Anaphylactic reaction to intravenous corticosteroids in the treatment of ocular toxoplasmosis: a case report.

Introduction: This case report presents for the first time an acute systemic allergic reaction to corticosteroids in a patient with ocular toxoplasmosis after treatment with intravenous cortisone, and discusses alternative treatments.

Case Presentation: We present the case of a 57-year-old Caucasian woman with an anaphylactic reaction after intravenous injection of prednisolone-21-hydrogensuccinate (Solu-Decortin® H) given for the treatment of toxoplasmosis-associated chorioretinitis. Immediately after the injection, she developed an acute erythema of the legs and abdomen, angioedema, hypotension (blood pressure 80/40mmHg), tachycardia (heart rate 140/minute), hyperthermia (38.

Anterior chamber paracentesis after central retinal artery occlusion: a tenable therapy?

Background: The goal of this study was to investigate the visual outcome of acute central retinal artery occlusion (CRAO) after current standard therapy with and without paracentesis. In addition, we investigated whether there was a dependence of the resulting visual acuity on the time between first symptoms and implementation of paracentesis. Finally, we analysed risk factors for CRAO.

[Three cases--one diagnosis: ocular manifestations of sarcoidosis].

Introduction: Sarcoidosis can manifest itself in a variety of affection patterns in the eye. Early diagnosis and treatment are of crucial importance. Therefore the following three cases present occular symptoms associated with sarcoidosis.

[A rare manifestation of sarcoidosis].

This article reports the case of a 14-year-old boy who was presented in the case conference with symptoms of decreased visual acuity, scintillating scotomas and photophobia. Physical examination revealed right facial paralysis, parotid gland swelling, high fever and poor general condition. Ophthalmoscopy revealed anterior and posterior uveitis including macular edema and chorioretinal infiltrates.

Factors independently associated with increased risk of pain development after ophthalmic surgery.

Background And Objective: Little has been documented about the development of pain after ophthalmic surgery. This study was designed to assess the incidence and severity of postoperative pain following ophthalmic surgery, and to identify key factors independently associated with development of such pain.

Methods: In a prospective, observational cohort study, 500 patients undergoing elective ophthalmic surgery were examined by assessing numerical analogue scales and analgesic requirements.

[The combination of retrobulbar block with general anaesthesia may lead to pre-emptive analgesia in patients undergoing pars plana vitrectomy].

Subject: To determine whether additional regional blocking provides pre-emptive analgesia in patients undergoing elective pars plana vitrectomy.

Methods: In a prospectively randomised, double-blinded trial we investigated the potential benefit of combining regional anaesthesia (RA) with general anaesthesia (GA). In each group 25 patients undergoing pars plana vitrectomy were either done under GA (group A), GA combined with retrobulbar block (group B) or GA combined with peribulbar block (group C).

[Autologous subretinal transplantation of cultivated porcine iris pigment epithelial cells (IPE)].

Background: Subretina transplantation of epithelium may be a therapeutic option for surgical treatment of age-related macular degeration (AMD). Various experimental data have demonstrated that homologous transplantation of retinal pigment epithelium (RPE) can prevent photoreceptor deterioration. However, most investigators experienced immunogenic graft rejection when using homologous pigmented cells for grafting.

Human and porcine anterior lens capsule as support for growing and grafting retinal pigment epithelium and iris pigment epithelium.

Purpose: To establish a method for transplantation of cultured monolayers of RPE and IPE into the subretinal space, anterior lens capsule was evaluated for its suitability to serve as growth support and carrier for transplantation procedures.

Materials And Methods: Twenty-four anterior lens capsules were obtained from porcine eyes. The same number of human lens capsules was obtained during cataract surgery.

[Subretinal transplantation of confluent pigment epithelium: a novel device for non-traumatic tissue handling].

Background: Subretinal transplantation of pigment epithelium may be a therapeutic option in the treatment of age-related macular degeneration. Suspensions of pigment epithelial cells as well as confluent cell layers are being considered.

Methods: We developed a surgical device which permits to load living tissue, without exerting mechanical stress to the cells themselves, and to deliver it precisely onto the subretinal target site.

[EOG in adult vitelliform macular degeneration, butterfly-shaped pattern dystrophy and Best disease].

Objectives: We evaluated the EOG in the various stages of foveomacular dystrophy (also called adult-onset vitelliform macular dystrophy) and compared these findings to those in Best's disease and butterfly-shaped dystrophy.

Patients And Methods: The records of 49 patients (98 eyes) in whom foveomacular dystrophy had been diagnosed by ophthalmoscopy or by fundus photographs and fluorescein angiography were retrospectively reviewed. Fifty-seven eyes were followed up (range 1.

Subretinal lavage: a technique of continuous subretinal irrigation for removal of traumatic submacular hemorrhage.

A 12-year-old female patient suffered a horse kick to her face, resulting in various orbital fractures and blunt eye trauma. Upon ophthalmoscopy, an extensive subretinal hemorrhage was revealed under the macula, reaching to both vascular arcades. The visual acuity was 20/300.

[Ultrasound biomicroscopy for localization of artificial lens haptics after trans-scleral suture fixation].

