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Ординатура / Офтальмология / Английские материалы / Oxford American Handbook of Ophthalmology_Tsai, Denniston, Murray_2011

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716 CHAPTER 23 Miscellaneous

Rubinstein–Taybi syndrome (otopalatodigital syndrome) Developmental abnormality; hypertelorism, colobomas; broad thumbs/big toes, maxillary/ mandibular hypoplasia, hypertrichosis, dIQ.

Sandhoff’s disease Autosomal recessive (Ch 5q, HEXB); GM2 gangliosidosis with deficiency of hexosominadase A and B; cherry-red spot, optic atrophy; splenomegaly, neurodegeneration.

Stargardt’s disease (and fundus flavimaculatus) Autosomal recessive (usually Ch1p, ABCA4); most common of the macular dystrophies, with two clinical presentations: Stargardt’s (“beaten-bronze” atrophy, yellowish flecks of the posterior pole, significant dVA) and fundus flavimaculatus (widespread pisciform flecks with relative preservation of vision), p. 459.

Steele–Richardson–Olszewski (progressive supranuclear palsy) Neurodegenerative disease of the elderly; supranuclear vertical gaze; postural instability, Parkinsonism, pseudobulbar palsy, and dementia.

Stickler’s syndrome (hereditary arthro-ophthalmopathy) Autosomal dominant (Ch12q, COL2A1); abnormality of type II collagen; high myopia, optically empty vitreous, retinal detachments, cataract, ectopia lentis, glaucoma; arthropathy, Pierre Robin sequence (micrognathia, high arched/cleft palate), sensorineural deafness, mitral valve prolapse, p. 389.

Sturge–Weber syndrome Phakomatosis with port-wine stain of the face with ocular and CNS hemangiomas, p. 645.

Tay–Sachs disease Autosomal recessive (Ch15q, HEXA); GM2 gangliosidosis with deficiency of hexosominadase A; cherry-red spot, optic atrophy; neurodegeneration.

Treacher–Collins syndrome (mandibulofacial dysostosis) Autosomal dominant (Ch5q); clefting syndrome; antimongoloid palpebral fissures, lower lid colobomas, dermoids; mandibular hypoplasia, zygoma hypoplasia, choanal atresia.

Turcot syndrome Variant of familial adenomatous polyposis (autosomal dominant) with CNS neuroepithelial tumors, especially medulloblastoma and glioma; atypical CHRPE, p. 510.

Turner syndrome XO; 1 in 2000 live female births; antimongoloid palpebral fissures, cataracts, convergence insufficiency; short stature, wide carrying angle, low hair line, webbed neck, primary gonadal failure, congenital heart defects, p. 638.

Vogt-Koyanagi–Harada syndrome Multisystem inflammatory disease; bilateral granulomatous panuveitis; vitiligo, alopecia, deafness, tinnitus, sterile meningoencephalitis and cranial neuropathies, p. 342.

Von-Hippel Lindau Autosomal dominant (Ch3p, VHL gene); phakomatosis with retinal capillary hemangiomas, CNS hemangioblastomas, renal cell carcinomas, and other tumors, p. 645.

Waardenburg syndrome Autosomal dominant (PAX3); heterochromia, hypertelorism; white forelock, deafness.

EPONYMOUS SYNDROMES 717

Walker–Warburg syndromeAutosomal recessive; retinal dysplasia; muscular dystrophy, Dandy–Walker malformation.

Wallenberg syndrome (lateral medullary syndrome) Lesion of the lateral medulla (typically posterior inferior cerebellar artery occlusion) resulting in ipsilateral Horner’s syndrome, ipsilateral cerebellar signs, ipsilateral palatal paralysis, ipsilateral decreased facial sensation (pain and temperature), contralateral decreased somatic sensation (pain and temperature).

Weill–Marchesani syndrome Autosomal recessive; ectopia lentis, microspherophakia, retinal detachment, anomalous angles; short stature, brachydactyly, dIQ, p. 258.

