David G Cogan

The occurrence of cutaneous melanoma and intraocular melanoma as double primary cancers in the same patient and in different members of the same family has suggested that these two forms of melanoma are etiologically related. It is theoretically possible that the link between these two pigment cell malignancies may be the dysplastic nevus syndrome, and patients with the dysplastic nevus syndrome may have an increased risk of intraocular melanoma and cutaneous melanoma. We studied two new ...

We studied the cutaneous delayed hypersensitivity responses to a soluble melanoma antigen in 32 patients with the initial clinical diagnosis of ocular melanoma and in seven control patients. Eighteen out of 19 patients who had pathologically confirmed ocular melanomas were positive to this antigen, as were eight other patients clinically thought to have choroidal melanomas. All seven controls were negative on skin testing with this antigen, as were five patients who were initially ...

Data regarding the etiology and subsequent course of 54 patients with an occlusion of the central retinal artery included the following: of 44 patients over 40 years of age at the time of the central retinal artery occlusion, eight (18%) had cerebrovascular accidents, but only two patients (5%) had a stroke clearly related to the vessels involving the affected central retinal artery. Five patients (11%) had occlusive disease of the ipsilateral internal carotid artery; two of these had ...

Tryptic digestion of the retina with subsequent staining by suitable dyes has permitted identification of two types of cells associated with the capillary wall. One type is the endothelial cell lining the lumen. The other type we have elected to call the mural cell because it is encased within the vessel wall, covered on both its inner and outer surfaces by basement membrane. At the present writing we are unable to state whether or not mural cells comparable to those in the retinal ...

The sphingolipidoses constitute a segment of the inborn errors of metabolism in which glycolipids having a sphingosine base accumulate in the tissues. At the ultrastructural level the stored substance forms multimembranous inclusion bodies in lysosomes.Those sphingolipidoses which have some ophthalmic manifestations are: Farber's disease, Niemann-Pick disease, Tay-Sachs' disease, generalized gangliosidosis, Gaucher's disease, Krabbe's disease, Fabry's disease, and metachromatic ...

Review of inpatient records at the Massachusetts Eye and Ear Infirmary for ten years and the inpatient and outpatient records at the Children's Hospital Medical Center for eight years revealed no diagnosed cases of synchysis scintillans. The pathology reports from the Ophthalmic Pathology Laboratory at the Massachusetts Eye and Ear Infirmary for the last ten years revealed 12 eyes with cholesterol crystals in the vitreous cavities or subretinal spaces, or both. All were blind, long-term ...

Trypsin digestion of the retina has been advantageously employed to study the morphology of retinal vessels in flat mounts.1 These two-dimensional observations, however, are inadequate for the study of the relationships of the vessels, particularly of the capillaries, to each other at various depths in the retina. It is our purpose in this communication, therefore, to report experience with preparation of trypsin-digested retinas examined in three dimensions.The retinas were first ...

Voluntary saccades were studied by electro-oculography in ten patients with myasthenia gravis (MG) and in eight patients with other types of ophthalmoplegia. Despite limited range of eye movements, maximum velocities of 20 degree and 40 degree saccades in patients with MG were not significantly different from those in normal individuals, whereas maximum velocities in patients with other types of ophthalmoplegia were significantly decreased. In some myasthenic patients, small amplitude ...

The 13-15 trisomy syndrome (also called D-trisomy and Patau syndrome1) comprises an entity in which an extra chromosome is associated with the 13-15 or D group of paired chromosomes. Its clinical features consist of multiple congenital abnormalities that commonly include ocular defects. The most frequent systemic abnormalities are harelip, cleft palate, umbilical hernia, polydactyly, cardiac defects, and malformations of the central nervous system. Although born full term, infants with ...

Vascular occlusion in the eyes from cardiac myxomas was diagnosed in two cases, belatedly in one and not until after death in the other. Suspicion of a myxomatous origin should be aroused by the combination of unexplained retinal (or choroidal) vascular disease occurring with multifocal neurological symptoms and with systemic symptoms suggesting atypical subacute bacterial endocarditis. The first patient had unilateral retinal artery occlusion by embolic material believed to have been ...

Rapid eye movements, having high velocity and low amplitude, are described in 11 patients with myasthenia gravis. These movements occur with various degrees of ophthalmoplegia. To distinguish them from the somewhat similar lid-twitch phenomenon, they are called quiver movements. We believed that their presence is pathognomonic of myasthenia and results from a differential involvement of the two myoneural mechanisms that are peculiar to the extraocular muscles.

Symptoms referable to the visual system may be the earliest and most prominent signs of idiopathic dementing disease (Alzheimer's type) despite the lack of objective signs in the eyes or visual system. Three such patients are described. The first patient, who had ultimately proven Alzheimer's disease, initially complained of poor vision and spatial disorientation. Her course was characterized by progressive topographic agnosia during a ten-year period. The second patient first sought ...