LISDEXAMFETAMINE (VYVANSE) USE ASSOCIATED WITH BRANCH RETINAL ARTERY OCCLUSION.

BACKGROUND/PURPOSE: Branch retinal artery occlusions (BRAO) are primarily associated with the aging population and are rare in young adults. The etiology of BRAO includes embolic or nonembolic sources. Lisdexamfetamine has been associated with vasospastic ischemic events in multiple areas of the body. However, there are currently no reported cases of BRAO associated with lisdexamfetamine use. Here, we present a case that suggests a correlation between lisdexamfetamine use and a nonembolic BRAO in a young adult man. METHODS/RESULTS: A 32-year-old man presented with sudden left eye blurred vision 17 days after beginning lisdexamfetamine. Fundus examination confirmed the BRAO diagnosis. Following evaluation by a retina specialist, vasospasm was considered the most likely cause for the BRAO. Other possible etiologies were unlikely due to diagnostic testing. CONCLUSION: The temporal association between lisdexamfetamine and BRAO symptom onset suggests vasospastic occlusion. Lisdexamfetamine-associated adverse events should be considered as a possible etiology for BRAO.

Exudative retinal detachment after laser in retinopathy of prematurity.

Treatment of retinopathy of prematurity with laser photocoagulation can be very effective in preventing future blindness, but its complications should be well understood by the ophthalmologists performing the treatment. We present the case of a 4-month-old girl in whom laser photocoagulation led to an exudative retinal detachment in both eyes. The fluid eventually resolved after treatment with topical and systemic steroids, but the effects of persistent fluid led to permanent photoreceptor loss. Optical coherence tomography can be useful in diagnosing the complication of exudative retinal detachment after laser photocoagulation and monitoring treatment response.

Leptomeningeal Carcinomatosis with Delayed Ocular Manifestations.

The most common presenting symptoms of leptomeningeal carcinomatosis (LC) are ocular manifestations with vision loss. There are multiple reports of undiagnosed LC causing sudden, complete, monocular vision loss as the presenting symptom; however, sudden bilateral vision loss 6 months following diagnosis has not been described. Any new ocular involvement or worsening of previous ocular symptoms warrants reimaging and prompt ophthalmology consultation, as this likely indicates disease progression. This report details a unique case of LC where a previously diagnosed patient developed sudden, complete, bilateral vision loss and multiple cranial nerve palsies with progression of LC on imaging.

Spontaneous improvement of levator palpebrae superioris function after traumatic transection.

Direct traumatic injury to the levator palpebrae superioris aponeurosis typically results in upper eyelid ptosis. The mechanisms can involve mechanical or neurogenic etiologies. Prompt surgical exploration and repair are required for restoration of normal function. In cases where prompt surgical intervention is not performed or the levator palpebrae superioris aponeurosis cannot be repaired, the restorative options are limited. The options are further restricted by concurrent ipsilateral frontalis paresis. This report details a spontaneous return of levator function nine months after complete traumatic transection of the levator palpebrae superioris aponeurosis complicated by concurrent ipsilateral frontalis paresis.

Synthesis and biological evaluation of novel hygromycin A antibacterial agents.

Novel hygromycin A derivatives bearing a variety of functionalized aminocyclitol moieties have been synthesized in an effort to increase the antibacterial activity and drug-like properties of this class of agents. A systematic study of the effect of alkylation and removal of the hydroxyls of the aminocyclitol directed us to a series of alkylated aminocyclitol derivatives with improved gram-positive activity.