Wildervanck syndrome Klippel–Feil malformation (short neck due to cervical vertebrae anomalies) with deafness and Duane’s syndrome.

Wyburn–Mason syndrome Phakomatosis with arteriovenous malformations of retina, orbit, and CNS, p. 645.

Zellweger syndrome (cerebrohepatorenal syndrome) Autosomal recessive; severe end of a spectrum of peroxisomal disorders that includes neonatal adrenoleukodystrophy and infantile Refsum’s disease; cataract, optic nerve hypoplasia, pigmentary retinopathy, corneal clouding; high forehead, flat brows; life expectancy <1 year.

718 CHAPTER 23 Miscellaneous

Web resources for ophthalmologists (1)

Box 23.1 Ophthalmic and related associations

American Academy of Ophthalmology www.aao.org

Association for Research in Vision and Ophthalmology www.arvo.org American Society of Cataract and Refractive Surgery www.ascrs.org American Society of Retina Specialists www.asrs.org

International Council of Ophthalmology (ICO) www.icoph.org International Society for Clinical Electrophysiology of Vision www.iscev.org

International Society for Refractive Surgery www.isrs.org

Box 23.2 American Medical Colleges (US)

American Society of Anesthesiologists www.asahq.org American Academy of Family Physicians www.aafp.org

American College of Obstetricians and Gynecologists www.acog.org American Academy of Ophthalmology www.aao.org

American College of Pediatricians www.acpeds.org College of American Pathologists www.cap.org American College of Physicians www.acponline.org American College of Surgeons www.facs.org American College of Radiology www.acr.org American College of Psychiatrists www.acpsych.org

Box 23.3 Other professional bodies

American Medical Association www.ama-assn.org

United States Department of Health and Human Services www.hhs.gov National Institute of Health www.nih.gov

WEB RESOURCES FOR OPHTHALMOLOGISTS (2) 719

Web resources for ophthalmologists (2)

Box 23.4 Ophthalmic and medical resources

PubMED and MEDLINE www.pubmed.com

Cochrane Eye and Vision Site www.cochraneeyes.org

Clinical Evidence www.clinicalevidence.com

Emedicine www.emedicine.com

Internet Ophthalmology www.ophthal.org

Centers for Disease Control and Prevention www.cdc.gov

World Health Organization www.who.int

Box 23.5 Journals

Ophthalmic

American Journal of Ophthalmology www.ajo.com

Archives of Ophthalmology www.archopht.ama-assn.org

British Journal of Ophthalmology www.bjo.bmjjournals.com

Cornea www.cornealjrnl.com

Current Opinion in Ophthalmology www.co-ophthalmology.com Digital Journal of Ophthalmology www.djo.harvard.edu

Eye www.nature.com/eye

International Ophthalmology Clinics www.internat-ophthalmology.com Investigative Ophthalmology & Visual Science www.iovs.org

Journal of Cataract and Refractive Surgery www.ascrs.org/publicats/jcrs

Journal of Glaucoma www.glaucomajournal.com Ophthalmology www.ophsource.org/periodicals/ophtha

General

British Medical Journal www.bmj.bmjournals.com

New England Journal of Medicine www.nejm.org

The Lancet www.thelancet.com

720 CHAPTER 23 Miscellaneous

Reference intervals

Hematology

CBC

Hb

13.0–18.0 g/dL

 

11.5–16.5 g/dL

Hct

0.40–0.52

 

0.36–0.47

RCC

4.5–6.5 x 1012/L

 

3.8–5.8 x 1012/L

MCV

77–95 fL

MCH

27.0–32.0 pg

Reticulocytes

50–100 x 109/L (0.52.5%)

