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Siddiqui MZ, Elhusseiny AM, Phillips PH, Ramakrishnaiah RH, Gokden M, Carrillo LF, Chacko JG. Diffuse Leptomeningeal Glioneuronal Tumor Presenting With Progressive Cranial Neuropathies. J Neuroophthalmol 2024; 44:e129-e131. [PMID: 38366543 DOI: 10.1097/wno.0000000000001779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Affiliation(s)
- Mohammad Z Siddiqui
- Department of Ophthalmology (MZS, AME, PHP, JGC), Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Radiology (RR), Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Department of Pathology (MG, LC), University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Fong JW, Chacko JG. Demographic and clinical characteristics of age-related distance esotropia. J AAPOS 2023; 27:145.e1-145.e3. [PMID: 37182653 DOI: 10.1016/j.jaapos.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/03/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Age-related distance esotropia (ARDE), is an acquired, small, comitant esodeviation that is greater at distance than at near. It occurs in older adult patients without a history of neurological event or prior strabismus. It has been observed more frequently in White adults than in other racial groups. The purpose of this study was to assess the demographic and clinical characteristics of patients with ARDE presenting at a tertiary neuro-ophthalmology clinic. METHODS In this retrospective study, ICD-9/10 (ICD-9 378.85 and ICD-10 H51.8) codes were used to identify all patients with ARDE from 2005 to 2020 seen in a single tertiary neuro-ophthalmology clinic. ARDE was defined as esotropia greater at distance than near with associated clinical signs of adnexal tissue laxity. Patients with history or findings compatible with other etiologies of strabismus, such as thyroid eye disease, neuromuscular disorders, sensory deviations, sudden onset of diplopia, and high myopia, as well as those with prior strabismus surgery, were excluded. RESULTS A total of 89 patients (59 females [66%]) met inclusion criteria. Mean patient age was 76.6 years. All patients were White except for a single patient of African descent. Mean follow-up time was 25.2 months. Mean esodeviation at distance on presentation was 6.6Δ. Of the 87 patients electing nonsurgical treatment, 80 achieved remission of diplopia symptoms with prism therapy alone. Of the 89 patients, 59 had no neuroimaging. CONCLUSIONS ARDE in our neuro-ophthalmology clinic population was diagnosed almost exclusively in older White adults. Prism therapy was effective for a majority of our patients.
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Affiliation(s)
- Joseph W Fong
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, Tennessee.
| | - Joseph G Chacko
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Chacko JA, Broyles HV, Chacko JG, Uwaydat SH. Documented Reperfusion of the Retina on Fluorescein Angiography after Administration of Intravenous Prostaglandin E1 for Central Retinal Artery Occlusion: A Case Report. Case Rep Ophthalmol 2023; 14:469-476. [PMID: 37901635 PMCID: PMC10601880 DOI: 10.1159/000533404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/27/2023] [Indexed: 10/31/2023] Open
Abstract
Central retinal artery occlusion (CRAO) can result in devastating permanent vision loss. Presently, there is no evidence-based treatment for CRAO that is widely accepted. In the literature, multiple studies propose intravenous (IV) prostaglandin E1 (IV PGE1) as a potential treatment option for patients with CRAO. We illustrate 2 cases of CRAO successfully treated with IV PGE1. In both cases, our patients with vascular risk factors were diagnosed with CRAO of the left eye. They were started on twice daily IV 40 μg PGE1 in 100 mL normal saline, with each dose administered over 3 h. In the first case, we documented reperfusion of the retina on fluorescein angiography after administration of IV PGE1. In the second case, our patient improved from no light perception visual acuity (VA) to count fingers VA within 48 h of treatment with IV PGE1. Our study highlights the vasodilatory effect of IV PGE1. Due to its mechanism of action and safety profile, it should be considered a potential treatment option for CRAO. Further randomized controlled trials are necessary to determine the overall therapeutic effect of IV PGE1 for CRAO.
