Database : MEDLINE
Search on : Mydriasis [Words]
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[PMID]: 29512320
[Au] Autor:Holt NR; Nickson CP
[Ad] Address:Department of General Internal Medicine, Alfred Hospital, Melbourne, Victoria, Australia.
[Ti] Title:Severe methanol poisoning with neurological sequelae: implications for diagnosis and management.
[So] Source:Intern Med J;48(3):335-339, 2018 Mar.
[Is] ISSN:1445-5994
[Cp] Country of publication:Australia
[La] Language:eng
[Ab] Abstract:A 22-year-old woman presented with methanol toxicity manifesting as headache, reduced conscious state and visual change after consuming home-made grappa. She progressed to a coma with fixed mydriasis and severe acidaemia (pH 6.55). She was treated with empirical antidote administration (intravenous ethanol) and enhanced elimination through haemodialysis. She survived despite her delayed presentation but developed significant neurological sequelae, including visual impairment. We provide an overview of key elements of diagnosis and recent updates in treatment recommendations.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:In-Data-Review
[do] DOI:10.1111/imj.13725

  2 / 2395 MEDLINE  
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[PMID]: 29506872
[Au] Autor:Johnson NR; Singh NR; Oztel M; Vangaveti VN; Rahmel BB; Ramalingam L
[Ad] Address:Maxillofacial Department, The Townsville Hospital, Townsville, Queensland, Australia; The University of Queensland, School of Medicine, Brisbane, Queensland, Australia. Electronic address: nigel.johnson1@uqconnect.edu.au.
[Ti] Title:Ophthalmological injuries associated with fractures of the orbitozygomaticomaxillary complex.
[So] Source:Br J Oral Maxillofac Surg;, 2018 Mar 02.
[Is] ISSN:1532-1940
[Cp] Country of publication:Scotland
[La] Language:eng
[Ab] Abstract:Our aim was to evaluate ophthalmological injuries associated with fractures of the orbitozygomaticomaxillary complex that required operative treatment, and we collected data retrospectively over a period of five years (2012-2016 inclusive). Of the 190 patients, 162 were male with a median age of 31 (IQR 25 -39) years. Assault was the most common mechanism of injury (125/190, 66%). Minor ophthalmic injuries (those unlikely to cause permanent visual disturbance) and major ophthalmic injuries (those with the potential to cause permanent visual disturbance) were recorded. The common minor ophthalmic injuries were: diplopia, enophthalmos, proptosis, subconjunctival haemorrhage, and restriction of the extraocular muscles. Commotio retinae, traumatic mydriasis, retro-orbital haemorrhage, and hyphaema were the common major ophthalmic injuries. All 13 different major ophthalmic injuries were recorded in the group who had had orbital fractures reconstructed, which suggested that more intraocular damage can be caused by this type of fracture than by others. Visual acuity was reduced in 26/190 patients with only four having persistent postoperative changes at six weeks. The odds ratio for those patients who had a major ophthalmological injury and were unable to drive was 0.07 (95% CI 0.02 to 0.21, p=0.001), which was highly significant. Ophthalmological assessment is strongly recommended for patients with fractures of the orbitozygomaticomaxillary complex.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[St] Status:Publisher

  3 / 2395 MEDLINE  
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[PMID]: 29198552
[Au] Autor:Wu TE; Chen HS
[Ad] Address:Department of Ophthalmology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.
[Ti] Title:Increased prevalence of proliferative retinopathy in patients with acromegaly.
[So] Source:J Chin Med Assoc;81(3):230-235, 2018 Mar.
[Is] ISSN:1728-7731
[Cp] Country of publication:China (Republic : 1949- )
[La] Language:eng
[Ab] Abstract:BACKGROUND: This pilot study was carried to determine the prevalence of retinopathy, especially proliferative retinopathy, in patients with acromegaly. METHODS: We analyzed 43 acromegalic patients and 129 age- and gender-matched patients with type 2 diabetes. The retinopathy status was determined from the medical records based on the ophthalmologist consultations of patients with acromegaly. Color photographs of the macula- and disc-centered views were obtained at an angle of 45° with a fundus camera after pharmacologic-induced mydriasis in patients with type 2 diabetes. RESULTS: Compared with age- and gender-matched patients with type 2 diabetes, the acromegalic patients had lower fasting plasma glucose levels and lower systolic and diastolic blood pressures, but were taller and had higher IGF-1 levels. Any degree of retinopathy was present in 9.3% (4 of 43) of patients with acromegaly and 34.9% (45 of 129) of patients with type 2 diabetes (odds ratio [OR] = 0.191; 95% confidence interval [CI] = 0.064-0.570). Proliferative retinopathy was present in 9.3% (4 of 43) of patients with acromegaly and 9.3% (12 of 129) of patients with type 2 diabetes (OR = 1.000; 95% CI = 0.305-3.281). Non-proliferative retinopathy was absent in patients with acromegaly, but present in 25.9% (33 of 129) of patients with type 2 diabetes. CONCLUSION: The high proliferative, but absence of non-proliferative retinopathy in our patients with acromegaly may reflect the pathogenic effect of IGF-1 on neovascularization. IGF-1 may play an important role in proliferative retinopathy, but may play no role in non-proliferative retinopathy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180303
[Lr] Last revision date:180303
[St] Status:In-Data-Review

