ABSTRACT
OBJECTIVE: To report a previously undescribed clinical entity involving an unusual inflammatory lesion of the choroid. PATIENTS: Six young, healthy patients experienced acute unilateral visual loss secondary to unifocal choroiditis in the macula. RESULTS: All patients exhibited a solitary, elevated, yellow-white active focus of choroiditis with overlying subretinal fluid and in some cases subretinal hemorrhaging. The lesions were approximately 1 disc diameter in size and, on follow-up, showed minimal growth, then gradual resolution of the subretinal fluid. No other signs of ocular inflammation were noted, except in 1 patient who had anterior chamber and vitreous inflammation. In the 3 patients with prolonged follow-up, elevated white plaquelike lesions persisted with little change over time. Relapses were seen, and some permanent visual loss occurred in 1 of the 3 patients. Systemic evaluations revealed no definitive etiology. CONCLUSIONS: To our knowledge, these patients exhibit an undescribed clinical entity, separable from previously established choroidal disorders. The cause of the lesions remains uncertain. We call this entity "unifocal helioid choroiditis."
Subject(s)
Choroid/pathology , Choroiditis/pathology , Adolescent , Adult , Blindness/etiology , Child , Choroiditis/complications , Female , Fluorescein Angiography , Fundus Oculi , Humans , Macula Lutea/pathology , Male , Visual AcuityABSTRACT
Five patients presenting with signs and symptoms of primary optic nerve disease were, after careful examination, diagnosed as having the multiple evanescent white-dot syndrome. Optic nerve findings in these patients included disc edema, central visual loss, enlarged blind spots, and other optic nerve field defects. The subtlety of the white spots in some cases made the diagnosis difficult. Multiple evanescent white-dot syndrome should be considered in the differential diagnosis of young, healthy patients who present with unilateral or bilateral optic nerve dysfunction.
Subject(s)
Optic Nerve Diseases/pathology , Optic Nerve/pathology , Retinal Diseases/pathology , Adult , Diagnostic Errors , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Optic Nerve Diseases/complications , Optic Nerve Diseases/diagnosis , Papilledema/pathology , Retinal Diseases/complications , Retinal Diseases/diagnosis , Syndrome , Visual Acuity , Visual FieldsABSTRACT
We studied the photographic records of 292 eyes, including 103 eyes with branch retinal vein occlusion, 90 fellow eyes, and 99 control eyes without branch retinal vein occlusion. All arteriovenous crossings within three disk diameters of the optic disk, including the crossings at the sites of branch retinal vein occlusions, were studied. The relative positions of the crossing artery and vein could be determined at 1,939 crossings in all eyes. Crossings at which a vein crossed over an artery were a common finding (22.3% to 33.0% of crossings), but were rare at the crossings where branch retinal vein occlusions were found (2.4%). A greater proportion of arterial overcrossings was found in eyes with branch retinal vein occlusions (77.7%) compared to fellow eyes (70.6%) or control eyes (67.0%). Our data indicate that arterial overcrossings are at relatively higher risk of branch retinal vein occlusion than venous overcrossings, and that the risk of branch vein occlusion in an eye is proportional to the number of arterial overcrossings in the eye.