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Affiliation(s)
- J. Anthony Chacko
- Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Heather V. Broyles
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Joseph G. Chacko
- Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Sami H. Uwaydat
- Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
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Chauhan MZ, Chacko JG, Ghaffarieh A, Moulin CM, Pelaez D, Uwaydat SH, Bhattacharya SK. Mitochondrial Triglyceride Dysregulation in Optic Nerves Following Indirect Traumatic Optic Neuropathy. Biomolecules 2022; 12:biom12121885. [PMID: 36551313 PMCID: PMC9775509 DOI: 10.3390/biom12121885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The purpose of this work is to identify mitochondrial optic nerve (ON) lipid alterations associated with sonication-induced traumatic optic neuropathy (TON). Briefly, a mouse model of indirect TON was generated using sound energy concentrated focally at the entrance of the optic canal using a laboratory sonifier (Branson Digital Sonifier 450, Danbury, CT, USA) with a microtip probe. We performed an analysis of a previously generated dataset from high-performance liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS). We analyzed lipids from isolated mitochondria from the ON at 1 day, 7 days, and 14 days post-sonication compared to non-sonicated controls. Lipid abundance alterations in post-sonicated ON mitochondria were evaluated with 1-way ANOVA (FDR-adjusted significant p-value < 0.01), debiased sparse partial correlation (DSPC) network modeling, and partial least squares-discriminant analysis (PLS-DA). We find temporal alterations in triglyceride metabolism are observed in ON mitochondria of mice following sonication-induced optic neuropathy with notable depletions of TG(18:1/18:2/18:2), TG(18:1/18:1/18:1), and TG(16:0/16:0/18:1). Depletion of mitochondrial triglycerides may mediate ON damage in indirect traumatic optic neuropathy through loss energy substrates for neuronal metabolism.
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Affiliation(s)
- Muhammad Z. Chauhan
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
- Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joseph G. Chacko
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
| | - Alireza Ghaffarieh
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
| | - Chloe M. Moulin
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Daniel Pelaez
- Dr. Nasser Al-Rashid Orbital Vision Research Center, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Sami H. Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences Little Rock, Little Rock, AR 72205, USA
- Correspondence: (S.H.U.); (S.K.B.); Tel.: +305-482-4103 (S.K.B.)
| | - Sanjoy K. Bhattacharya
- Miami Integrative Metabolomics Research Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Correspondence: (S.H.U.); (S.K.B.); Tel.: +305-482-4103 (S.K.B.)
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Hsu C, Uwaydat SH, Chacko JG. Toxoplasma Neuroretinitis. Case Rep Ophthalmol 2022; 13:751-755. [PMID: 36845446 PMCID: PMC9944202 DOI: 10.1159/000526682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 11/19/2022] Open
Abstract
Neuroretinitis is an inflammatory condition with rapid unilateral vision loss, optic disc edema, and macular star formation. While neuroretinitis is commonly due to infectious causes such as Bartonella henselae, neuroretinitis due to toxoplasmosis is uncommon. A 29-year-old male presents to our neuro-ophthalmology clinic on December 7, 2021, at the University of Arkansas for Medical Sciences with symptoms of left eye pain and blurred vision. Subsequent workup led to the diagnosis and treatment of toxoplasma neuroretinitis. The fundus exam eventually demonstrated a notable macular star. Treatment was well tolerated, and the patient regained total visual acuity in the affected eye. Toxoplasma neuroretinitis is known for a characteristic appearance of optic disc edema prior to appearance of stellate maculopathy with vitreous inflammation and peripheral chorioretinal scars. Although loss of vision due to toxoplasmosis is rare, it should be included as part of the differential diagnosis with pertinent history.
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Affiliation(s)
- Christine Hsu
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Sami H. Uwaydat
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Chauhan MZ, Chacko JG, Phillips PH, Siddiqui MZ, Uwaydat SH. Association of Acute Zonal Occult Outer Retinopathy With Multiple Sclerosis: A Report of 2 Cases. J Neuroophthalmol 2022; 42:e377-e380. [PMID: 34270517 DOI: 10.1097/wno.0000000000001283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Muhammad Z Chauhan
- Department of Ophthalmology (MZC), College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; and Department of Ophthalmology (JGC, PHP, MZS, SHU), Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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Affiliation(s)
- Joseph W Fong
- Department of Ophthalmology, Jones Eye Institute, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas
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Taylor-Cooke PA, Chacko JG, Chelette K, Mennemeier MS. Lateralized Effects in Troxler Fading and Parvo and Magnocellular Processing Tasks after Localized 1Hz rTMS. Front Neurol Neurosci Res 2021; 2:100013. [PMID: 34296218 PMCID: PMC8294715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Troxler Fading (TF) is a complex visual phenomenon with uncertain mechanisms. This study was performed to test hypotheses concerning the contributions of parvocellular and magnocelluar processing in extrastriate pathways to TF. The study used low-frequency, repetitive Transcranial Magnetic Stimulation (rTMS) delivered at target sites in the parietal, temporal and dorsolateral frontal cortex to alter performance on a TF paradigm and on tests sensitive to parvocellular and magnocellular processing. Nine, right-handed, healthy subjects completed 3 tasks, TF, Texture Detection (TD), and Motion Detection (MD), at baseline and after undergoing 15 minutes of low-frequency rTMS at each cortical site on separate occasions. Results revealed lateralized effects of rTMS on each test. Left temporal stimulation slowed the parvocellular, TD task and it accelerated TF. Right parietal stimulation markedly accelerated TF whereas left parietal stimulation slowed TF. Right frontal stimulation accelerated performance on the magnocellular, MD task. Taken together and in the context of other research studies, the findings suggest hemispheric specialization both for TF and for the parvocellular and magnocellular processing tasks.