  4 / 2395 MEDLINE  
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[PMID]: 29478226
[Au] Autor:Mansoori T; Agraharam SG
[Ad] Address:Sita Lakshmi Glaucoma Center, Anand Eye Institute, Habsiguda, Hyderabad, Telangana, 500007, India. tarannummansoori@yahoo.com.
[Ti] Title:Reverse Pupillary Block After Retinal Detachment Surgery in an Eye with Toric Implantable Collamer Lens.
[So] Source:Int Ophthalmol;, 2018 Feb 24.
[Is] ISSN:1573-2630
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:PURPOSE: To report an interesting phenomenon, after vitreoretinal surgery, in an eye with toric implantable collamer lens (ICL). METHODS: A 20-year-old male presented with raised intraocular pressure (IOP) after the retinal detachment surgery in the left eye. He had toric ICL in both the eyes, and left eye showed shallow peripheral anterior chamber depth (ACD), narrow iridocorneal angle (ICA), increased ICL vault and pigments debris blocking central hole. After dilation, peripheral ACD deepened, ICL vault decreased and ICA increased, with posterior bowing of iris. RESULTS: Patient was managed with topical steroids and antiglaucoma medications. A month later, after inflammation subsided, central hole of ICL became patent, peripheral ACD deepened, ICA increased and IOP was normal without medications, however, after dilation, posterior bowing of iris persisted. He was speculated to have unusual presentation of reverse pupillary block in the left eye after mydriasis. This phenomenon was not observed in the right eye. CONCLUSION: Reverse pupillary block, after dilation is an unusual phenomenon, which was seen in a silicone-filled eye with toric ICL implant. In cases of inflammatory debris blocking Aquaport opening of ICL, conservative management with topical steroids and antiglaucoma medications can help reduce inflammation and IOP, alleviating need for any intervention, such as laser iridotomy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180225
[Lr] Last revision date:180225
[St] Status:Publisher
[do] DOI:10.1007/s10792-018-0848-8

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[PMID]: 29412150
[Au] Autor:Khalaily S; Tsumi E; Lifshitz T; Kratz A; Levy J
[Ad] Address:Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: kh_soltan@yahoo.com.
[Ti] Title:Airsoft gun-related ocular injuries: long-term follow-up.
[So] Source:J AAPOS;, 2018 Feb 15.
[Is] ISSN:1528-3933
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To describe the long-term ocular effects of airsoft gun pellet injuries. METHODS: The present study extends by 7-10 years the results of a 2010 study on the acute ocular findings related to airsoft gun pellet injuries in 59 patients, wherein we found a variety of anterior and posterior segment injuries, including hyphema (66%), corneal edema (61%), corneal erosions (59%), and traumatic mydriasis (25%), as well as retinal edema in (22%), retinal hemorrhages and mild vitreous hemorrhage in (2.1%), and, in 1 patient, elevated intraocular pressure and traumatic cataract. RESULTS: Of the 59 patients in the original study, up-to-date medical records were available for 26 (44%; 20 males). The mean follow-up time was 8 years (range, 7.2-10.3 years); the mean age, 17.1 years. Persistent abnormal findings included traumatic cataract in 3 cases (11.5%) and iris dialysis in 1 case (3.8%). In all traumatic cataract cases, cataract was not present at the time of initial examination after injury. Final mean best-corrected visual acuity was 0.92 (range 0.67-1.0), logMAR 0.03 (range 0.18-0). CONCLUSIONS: While most acute airsoft gun-related ocular injuries are transient, some patients may develop significant and potentially sight-threatening ocular damage, even in the absence of significant pathologic findings at the time of the injury. Long-term follow-up on these patients is advisable.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[St] Status:Publisher

