A randomized study of 5-fluorouracil and filtration surgery.

We conducted a randomized study of 26 patients with a poor prognosis undergoing filtration surgery with and without a low dose of 5-fluorouracil. Mean preoperative intraocular pressure (+/- S.E.M.) in the 5-fluorouracil group (n = 14) was 38.4 +/- 3.08 mm Hg; in the control group (n = 12) it was 41.2 +/- 5.0 mm Hg. Mean postoperative intraocular pressure (+/- S.E.M.) at six to 18 months was 14.4 +/- 1.4 mm Hg in the 5-fluorouracil group and 30.7 +/- 3.9 mm Hg in the control group (P less than .01). Of 14 patients in the 5-fluorouracil group, 12 had a successful outcome at 12 months. Of 12 patients in the control group, three had a successful outcome during this same interval.

A prospective, randomized study of 5-fluorouracil and filtration surgery.

Our study shows that use of a small dose of subconjunctival 5-FU provides significantly lower postoperative intraocular pressure than does no antimetabolite treatment. Morphology of the postoperative blebs suggests that increased filtration results in lower intraocular pressure in the 5-FU group. Corneal epithelial defects were as common with a low dose as with higher doses previously described.

Stromal keratitis complicating anterior membrane dystrophy.

Recurrent erosion of the cornea has been well documented in patients with nontraumatic anterior membrane dystrophies of various types. We examined five patients who, in addition to an erosion, developed stromal keratitis. Three of these patients were subjected to a complete microbiologic workup, but the lesions were all sterile. The lesions healed with conservative treatment of patching and, in some cases, a soft contact lens. Stromal keratitis should be recognized as a complication of the non-traumatic recurrent erosion syndrome, which in turn is frequently associated with anterior membrane dystrophy. The finding of such anterior membrane changes in either eye will lead to the correct diagnosis and treatment of the affected eye.

Photic maculopathy secondary to short-circuiting of a high-tension electric current.

A 21-year-old man was exposed accidentally to the flash of a high-tension short circuit. He subsequently developed a yellow-gray foveolar lesion with mild central visual loss. Fluorescein angiography demonstrated the area of retinal pigment epithelial disruption and was used to follow its evolution over eight months. The energy level at the retina was estimated at 0.87 Joules/cm2, insufficient to create a thermal burn. Therefore, although the patient suffered thermal facial burns, the foveolar lesion represents a photochemical injury to the retinal pigment epithelium and, hence, is similar to solar retinopathy, eclipse blindness, and arc-welder's retinopathy.

Choroidal vascular changes in toxemia of pregnancy.

Twenty-seven patients with toxemia of pregnancy were examined during a postpartum period of two days to eight months. Five of these manifested abnormal photographic and angiographic findings including disk and retinal edema, retinal striae, deep retinal yellow-white focal lesions, choroidal nonfilling, leakage of dye from the optic disk and deep retinal lesions, and retinal pigment epithelial window defects. The location and configuration of the leakage correlated with the defects seen on color photography. The normal retinal, and predominantly abnormal choroidal vascular patterns provide evidence implicating choroidal vascular insufficiency as the primary basis for secondary retinal detachments seen in toxemia of pregnancy.

Thyroid ocular myopathy.

Based upon the ultrasonographic evidence of extraocular muscle abnormalities in all patients with orbitopathy and proven thyroid disease, we conclude that the basic abnormality of thyroid orbitopathy is a panmyositis and that all of the classes described by Werner are expressions of different degrees and manifestations of the same pathologic process. This thesis is supported by presentation of cases of varying severity who have in common extraocular muscle abnormalities. We believe that the process we describe acceptably explains all of the eye signs of this common orbitopathy.