WCC

4.0–11.0 x 109/L

Neutrophils

2.0–7.5 x 109/L

Lymphocytes

1.5–4.5 x 109/L

Eosinophils

0.04–0.4 x 109/L

Basophils

0.0–0.2 x 109/L

Monocytes

0.2–0.8 x 109/L

Platelets

150–400 x 109/L

ESR

age/2 (Male)

Hematinics

(age +10)/2 (Female)

 

Serum B12

150–700 ng/L

Serum folate

2.0–11.0 μg/L

Red cell folate

160–640 μg/L

Serum ferritin

15–300 μg/L

Clotting

 

INR

0.8–1.2

PT

12–14 s

APTT ratio

0.8–1.2

APTT

26.0–33.5 s

Protein C

80–135 u/dL

Protein S

80–135 u/dL

Antithrombin III

80–120 u/dL

APCR

2.12–4.0

REFERENCE INTERVALS 721

Biochemistry

Urinalysis and glucose

Sodium (Na)

135–145 mmol/L

 

 

Potassium (K)

3.5–5.0 mmol/L

 

Urea

3.0–6.5 mmol/L

 

Creatinine

60–125 μmol/L

 

Glucose (fasting)

3.5–5.5 mmol/L

 

Glucose (random)

3.5–11.0 mmol/L (normal/IGT)

 

LFTs and protein

Total protein

63–80 g/L

Albumin

32–50 g/L

Bilirubin

<17 μmol/L

Alkaline phosphatase

100–300 iu/L

ALT

5–60 iu/L

AST

5–42 iu/L

γGT

10–46 iu/L

Bone

Calcium (total)

2.15–2.55 mmol/L

Phosphate

0.7–1.5 mmol/L

Lipids

 

Cholesterol

3.9–6.0 mmol/L

Triglycerides

0.55–1.90 mmol/L

ACE

12–71 (age 20); 5–87 (age <20)

Iron studies

Iron

14–33 μmol/L

 

11–28 μmol/L

TIBC

45–75 μmol/L

Hormones

TSH

0.35–5.5 mU/L

Free T4

9–24 pmol/L

Cortisol (morning)

450–700 nmol/L

FSH

2–8 u/L (luteal); >25 u/L (menopausal)

LH

3–16 u/L (luteal)

Prolactin

<450 u/L

 

<650 u/L

722 CHAPTER 23 Miscellaneous

Arterial blood gases

 

PH

7.357.45

 

PaO2

>10.6 kPa

 

 

PaCO2

4.76.0 kPa

 

 

