Multimodal Imaging of Atypical Acute Syphilitic Posterior Placoid Chorioretinitis Mimicking a White Dot Syndrome.

As rates of infectious syphilis continue to rise in the U.S., it is important to be familiar with known manifestations of ocular syphilis as well as report presentations not previously described in the literature. Here, the authors report a case of a 49-year-old myopic woman presenting with bilateral white dots characteristic of a white dot syndrome; these white dots were not evident on slit-lamp examination and became obvious on fundus autofluorescence. She tested positive and was successfully treated for syphilis. This case demonstrates that ocular syphilis can present with white dots and should be on the differential diagnosis of white dot syndromes. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:e52-e55.].

Combined pars plana lensectomy/vitrectomy for idiopathic macular hole repair without postoperative prone positioning.

PURPOSE: The aim of this study is to determine the anatomic and visual outcomes following combined pars plana lensectomy/vitrectomy (CPPLV) as a primary procedure for idiopathic macular hole (MH) without post-operative prone positioning (PPP). MATERIALS AND METHODS: A retrospective chart review of 42 patients (47 eyes) with MH who underwent CPPLV was performed. No PPP was performed; however, patients were instructed to avoid the supine position during the first postoperative week. The main outcome measures included MH closure rate, best corrected post-operative Snellen visual acuity (BCVA), and procedure complications. RESULTS: Anatomical closure was achieved in 44 eyes (93.6%). The average BCVA in these eyes improved from 20/203 at baseline to 20/91 post-operatively, with 28 (63.6%) having 20/40 or better. Twenty-eight (59.6%) of the 47 eyes had a BCVA of 20/40 or better post-operatively and 35 (74.5%) eyes improved by at least 2 Snellen lines. Post-operative retinal detachment (RD) was observed in 4 eyes (8.5%) and late reopening of the hole in 4 (9.1%). DISCUSSION: The anatomical and visual outcomes and the RD rate of CPPLV with sulcus intraocular lens implantation without PPP are comparable to those of traditional MH surgery techniques. The main advantages include sparing the patient the inconvenience of PPP and eliminating the need for additional post-vitrectomy cataract extraction procedure.

Cataract secondary to electrical shock from a Taser gun.

A 35-year-old man presented with traumatic iritis, angle-recession glaucoma, and a retinal dialysis secondary to blunt trauma from a Taser gun in the right eye and a unique electrical cataract in the left eye. Taser guns, which can also function as stun guns, can lead to electrical cataract formation. Given the increasing use of Taser guns by law enforcement and citizens, blunt mechanical and electrical sequelae of Taser gun injuries should be recognized.

Acute idiopathic maculopathy: report of a bilateral case manifesting a macular hole.

PURPOSE: To report an unusual patient with bilateral acute idiopathic maculopathy that was associated with a macular hole and elevated coxackievirus titers. DESIGN: Observational case report. PARTICIPANT: A 30-year-old female. METHODS: A 30-year-old female with bilateral exudative maculopathy and a macular hole in the left eye was followed up with fundus photography, fluorescein angiography, and optical coherence tomography. A possible association with coxackievirus infection was evaluated. Pars plana vitrectomy in an attempt to close the macular hole also was performed. MAIN OUTCOME MEASURES: Evolution of the maculopathy process, angiographic and optical coherence tomographic findings, and response of the macular hole to vitrectomy. RESULTS: The clinical presentation and evolution of the maculopathy were most compatible with unilateral acute idiopathic maculopathy (UAIM), but with bilateral involvement. Moreover, the patient was found to have elevated coxackievirus titers at presentation. The subretinal infiltrates resolved in both eyes, with full recovery of vision in the right eye. In the left eye, the macular hole persisted despite resolution of the exudative process. Vitrectomy failed to seal the hole. We report some atypical features of this patient as they may shed light on the disease pathogenesis. CONCLUSION: We report a patient with UAIM with bilateral involvement, a macular hole in one eye, and elevated coxackievirus titers. Macular hole formation in UAIM has not, to our knowledge, been reported.