  6 / 2395 MEDLINE  
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[PMID]: 29450874
[Au] Autor:Karaca Ö; Ahiskalioglu A; Aksoy M; Dogan R; Oral Ahiskalioglu E
[Ti] Title:What happened? An inexplicable case: Accidental subdural block.
[So] Source:Agri;30(1):31-34, 2018 Jan.
[Is] ISSN:1300-0012
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Epidural block is an appropriate anesthesia method for outpatient operation. This technique is generally safe and efficient. We present the case of a 20-year-old female patient with accidental subdural block after a single dose of epidural block for pilonidal sinus surgery. Sudden apnea, unconsciousness, and bilateral mydriasis occurred within a few minutes after injection. Within 80 minutes after injection, the patient regained full consciousness and spontaneous respiration, with motor block in lower extremities and sensory block until the T4 level. Motor block continued until 165 minutes after injection, whereas sensory block ended 225 minutes later.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Process
[do] DOI:10.5505/agri.2016.68736

  7 / 2395 MEDLINE  
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[PMID]: 29446702
[Au] Autor:Uçan Gündüz G; Parmak Yener N; Kilinçel O; Gündüz C
[Ad] Address:1 Department of Ophthalmology, Faculty of Medicine, Uludag University , Bursa, Turkey .
[Ti] Title:How Does Usage of Serotonin Noradrenaline Reuptake Inhibitors Affect Intraocular Pressure in Depression Patients?
[So] Source:J Ocul Pharmacol Ther;, 2018 Feb 15.
[Is] ISSN:1557-7732
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To evaluate anterior segment parameters and intraocular pressure (IOP) modifications in patients using serotonin noradrenaline reuptake inhibitors (SNRIs) due to major depressive disorder. METHODS: This cross-sectional study included 170 eyes of 85 subjects. All subjects were divided into three groups: group 1 included 44 healthy control subjects, group 2 included 22 patients receiving antidepressants for 1 week to 6 months, and group 3 included 19 patients receiving antidepressants for >6 months. All subjects underwent a detailed ophthalmologic examination, including gonioscopy. Anterior segments of all subjects were evaluated with the Scheimpflug system and pupil diameter (PD), central corneal thickness, anterior chamber depth (ACD), anterior chamber volume, and anterior chamber angle (ACA) measurements were enrolled. RESULTS: The median IOP was significantly lower in patients using antidepressants [16.0 (11.0-21.0) mmHg] than the control group [17.5 (12.0-21.0) mmHg] (P = 0.041). The PD was significantly larger in patients using antidepressants [3.56 (2.29-5.60) mm] than the control group [2.95 (2.00-4.40) mm] (P = 0.000). In the study group, PD was also significantly larger in patients using SNRIs for ≥6 months [3.67 (2.38-5.08) mm] than <6 months [3.31 (2.29-5.60) mm] (P = 0.000). The median ACD was significantly lower in patients using antidepressants for ≥6 months [3.21 (2.52-4.06) mm] than the control group [3.44 (2.63-4.29) mm] (P = 0.000). ACAs were measured between 25° and 55° by Scheimpflug imaging. CONCLUSIONS: Treatment of SNRIs causes mydriasis and decrease in width of ACD. These changes may not increase IOP as long as the patient has an open angle. SNRIs lead to decrease in IOP particularly in long-term usage.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180215
[Lr] Last revision date:180215
[St] Status:Publisher
[do] DOI:10.1089/jop.2017.0133