BE

± 2.0 mmol/L

Immunology

IgG

5.3–16.5 g/L

IgA

0.8–4.0 g/L

IgM

0.5–2.0 g/L

C3

0.9–2.1 g/L

C4

0.12–0.53 g/L

C1 esterase

0.11–0.36 g/L

CH50

80–120%

CSF analysis

Lymphocytes

<4/mL

Neutrophils

0/mL

Glucose

2/3 plasma level

Protein

<0.4 g/L

Opening pressure

<20 cmH2O, or <25 cmH2O in the obese

Index

A

Abnormal head posture, 578–9

Abnormal retinal correspondence (ARC), 578–9

Accomodative lens, 238 Acetazolamide, 86, 290, 291,

429, 533, 705 Acetylcysteine, 147, 178 Acquired lid disorders,

124

floppy eyelid syndrome, 124

lid retraction, 125 Acquired pendular

nystagmus, 559 Actinic keratosis, 114 Acuity

appropriate clinical test, selecting, 5

distance acuity, 5 LogMAR charts, 7 pinhole acuity, 7 Snellen charts, 6

measuring visual acuity, 5 near (reading) acuity, 7 testing low visual acuity, 8

Acute angle-closure glaucoma (AACG), 273

treatment, 274 Acute anterior uveitis

(AAU), 325–6 causes, 326 HLA-B27-associated

AAU, 325

idiopathic acute anterior uveitis, 325

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE), 368–70

Acute red eye, 648 Acute retinal necrosis

(ARN), 347, 348 Acute zonal occult outer

retinopathy (AZOOR), 371–2

Acyclovir, 147, 174, 177 Adenovirus, 142

Adie’s tonic pupil, 556 Adult inclusion

conjunctivitis, 144 Adult vitelliform

degeneration, 460

723

Age-related macular degeneration (AMD), 408

neovascular, 410–3 non-neovascular, 408,

410–3 Albinism, 464

laser procedures, in diabetic eye disease, 466–7

macular laser, 466–7 ocular, 464 oculocutaneous, 464, 465 panretinal

photocoagulation, 466 Allergic conjunctivitis, 146–7

atopic keratoconjunctivitis, 147

seasonal and perennial allergic

rhinoconjunctivitis, 146 vernal keratoconjunctivitis,

146–7

Alphabet patterns, 593–4 A pattern, 593

causes of, 594 λ–pattern, 594 V pattern, 593–4 X-pattern, 594 Y-pattern, 594

Altitudinal field defects, 49 Amblyopia, 576–7

causes of, 576 clinical features, 576 treatment, 576–7

Ametropic amblyopia, 576 Amikacin, 254–5

Amino acid metabolism disorders, 640

Amitriptyline, 541–2 Amoxicillin, 360 Amphotericin B, 366 Amsler charts, 25 Amsler grid, 24, 48 Anaphylaxis, treatment

of, 693 Anemia, 451

Angioid streaks, 433 Angle recession glaucoma,

287 Aniridia, 631

Anisocoria, 659–60 in bright light, 659 in dim light, 659–60

Anisometropic amblyopia, 576

Ankyloblepharon, 124 Ankylosing spondylitis

(AS), 329

Anterior chamber (AC) depth measurement, 19 ophthalmic signs, 668 reaction, 19

Anterior chamber intraocular lens (ACIOL), 248

Anterior ischemic optic neuropathy (AION), 524

arteritic, 524 nonarteritic, 526, 527 posterior ischemic optic

neuropathy, 526 Anterior scleritis, 221–2 Anterior segment

dysgenesis, 631, 635 Anterior segment

examination, 17, 19 anterior chamber

depth measurement, 19 reaction, 19

illumination techniques, 18 Anterior segment ischemia,

328

Anterior segment OCT (ASOCT), 69

Anticholinesterases, 563 Antihypertensives, 449 Antimetabolites, 302 Antiretroviral therapy

(ART), 352

Anti-VEGF therapy, 413, 415 A pattern, 593

Applanation tonometry, 18 Arcuate scotoma, 49 Argon laser trabeculoplasty

(ALT), 295–6 Arterial supply, 107 Ascorbic acid, 86 Aspergillosis, 366 Asthenopia, 656 Astigmatic/meridional

amblyopia, 576 Astigmatic targeting, 239–40 Astigmatism, 237 Astrocytoma, 509

Atopic keratoconjunctivitis, 147

Atovaquone, 362

Atypical optic neuritis, 523 Autoimmune thyroid

disease, 475 Autoimmune thyroiditis, 475

724 INDEX

Automated perimetry, 56 performance and

interpretation, 53 protocols, 56

Autonomic nervous system, 518

Avellino dystrophy, 188 Azathioprine, 335, 338, 340,

342, 344, 563, 709, 710 Azelastine, 146

B

Babies/infants, behavioral tests for, 9

Bacterial blepharitis, 110 Bacterial conjunctivitis,

140–1 acute, 140

gonococcus, 140–1 Baerveldt/Molteno, 308 Band keratopathy, 183

Bartonella henselae, 359 Basal cell carcinoma (BCC),

115

Basement membrane (BM) zone, 160

Basic esotropia, 585 Behavioral tests for babies/

infants, 9

Behçet’s disease, 340, 341 Benign intracranial

hypertension, 533 Benign reactive lymphoid

hyperplasia, 490 Benign tumors, 114 Best’s disease, 459, 460 β-blockers, 292, 702 Bevacizumab, 415, 431 Binasal field defect, 49 Binocular interaction,

