Case Series: West African Crystalline Maculopathy.

SIGNIFICANCE: West African crystalline maculopathy is a rare crystalline maculopathy without a clear etiology. Although the crystals do not appear to be visually significant, there may be a role in the breakdown of the blood-retina barrier within the pathogenesis of this disorder. PURPOSE: The purpose of this case series is to describe two cases of West African crystalline maculopathy. These crystals do not affect vision, nor visual function. Because there are only 39 other documented cases in the literature, it is imperative to understand the differences and similarities in this rare maculopathy. CASE SERIES: Case 1 was a 65-year-old Black woman with a history of proliferative diabetic retinopathy after panretinal photocoagulation was seen for routine examination. She recently emigrated from Tema, Ghana. Examination revealed asymmetric macular crystals consistent with West African crystalline maculopathy and quiescent proliferative diabetic retinopathy. Case 2 was a 60-year-old Black woman that presented for routine examination. She recently emigrated from Nigeria. Examination revealed macular crystals consistent with West African crystalline maculopathy with evidence of stage 1 hypertensive retinopathy and extramacular drusen. CONCLUSIONS: West African crystalline maculopathy is a rare disorder that should be considered in patients who present with asymptomatic foveal crystalline deposits who are immigrants from West African countries.

Necrotising herpetic retinopathies: a review and progressive outer retinal necrosis case report.

Necrotising retinopathies can be visually devastating. Most often associated with the viral family Herpesviridae and seen in both immune-competent and immunocompromised hosts, possible complications of necrotising retinopathies include progressive retinal necrosis with or without macular involvement, optic neuropathy and ultimately, secondary retinal detachment. Examples include progressive outer retinal necrosis, acute retinal necrosis and cytomegaloviral retinitis. If diagnosed early and treated aggressively, visual complications can be prevented; however, there is no current consensus on the most appropriate antiviral regimen for each of the different varieties of necrotising herpetic retinopathy. This paper reviews aspects of varieties of necrotising herpetic retinopathy, including pathophysiology, treatment and diagnostic testing.

Progressive, asymptomatic papilledema as the presenting sign of a Chiari I malformation.

BACKGROUND: Chiari I malformation (CM1) is the caudal herniation of the cerebellar tonsils into the foramen magnum. It can cause several neurological signs and symptoms, or be asymptomatic. Papilledema is a potential, but unusual, manifestation of CM1. While CM1 is often asymptomatic, papilledema is less likely to be. We present the first reported case of a progressive, asymptomatic papilledema as the sole presenting sign of a CM1; CASE REPORT: A 39 year old woman presented without neurological symptoms and was found to have optic disc edema. Humphrey visual fields were normal and B-scan showed no drusen. On a subsequent visit, optical coherence tomography showed advanced disc edema. Neuroimaging revealed a CM1. The patient was referred for neurological consultation for the management of the papilledema secondary to CM1; CONCLUSIONS: This case represents the importance of a thorough ocular examination, as the patient's asymptomatic neurologic condition would not have been diagnosed without the discovery of the papilledema.