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Affiliation(s)
- Patricia A. Taylor-Cooke
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, USA
| | - Joseph G. Chacko
- Departments of Ophthalmology and Neurology, University of Arkansas for Medical Sciences, USA
| | | | - Mark S. Mennemeier
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, USA
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Chacko JA, Strati P, Stout PW, Archer RL, Baltz BP, Chacko JG. Primary mediastinal large B-cell lymphoma in a patient on Fingolimod for relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2021; 49:102776. [PMID: 33508568 DOI: 10.1016/j.msard.2021.102776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/03/2021] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND There are multiple case reports in the literature describing an association between fingolimod and cutaneous neoplasms. OBJECTIVE Investigate and report a case of a primary mediastinal large B-cell lymphoma in a patient on fingolimod for Relapsing-Remitting Multiple Sclerosis (RRMS). METHODS Case Report. RESULTS The patient developed a primary mediastinal large B-cell lymphoma after seven years of treatment with fingolimod. The patient is currently in complete remission after cessation of treatment, surgical resection, chemotherapy, and radiation therapy. CONCLUSION This case report highlights the first primary mediastinal large B-cell lymphoma associated with fingolimod treatment. It should be considered a rare, but potential adverse effect of fingolimod.
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Affiliation(s)
- Joseph A Chacko
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Paolo Strati
- Department of Lymphoma/Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paul W Stout
- Arkansas Pathology Associates PA, Little Rock, AR, USA
| | - Robert L Archer
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Brad P Baltz
- Hematology/Oncology Division, CHI St. Vincent Infirmary, Little Rock, AR, USA
| | - Joseph G Chacko
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Wright HE, Brodsky MC, Chacko JG, Ramakrishnaiah RH, Phillips PH. Diplopia is better than no plopia! Surv Ophthalmol 2017; 62:875-881. [DOI: 10.1016/j.survophthal.2017.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 03/29/2017] [Indexed: 12/17/2022]
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Abstract
Giant-cell arteritis (GCA) is a systemic autoimmune disease affecting primarily the elderly. Giant cell arteritis can cause sudden and potentially bilateral sequential vision loss in the elderly. Therefore, it is considered a medical emergency in ophthalmology and a significant cause of morbidity in an increasingly aging population. Ophthalmologists need to be able to recognize the classic symptoms and signs of this disease, and then be able to work-up and treat these patients in an efficient manner. An in-depth review of GCA from the literature as well as personal clinical experience follows.
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Affiliation(s)
- Joseph G Chacko
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, 4301 W. Markham, #523, Little Rock, AR 72205, USA
| | | | - Michael W Salter
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, 4301 W. Markham, #523, Little Rock, AR 72205, USA
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Vora A, Chacko JG. Paraneoplastic myasthenia gravis. J Ark Med Soc 2013; 109:180-182. [PMID: 23451406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Amy Vora
- Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Dumitrascu OM, Chacko JG, Nazarian S. Cryptococcal Meningitis in a Young Obese Female with Takayasu Arteritis and Idiopathic Intracranial Hypertension. Neuroophthalmology 2012. [DOI: 10.3109/01658107.2012.686554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Deacon BS, Chacko JG. Case of the missed opportunity for temporal artery biopsy. J Ark Med Soc 2009; 106:86-87. [PMID: 19813397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Chacko JG, Phillips PH. Optic nerve head drusen simulating a bitemporal hemianopia. Ann Ophthalmol (Skokie) 2009; 41:47-49. [PMID: 19413228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 70-year-old man right eye over 5 weeks. He was found clinically to have a bitemporal hemianopia and bilateral disc edema. Testing revealed optic nerve head drusen (ONHD) bilaterally causing enlarged blind spots (pseudo-bitemporal hemianopia). This case illustrates that ONHD should be listed in the differential diagnosis for bitemporal hemianopia when brain imaging is normal.
