Fluoroangiographic findings in hemodialyzed patients.

After having highlighted the main possible ocular abnormalities in patients affected by chronic renal failure treated with hemodialysis, we describe our observations in 12 hemodialyzed patients. Evaluation of the examined fluoroangiographic patterns was interesting because, in seven patients (58.4%), focal choroidal perfusion defects were found, mainly localized in the posterior pole and nasal portion. Similar fluoroangiographic findings have been observed in patients with hypertension and diabetes mellitus and anatomic and histologic studies have proved the existence of diabetic choroidopathy; therefore, we suggest that the onset of choroidopathy in hemodialyzed patients depends on an early arteriolar atherosclerosis of the choroidal membrane, probably secondary to chronic renal failure rather than to extracorporeal dialysis.

Monolateral chorioretinitis with multiple foci in one case of Lyme disease.

Lyme disease involves numerous anatomic areas and systems and is caused by a spirochete, Borrelia burgdorferi. In this article, we describe one case of monolateral chorioretinitis with multiple foci in a 22-year-old myopic man. The diagnosis of this disease was confirmed by positive specific anti-B. burgdorferi antibodies titrated with an enzyme-linked immunosorbent assay method and by serum-conversion occurring approximately six weeks after the end of therapy. Considering the potential effect of this disease on the world's population, we wish to draw attention to its occurrence because it frequently involves ocular structures. Prompt and adequate therapy guarantees complete healing and avoids both short- and long-term complications.

Visual disturbances associated with primary empty sella syndrome in patients with chronic renal failure.

After describing the main clinical features of primary empty sella syndrome and the main hormonal alterations in chronic renal failure, the authors report the results obtained in a group of 33 patients undergoing dialysis three times a week. Each patient had a complete ophthalmologic examination, with electroretinography and visual-evoked potentials, a complete radiologic examination, including skull stratigraphy (particularly of the sellar and parasellar bony structures), and a computed tomographic scan. In the whole group, visual acuity, ocular and lid motility, and visual fields were normal. In two patients, a slight bilateral papilledema, associated with a P100 latency increase and normal morphology and visual-evoked potentials, was reported. Two patients had initial unilateral papillary pallor associated with P100 amplitude alterations. In all four of these patients, radiologic examination showed a markedly pathologic sellar widening with thickening and double contour image of the floor. The report of a primary empty sella was confirmed by computed tomography in all four cases. The authors discuss the possible etiopathogenic mechanisms of the neuroophthalmologic symptoms associated with this syndrome.