Intraocular manifestations of tuberculosis (TB) are rare, but TB infection is common worldwide, especially in developing economies, and in immigrant populations and immunocompromised patients in developed nations. The current review focuses on the clinical characteristics and diagnostic modalities useful in the diagnosis of intraocular TB. Specifically, IFN-gamma Release Assays (IGRAs), antigen-detection assays, and polymerase chain reactions will be discussed. Clinical management of TB patients includes counseling and testing for HIV infection. The use of corticosteroids along with anti-tuberculous medications and special therapeutic considerations in immunocompromised patients are discussed.
The authors report in vivo morphology of opaque bubble layers with ultrahigh-resolution anterior-segment optical coherence tomography (UHR-OCT) in 3 patients. Two patients were operated on with a 30-kHz IntraLase femtosecond laser (Abbott Medical Optics, Abbott Park, IL) and one patient was operated on with a 500-kHz VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany). UHR-OCT images from the patient operated on with the 500-kHz femtosecond laser revealed that the opaque bubble layer extended anterior to the flap dissection plane up to Bowman's membrane. The lamellar flap dissection was incomplete in this patient. The opaque bubble layer in the patients operated on with the 30-kHz femtosecond laser extended posterior to the flap dissection plane and these patients experienced complete lamellar dissections with uncomplicated flap lifts. UHR-OCT imaging can be used to demonstrate the structural characteristics of OBL. It has the potential to be used to predict incomplete lamellar flap dissections in patients with opaque bubble layers.
Patient education with emphasis on compliance with nutritional supplements is essential after bariatric surgery. Consider vitamin A deficiency in the differential diagnosis of dry eye after LASIK surgery.
771ducklings. I t was rarely evident beyond a 1:4 dilution of the plasma, and was fully removed by heating the plasma for one-half hour at 55-56'C followed by centrifugation to remove the precipitate which formed. In infected ducks 3 months of age or older these heat-labile agglutinins generally decreased as the infection progressed, except in individuals which exhibited a strong innate resistance to the parasites. The heat-labile agglutinins disappeared completely at the peak of a severe infection. Heat-stable agglutinins appeared in the plasma of most of the infected birds. These, unlike the heat-labile agglutinins, were not demonstrable in undiluted plasma but often were active in plasma diluted as far as 1:lOOO. In ducklings infected when they were one month old or younger, heat-stable agglutinins did not appear. As in severely infected older ducks, the heat-labile agglutinins vanished at the peak of the infection. If such ducklings were saved from death by treatment with quinine the heat-labile agglutinins reappeared to a varying degree. Relapses, like inistial infections, were accompanied by a lack of heat-labile agglutinins.
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