First Case of Subretinal Ocular Angiostrongyliasis Associated with Retinal Detachment in the United States.

Angiostrongylus cantonensis, commonly known as the rat lungworm, is mostly found in Asia, the Pacific Basin, and the Caribbean, but is also endemic in Hawai'i, especially on the Island of Hawai'i. Ocular angiostrongyliasis is an uncommon but previously reported complication associated with permanent vision loss. This is the first reported case of ocular angiostrongyliasis involving the retina or posterior segment of the eye in the US. A 24-year-old male from Chicago visited the Island of Hawai'i, where he worked on a farm and ate a vegetarian diet. When he returned to Chicago, he became sick and was hospitalized for eosinophilic meningitis. One month later, he developed a retinal detachment which required surgical repair involving a pars plana vitrectomy. During the reattachment of the retina during surgery, a live motile was identified nematode in the subretinal space. An endolaser probe immobilized and killed the nematode, and it was subsequently extracted through the sclerotomy. Thermal scars around all retinal holes including the retinotomy site were made to stabilize the retina, and perfluoropropane gas was injected to achieve temporary tamponade. Thereafter, the patient's cerebrospinal fluid returned positive for angiostrongylus cantonensis antibodies. During extended follow-up, the patient eventually lost all vision in the affected eye due to recurrent retinal detachment. This case of ocular angiostrongyliasis demonstrates the importance of obtaining travel history from endemic areas, knowing the risk of developing eosinophilic meningitis, and understanding the risk of permanent vision loss in cases involving the retina.

CYSTOID MACULAR EDEMA SECONDARY TO RITUXIMAB.

BACKGROUND/PURPOSE: To describe a case of bilateral macular edema appearing after treatment with rituximab. METHODS: This is a case report describing macular edema after rituximab infusions. The information was collected retrospectively through chart review. RESULTS: A 53-year-old patient known for IgG4-related disease of the face and sinuses presented with bilateral decreased visual acuity from cystoid macular edema shortly after undergoing two rituximab infusions. Laboratory workup did not reveal any underlying systemic etiology. Treatment with topical and oral corticosteroids as well as with anti-vascular endothelial growth factor injections led to mild improvement. Treatment with intraocular triamcinolone resulted in complete resolution of the edema, although accompanied by an increase in intraocular pressure. CONCLUSION: Rituximab has been previously associated with macular edema. Macular edema causing visual loss shortly after receiving rituximab may respond to discontinuation of the rituximab and local steroid injection.

Multiple concomitant cranial nerve palsies secondary to preeclampsia.

A 32-year-old primigravid woman developed pre-eclampsia after delivery of twins along with left fifth, sixth, and seventh cranial neuropathies. She also had evidence of hepatic and renal involvement. Results of patient evaluation were otherwise unremarkable, and the palsies completely resolved over 3 months after treatment with valacyclovir and systemic corticosteroids.

Factors associated with outcomes of pneumatic retinopexy for rhegmatogenous retinal detachments: a retrospective review of 422 cases.

BACKGROUND: To determine the factors associated with anatomical and visual outcomes, and complications when using pneumatic retinopexy in the management of rhegmatogenous retinal detachments. METHODS: On a whole, 406 patients having undergone 422 primary pneumatic retinopexies for the management of rhegmatogenous retinal detachment at a tertiary care hospital, between January 2004 and December 2009, with a minimum follow-up of 3 months were included in this case series. Multivariate logistic regression was used to estimate associations of demographic and clinical factors with anatomical and visual outcomes. RESULTS: The single operation success rate was 60.7%, and final anatomical success was 99.5%. Male gender and the presence of complications were associated with single operation failure, whereas age over 65 years, poor preoperative visual acuity, the presence of complications were associated with poorer visual outcomes. Better preoperative visual acuity and absence of complications were associated with obtaining both a good visual outcome and anatomical success after a single intervention. The most common complications included new or missed tears (16.3%), delayed subretinal fluid reabsorption (12.1%), and epiretinal membrane (10.2%). CONCLUSION: Several factors are associated with pneumatic retinopexy outcomes for rhegmatogenous retinal detachments. These factors should be taken into consideration when identifying patients who would benefit from pneumatic retinopexy and those who are at risk of requiring additional interventions.

Methodology for the construction and comparison of 3D models of the human cornea.

This paper describes a methodology to build and compare 3D models (or atlases) of the cornea for specific populations. Using topography data of the anterior and posterior corneal surfaces, average and statistical variation maps are computed after registration of individual corneas on a reference sphere. With this methodology, a normal population model is constructed and compared with known eye anatomic data. Comparison of left and right eyes is also performed to see their natural symmetry. Our results demonstrate that spatial normalization is an important step for corneal atlas construction and comparison.