ABSTRACT
AIM: To examine the effect of up to 6 weeks of corticosteroid treatment on the positive temporal artery biopsy rate in giant cell arteritis (GCA). METHODS: Prospective comparative clinical study of 11 patients meeting the American College of Rheumatology criteria for diagnosis of GCA. Patients underwent temporal artery biopsy within 1 week, at 2-3 weeks, or after 4 weeks of corticosteroid treatment. RESULTS: Overall, nine of 11 (82%) patients had positive temporal artery biopsies. Six of seven (86%) biopsies performed after 4 or more weeks of steroid treatment were positive. CONCLUSION: Temporal artery biopsy is useful several weeks after institution of steroids.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Biopsy/standards , Giant Cell Arteritis/pathology , Hydrocortisone/administration & dosage , Prednisolone/administration & dosage , Administration, Oral , Aged , Aged, 80 and over , Biopsy/methods , Drug Therapy, Combination , Female , Giant Cell Arteritis/drug therapy , Humans , Infusions, Intravenous , MaleSubject(s)
Cranial Nerve Neoplasms/diagnosis , Lymphoma, B-Cell/diagnosis , Optic Nerve Diseases/diagnosis , Optic Nerve/pathology , Aged , Biopsy , Bone Marrow/pathology , Cranial Nerve Neoplasms/radiotherapy , Female , Humans , Lymphoma, B-Cell/radiotherapy , Lymphoproliferative Disorders/diagnosis , Optic Atrophy/diagnosis , Optic Nerve Diseases/radiotherapy , Visual Acuity , Visual FieldsABSTRACT
PURPOSE: To report on a patient who developed retinal toxicity from an intraocular copper foreign body in the absence of any signs of chalcosis or inflammation. METHOD: Case report. RESULT: Removal of the copper foreign body resulted in electroretinographic improvement and the patient has retained good vision. CONCLUSION: Retinal toxicity from intraocular copper can be subclinical and such foreign bodies should be removed. Removal of the foreign body can be associated with at least partial reversal of retinal toxicity.
Subject(s)
Copper/poisoning , Eye Foreign Bodies/surgery , Retinal Diseases/chemically induced , Vitreous Body , Adolescent , Electroretinography , Humans , Male , Postoperative Period , Retina/physiopathology , Retinal Diseases/physiopathology , Visual Acuity , VitrectomySubject(s)
Glaucoma/diagnosis , Optometry , Visual Field Tests/methods , Adult , Aged , Humans , Middle Aged , Practice Guidelines as TopicABSTRACT
PURPOSE: Approximately 6% of general practitioners have worked in ophthalmology but to our knowledge the relevance of this training has not previously been evaluated. METHODS: We sent an anonymous questionnaire to all doctors who had held general practitioner registrar (vocational training) posts in ophthalmology in the Northern Region during a 5-year period (1989-1994). RESULTS: Twenty-six of 48 (54%) questionnaires were returned. Twenty-five of 26 respondents (96%) thought the training was useful, with 22 (91.7%) continuing to use some ophthalmic practical skills and 17 (65.4%) said they had received adequate and relevant clinical exposure. Twenty-one (87.5%) of those in general practice felt that they were more confident with eye problems than their peers and 12 (50%) said their referral patterns differed. Eleven (46%) had provided advice for colleagues. However, 9 (34.6%) commented on the large service commitment and 5 (19%) felt that supervision had been inadequate. Only 9 (34.6%) had received relevant teaching and 18 (69%) thought more was necessary. CONCLUSION: We conclude that general practitioner registrar posts in ophthalmology are useful and rewarding but that there is scope for improvement.
Subject(s)
Attitude of Health Personnel , Education, Medical, Graduate/standards , Family Practice/education , Ophthalmology/education , England , Humans , Surveys and QuestionnairesSubject(s)
Cyclosporine/adverse effects , Eye Diseases/etiology , Eyelashes/drug effects , Cyclosporine/therapeutic use , Eyelashes/pathology , Eyelashes/ultrastructure , Hair Diseases/chemically induced , Hair Diseases/complications , Hair Diseases/pathology , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Keratins/ultrastructure , Kidney Transplantation , Male , Microscopy, Electron, Scanning , Middle AgedABSTRACT
PURPOSE: The aim of the study was to determine whether patients presenting with an isolated posterior vitreous detachment require follow-up to identify retinal breaks not apparent at presentation and whether some histories are more predictive of associated serious posterior segment pathology. METHODS: The notes of 295 patients presenting to eye casualty with flashes and/or floaters were reviewed. RESULTS: One hundred and eighty-nine patients (64%) had isolated posterior vitreous detachments, 49 (16.6%) had retinal detachments and 31 (10.5%) had flat retinal tears. Three new breaks (3.3% of all tears found, 1.9% of review appointments) were identified only at follow-up. Although a subjective reduction in vision and a history of less than 6 weeks' duration were strongly predictive of retinal breaks, the large group of patients presenting with floaters alone (124/295, 42%) still harboured a significant proportion (26.7%) of the retinal breaks. CONCLUSIONS: A follow-up visit for patients with an isolated posterior vitreous detachment can be justified to detect the small percentage of asymptomatic retinal breaks. Although a subjective reduction of vision is the symptom most predictive of serious posterior segment pathology, it would be unsafe to identify particular subgroups of patients alone for careful examination.
