Subretinal and disc neovascularisation in serpiginous choroiditis.

Three out of 15 patients with serpiginous choroiditis who have been followed up for 1 to 10 years (mean 4.9 years) developed subretinal neovascularisation in the macula. In one eye new vessels were treated with argon laser without attaining permanent obliteration, in the second eye the neovascular membrane was regarded as untreatable because it was under the fovea, and in the third eye new vessels became obliterated spontaneously after atrophy of the surrounding choriocapillaris and the pigment epithelium of the retina. In a furth patient disc new vessels were seen at the active stage of serpiginous choroiditis; these new vessels disappeared after scarring of the initial chorioretinal lesions.     

Subretinal neovascularisation in eyes with localised inferior posterior staphylomas.

We report seven cases of subretinal neovascularisation with inferior posterior staphyloma. The upper border of the shallow staphyloma, detected by B-mode echography, invaded the macular area, and there was a neovascular net at the edge of the staphyloma. Three of the cases showed chorioretinal atrophy at the upper edge of the staphyloma in the same location as the neovascular net. Our cases were identical to those of subretinal neovascularisation in high myopic eyes in which the rupture of Bruch's membrane was related to the deformity of the scleral shell. As our cases included not-high-myopic eyes, the results suggest that the identical mechanism might be involved in the occurrence of neovascular maculopathy in the pathological high myopic eye and in the not-high-myopic eye with posterior staphyloma. Localised inferior posterior staphyloma may be an important cause of 'idiopathic' subretinal neovascularisation.     

Subretinal fibrosis in Stargardt's disease: case report

The authors describe the clinical characteristics of a 14-year-old female patient with ophthalmoscopic and angiographic aspects of Stargardt's disease in both eyes who developed subretinal fibrosis and localized retinal pigment epithelial hyperplasia in the posterior pole of the right eye 6 months after a mild blunt trauma to the right globe. The left fundus remains with the typical presentation of Stargardt's disease. Our findings support the theory that ocular trauma occurring in patients with Stargardt's disease can precipitate a sequence of events leading to the development of subretinal fibrosis and significant visual loss.     

Retinal arteritis in a case of sarcoidosis. A case report

Retinal vasculitis is a common finding and occurs in 10% - 83% of patients with sarcoidosis. In most cases, there are bilateral, peripheral and nonischemic periphlebitis. In contrast, periarterial involvement is rarely observed. We report a case of retinal vasculitis associated with sarcoidosis and its differential diagnosis. Sarcoidosis should not be excluded in case of periarteritis.     

儿童眼结节病1例

结节病是一种罕见的和潜在的致残儿科疾病。此病临床治疗困难,需要长期监测。我们报告了1例9岁的白人女孩的情况,就诊最初表现为双侧慢性前葡萄膜炎、白内障和继发于结节病的青光眼。在过去的2a,患者接受左布诺洛尔滴剂,局部和全身类固醇治疗,随后要求折叠式人工晶状体植入。在白内障手术后的2mo,患者葡萄膜炎以局部类固醇和低剂量甲氨蝶呤一直控制良好。她全血计数和肾功能定期监测,没有甲氨蝶呤不良影响的报告。结节病是一多系统疾病,需要眼科学家,神经学家和儿科医师多学科的投入。内科和外科治疗本病富于挑战。本例强调了低剂量甲氨蝶呤在儿童慢性葡萄膜炎治疗中的安全性和对此病及时治疗以防止显著发病的需要。     

Peripapillary choroidal neovascularisation in sarcoidosis

Purpose : To describe a rare manifestation of sarcoidosis. Methods : Case report of a patient with histologically proven sarcoidosis, who developed peripapillary choroidal neovascularisation in the absence of uveitis or optic nerve disease. Results : Oral corticosteroids achieved reduction in the size of the peripapillary choroidal neovascularisation. Laser treatment was effective in treating the remaining peripapillary choroidal neovascularisation, resulting in improvement of visual acuity. Conclusions : Isolated peripapillary choroidal neovascularisation is a previously unreported complication of sarcoidosis. A combination of oral corticosteroids and laser can be successful in treating this type of lesion, thereby preventing permanent visual loss.     

A case of macular subretinal neovascularisation in chronic uveitis probably caused by sarcoidosis.

A 29-year-old-man with a 7-year history of bilateral chronic uveitis developed subretinal neovascularisation in the macular area of his right eye. There was a history suggesting sarcoidosis. Long-term therapy with systemic corticosteroids decreased the activity of the uveitis, and the subretinal neovascularisation changed into a cystic scar. After the systemic corticosteroids were discontinued there was a recurrence of the uveitis but not of the subretinal neovascularisation.     

