Idiopathic choriovitreal membrane--a case report.

A case of a macular idiopathic choriovitreal membrane is described which developed in a diabetic man. On initial examination the patient was found to have a pigment epithelial detachment with a choroidal neovascular membrane (CNVM) in the right eye. Two months after the first visit the CNVM was seen to have penetrated the retina and presented as a choriovitreal membrane. Panretinal photocoagulation was applied after which the choriovitreal membrane demonstrated fibrotic involution. This case is unusual in that the choriovitreal membrane developed in the absence of a choroidal or retinal pigment epithelial disease process that may be associated with a CNVM as well as in the absence of previous macular laser treatment.

Macular capillary hemodynamic changes associated with Raynaud's phenomenon.

BACKGROUND: Raynaud's phenomenon is an episodic, reversible spasm of the digital arterioles. Previous studies have suggested that Raynaud's phenomenon may be associated with alterations in the ocular circulation. The authors used the blue field entoptic simulation technique to study macular retinal capillary hemodynamics in patients with Raynaud's phenomenon. METHODS: Forty-two volunteers participated in the study: 18 with a connective tissue disease and secondary Raynaud's phenomenon, 8 with a connective tissue disease and no Raynaud's phenomenon, and 16 healthy volunteers. The mean of three blue field entoptic density and velocity measurements was determined before as well as during and 10 minutes after the immersion of one hand in ice water. RESULTS: Patients with severe Raynaud's phenomenon demonstrated a statistically significant 30% decrease in retinal capillary flow during immersion of a hand in ice water (P less than 0.05), which remained 17% reduced (P less than 0.05) for at least 10 minutes after removal. The decrease in capillary flow was not observed in control individuals or in individuals with connective tissue disease who demonstrated minimal or no Raynaud's phenomenon. CONCLUSION: The prolonged reduction in retinal capillary flow observed in subjects with Raynaud's phenomenon is probably caused by retinal arteriolar vasoconstriction and is similar to concurrent arteriolar vasoconstriction reported in other systemic vascular beds. In the retina, the recurrent ischemic episodes may result in dysfunction or injury.

Pseudophakia in children: precautions, technique, and feasibility.

Intraocular lens implantation in young children can yield satisfactory results when the surgical techniques are modified and adapted to the child's eye. Between June 1983 and July 1988, 84 posterior chamber lenses were implanted in 80 children aged 2 months to 8 years. An elective posterior capsulotomy followed by an anterior vitrectomy was performed in all cases prior to the lens insertion. This step allowed a permanent clear visual axis which in turn has facilitated visual rehabilitation of the pseudophakic eye. The best results occurred in the developmental cataract group followed by the traumatic cataract group; the poorest visual outcome occurred in patients with unilateral congenital cataracts. Amblyopia treatment and alternative methods of correcting pediatric aphakia are discussed.

Ciliary sulcus reconstruction for posterior implantation in the absence of an intact posterior capsule.

Secondary implantation of a posterior chamber intraocular lens in an aphakic eye devoid of an intact posterior capsule requires a special surgical approach. When lens capsule remnants remain in the periphery, the ciliary sulcus can be reconstructed to accommodate a posterior chamber lens. The fibrotic lens or capsular residues that often remain adherent to the posterior surface of the iris are divided with sharp intraocular scissors, and a shelf is created that is sufficient to support the lens haptics. A series of 28 cases, including 16 involving young children, demonstrates the feasibility and the favorable visual results obtainable with this surgical technique.

Orbital varix--an unusual cause of proptosis. A case report.

An orbital varix is a pathological enlargement of the venous channels within the orbit. It is an unusual cause of proptosis, the proptosis being unilateral, painless and intermittent. The diagnosis is established by means of orbital venography, an investigation seldom performed.

Retinal complications in the acquired immunodeficiency syndrome. A case report.

Increasing numbers of patients with the acquired immunodeficiency syndrome (AIDS) are being reported. In the US literature the eye complications have been well documented but because so few cases of AIDS have been reported in South Africa, the retinal complications are largely unknown to those treating these patients. The retinal complications are due to cytomegalovirus (CMV) retinitis. The patient described here developed the typical signs in both eyes. It is essential to examine the fundi of AIDS patients regularly. The presence of cotton-wool spots always precedes CMV retinitis, which leads to blindness; it is also of prognostic significance since all reported patients with CMV retinitis have died.