691/1916. Necrotizing retinopathy with herpes zoster ophthalmicus: a light and electron microscopical study. A necrotizing retinopathy following a vesicular cutaneous eruption in the distribution of the right trigeminal nerve developed in a patient who had been receiving systemic corticosteroid therapy one week prior to the onset of herpes zoster ophthalmicus. Seven weeks after the herpetic symptoms began, the patient died of pneumonia following an intracerebral hematoma. At postmortem examination, unexpected multiple focal and confluent lesions, which corresponded to areas of extensive retinal necrosis, were observed in the fundus of the right eye. Intranuclear inclusions with a perinuclear halo were identified within the affected sensory retina. Electron microscopy of the retinal lesions disclosed round to oval enveloped viral particles that were characteristic of the herpes viruses. A mild lymphocytic infiltrate was evident in a demyelinated right Gasserian ganglion. Demyelination and necrosis of the right trigeminal sensory tract and adjacent areas were evident within the brain stem. ( info) |
692/1916. Investigation of a family with von Hippel-Lindau syndrome. A family with Von Hippel-Lindau syndrome has been investigated with Ultrasound, CT and MRI. The major lesions found were posterior fossa haemangioblastomas, retinal haemangioblastomas and renal cell carcinoma. Screening of family members has been undertaken due to the known autosomal dominant inheritance of this condition. ( info) |
693/1916. Retinal capillary hemangioma. Capillary hemangiomas of the retina, which commonly occur as part of von Hippel's disease, are classically composed of a retinal capillary tumor, a large feeder arteriole, and a draining venule. The fundamental pathology is a hamartomatous lesion. In this paper, the case of an early, incipient lesion will be presented. Since approximately 25 percent of patients with angiomatosis retinae develop the life-threatening von hippel-lindau disease, the eye care practitioner needs to be aware of this condition. Also included in the discussion are the treatment options available for these retinal abnormalities. ( info) |
694/1916. Solitary retinal astrocytoma. Astrocytic hamartomas are typically white, well-circumscribed, elevated lesions arising in single or multiple areas of the retina and epi- or peripapillary optic nerve. These lesions are most commonly associated with tuberous sclerosis and less commonly associated with neurofibromatosis. However, solitary retinal or optic nerve astrocytomas can be found in normal individuals. This paper reviews the case of a 48-year-old white female who presented with a solitary retinal astrocytoma of the right eye, without any other physical or ocular disorder. The histopathological and clinical appearance and course of astrocytomas, its differential diagnosis from other retinal and optic nerve lesions, and its association with tuberous sclerosis are discussed. ( info) |
695/1916. Removal of submacular cysticercosis: a case report. We report a case of submacular cysticercosis which was removed by pars plana vitrectomy and retinotomy with favorable result. Preoperative visual acuity was counting fingers of one foot and improved to 10/200 at five weeks postoperatively. The technique illustrates another approach to the surgical management of submacular cysticercosis. It is also applicable for removal of posterior location of subretinal cysticercus which it is difficult or impossible to approach externally. ( info) |
696/1916. Photocoagulation for serous detachment of the macula secondary to retinal astrocytoma. Retinal astrocytomas are rare, usually asymptomatic, hamartomatous retinal tumors that are most commonly seen in patients with tuberous sclerosis. Serous detachment of the macula is a rare complication of retinal astrocytomas. The first successful treatment with laser photocoagulation of two eyes (two patients) with decreased vision due to a serous detachment of the macula from a retinal astrocytoma is described. Laser photocoagulation should be considered for retinal astrocytomas causing persistent or increasing exudation that is threatening the macula or causing visual loss. ( info) |
697/1916. hypertensive retinopathy caused by a rare ovarian tumor: case report and photo essay. A 38-year-old female presented for an optometric exam complaining that her "vision had occasionally gone blank while reading during the past 2 months". Although visual acuity was 20/20 in both eyes, hypertensive retinopathy was present in both eyes. blood pressure was measured to be 210/142. After inadequate response to initial treatment, her family physician referred her to an internist. Ultimately, a four pound Sertoli-Leydig ovarian tumor was found to be causing malignant hypertension. Removal of the tumor and medical treatment of the hypertension cleared the hypertensive retinopathy within 4 months. Prompt optometric care led to the timely discovery of this tumor, and probably prolonged this woman's life. This case illustrates the valuable role optometric care can have in the management of hypertension from any cause. Coordination with the primary physician as to the status of the hypertensive retinopathy is an integral part of the total management. Retinal photographs at presentation and at various stages of treatment dramatically show how the level of fundus pathology is related to the level of hypertension. ( info) |
698/1916. Papillopathies associated with unusual calcifications in the retrolaminar optic nerve. We examined three patients with optic disc edema and peripapillary hemorrhages. Each was found by standard echography to have calcified nodules within the retrobulbar portion of the optic nerves. These nodules were located approximately 2 mm posterior to the lamina cribrosa. Each patient had unilateral congestion of the optic nerve head with dilated, tortuous retinal veins that appeared much like a partial central retinal vein occlusion; one patient subsequently developed optic atrophy. The central location of the calcifications within the anterior aspect of the optic nerves suggests that each nodule may have been situated within the central retinal vein or artery. Calcifications within the retrolaminar space may be associated with some etiologies of unilateral congestion of the optic nerve head. ( info) |
699/1916. macular edema-like change and pseudopapilledema in a case of Scheie syndrome. We reported a case of Scheie syndrome in which diffuse fine corneal deposits, pigmentary retinal degeneration, pseudopapilledema, and macular edema-like change were observed bilaterally. This is the first report describing macular change in Scheie syndrome. ( info) |
700/1916. Intraretinal gray lesions as a sign of reversible visual loss following prolonged ophthalmic artery hypoperfusion. A 49-year-old woman developed severe unilateral visual loss following carotid artery ligation for a carotid-cavernous fistula. The pathophysiology was presumed to be an ophthalmic artery steal caused by the fistula. This was confirmed when visual acuity was restored by a subsequent ligation of the ophthalmic artery, despite 2 weeks of profound visual loss and ocular ischemia. Superficial cotton-wool spots and deep gray intraretinal lesions developed in the retina during the period of ocular ischemia. We postulate that the deep intraretinal lesions are clinical manifestations of a zone of retinal microvascular watershed ischemia, and that their presence may be an important diagnostic guide to the presence of reversible ocular ischemia. ( info) |