abnormal, 576 Binocular single vision (BSV), 31, 578–9

abnormalities of, 578–9 adaptive mechanisms,

578–9

confusion and diplopia, 578

microtropia, 579 levels of, 578

Binocular status, tests of, 9–10, 10

Biomicroscopy, slit-lamp overview, 13–14

use of, 15–16 Birdshot

retinochoroidopathy (BSRC), 370

Bitemporal hemianopia, 49 Bjerrum screen, 50 Blebitis, 305, 306

Blepharitis, 110–1 bacterial blepharitis, 110 meibomianitis, 110

seborrheic blepharitis, 111 Blepharochalasis, 122 Blepharoconjunctivitis, 174 Blepharophimosis

syndrome, 123 Blepharospasm, 567–8, 682 Blind children, 608–9, 611

disability, 608 equipment, 608 implications, 609 prognosis, 609 resources, 609 schooling, 608

in social context, 609 treatment, 608

Blind spot enlargement, 49 Bloch–Sulzberger syndrome,

634 Blunt trauma

assessment, 92 clinical features, 92–3

anterior segment, 92 globe, 92

posterior segment, 93 treatment, 94

Borrelia burdorferi, 359 Bradyzoite, 361–3 Branch retinal arteriolar

occlusion (BRAO), 446 Branch retinal vein

occlusion (BRVO), 442 Brimonidine/timolol, 294 Brown syndrome, 591 Brow ptosis, 122

Brucella, 359 Bupivicaine, 690

C

Caloric tests, 32 Canaliculitis, 134 Candidiasis, 366 Canthal tendons, 106 Capillary hemangioma,

489, 507 Carbimazole, 482

Carbohydrate metabolism disorders, 640

Carbomer, 180 Carbonic anhydrase

inhibitors, 292 Cardiff acuity cards, 9 Cataract

age of onset, 232 clinical presentations,

230–1 extraction

extracapsular, 246 intracapsular, 246

phacoemulsification. See Phacoemulsification

grading systems, 232 maturity of cataract, 232 morphology, 232 pathogenesis, 230

risk factors, 230 types, 233

Cataract surgery assessment

outpatient appointment, 234–5

preoperative, 235 referrals, 234

complications intraoperative, 251–2 postoperative, 252

and concurrent eye disease

diabetes, 249 glaucoma, 249

intraoperative floppy iris syndrome, 249

postvitrectomy, 250 uveitis, 250

consent and planning, 236–7

perioperative, 239–40 postoperative, 241

Cavernous hemangioma, 489, 508

CD4 level and typical diseases, 350

Ceftazidime, 254–5 Ceftriaxone, 360 Cefuroxime, 168, 472 Celluvisc, 178

Central areolar choroidal dystrophy, 461

Central nervous system (CNS), flashes and floaters, 654

Central retinal artery occlusion (CRAO), 443–5

Central retinal vein occlusion (CRVO), 439–40, 441, 441

Central scotoma, 49 Central serous

chorioretinopathy (CSCR), 426–7

Central serous retinopathy (CSR). See Central serous chorioretinopathy (CSCR)

