Chorioretinitis sclopetaria.

Chorioretinitis sclopetaria occurs as a result of missiles penetrating into the orbit and grazing, but not perforating, the sclera. Localized destruction of both the retina and choroid develops adjacent to the impact site and these structures are subsequently replaced by a connective tissue response. Extensive damage is produced in the retinal circulation, which is not confined to the zones containing connective tissue plaques. Residual field defects are found to relate more closely to areas of retinal capillary non-filling than to the while scarred areas.

Indirect choroidal tears at the posterior pole: a fluorescein angiographic and perimetric study.

Retinal fluorescein angiographic and visual field studies were performed on 10 patients who had developed indireect choroidal tears, these procedures being repeated at intervals until the retinal disturbances stabilised. Fluorographic investigations revealed that a transient breakdown of the choroidoretinal barrier to fluorescein dye could be detected in cases investigated within 4 days of injury, and also that the late complication of neovascularisation, producing a serous maculopathy, may resolve and good central vision be retained without recourse to photocoagulation therapy. Patients who had visual field examinations performed within a few days of trauma were noted to have dense central scotomata, but some recovery occurred in most cases, although to a variable degree. Field defects away from fixation corresponded to an extent with areas of post-traumatic pigmentary retinopathy, but in some portions of retina with normal background appearances sensitivity was also noted to be reduced. Scotomata corresponding specifically to choroidal tears or nerve fibre bundle defects were not recorded. Improvement of visual acuity may be expected, except in cases where a choroidal tear has involved the fovea or progressive choroidal neovascularisation led to permanent macular damage.

Adult toxocariasis. Uniocular retinal lesions in the 20- to 50-year age group.

Uniocular posterior polar lesions thought to be characteristic of suspected adult ocular toxocariasis have been observed in a group of eight patients whose ages ranged from 20 to 50 years. Six patients had positive fluorescent antibody tests for Toxocara species, whereas control serological studies showed that only 4% of healthy adults in the same age group had positive fluorescent antibody responses. All the patients with clearly defined progression of their retinal lesions had positive fluorescent antibody tests. In two patients positive tests reverted to negative within 2 years.

Retinal tumours in neurofibromatosis.

A 45-year-old male with von Recklinghausen's disease was noted to have hamartomatous lesions of the retinae similar to those more commonly described in Bourneville's disease and von Hippel-Lindau's disease. These findings would appear to support the concept that the retinal changes in neurofibromatosis occupy an intermediate position between those seen in the other two phakomatoses.

Ocular toxocariasis in adults.

Human infection by toxocara larvae has been thought to be predominantly a disease of young children, but the percentage of the population with antibodies to this nematode worm has recently been shown to increase with age. Although a definite diagnosis of ocular toxocariasis can be made only by identifying the larva histologically, the evidence in three cases presenting with recent uniocular loss of vision strongly suggests that adults may also be affected. The lesions noted on ophthalmoscopy closely resembled toxocaral granulomata in children. Toxocaral fluorescent antibody tests were positive in each case.