Evaluation and management of apparent life-threatening events in infants.

Apparent life-threatening events (ALTEs) are frightening to caregivers and clinicians alike. This article provides a comprehensive review of the causes, management, and consequences of ALTEs. The information provided was collected from an extensive literature review using the search terms ALTE, sudden infant death syndrome, and apnea.

Structural alterations of the erythrocyte membrane proteins in diabetic retinopathy.

Background: Several rheological disorders of the erythrocytes, such as increased aggregation and decreased deformability, have been observed in diabetes mellitus and have been implicated in the development of diabetic microangiopathy. Structural alterations of the erythrocyte membrane proteins caused by the diabetic process may be at the origin of those observations. In the present study, we searched for erythrocyte membrane protein alterations in diabetic retinopathy.

Ulcerative keratitis in contact lens wearers.

Purpose: To determine the clinical microbiological characteristics of corneal ulcers in contact lens wearers.

Methods: A retrospective study of 23 patients admitted to our department with contact lens-related corneal ulcers during a 43-month period. Detailed demographic data, the type of contact lens, duration of lens wear, and wearing schedule were derived from a self-administered questionnaire.

Does identification of the causal organism of corneal ulcers influence the outcome?

Purpose: To investigate whether identification of the causal organism in corneal ulcers influences their outcome.

Methods: We retrospectively studied 114 patients, 72 males and 42 females aged 6-89 years, admitted to this eye clinic during the years 1994-2000 on account of an infectious corneal ulcer. Their examination included a detailed history, visual acuity measurement, and biomicroscopy in everyday follow-up.

Severe ocular injuries in Greek children.

Objective: To determine the epidemiological characteristics of severe eye injuries in childhood, in a mixed urban and rural Greek setting.

Methods: Retrospective analysis of 95 cases (103 eyes) of eye injuries in children younger than 17 years of age admitted to the Department of Ophthalmology, University Hospital of Patras, Greece, during a five-year period. The data were analyzed with respect to age, sex, type, cause and mode of injury, method of management, duration of hospitalization and final visual deficit.

Evaluating the management of diabetic retinopathy in a teaching center.

Purpose: To evaluate the efficacy of the management of diabetic retinopathy (DR) in the teaching center of the University Eye Clinic of Patras in Greece.

Methods: From 1989 to 1999, 302 patients with type I (5.3%) and type II (94.

Corneal complications following abuse of topical anesthetics.

Purpose: To describe corneal complications in three patients following abuse of topical anesthetics.

Materials And Methods: We describe one case with bilateral corneal perforation, another with unilateral corneal perforation and a third case of chronic keratitis following excessive use of topical anesthetics.

Results: Two patients continued to instill topical anesthetic drops despite all recommendations to stop.

Levels of specific antibodies towards the major antigenic determinant of slime-producing Staphylococcus epidermidis determined by an enzyme immunoassay and their protective effect in experimental keratitis.

Staphylococcus epidermidis is an important cause of bacterial keratitis. Certain S. epidermidis strains produce an extracellular slime layer rich in an acidic polysaccharide with a molecular size of 20 kDa (20-kDa PS).

Bilateral panophthalmitis as the initial presentation of meningococcal meningitis in an infant.

Endophthalmitis is a well-recognized, frequently devastating ophthalmic disease. The colonization of the eye and the subsequent development of endophthalmitis may be exogenous (including postsurgical and post-traumatic infections) or it may be of endogenous origin, representing a metastasis from a focus of infection elsewhere in the body associated with bacteremia (such as meningitis or cellulitis).

Comparison of lodoxamide 0.1% ophthalmic solution and levocabastine 0.05% ophthalmic suspension in vernal keratoconjunctivitis.

Purpose: To compare the clinical efficacy and safety of lodoxamide 0.1% ophthalmic solution with levocabastine 0.05% ophthalmic suspension, each given four times daily (QID) for three months to patients with vernal keratoconjunctivitis (VKC).

Contrast sensitivity function in patients with impaired oral glucose tolerance.

Purpose: To evaluate contrast sensitivity function in patients with impaired oral glucose tolerance test (OGTT) compared with normal subjects.

Methods: Sixteen patients with impaired OGTT and 11 normal control subjects were tested for contrast sensitivity function at four spatial frequencies. Glucose intolerance was established by the 1985 World Health Organization criteria.

Contrast sensitivity function in patients with beta-thalassemia major.

Purpose: To investigate contrast sensitivity function in patients with beta-thalassemia major, after regular transfusion and chelation therapy.

Methods: We measured contrast sensitivity at four spatial frequencies in 30 patients with beta-thalassemia major and in 30 matched normal control subjects. All subjects underwent an ophthalmic examination that included fluorescein angiography.