  8 / 2395 MEDLINE  
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[PMID]: 29328565
[Au] Autor:Jovanovic V; Nikolic L
[Ti] Title:Urrets-Zavalia syndrome after deep anterior lamellar keratoplasty
[So] Source:Vojnosanit Pregl;73(10):973-5, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] Country of publication:Serbia
[La] Language:eng
[Ab] Abstract:Introduction: Urrets-Zavalia syndrome is an uncommon complication of the deep anterior lamellar keratoplasty in keratoconus. The manifestations of this syndrome are an irreversible mydriasis, iris atrophy and secondary glaucoma. Case report: Deep anterior lamellar keratoplasty was done for keratoconus with a presumably healed corneal hydrops in a 21-year-old Caucasian man. The graft remained clear, but the surgery was complicated by a fixed, dilated pupil, patches of iris atrophy, ectropium of the iris pigment layer and glaukomflecken in the lens. Conclusion: Although safer than penetrating keratoplasty, the deep anterior lamellar by not trying to secure an unhealed Descemet's membrane with air. Instead, a new Descemet's membrane transplanted within a penetrating graft is a safer choice.
[Mh] MeSH terms primary: Corneal Transplantation/adverse effects
Glaucoma/etiology
Iris Diseases/etiology
Keratoconus/surgery
Mydriasis/etiology
[Mh] MeSH terms secundary: Atrophy
Glaucoma/diagnosis
Humans
Iris/pathology
Iris Diseases/diagnosis
Keratoconus/diagnosis
Male
Mydriasis/diagnosis
Syndrome
Young Adult
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180213
[Lr] Last revision date:180213
[Js] Journal subset:IM
[Da] Date of entry for processing:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141109088J

  9 / 2395 MEDLINE  
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[PMID]: 29426462
[Au] Autor:Nakatsuka AS; Beaver HA; Lee AG
[Ad] Address:University of Texas Medical Branch, Galveston, TX. Electronic address: austin32@hawaii.edu.
[Ti] Title:Mydriasis due to Opcon-A: An indication to avoid pharmacologic testing for anisocoria.
[So] Source:Can J Ophthalmol;53(1):e6-e7, 2018 Feb.
[Is] ISSN:1715-3360
[Cp] Country of publication:England
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180210
[Lr] Last revision date:180210
[St] Status:In-Data-Review

  10 / 2395 MEDLINE  
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[PMID]: 29300374
[Au] Autor:Regalado ES; Mellor-Crummey L; De Backer J; Braverman AC; Ades L; Benedict S; Bradley TJ; Brickner ME; Chatfield KC; Child A; Feist C; Holmes KW; Iannucci G; Lorenz B; Mark P; Morisaki T; Morisaki H; Morris SA; Mitchell AL; Ostergaard JR; Richer J; Sallee D; Shalhub S; Tekin M; Estrera A; Musolino P; Yetman A; Pyeritz R; Milewicz DM; Montalcino Aortic Consortium
[Ad] Address:Department of Internal Medicine, University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA.
[Ti] Title:Clinical history and management recommendations of the smooth muscle dysfunction syndrome due to ACTA2 arginine 179 alterations.
[So] Source:Genet Med;, 2018 Jan 04.
[Is] ISSN:1530-0366
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PurposeSmooth muscle dysfunction syndrome (SMDS) due to heterozygous ACTA2 arginine 179 alterations is characterized by patent ductus arteriosus, vasculopathy (aneurysm and occlusive lesions), pulmonary arterial hypertension, and other complications in smooth muscle-dependent organs. We sought to define the clinical history of SMDS to develop recommendations for evaluation and management.MethodsMedical records of 33 patients with SMDS (median age 12 years) were abstracted and analyzed.ResultsAll patients had congenital mydriasis and related pupillary abnormalities at birth and presented in infancy with a patent ductus arteriosus or aortopulmonary window. Patients had cerebrovascular disease characterized by small vessel disease (hyperintense periventricular white matter lesions; 95%), intracranial artery stenosis (77%), ischemic strokes (27%), and seizures (18%). Twelve (36%) patients had thoracic aortic aneurysm repair or dissection at median age of 14 years and aortic disease was fully penetrant by the age of 25 years. Three (9%) patients had axillary artery aneurysms complicated by thromboembolic episodes. Nine patients died between the ages of 0.5 and 32 years due to aortic, pulmonary, or stroke complications, or unknown causes.ConclusionBased on these data, recommendations are provided for the surveillance and management of SMDS to help prevent early-onset life-threatening complications.GENETICS in MEDICINE advance online publication, 4 January 2018; doi:10.1038/gim.2017.245.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180210
[Lr] Last revision date:180210
[St] Status:Publisher
[do] DOI:10.1038/gim.2017.245


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