ABSTRACT
CASE REPORT: We present a case of ocular loiasis with a subconjunctival filaria, 5.5cm long, and a severe microfilaremia, 1 microfilaria/ml, on a previously asymptomatic woman from Equatorial Guinea, with a past medical history of hypereosinophilia of unknown origin. DISCUSSION: Ocular loiasis is an imported infestation with a very low rate in our country. Nevertheless, chronic infestation in immigrants coming from endemic areas of Africa may increase the rate of this disease in our country.
Subject(s)
Eosinophilia/complications , Eye Infections, Parasitic/complications , Loiasis/complications , Female , Humans , Young AdultABSTRACT
OBJECTIVE: To determine the weight loss associated with resolution of papilledema from idiopathic intracranial hypertension (IIH). DESIGN: A retrospective study. PARTICIPANTS: Fifteen consecutive female patients with IIH associated with obesity were studied. INTERVENTION: Patients underwent weight loss and treatment with acetazolamide during a 24-week period. MAIN OUTCOME MEASURES: The severity of papilledema was graded: absent (grade 0), mild (grade 1), moderate (grade 2), and marked (grade 3), based on a predetermined grading system ("gold standard") using stereoscopic photographs and the Frisén classification. RESULTS: The 15 patients, with mean age of 31.3+/-8.8 years, had a mean weight of 110.5+/-28.7 kg and mean body mass index of 40.7+/-13.0 kg/m2. Eleven (73.3%) patients had improved papilledema during the 24-week study period, of which 10 (66.7%) had complete resolution of papilledema within a median time of 8.5 weeks. An average of 3.3% weight loss (+/-0.5% standard error of the mean) was observed among patients having a one-grade change in papilledema. Weight loss of 6.2%+/-0.6% standard error of the mean was associated with a three-grade change in papilledema (i.e., complete resolution of marked papilledema). Nine of the ten patients with complete resolution of papilledema also took acetazolamide. However, none (26.7%) of the four patients without weight loss had improvement in papilledema despite similar treatment with acetazolamide. CONCLUSIONS: Approximately 6% weight loss was associated with resolution of marked papilledema in these authors' patients. The benefit of acetazolamide in IIH is questioned since weight loss, rather than acetazolamide, appeared to have been the catalyst for reducing the severity of papilledema.
Subject(s)
Acetazolamide/therapeutic use , Pseudotumor Cerebri/therapy , Weight Loss , Adult , Body Mass Index , Body Weight , Female , Humans , Middle Aged , Obesity/complications , Papilledema/etiology , Papilledema/physiopathology , Papilledema/therapy , Pseudotumor Cerebri/complications , Retrospective StudiesABSTRACT
OBJECTIVE: To characterize the presentation, role of diagnostic imaging, and course in patients with optic nerve avulsion. METHODS: A retrospective review of medical records of all 6 patients with optic nerve avulsion who were seen at the Massachusetts Eye and Ear Infirmary, Boston, from January 1, 1991, to July 31, 1995. RESULTS: The initial visual acuity ranged from 20/100 to no light perception. All 6 patients underwent neuroimaging, including computed tomography, magnetic resonance imaging, or both. B-scan ultrasonography was performed on 4 patients, and the condition of 1 patient was evaluated with color Doppler ultrasonography to assess the optic nerve vasculature. In 1 patient, a computed tomographic scan was suggestive of an optic nerve avulsion. Neuroimaging in the other 5 patients, including 2 patients who underwent magnetic resonance imaging, failed to demonstrate an avulsion. During a follow-up period of up to 25 months, 4 patients showed no improvement in visual acuity, 1 patient improved from no light perception to bare light perception, and 1 patient improved from 20/100 to 20/25. CONCLUSIONS: These data suggest that final visual outcome was dependent on initial postinjury visual acuity. Neuroimaging, B-scans, and Doppler ultrasonography were usually not helpful in establishing the presence of optic nerve avulsion, although they may be useful in evaluating comorbid conditions.
Subject(s)
Eye Injuries/diagnosis , Optic Nerve Injuries , Wounds, Nonpenetrating/diagnosis , Adolescent , Adult , Eye Diseases/diagnosis , Eye Diseases/etiology , Eye Diseases/therapy , Eye Injuries/etiology , Eye Injuries/therapy , Follow-Up Studies , Fundus Oculi , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Optic Nerve/diagnostic imaging , Retrospective Studies , Tomography, X-Ray Computed , Ultrasonography, Doppler, Color , Visual Acuity , Visual Fields , Wounds, Nonpenetrating/etiology , Wounds, Nonpenetrating/therapyABSTRACT
Relatively little information exists concerning the delivery of ophthalmic services via telemedicine, yet ophthalmology is particularly amenable to the utilization of such applications. This paper discusses the technological issues pertinent to the research, development, and assessment of teleophthalmology delivery systems and begins to define the parameters that will determine the sustainability of teleophthalmology. A prototype urban teleophthalmology delivery system is presented in the context of improving access to eye care for an underserved inner-city population. Potential enhancements to the prototype telephthalmology system are discussed.
Subject(s)
Ophthalmology , Telemedicine/organization & administration , Adolescent , Adult , Aged , Child , Child, Preschool , Community Health Services , Computer Communication Networks/organization & administration , Humans , Infant , Middle Aged , Schools, Medical , Urban Health ServicesABSTRACT
Ocular dysfunction accounts for nearly 70% of the initial manifestations of myasthenia gravis. Since the prevalence rate of myasthenia gravis is two to 10 cases per 100,000 population, it is important for clinicians to be cognizant of this disorder and its varied ocular presentations. The clinical manifestations, diagnosis, treatment, and prognosis of ocular myasthenia gravis are reviewed.
Subject(s)
Eye Diseases/etiology , Myasthenia Gravis/complications , Eye Diseases/diagnosis , Eye Diseases/therapy , Female , Humans , Male , Myasthenia Gravis/diagnosis , Myasthenia Gravis/therapy , Prevalence , PrognosisABSTRACT
By using a recently developed method for quantifying the degree of mottling of colored tablets, the effects of manufacturing variables such as the method and temperature of granule drying, granule size, and compaction pressure were investigated. Tablets of dibasic calcium phosphate colored with FD&C Blue No. 1 dye were used. Drying temperature had little effect, but the method of granule drying, granule size, and compaction pressure were major influences on mottling. Mechanisms to explain these results, based on the migration of dye during the drying process, are proposed.
Subject(s)
Color , Drug Compounding , Particle Size , Pressure , TemperatureABSTRACT
The effects of several formulation variables were quantified with respect to factors affecting tablet mottling. Tablet mottling occurred with several commonly used binders and could not be prevented by using highly viscous binding solutions. However, mottling was reduced initially by increasing granule strength. Tablet diluents and dye-adsorbent materials had a profound effect on mottling, not by preventing dye migration but by affecting granule fragmentation on compression and the extent to which the dye-deficient material at the center of the granule was revealed. The lake form of FD&C Blue No. 1 was found to bleed in the presence of diluents that raised the pH of the granulating fluid above 6.4. Anionic impurities in the diluents also caused leaching of free dye and, consequently, increased tablet mottling. The conclusions from this study and previous papers were drawn together to give general principles for the production of uniformly colored tablets by aqueous granulation techniques.
