Increased scleral rigidity and age-related macular degeneration.

The coefficient of scleral rigidity of the eyes of 29 patients with age-related macular degeneration (ARMD) was significantly higher than the rigidity of 25 control patients, frequency matched for age. The data suggest that an increased scleral rigidity may be a significant risk factor for the development of the disorder.

Recurrent tears following successful retinal detachment surgery.

In 17 cases of recurrent retinal tears occurring after successful retinal detachment surgery, the new tears developed on or near the treated primary tear in seven cases and away from the treated tear in ten cases. It took an average of 25.6 months for the second tears to develop, and almost all of the recurrent tears were the same distance from the limbus as the primary tear. The benefit of the 360 degree encircling band and the relationship of the thermal injury to production of a second tear is discussed.

Brittle cornea, blue sclera, and red hair syndrome (the brittle cornea syndrome).

A syndrome of red hair, blue sclera, and brittle cornea with recurrent spontaneous perforations is presented in 2 siblings of a Tunisian Jewish family. The genetic transmission of this disorder is autosomal recessive. This is the second description of this syndrome, which should be called the 'brittle cornea syndrome'. This syndrome has so far been reported only in Tunisian Jewish families.

Familial band-shaped keratopathy.

A brother and sister out of a consanguinous family of four siblings are presented as prototypes of primary band-shaped keratopathy. The disease manifested sever progressive changes of secondary nature over two years of follow-up. Histology and treatment are described.

An unusual macular lesion simulating a neoplasm.

A 55-year-old woman with reticulum cell sarcoma of the stomach presented with a sudden decrease in vision and acute blood loss anaemia with thrombocytopenia. Superficial retinal haemorrhages were present in both eyes. These haemorrhages were absorbed gradually, yet a large macular mass appeared in the right eye which simulated a neoplasm. This mass disappeared over a period of a few weeks leaving minimal changes in the pigment epithelium and remarkably good visual acuity.

Explosive intraocular foreign bodies.

We examined two patients, each with a foreign body composed of smokeless gunpowder in the vitreous body of one eye and multiple similar foreign bodies in the eyelids, conjunctiva, and cornea. No damage to the eye was caused by the retention of these foreign bodies for over three years in one case and two years in the other. The composition of these foreign bodies appeared to be nontoxic to the eye and thus, extraction of the foreign bodies did not seem to be necessary.

Retinal ischemia (capillary nonperfusion) in diabetic retinopathy of patients with and without systemic hypertension.

In a study of 138 patients with diabetic retinopathy and good fluorescein angiograms, areas of CNP were found in 66.5% using a macular centered photograph. There was no statistically significant correlation between the appearance of CNP, their size and number with the level of systolic and diastolic blood pressures, the duration of diabetes (at the onset of diabetic retinopathy), the age at onset of diabetes, the age at examination, the control of the diabetes and the treatment of hypertension. The only borderline statistically significant difference was found between patients with constant hypertension when compared to patients with labile hypertension.

Retinal ischemia (capillary nonperfusion) and retinal neovascularization in patients with diabetic retinopathy.

138 diabetic retinopathy patients with good fluorescein angiograms of the macular areas were studied. Areas of capillary nonperfusion (CNP) were surrounded by other capillary abnormalities and were often based on a larger retinal vessel. A satistically highly significant anatomical relationship was found between CNP and neovascularization. In addition, the frequency of neovascularization increased with the increase in size of CNP.

Reopening of occluded filtering blebs by argon laser photocoagulation.

We attempted to re-establish filtration in 11 glaucomatous eyes of patients who had undergone fistulizing surgery in the past, had poor or no filtration at various periods of time after surgery, and intraocular pressure above normal levels. Our technique consisted of applying an argon laser beam to the anterior chamber angle at the sclerotomy site of previous filtering and anterior to the iridectomy. Approximately 200 spots of 50 mu size were applied to this target with the help of a Goldmann prismatic goniolens. In five of 11 eyes the fistulizing blebs showed signs of activity shortly after the laser treatment with normalization of IOP during a follow-up period of over one year. Success was obtained in eyes with incomplete scarring of their fistulizing blebs with poor and nonfunctioning filtering cysts. Pigmentation of the target at the occluded sclerotomy site was significant.

Retinal vein occlusion.

A brief description is given of the main clinical, histological and epidemiological circumstances of retinal vein occlusion. In an assessment of the pathogeneis of the condition, primacy is given to the role of arteriolar flow insufficiency and stress is laid on the long-standing capillaropathy which precedes the heamorrhagic phase of the disease. Basic therapeutic considerations are mentioned but stress is laid on the diagnosis of the pre-occlusive stage and on measures of a preventive nature that may be taken. Retinal vein occlusion and haemorrhagic cerebral infarct are compared with regard to their pathogenesis and the advantages are discussed of a common ophthalmoscopic study of retinal vein occlusion with neurologists interested in cerebral vascular disease leading to an interchange of therapeutic experience in both conditions. Finally, there are detailed the studies in retinal vein occlusion being conducted by the Jerusalem Institute for the Prevention of Blindness. These are studies of incidence, natural history and of pathogenesis as observed in the experimental disease produced in rhesus monkey.

Focal chorioretinitis and iridocyclitis associated with scleroderma.

A case of chorioretinitis and iridocyclitis in a patient with progressive systemic sclerosis is reported and the literature on the ocular manifestations of the disease is briefly reviewed.

Sector retinitis pigmentosa: a fluorescein angiographic study.

Flourescein angiography has been proved to be of value in the study of the chorioretinal abnormaliteis in sector retinitis pigmentosa. The findings from two patients, one being in an early and the other in a more advanced stage were analyzed. The pigment epithelium was found to be disturbed in a larger area than visible by ophthalmoscopy. In the impaired quadrant the retinal vessels were narrowed showing delayed and slow dye transit. Through the discolorated pigment epithelium leaky choriocapillaries were disclosed. Moreover, in the severly affected patient, areas missing choriocapillar perfusion and retinal circulation were also detected.