Use of topical brimonidine to prevent intraocular pressure elevations following Nd:YAG-laser posterior capsulotomy.

Background And Objective: To evaluate the efficacy of topical brimonidine tartrate 0.2% (Allergan, Irvine, CA) in the prophylactic treatment of acute intraocular pressure (IOP) rises following Nd:YAG laser posterior capsulotomy.

Patients And Methods: This was a double-masked, randomized, placebo-controlled clinical study in 60 patients who underwent Nd:YAG laser posterior capsulotomy after extracapsular cataract extraction.

Contrast sensitivity after extracapsular and intracapsular cataract extraction.

Contrast sensitivity function after cataract extraction and intraocular lens implantation has been mainly correlated to the type or the material of the intraocular lens. Our purpose was to identify other possible factors, like posterior capsule, to contrast sensitivity alterations after cataract surgery, comparing patients operated for cataract by techniques that mainly differed on the posterior capsule's integrity. The intraocular lens implanted was either a posterior or an anterior chamber one, always monofocal and made of PMMA.

Contrast sensitivity function after cataract extraction and intraocular lens implantation.

Divergent contrast sensitivity findings have been reported in patients with intraocular lens implants. The purpose of this study was to determine contrast thresholds of patients with good visual acuity after uncomplicated cataract extraction and posterior chamber conventional IOL implantation. Fifty-two eyes of fifty two patients, who had undergone uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens implantation together with 48 eyes of 48 control subjects were tested for contrast sensitivity function.

Clinical trial with diffractive multifocal intraocular lens implantation.

This study presents results obtained after implantation of 25 diffractive multifocal intraocular lenses. The follow-up ranged from six to 12 months. Visual acuity for distance without correction was 0.

The corneal epithelium basement membrane complexes after alkali burn: an ultrastructural study.

Chemical burns were produced using a 4 N NaOH solution in 21 rabbit corneas. The ultrastructural findings were examined under an electron microscope five minutes and 1, 2, 4, 8, 15, and 30 days after the burn. A morphologic disturbance of the basement membrane and its complexes was detected from the first day of the experiment.

Acyclovir--a promising antiviral agent: a review of the preclinical and clinical data in ocular herpes simplex management.

Acyclovir (Aciclovir), previously known as acycloguanosine, has been found to be a potent and selective inhibitor of viruses of the herpes group. A clear therapeutic effect has been demonstrated in animals and in clinical studies, especially for herpes simplex virus (HSV) infection of the eye. Various reports indicate that acyclovir is as effective as or superior to other available antiviral agents with low host toxicity and mild side effects.

Epidemiologic research on the role of studying and urban environment in the development of myopia during school-age years.

Four hundred seventy-four Greek male subjects received an ophthalmologic examination and completed a questionnaire. The following were found: (1) the years of studying and urban residence are factors that strongly influence the prevalence of myopia; discriminant factor analysis classified correctly 81% of the subjects into the myopic or the nonmyopic group; (2) the incidence of myopia is significantly higher in the studying v the nonstudying groups; (3) the prevalence of myopia is higher in the more educated group; (4) there is no statistical difference between the orientation of myopes and nonmyopes toward studies or other occupations; (5) although the presence of myopia is determined by the years of studying and urban residence, the degree of myopia is not influenced to a statistically significant level by these factors; and (6) the results indicate that the interaction of these two variables is more significant in their contribution to the onset of myopia than the sum of each variable alone.

Visual correction of keratoconus with soft contact lenses.

Soft contact lenses were fitted on 96 eyes of 52 patients suffering from keratoconus. The visual acuity of 66 eyes was 4/10 or better with soft contact lenses alone. The amount of astigmatism corrected with soft contact lenses varied between 1.

Response of the cornea to far ultraviolet light: an ultrastructural study.

Quantitative changes were measured and ultrastructural alterations were detected in rabbit corneas after exposure to a far ultraviolet irradiation (UV). Low dose exposure (105 - 8 x 105 erg/cm2) resulted one day later in a thicker epithelium and loss of the intercellular permeability barrier. In corneas exposed to higher doses (5 x 106 erg/cm2), the epithelium was considerably thinner one day later, whereas 4 days later it was of normal thickness and the endothelial cells became degenerated.

Excretion of vanilmandelic acid in the urine of retinoblastoma patients.

The idea of determining the urinary excretion of vanilmandelic acid (VMA) in children with retinoblastoma derives from the fact that elevated amounts of VMA were found in children with neurogenic tumours and especially neuroblastoma. The method of VMA analysis and the results are discussed. In view of the fact that in only 5 out of our 12 patients an elevated urinary VMA excretion was found, we cannot recommend this determination as a routine diagnostic procedure.