Correct positioning of transscleral haptics for sulcus fixation of IOL haptics may be difficult due to lack of visual control by the surgeon. We determined the haptic sites in eyes which underwent secondary IOL implantation with transscleral suturing using ultrasound biomicroscopy (UBM) (Humphrey Instruments, Inc., San Leandro, CA, USA).

[Temporary keratoprosthesis, vitrectomy and autokeratoplasty in endophthalmitis treatment].

Postsurgical endophthalmitis frequently requires emergency vitrectomy. Loss of corneal transparency can preclude vitreoretinal surgery. Due to the narrow time frame in which surgical treatment needs to be performed, donor corneas are often not available for grafting.

Growth inhibition of human Tenon's capsule fibroblasts and rabbit dermal fibroblasts with non-carcinogenic N-alkylated anthracyclines.

Bleb fibrosis after glaucoma filtering surgery and proliferative vitreoretinopathy after retinal detachment surgery are complications caused by proliferation of fibroblasts or fibroblastlike cells. The anthracycline daunomycin (DNM) has been used for treatment of those proliferative processes in humans. However, complications such as conjunctival necrosis and corneal or scleral ulcerations have been reported after administration of DNM to glaucoma patients.

Retinal separation, retinotomy, and macular relocation: II. A surgical approach for age-related macular degeneration?

Three cases of age-related maculopathy with severe and recent massive submacular hemorrhage were treated by performing complete vitrectomy. A total retinal detachment was created by infusion of fluid underneath the retina, followed by a peripheral circumferential retinotomy. This allowed access to the subretinal space for removal of blood and membranes and, more importantly, permitted rotation of the retina with relocation of the fovea.

Retinal separation, retinotomy, and macular relocation: I. Experimental studies in the rabbit eye.

An animal model in the rabbit eye was utilized to study mobilization and relocation of the fovea as a potentially beneficial surgical approach to age-related macular disease. After lentectomy and vitrectomy, the retina was completely separated from the pigment epithelium by means of infusion into the subretinal space. A 360 degrees peripheral retinotomy was performed.

Ocular toxicity of daunomycin: effects of subdivided doses on the rabbit retina after vitreous gas compression.

Daunomycin is a potent antiproliferative agent which has been shown to prevent experimental proliferative vitreoretinopathy. However, toxic effects on the rabbit retina have been reported even for the lowest effective doses. In a previous report we demonstrated that subdivided doses rather than single doses of daunomycin improves the efficacy in prevention of experimental proliferative vitreoretinopathy.

N,N-dimethyladriamycin for treatment of experimental proliferative vitreoretinopathy: efficacy and toxicity on the rabbit retina.

N,N-Dimethyladriamycin (Me-2-ADM) derives from adriamycin (doxorubicin) by N-methylation of its aminosugar moiety. In contrast to the parent agent, Me-2-ADM lacks mutagenicity and carcinogenicity. To evaluate its suitability for treatment of proliferative vitreoretinopathy (PVR), we studied the ability of Me-2-ADM to prevent traction retinal detachment in a model of PVR in rabbits.

Aclacinomycin A in the treatment of experimental proliferative vitreoretinopathy. Efficacy and toxicity in the rabbit eye.

Purpose: Aclacinomycin A is an oligosaccharide anthracycline that, by contrast with daunomycin, lacks carcinogenicity. The authors evaluated the efficacy of aclacinomycin A in prevention of experimental proliferative vitreoretinopathy (PVR) and its toxicity on the rabbit retina.

Methods: Dutch-belted rabbit were used to create a model for traction retinal detachment.

The effect of combined daunorubicin and triamcinolone acetonide treatment on a refined experimental model of proliferative vitreoretinopathy.

Prior studies have shown that intravitreal daunorubicin (9-15 nmol) and triamcinolone acetonide (2 mg) are effective individually in preventing retinal detachment in experimental proliferative vitreoretinopathy. This report compares the efficacy of the combination of daunorubicin (15 nmol) and triamcinolone acetonide (2 mg) with that of daunorubicin alone in a refined experimental model of proliferative vitreoretinopathy. The degree of retinal detachment in each treatment group was graded, with the unequivocal absence or presence of retinal detachment used as an indicator of treatment success or failure.

[Discrimination difficulties--expression of disordered relative localization?].

Spatial uncertainty was examined according to a procedure suggested by Bedell and Flom (1981) ("triangle procedure") and additionally with a line-division test designed by Kundt. A horizontal line of a length of about 20 degrees and a shorter one of 4.3 degrees was divided into two equal parts.

[Onchocerciasis infection following temporary stay in endemic areas].

We report the clinical picture of an European female patient, who suffered from Onchocercosis after a 4 year stay in endemic areas in Africa. The diagnosis was based on repeated skin-snips. Despite two courses of systemic chemotherapy, initial corneal changes could be observed as peripheral superficial stroma infiltrations.

[Post-concussion decrease in aniseikonia tolerance].

Besides loss of convergence and accommodation, head injuries can cause fusion deficiency. Part function of sensory fusion is tolerance to sphaerical and meridional aniseikonia. We will present a patient, whose aniseikonia tolerance decreased after a brain concussion.