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Affiliation(s)
- Joseph G Chacko
- Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
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Chacko JG, Schatz NJ, Glaser JS. Delayed optic nerve complications after proton beam irradiation. Ann Ophthalmol (Skokie) 2008; 40:166-170. [PMID: 19230355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We present two cases of delayed optic nerve complications following proton beam radiotherapy. Patient 1 received radiotherapy after surgery for clival chordoma and developed sequential radiation optic neuropathy at 5 and 9 months. Patient 2 developed optic nerve hemorrhage post radiotherapy for optic nerve sheath meningioma. These two cases of blindness demonstrate the risks associated with proton beam radiotherapy.
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Affiliation(s)
- Joseph G Chacko
- Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.
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Chacko JG, Figueroa RE, Johnson MH, Marcus DM, Brooks SE. Detection and localization of steel intraocular foreign bodies using computed tomography. A comparison of helical and conventional axial scanning. Ophthalmology 1997; 104:319-23. [PMID: 9052639 DOI: 10.1016/s0161-6420(97)30317-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To compare the sensitivity and specificity of detection, and accuracy of localization, of small steel intraocular and episcleral foreign bodies, using conventional axial and helical computed tomographic scanning in an experimental model. METHODS Small steel foreign bodies ranging in size from 0.048 to 0.179 mm3 were placed in intraocular and episcleral locations in eye bank eyes mounted in the orbits of a human skull and scanned using helical and conventional axial techniques. Helical scanning was performed using 1-mm and 3-mm thick sections. Conventional axial scanning was performed using 3-mm thick sections. Images were reviewed by masked observers to determine sensitivity, specificity, and accuracy of localization for each imaging method. RESULTS Steel foreign bodies as small as 0.048 mm3 were detectable with each scanning protocol. Although the helical scans appeared to provide higher levels of sensitivity compared to conventional axial scanning, the difference in outcome between the scan types was not statistically significant. Sensitivity was dependent on the size of the foreign body and ranged from 45% to 65% for the smaller ones (< 0.06 mm3) to 100% for the larger ones (> 0.06 mm3). Multiplanar reformatting of images was helpful in achieving optimal accuracy. CONCLUSION In an experimental model of steel intraocular foreign body, helical computed tomographic scanning provided images of high quality similar to that of conventional axial scanning.
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Affiliation(s)
- J G Chacko
- Department of Ophthalmology, Medical College of Georgia, Augusta 30912, USA
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Lord R, Naish C, Taylor C, Stanford CA, Stanford CJ, Chacko JG, Debanbu V, Samson PD, Berchmans J, Surendran D. Skin test studies on close contacts of leprosy patients in India. Int J Lepr Other Mycobact Dis 1989; 57:801-9. [PMID: 2809346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Skin-test studies with a series of tuberculins have been carried out in close contacts of multibacillary (MB) leprosy patients around three leprosy centers in India, and casual contacts of the disease around two centers. The results show that the rate of acquisition of leprosin A positivity is associated with age and the closeness of contact with MB leprosy. At the age of 15 years, the differences between the two types of contact were highly significant (p less than 0.00001). Many responses to leprosin A are directed toward the group iv species-specific, antigens of the leprosy bacillus, and the significance of positivity is discussed in relation to protective immunity from leprosy. The differences from Iran show that positivity to leprosin A is not solely the effect of the degree of contact with the disease, but must also have a genetic or environmental element, the latter being favored. The results from Miraj show that the high levels of tuberculin, scrofulin, and vaccin positivity seen in Fathimanagar, and to a lesser extent in Karigiri, are not a consequence of contact with leprosy. BCG vaccination made little difference to the leprosin A positivity of close contacts of leprosy patients, although it significantly enhanced positivity among casual contacts around Miraj (p less than 0.002). BCG vaccination significantly increased tuberculin positivity in Miraj and Karigri, and in those under 11 years of age in Fathimanagar. It made no difference to the already high level of positivity found in older persons around Fathimanagar.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Lord
- Middlesex Hospital Medical School St. Bartholomew's Hospital Medical College, C.A. Stanford
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