacteriuria in the neonates studied. The organisms encountered in this study were Escherichia coli (58.4%), Klebsiella species (35.3%) and Proteus species (5.9%). Of the bacterial isolates, 67% were sensitive to Ampicillin and 97% to Gentamycin. The combination of these antibiotics was effective in all cases in the present study. The study has highlighted the need for routine urine culture in our high risk neonates.

Bacteriuria↗
PubMed1982

Malignant catarrhal fever in farmed Rusa deer (Cervus timorensis). 1. Clinico-pathological observations.

A sporadic fatal disease is described in 7 Rusa deer (Cervus timorensis) from 5 deer farms in Victoria. Bilateral ophthalmia and wasting were the most significant signs in a clinical course varying from 4 to 34 days. Bilateral hypopyon, peripheral corneal opacities and interstitial mononuclear cell infiltration of the renal cortex with pronounced mural thickening and dilatation of vessels at the cortico-medullary junction were the only consistent lesions. Haemorrhagic ileitis, colitis and typhlitis were the major lesions in two deer that died 4 and 6 days after onset of clinical disease. Ecchymotic haemorrhages and sub-serosal haematomas on the intestines and mesentery were the main finding in cases with a longer clinical course. Other gross lesions varied between cases. The most significant histological lesion was fibrinoid necrotising vasculitis with adventitial lymphoid cell infiltration characteristic of bovine malignant catarrhal fever. Mucosal erosions seen in protracted cases of this disease were associated with lymphoid cell infiltration into foci of degenerating epithelial cells. In many lymph nodes there was severe follicular necroses. In chronic cases extensive proliferation of lymphoblastoid cells was seen in the parafollicular cortex and medullary sinuses of nodes which also showed discrete follicular necrosis.

Animals↗
PubMed1982

Contrast sensitivity measurement in retinal diseases by laser generated sinusoidal grating.

The contrast sensitivity function (CSF) of 83 patients with retinal diseases was measured by laser-generated sinusoidal grating pattern, which enables the direct measurement of the CSF between the retina and the brain. The CSF abnormality in various retinal diseases was not specific to each disease, and the severity may determine the pattern. The abnormal patterns and rough correlation with visual acuity (V.A.) are: (1) attenuation at high frequency ranges (V.A. greater than 0.8), (2) attenuation at intermediate and high frequency ranges (0.4 less than V.A. less than 0.7), (3) attenuation at all frequency ranges (V.A. less than 0.3). Some cases, however, showed discrepancy between visual acuity and CSF. At the recovery stage of central serous retinopathy and retinal branch vein occlusion, CSF showed delayed recovery or attenuated sensitivity even when visual acuity was restored to 1.0 or more. In retinitis pigmentosa and pre-retinal macular fibrosis, CSF showed more sensitive detection of abnormal macular function than visual acuity measurement. At the post-corticosteroid therapy of Harada's disease and Sympathetic Ophthalmia, CSF recovered more rapidly than visual acuity when retinal detachment was absorbed. Those discrepancies suggest that CSF measurement may be useful for evaluating progression or regression of these diseases.

Adolescent↗