Peripheral ulcerative keratitis in sarcoidosis: a case report

PURPOSE: To document a case of peripheral ulcerative keratitis (PUK) that progressed to corneal perforation in the setting of recently diagnosed sarcoidosis. DESIGN: Observational case report. METHODS: A 42-year-old white woman presented with a 2-day history of tearing and decreased vision OD, secondary to PUK with corneal perforation. Slit-lamp evaluation revealed bilateral peripheral corneal thinning with vascularized scarring. History, clinical examination, chart review, peripheral lamellar keratoplasty, serologies, and bronchoscopy with biopsy were performed. RESULTS: After lamellar keratoplasty, visual acuity was 20/400 OD and 20/20 OS. She was treated with oral prednisone and high-dose Cytoxan therapy. One year postperforation, she received a limbus-to-limbus penetrating keratoplasty OD. One year after penetrating keratoplasty, the patient's BCVA OD is 20/40. She has stable scarring OS. Workup has revealed serologic and pathologic evidence of sarcoidosis without evidence of any other seropositive vasculitic disease. CONCLUSION: This patient represents the first known case report of PUK in sarcoidosis. Oral Cytoxan, steroids, and topical cyclosporine have stabilized the disease process in this patient.     

Foveal neovascularisation in diabetic retinopathy: case report and review of literature

To report a rare case of unilateral foveal neovascularisation in an asymptomatic patient with 15-year history of insulin-dependent diabetes mellitus and bilateral proliferative diabetic retinopathy and diabetic macular edema. Fundus fluorescein angiography and optical coherence tomography scan confirmed the presence of foveal neovascularisation. There was complete regression of the foveal neovascularisation after pan retinal laser photocoagulation. We review the literature on foveal neovascularisation in diabetic retinopathy and propose a possible pathogenic mechanism for development of foveal neovascularisation in diabetic retinopathy and the reason for the response to pan retinal laser photocoagulation.     

Branch retinal vein occlusion and sarcoidosis in a child: a case report

We report a case of branch retinal vein occlusion associated with sarcoidosis in a child. A 13-year-old boy with a history of chronic fatigue was referred for ophthalmologic examination. Fundus examination in the right eye showed periphlebitis of the inferotemporal branch retinal vein, with nerve fiber layer hemorrhages without iridocyclitis. A fluorescein angiogram confirmed the occlusion of the inferotemporal branch retinal vein. His left eye was normal. The diagnosis of sarcoidosis, suggested by the presence of bilateral hilar adenopathy, increased angiotensin-converting enzyme levels, and lymphocytosis in the broncho-alveolar lavage, was confirmed by liver biopsy demonstrating epithelioid granulomas. Branch retinal vein occlusion was successfully treated with systemic corticosteroids. Branch retinal vein occlusion may occur as a rare vascular complication of sarcoidosis even without iridocyclitis.     

Subretinal neovascularization following ruptured retinal arterial macroaneurysm: case report

A 51-year-old black woman was referred to our Retina Clinic for evaluation of loss of vision in her left eye. She was previously diagnosed with a ruptured retinal arterial macroaneurism (RAM) in the same eye. The ophthalmoscopic examination of the affected eye disclosed a subretinal lesion with some hemorrhage and exudation in the same area previously diagnosed with ruptured RAM. Fluorescein angiography revealed a gradually hyperfluorescent net of vessels located in the subfoveal region, consistent with the diagnosis of subretinal neovascular membrane. In this paper we stress the possibility of subretinal neovascularization following a ruptured RAM, even as a rare event.     

亚洲少年眼和肾结节病1例

结节病通常导致年轻人患双侧肺门淋巴腺病,肺实质疾病和/或皮肤损伤等。儿童结节病是一种相对罕见的疾病,尤其是眼和肾脏同时受累的儿童患者。我们这里呈现了一个双侧复发性前葡萄膜炎伴发肾功能衰竭的结节病的少年亚裔病情。口服类固醇与甲氨喋呤后临床症状得到明显改善。因顽固性青光眼行小梁切除术后双眼视力令人满意。因此,给予及时的诊断及迅速适当的处理能避免这类罕见疾病的眼部发病率。     

Subretinal fibrosis after photodynamic therapy in subfoveal choroidal neovascularisation in highly myopic eyes

AIMS: To analyse the occurrence of subretinal fibrosis (SRF) after photodynamic therapy (PDT) with verteporfin in highly myopic eyes with subfoveal choroidal neovascularisation (CNV). METHODS: PDT with verteporfin was performed on 33 eyes of 32 highly myopic patients with subfoveal CNV. Patients were followed for 14-24 months and best corrected visual acuity (BCVA) and angiographic and funduscopic findings were recorded. RESULTS: Two patients (two eyes) were lost to follow up. SRF appeared in 14 of 31 eyes. SRF appeared more frequently in eyes with a spherical equivalent (SE) of less than -10 D, in patients of age equal to or less than 55 years, and when CNVs were larger than 1500 micro m in diameter. SRF appeared more frequently in the group of patients with worse final BCVA. CONCLUSIONS: The appearance of SRF after treatment is correlated with size of the CNV and SE. The results of this study indicate that highly myopic eyes with CNV treated with PDT do not show a decrease in BCVA, even though they develop SRF. The appearance of SRF after PDT in highly myopic CNV does not always imply a loss of BCVA from baseline, though its presence is more frequent in eyes with lower BCVA.     

Papillitis, retinal neovascularisation and recurrent retinal vein occlusion in Toxoplasma retinochoroiditis: a case report with uncommon clinical signs

A clinical case report, illustrative of three uncommon features of ocular toxoplasmosis, is presented. The unusual signs were recurrent retinal vein occlusion, papillitis and florid disc neovascularisation.