Fibromuscular dysplasia: a rare cause of cilioretinal artery occlusion in childhood.

OBJECTIVE: To report a case of cilioretinal artery occlusion with angiographic findings characteristic of the "string of beads" associated with renovascular hypertension secondary to fibromuscular dysplasia of the renal artery in a child. DESIGN: Case report. INTERVENTION: The patient underwent ex vivo renal artery reconstruction with saphenous vein graft and reimplantation. MAIN OUTCOME MEASURES: The main clinical outcomes were control of severe hypertension, reversible hypertensive retinopathy, and improvement of vision. RESULTS: Revascularization of the kidney improved renal function, and renovascular hypertension was clearly improved. Visual acuity improved to 20/200. CONCLUSIONS: A child with hypertensive retinopathy and arterial occlusion in the retina should undergo investigation to rule out a surgically curable hypertension. Magnetic resonance angiography of extrarenal vessels may reveal other sites of involvement of fibromuscular dysplasia. Evaluation and early diagnosis of renovascular hypertension will prevent severe end-organ damage.

Immunobiological diagnosis of tropical ocular diseases: Toxocara, Pythium insidiosum, Pseudomonas (Burkholderia) pseudomallei, Mycobacterium chelonei and Toxoplasma gondii.

Of the sera obtained from 18 patients with ocular diseases comprising ocular larva migrans (OLM), Toxoplasma gondii, Mycobacterium chelonei, Pythium insidiosum bacteria and tumour, 3 sera were positive for Toxocara antibody at the titre over 1/1600 ELISA. All 3 of these sera came from males with unilateral grayish fundi. We demonstrated the value of the direct immunofluorescent assay (DIFA) on vitreous specimens from 7 cases of Toxoplasma retinitis. One vitreous specimen under electronmicroscopic examination revealed bradyzoites of T. gondii. In addition, a few cases of keratoconjunctivitis/ corneal ulcer with endophthalmitis, due to P. insidiosum, Ps. pseudomallei and Mycobacterium chelonei, were also diagnosed.