Metabolic, pediatric, and systemic ophthalmology (New York, N.Y. : 1985)最新文献

In this study we show how the Pattern ERG (PERG) can be used to distinguish between optic nerve and retinal disease. Records from eyes with RBN and delayed visual evoked responses are compared with those recorded from the normal fellow eyes. In optic nerve disease there is a selective reduction of the later negative component of the response. PERG's were also recorded from patients with mild diabetic retinopathy. These were divided into three groups on the basis of the delay in their Visual Evoked Potential (VEP). The amplitude of both positive and negative components fall with increasing severity of the disease thus showing that the abnormally long delau in VEP found in some cases is due to retinal disease rather than optic nerve disease.

One of my patients had severe uveitis with retinal phlebitis, retinal exudation and vitreous bleeding against high-dose steroid therapy. After high-dose intravenous gammaglobulin therapy was applied, retinal exudation and phlebitis subsided and visual acuity increased dramatically.

A 24-year old woman displayed a coloboma of the right optic nerve with multiple small parapapillary retinochoroidal colobomas. This rare association makes one suspect that the pathogenesis of colobomatous defects of the optic disc area are caused by a faulty closure of the embryonic fissure and an abnormal maturation of the cells of the anlage of the optic nerve head.

Serum IgA, IgC, IgM and secretory IgA levels in patients with Behçet disease were examined. Among them, serum IgA and secretory IgA levels, which increase in mucosal inflammation, were significantly higher than controls (p less than 0.001, p greater than 0.01). These results indicate that mucosal inflammation, oral and gastrointestinal inflammation, may lead to gram-negative bacterial infection and endotoxin-induced uveitis in patients with Behçet disease.

Visual psychophysics represent an invaluable way of studying the visual system aging process. First of all, the author considers the modifications induced by aging on the optic characteristics of the human eye. Subsequently, he outlines the specific reduction of visual acuity, contrast sensitivity, flicker fusion and color vision caused by optic nerve and visual pathway aging. He points to the role and importance of psychophysic investigations in the accurate definition of visual system aging.

The latency of the visual evoked potentials elicited by pattern-reversal and onset-offset stimulation was measured in 75 healthy subjects aged 21 to 80 years. In 24 of these subjects the contrast sensitivity threshold was recorded by electrofunctional method. There is a close correlation between increasing latency of visual evoked potentials and age increase. This finding is of greater importance after 60 years. The delayed latencies are obtained with both pattern-reversal and onset-offset stimulation, and are more striking using stimuli of small size. In the old people the contrast sensitivity shows a raised threshold, especially for small stimuli. These age-related changes of the visual evoked potentials and contrast sensitivity are due to optical factors--the most important is the reduction of the retinal illuminance caused by senile miosis--and to neural factors as degeneration and demyelination of the optic nerve axons and abnormalities of the neurotransmitters.

The authors examined 84 patients with pulmonary TBC treated with ethambutol (25 mg/Kg/die). The patients were divided into two groups on the basis of zinc plasma levels: 53 patients with zinc plasma level greater than 1 mg/l and 31 with zinc plasma levels less than 0.7 mg/l. The two groups underwent periodical follow-up of visual acuity, fundus, color vision (Fransworth 100 HUE) and visual field. The checks were monthly on the first group and fortnightly in the second. Eight patients presented signs of optic neuropathy. Patients with lower zinc plasma levels showed a higher percentage of optic neuropathy.

Progresses in biochemistry permit one to distinguish three biochemical forms of Zellweger Syndrome: 1) hyperpipecolic acidemia, 2) neonatal adrenoleukodystrophy, and 3) infantile Refsum's disease, which have similar clinical manifestations. A seven-month-old male patient with Zellweger Syndrome is presented. He had absence of peroxismes in the liver and elevated pipecolic acids and abnormal levels of bile acids in the blood. The child had a typical neurologic clinical manifestation with hepatomegaly. The ophthalmoscopy revealed grey disks and retinitis pigmentosa with extinguished ERG and law and delayed VEP. The importance of the constant retinal involvement in Zellweger Syndrome is discussed.

A single case of "cold: corneal abscess in a psoriatic patient was considered worth reporting as there are no other cases described in the literature. The importance of the correct diagnosis and the management are discussed.