Posttraumatic endophthalmitis.

Nineteen consecutive cases of culture-proved posttraumatic endophthalmitis occurred. Over an eight-year period, 19 (7.4%) of 257 patients with penetrating trauma had endophthalmitis develop, and 19 (31.

Serous choroidal detachment after retinal detachment surgery.

In a prospective evaluation of 154 consecutive retinal detachment procedures, the incidence of choroidal detachment was 39.6%. The age of the patient, drainage of subretinal fluid, and vortex compression by the explant seem to be the most important correlative factors.

Retinal telangiectasia secondary to bilateral carotid artery occlusion.

A man complaining of blurred vision had diffuse retinal capillary telangiectasia as a primary retinal finding. Evaluation of the carotid arteries by a noninvasive angiographic method revealed bilateral, silent occlusions of both common carotid arteries. Thus, some cases of "idiopathic retinal capillary telangiectasia" may in fact be harbingers of underlying carotid artery disease.

Vascular leakage, neovascularization, and vitreous hemorrhage in senile bullous retinoschisis.

Retinal detachment is the primary complication of bullous retinoschisis, a benign abnormality of the peripheral retina. We examined three patients (all women, 43, 55, and 56 years old) with typical bullous retinoschisis who had vitreous hemorrhage. In each case, there were sclerotic retinal vessels over the surface of the schisis cavity along with neovascularization above the central portion of the cyst.

Prostacyclin and thromboxane A2 derivatives in rhegmatogenous subretinal fluid.

Aberrations in prostacyclin and thromboxane A2 metabolism have been implicated in a wide spectrum of systemic disease. To our knowledge, derivatives of prostacyclin and thromboxane A2 have not been demonstrated previously in the subretinal fluid of rhegmatogenous detachments. Radioimmunoassays to determine levels of stable derivatives of prostacyclin and thromboxane A2, 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) and thromboxane B2, in rhegmatogenous subretinal fluid samples from ten patients showed the following: 6-keto-PGF1 alpha level, less than 100 to 1,268 pg/mL; thromboxane B2 level, less than 100 to 3,619 pg/mL.

Ischemic optic neuropathy associated with Crohn's disease.

A 24-year-old man with Crohn's disease suffered bilateral ischemic optic neuropathy following the resolution of an episode of "uveitis." Additional findings of corneal infiltrates, vitritis, retinovascular sheathing, and arthritis suggest an inflammatory basis for his ischemic optic neuropathy. Vasculitis as an extraintestinal manifestation of inflammatory bowel disease is a possible etiology.

Surgical results in ocular trauma involving the posterior segment.

Of 106 eyes with trauma involving the posterior segment, 12 could not be repaired, 74 were treated with vitrectomy, and 20 without vitrectomy. Fifty-five eyes (52%) achieved functional success (defined as a final visual acuity of 6/30 [20/100] or better or as a postoperative improvement in visual acuity from light perception or worse to 6/240 [5/200] or better), 16 (15%) attained anatomic success (attached retinas and generally clear media) but were functional failures, and 35 (33%) were both anatomic and functional failures. The prognosis was better in cases with intraocular foreign bodies and worse in cases with retinal detachments, marked vitreous hemorrhage, and large scleral lacerations.

Erythrocyte - endothelial cell adherence in sickle cell disease, diabetes mellitus, and falciparum malaria: adverse effects reversed with piracetam.

The erythrocytes of patients with sickle hemoglobin, diabetes, and Falciparum malaria adhere disproportionately to endothelial cells. Such pathophysiological activity compromises the microcirculation and results in clinical disease. Since Piracetam (2-oxo-1 pyrrolidine acetamide) has been shown to have a number of clinically beneficial actions on the formed elements of the blood including disengagement of adherent diabetic and sickle erythrocytes there is a rational basis for the trial of Piracetam as an adjuvant drug in SS disease and in diabetes mellitus to improve function of the microcirculation.

Efficacy of argon laser photocoagulation in the treatment of circinate diabetic retinopathy.

We evaluated 115 eyes in 105 diabetic patients with circinate retinopathy and, in most cases, associated macular edema. Of these 115 eyes, 68 were treated with argon laser photocoagulation to leaking vessels, primarily in the center of the circinate ring. Forty-seven eyes that had similar findings but received no treatment were followed up for one year and some patients were followed up for as long as three years.

