Severance of Optic Nerve Following Traffic Accident and Its Electron Microscopic Findings

The optic nerve do not easily sever because of its anatomic status in the orbit. The purpose of this study is to investigate electron microscopic findings in the proximal portion of the severed optic nerve which remained in the orbit for about 4.5 months. Thirty seven-year-old woman showed the protruded eyeball and deep skin laceration following traffic accident. Computerized tomography and MRI demonstrated the complete severance in her left optic nerve. Her eyeball containing the proximal portion of the severed optic nerve was enucleated at about 4.5 months after traffic accident. Eletron microscopic findings showed several macrophages, fibroblast, and dense collagen fibers, which mean the fibrosis histopathologically. The fibrosis was the main pathologic outcome in the proximal portion of the severed optic nerve. We suggest that the process of the fibrosis could result from the incorporation of the fibroblast within the meninges around the optic nerve and the proliferation of the fibroblast within fibrovascular septa of the pia mater which extend into the optic nerve.

Indocyanine Green Angiographic Findings in Harada Disease

ICG angiography, an excellent method for the study of choroidal disorders, was used to evaluate the intraocular vascular abnormalities associated with Harada disease. 25-year-old male with Harada disease was examined by using fluorescein angiography and ICG angiography during the whole course of the disease. In the acute stage of the disease, FAG showed dye leakage and pooling into the subretinal space in the posterior pole. The dye leakage and pooling were improved or disappeared during follow up period. In ICG angiography, filling delay of choroidal circulation and numerous hypofluorescent spots were the most remarkable findings in the acute stage of the disease. In the early to late phase choroidal vessels were indistinct. The filling delay and indistinct choroidal vessels in the acute stage were gradually improved or more clearly visualized during the whole course of the disease. However, multiple hypofluorescent spots were still present till the recovery stage of the disease. Also, ICG angiography showed several dye leakages as hyperfluorescent spots and pooling as hypofluorescent or hyperfluorescent area. The choroidal tissue staining appeared during the recovery stage of the disease. ICG angiography clearly revealed the disturbance of choroidal circulation in Harada disease, and filling delay of the choroidal circulation and indistinct choroidal vessels. ICG angiography helps to demonstrate the pathologic findings of Harada disease clinically.

Visual Acuity in Childhood Astigmatism

Astigmatism may influence the development of amblyopia and possibly also the development of refractive errors. The length of the sensitive period and the minimum amount of astigmatism necessary to produce significant amblyopia are not yet clearly defined. The authors performed this clinical study to evaluate visual acuity of childhood astigmatism aged from 3 to 5 years. Of the 152 astigmatic eyes studied, the amount of astigmatism ranged from 1 to 2D was found in 46 eyes; 2 to 3 in 68' 3 to 4 in30 and 8eyes revealed over 4D. With-the-rule astigmatism was found in 120 eyes and against-the-rule stigmatism were in 3 eyes. With-the-rule astigmatism was more frequent than against-the-rule astigmatism. Of the 152 eye examined, the corrected visual acuity lower than 0.1 was found in 9 eyes; 0.1 to 0.3 in 54; 0.4 to 0.6 in 69; the rest 20 eyes showed relatively good, might be caused by astimatism was detected in 132 eyes.

Macroaneurysms of Retinal Arteries

Two patients with spontaneous intraretinal or subretinal hemorrhages were found, on evaluation by fluorescein angiography, to have macroaneurysms involving the major retinal arteries. Both patients were male in their seventies. One patient had a history of systemic hypertension. In the other patient, hypertension was discovered at the time of consultation. With absorption of the hemorrhage and the macular star, two patients experienced appreciable improvement in vision. Laser thrapy was not applied to both patients. The aneurysms diminished in size after 6 to 8 months as a result of fibrous changes within the arterial walls.