Primary ocular malignant lymphoma associated with the acquired immune deficiency syndrome.

A 42-year-old man who was human immunodeficiency virus (HIV)-positive complained of floaters in his right eye, which had existed for 1 week, followed by loss of central vision. Results of ophthalmoscopic examination disclosed confluent yellowish-white retinochoroidal infiltrates with perivascular sheathing, which were more prominent superiorly in the right eye. Approximately 10 small, white, intraretinal and choroidal lesions were observed in the nasal periphery of the left eye. Results of cytologic examination of the vitreous of the right eye showed neoplastic cells characteristic of large cell type malignant lymphoma. Shortly thereafter, cytologic examination of the cerebrospinal fluid also showed large cell malignant lymphoma. Magnetic resonance imaging (MRI) showed a mass involving the left cerebellar hemisphere. After bilateral whole-eye radiation therapy, there was complete resolution of the lymphomatous retinochoroidal infiltrates in both eyes. The ophthalmologic and neurologic manifestations of acquired immune deficiency syndrome (AIDS) are discussed. The authors believe this is the first report of ocular malignant lymphoma occurring in a patient with AIDS.

Irregular astigmatism induced by annular tinted contact lenses.

Three patients developed irregular corneal astigmatism while wearing annular tinted soft contact lenses on a daily basis for 1.5 to 3 years. There was severe keratometer mire distortion, and photokeratoscopy revealed central and midperipheral corneal topographical irregularities in four of six eyes. In a masked protocol, scanning electron microscopy of four contact lenses revealed physical deformations in three lenses worn on affected eyes. We propose that latent stress vectors were created when the affected contact lenses were tinted. With patient usage, the stress vectors matured into physical deformations that induced irregular astigmatism. The astigmatism resolved upon discontinuing wear of these lenses, and the patients were able to wear other lenses with no recurrence of symptoms.

Apocrine hidrocystomas of the lids, hypodontia, palmar-plantar hyperkeratosis, and onychodystrophy. A new variant of ectodermal dysplasia.

A fourth case of a newly recognized variant of ectodermal dysplasia is reported. This syndrome is characterized by bilateral apocrine hidrocystomas of the eyelid margins, hypodontia, palmar-plantar hyperkeratosis, and onychodystrophy. To our knowledge, this syndrome, with its striking ocular manifestations, has not been previously documented in the ophthalmic literature.

Outpatient cataract surgery by ophthalmology residents in a county hospital.

As more people come to depend on public hospitals for health care, fewer inpatient beds are available for elective ocular surgery. At our county hospital, ophthalmology residents with faculty supervision have successfully performed cataract surgery on an outpatient basis. The postoperative outcomes of these outpatients are similar to those of a corresponding inpatient population. Outpatient cataract surgery can preserve the quality of patient care while providing potential advantages.

Endocrine control of appetite: gastrointestinal hormonal effects on CNS appetitive structures.

Permanent semi-microelectrodes were implanted in the ventromedial hypothalamus (VMH), lateral hypothalamus (LH), amygdala (AMYG), medial forebrain bundle (MFB), anterior hypothalamus (AH), inferior colliculus (IC), and caudate nucleus (CN). Average evoked responses were recorded simultaneously from the above sites in freely behaving rats before and after administration of pentagastrin (100 microgram/kg), secretin 1 microgram/kg or cholecystokinin octapeptide (CCK-OP) (1 microgram/kg) in search of satiety signal. Gastrin and secretin had little effect while it appears that CCK may perform a regulatory function in a neurohumoral feedback mechanism.