Polymyalgia rheumatica and giant cell arteritis--rational diagnosis and treatment predicated and disordered prostaglandin metabolism.

We suggest that polymyalgia rheumatica with giant cell arteritis (PR-GCA) is an arachidonic acid metabolites mediated disease which can be diagnosed more accurately and monitored more precisely for therapeutic benefits by the serial determinations of the major urinary prostaglandin F, serum urinary lysozymes, serum acid phosphatase, and serum angiotensin converting enzyme rather than by the erythrocyte sedimentation rate, and, when necessary by temporal artery biopsy. The pathogenetic role proposed for prostaglandins (PG) and, even more precisely perhaps, the leukotrienes in this disease is consistent with the several published clinical observations that non-steroidal anti-inflammatory drug treatment produces in some cases a therapeutic paradox of symptomatic relief with concurrent, if clinically silent, progression of the arteritis, even to blindness. Furthermore, the impressive response of PR-GCA to low maintenance dose steroid therapy, a clinical conundrum for decades, is rationally explained on the basis of depressed or obstructed PG metabolism early on in the metabolic cascade.

Retinal pigment epithelial detachments in posterior scleritis.

A 12-year-old girl developed posterior scleritis and many detachments of the retinal pigment epithelium. Computed axial tomographic findings, reported in posterior scleritis for the first time, disclosed thickening of the posterior sclera. Computed axial tomography appears to be a sensitive test for the diagnosis of posterior scleritis.

Cystoid macular edema after retinal detachment surgery.

One hundred eyes in 98 patients were studied by fluorescein angiography and stereo color photography six weeks after successful scleral buckling surgery. Twenty-five percent of 67 phakic eyes and 40% of 33 aphakic eyes demonstrated cystoid macular edema. Older phakic patients were at significantly greater risk to develop cystoid macular edema than younger phakic patients.

Rhegmatogenous retinal detachment complicating cytomegalovirus retinitis.

Six eyes in four patients with cytomegalovirus retinitis developed retinal holes and retinal detachment. Holes appeared in areas of necrosis and were typically large and round with shaggy edges. Differentiation from exudative detachment was sometimes difficult because of obscuration of the fundus by vitreous haze.

Astrocytic hamartoma of the retina not associated with tuberous sclerosis.

A 6-year-old boy had a peripapillary lesion diagnosed as retinal astrocytic hamartoma, which was not associated with tuberous sclerosis, neurofibromatosis, or intraocular extension of a glioma. The patient was observed for nine years, during which time the lesion grew significantly. Because of this growth and the evidence of proximal optic nerve involvement on computed tomography, radiation therapy was administered with a resultant marked reduction in visual acuity.

Persistent hyperplastic primary vitreous. A clinicopathologic study of 62 cases and review of the literature.

This is a clinicopathologic study of 62 cases of persistent hyperplastic primary vitreous (PHPV). The cases were divided into two main groups. Group 1 consisted of 55 unilateral cases not associated with any systemic abnormalities, including 36 eyes (58%) which were considered "pure cases" (Group 1A) and 19 (31%) which disclosed other ocular abnormalities in addition to PHPV (Group 1B).

Anterior segment necrosis following treatment of central retinal artery occlusion: a clinicopathologic case report.

A 45-year-old man with an internal carotid artery occlusion, cerebral hemispheric infarction, and an ipsilateral central retinal artery occlusion developed anterior segment necrosis after retrobulbar injection of lidocaine hydrochloride (Xylocaine) for treatment of an occlusion of the central retinal artery. Multiple embolic plaques in the retinal circulation with occlusion of the posterior ciliary arteries were found. The clinical and postmortem histopathologic findings are presented.

Unusual ocular presentation of acute toxoplasmosis.

Four patients with toxoplasmosis are reported with unusual presenting ocular lesions. One patient had an active lesion that appeared to involve the optic nerve as well as focal toxoplasmosis chorioretinitis at the macula. A second patient had a pale optic nerve in association with the classical chorioretinal scars of toxoplasmosis.

Necrotizing vaso-occlusive retinitis.

We studied two adult patients with fulminating, necrotizing vaso-occlusive retinitis, and documented the progressive course of retinal necrosis, vitreoretinal interface contraction, and consequent retinal detachment. The systemic criteria for Behçet's disease were present in one patient, and partially fulfilled in the second.