Retinal detachment following endophthalmitis.

Fifty-five consecutive patients with a clinical diagnosis of bacterial endophthalmitis were reviewed. All patients were treated with systemic, periocular, topical, and intravitreal antibiotics. In addition, 33 of the patients underwent a pars plana vitrectomy. Nine retinal detachments occurred within six months of initial diagnosis. The higher frequency of retinal detachment in the vitrectomy group (21%) as compared to those patients managed without vitrectomy (9%) may be explained by a combination of surgical complications and the increased severity of endophthalmitis in the vitrectomy group. The two patients who developed retinal detachment during vitrectomy surgery rapidly progressed to no light perception. Conversely, the repair of retinal detachments diagnosed postoperatively had a good prognosis.

Argon laser choroidotomy for drainage of subretinal fluid.

We used the argon laser to perforate the choroid and drain subretinal fluid during retinal detachment surgery in 24 consecutive patients. The procedure was successful in 23 of 24 patients (95.8%). The laser settings required for perforation ranged from 0.02 to 0.2 s and from 200 mW to 2.0 W. Because it is not necessary to enter the subretinal space with a solid, pointed object, laser choroidotomy may reduce the incidence of retinal perforation. In addition, the laser has the advantage of cauterizing small vessels during choroidal puncture, which may reduce bleeding at the time of drainage.

Albinotic characteristics in congenital nystagmus.

We studied 26 white patients (19 males and seven females), ranging in age from 1 to 57 years, with congenital nystagmus for the characteristics of albinism. None of the patients was known to be an albino and none had readily apparent signs of albinism. The study also included 26 controls matched by age, sex, race, and complexion. Twelve of the 26 patients with congenital nystagmus had one or more of the following characteristics: detectable iris transillumination (six of 25 patients), choroidal depigmentation (four of 22 patients), and abnormal tanning history (eight of 26 patients). Iris transillumination and abnormal tanning were not found in any of the controls but two controls showed choroidal depigmentation and one showed blunting of the macular reflex (this was determined to be age-related). These differences were significant for iris transillumination (P = .01), blunting of the macular reflex (P = .01), and abnormal tanning (P = .002) but not significant for choroidal depigmentation (P = .38). Within the group of patients with congenital nystagmus, iris transillumination was significantly associated with blunting of the macular reflex (P = .03), choroidal depigmentation (P = .03), and abnormal tanning (P = .004) but not with eye color (P = .16) or visual acuity (P = .33). These findings suggested that many patients with apparently isolated congenital nystagmus may have subclinical albinism or a form of albinoidism.

Viewing through the asteroids.

Thirty to seventy percent of patients with asteroid hyalosis will also have diabetes. In this group of patients where view of the fundus is essential, it is often difficult or impossible by conventional ophthalmoscopy. We have noted the excellent visualization of fundus detail in asteroid hyalosis on routine fundus fluorescein angiography. The asteroid bodies are "optically removed" from the vitreous with this technique, thus affording a view for diagnosis previously thought impossible without actual vitrectomy. A series of patients, optimal camera filter combination, and a theory for this effect are presented.