Idiopathic intracranial hypertension: clinical features in Chinese patients.

PURPOSE: To describe the clinical features and visual outcomes of idiopathic intracranial hypertension (IIH) in Chinese patients. METHODS: We retrospectively reviewed the charts of patients diagnosed with IIH in Taipei Veterans General Hospital from 1981 to 2009. Demographic data, clinical features, laboratory data, treatment, and visual outcomes were analyzed. RESULTS: Twelve patients were included, seven female and five male patients. The mean age at onset was 32 (range, 13-65) years. Obesity was found in four (33%) patients. The most common clinical symptom was headache (75%), followed by transient visual obscuration (42%) and tinnitus (17%). Snellen visual acuity was equal to or better than 20/30 in 23 eyes, and the only eye with vision worse than 20/50 vision belonged to a patient who had been amblyopic since childhood. Visual field defects were detected in seven eyes by either Goldmann or automated perimetry. Generalized depression and an enlarged blind spot were the most common patterns. Ten patients were found to have bilateral disc edema. One patient with unilateral papilledema and one patient without papilledema were identified in the study. CONCLUSIONS: In IIH in Chinese, men are more likely to be affected than women, but obesity is not as frequent as reported in Western countries. Visual function outcomes are more favorable in Chinese patients.

Necrotizing retinitis induced by Angiostrongylus cantonensis.

PURPOSE: To describe a case of bilateral necrotizing retinitis induced by Angiostrongylus cantonensis. DESIGN: Interventional case report. METHODS: A 52-year-old Asian woman developed eosinophilic meningitis after eating several undercooked snails. One week later, sudden onset of vision loss was noted in both eyes. Widespread yellow retinal exudates were accompanied by bullous retinal detachment in both eyes. RESULTS: Angiostrongylus cantonensis infection was confirmed by positive enzyme-linked immunosorbent assay of the serum and cerebrospinal fluid, and a positive Western blot test of the subretinal fluid. After treatment with mebendazole, levamisole, and corticosteroid, these necrotizing patches regressed gradually. However, the final visual acuity was no light perception. CONCLUSIONS: Angiostrongylus cantonensis infection should be considered as one of the causes of necrotizing retinitis.

Comparison of the proliferation and differentiation ability between adult rat retinal stem cells and cerebral cortex-derived neural stem cells.

Recent studies have demonstrated that retinal stem cells (RSCs) and stem cells of the central nervous system both exhibited the abilities of self-renewal, proliferation and differentiation into multilineage. In the present study, we compared the proliferation and differentiation abilities between RSCs and cerebral corticex-derived neural stem cells (CNSCs) of adult rats. Stem cells isolated from pigmented ciliary margins of eyes and cerebral cortical tissues of adult rats were cultured in 96-well plates that contained serum-free medium with epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF). In contrast to RSCs, which stopped proliferating after the 8th week, the total cell count of neurospheres in CNSCs increased twofold at the 5th week and more than fourfold at the 10th week after in vitro culture. In contrast, RSCs stopped proliferating after 8 weeks of culture. After adding 2% fetal calf serum and withdrawing EGF and bFGF from the culture medium, the percentages of nestin-positive cells(20.6 +/- 2.7%), microtubule-associated-protein-2-positive neurons (33.2 +/- 3.9%) and glial-fibrillary-acidic-protein-positive glial cells(51.3 +/- 6.2%) in the differentiated CNSCs were significantly higher than those in the differentiated RSCs (10.2 +/- 1.9, 22.3 +/- 1.3 and 44.6 +/- 5.1%, respectively; p < 0.05). We also found that the combination of transforming growth factor beta type III with retinoic acid played an important role in the induction of CNSCs to differentiate into opsin-positive cells. Our data demonstrated that CNSCs displayed a higher ability of proliferation and retinal lineage. This report also offers an alternative protocol of cell reproduction for producing retinal cells.

Syphilitic uveitis as the initial manifestation of HIV infection.

Syphilis is an uncommon cause of uveitis in HIV-infected patients. We report a case of bilateral panuveitis and describe its characteristics as the initial manifestation of HIV infection. A 74-year-old heterosexual male complained of blurred vision and floaters in both eyes for 40 days. Slit lamp examination showed diffuse keratic precipitates and cells in the anterior chamber of both eyes. Fundus examination revealed multiple small white dots and scattered retinal hemorrhage over the mid-equatorial retina with marked vitritis. Physical examination disclosed multiple erythematous papules over bilateral palms compatible with secondary syphilis. Serologic tests--the venereal disease research laboratory (VDRL) test, fluorescent treponemal antibody absorption (FTA-ABS) test, and Treponema pallidum hemagglutination (TPHA) test--were all positive. Aqueous fluid also showed positive FTA-ABS reaction. Under the impression of acquired secondary syphilis, enzyme-linked immunosorbent assay and Western blot test were performed and revealed concurrent HIV infection. After intravenous administration of penicillin-G, 18 million units daily for 2 weeks, the vitritis and retinochoroiditis improved. All patients with panuveitis of unknown cause should undergo VDRL and FTA-ABS screening. Subsequent testing for HIV antibody in leutic uveitis is also mandatory.