Microbial endophthalmitis resulting from ocular trauma.

Twenty-seven cases of culture-positive endophthalmitis that developed after ocular trauma were reviewed. The intraocular culture specimens showed a virulent microbiologic spectrum with Bacillus sp as the most common isolate (8 eyes). The visual prognosis was poor, with only 22% of patients retaining 20/400 or better vision. This level of vision was achieved in 2 of 22 (9%) bacterial cases and in four of five (80%) fungal cases. Retinal detachment (5 cases) or retinal breaks (2 cases) at the time of the initial injury had a uniformly poor visual prognosis. Postoperative retinal detachment not associated with phthisis bulbi occurred in five eyes, three of which had successful retinal reattachment surgery. Delayed onset retinal detachment after successful initial management of traumatic endophthalmitis had a greater frequency of successful retinal reattachment surgery.

Clearance of intravitreal fluorouracil. Normal and aphakic vitrectomized eyes.

The ocular pharmacokinetics of 5-fluorouracil (5-FU) after intravitreal administration in the rabbit are described for the first time. Following a 1 mg intravitreal injection of C-14 labeled 5-FU in the phakic nonvitrectomized eye, a peak level of 664 micrograms/ml is achieved which declines to 7.8 micrograms/ml at 24 hours. For the aphakic vitrectomized eye comparable values are 669 micrograms/ml at 0.1 hour and 0.21 micrograms/ml at 24 hours. 5-FU is cleared more than two times more rapidly in aphakic vitrectomized eyes than normal eyes during the first 12 hours following injection. Following this, when the actual concentrations are relatively low, the rate of clearance appears relatively similar for both groups of eyes. Although it is difficult to extrapolate from previous in vitro results, potentially therapeutic vitreous concentrations are present in normal rabbit eyes for up to 72 hours following a single intravitreal injection.

Clinical and computed tomographic findings in the Foster Kennedy syndrome.

A 52-year-old man had progressive loss of visual acuity in his left eye associated with anosmia of five years duration. Clinical findings included papilledema in the right eye and optic atrophy in the left eye. A diagnosis of Foster Kennedy syndrome was made. Careful attention to the ophthalmoscopic appearance of the left eye disclosed optic disk swelling in regions without significant atrophy as well as dilated retinal veins. Both of these signs suggested increased intracranial pressure, rather than a primary anterior ischemic optic neuropathy. High resolution computed tomographic scanning confirmed the presence of a large subfrontal meningioma and an expanded right optic nerve sheath, consistent with the papilledema noted clinically.

Experimental posterior penetrating eye injury in the rhesus monkey: vitreous-lens admixture.

A standardised experimental posterior penetrating eye injury in the rhesus monkey with the vitreous-lens admixture resulted in limited fibrous ingrowth from the wound and minimal traction on the peripheral retina. Microscopically inflammation was noted in the iris, ciliary body, and as a perivascular infiltrate of the inner retina. Periretinal membranes did not occur, and cellular proliferation within the vitreous was less marked than observed after an identical wound and simulated vitreous haemorrhage in previously reported studies. The lens may be a less important stimulus to intravitreal fibroblastic proliferation than previously assumed.