Cephalocele, 486 Cerebrospinal fluid (CSF),

518

Cervical injuries, 610 Chalazion, 113 Chalcosis, 96

Chemical conjunctivitis, 622

Cicatricial ectropion, 117,

Chemical injury

119

assessment, 84

Ciliary body, 314, 601

treatment, 86

ophthalmic signs, 669

Chiasmal disorders, 537, 538

tumors

Child abuse, 610

ciliary body melanoma,

retinal hemorrhages, 610

496

shaken baby syndrome,

differential diagnosis, 496

610

medulloepithelioma, 496

Chlamydial conjunctivitis,

Cilioretinal artery occlusion,

144–5

446

adult inclusion

Circumscribed choroidal

conjunctivitis, 144

hemangioma, 501

trachoma, 144–5

Clindamycin/sulfadiazine,

Chlamydial neonatal

362

conjunctivitis, 621

Clinical skills

Chlorambucil, 340

anterior segment

Chloroquine, 435

examination, 17, 19

Chlorphenamine, 146

additional techniques

Chlorpromazine, 437

for, 18

Chorioretinitis, 353

biomicroscopy, slit-lamp

Choristomas, 637

overview, 13–14

Choroid, 314, 602

use of, 15–16

Choroidal dystrophies,

focimetry, 44–5

462–3

gonioscopy, 24–5

choroidal atrophies, 463

lids/ptosis examination,

choroideremia, 462

34–5

gyrate atrophy, 462–3

nasolacrimal system

Choroidal folds, 434

examination, 38–9

Choroidal hemangiomas,

ocular motility

501

examination, 29–30

circumscribed choroidal

ophthalmic history,

hemangioma, 501

obtaining, 2–4

diffuse choroidal

orbital examination, 36–7

hemangioma, 501

posterior segment

Sturge–Weber syndrome,

examination, 22–3

502

pupillary examination,

Choroidal melanoma, 497–9

27–8

clinical features, 497

refraction, 40–1

differential diagnosis, 498

practical hints, 42–3

investigations, 498

vision, assessment of

prognosis, 499

acuity, 5–6

treatment, 498–9

clinical tests in children

Choroidal metastasis, 503–4

and tests of binocular

Choroidal neovascular

status, 9–10

membrane (CNV), 411,

contrast and color,

416–17

11–12

causes of, 414

visual fields examination,

Choroidal nevus, 500

33

Choroidal osteoma, 503

Clofazimine, 438

Choroidal rupture, 93

Cloudy cornea, 617

Choroideremia, 462

Cluster headache, 655

Chromosomal syndromes,

CN III palsies, 547–9

638

CN IV palsy, 550, 551

Chronic progressive

CN VI palsy, 552, 553

external

Coats’ disease, 452

ophthalmoplegia

Collaborative Initial

(CPEO), 122, 565

Glaucoma Treatment

Cicatricial conjunctivitis,

Study (CIGTS), 299–301

148–9

Collaborative Normal

primary, 148–9

Tension Glaucoma Study

secondary, 149

(CNTGS), 272

INDEX 725

Coloboma, 124 Color vision, 11–12 Coma-associated eye

movements, 561 Comitant strabismus, 584–5

esotropia, 584–5 exotropia, 586–7 Commotio retinae, 93

Computerized tomography (CT), 75–6

Concretions, 153

Cone degenerations, 461 Confocal scanning laser

ophthalmoscopy, 70 Confusion, in binocular

single vision, 578 Congenital cataract, 625

assessment, 625 causes of, 626 management, 627

postoperative care, 627 postoperative

complications, 627 procedure, 627 timing, 627

Congenital cytomegalovirus, 619

clinical features of, 620 Congenital ectropion, 118 Congenital entropion, 120 Congenital exotropia, 586 Congenital fibrosis of

extraocular muscles, 592 Congenital hereditary

endothelial dystrophy (CHED), 192

Congenital hereditary stromal dystrophy (CHSD), 189

Congenital herpes simplex virus, 619

clinical features of, 620 Congenital hypertrophy of the retinal pigment

epithelium (CHRPE), 510 Congenital lid disorders,

124 ankyloblepharon, 124 coloboma, 124 cryptophthalmos, 124 epiblepharon, 124 epicanthic folds, 124 telecanthus, 124

Congenital ocular melanocytosis, 154

Congenital optic disc anomalies, 535–6

megalopapilla, 536 morning glory anomaly,

536

optic disc coloboma, 536 optic disc pit, 535