Bruce J. Busse

Macular and perimacular vascular remodelling sickling haemoglobinopathies.

The posterior pole vasculature of 100 patients with different sickling haemoglobinopathies was studied prospectively over a period of three years. Various abnormalities of the posterior pole vasculature were seen in 29 per cent of the patients. Continuous remodelling of the macular and perimacular vasculature occurred. Visual acuity was variably affected and sometimes remained intact.

Peripheral Retinal Microaneurysms in Chronic Leukemia

Of 25 patients with chronic leukemia, there was clinical evidence of peripheral retinal microaneurysm formation in two of eight patients with chronic lymphocytic leukemia and six of 17 patients with chronic myelogenous leukemia. There was no proliferative retinopathy in any of the 25 patients. An elevated leukocyte count seemed necessary for microaneurysm formation in leukemia, although some patients with elevated counts had no microaneurysms. The prolonged leukocytosis of chronic leukemia can produce peripheral capillary dropout, vascular stagnation, microaneurysm formation, and, rarely, peripheral proliferative retinopathy similar to sickle cell disease.

Spontaneous Remodeling of the Peripheral Retinal Vasculature in Sickling Disorders

Periodic photographic and angiographic surveys of patients with the earliest stages of sickle retinopathy showed a number of fundus findings. In seven cases (sickle cell anemia, four; sickle cell hemoglobin C, three), these findings included: (1) a variety of vascular abnormalities in the equatorial and post-equatorial retina such as segmented dilations of the vessel walls, hairpin-shaped vascular loops, hypertrophic, tortuous A-V anastomoses, intraluminal plugs, closure and loss of capillary bed, and terminal budding of capillaries; and (2) a continuous, spontaneous remodeling of the peripheral retinal vasculature due to successive closures and reopenings of equatorial retinal vessels. A centripetal recession of the peripheral retinal vasculature usually resulted. No correlation between the ophthalmoscopic and the systemic condition of the patients could be made.

Prospective Observation of Vascular Anastomoses Between the Retina and Choroid in Recurrent Toxoplasmosis

Prospective angiographic observations demonstrated the formation of both choroidoretinal arteriolar anastomoses as well as retinochoroidal venular anastomoses in the ocular fundus of a young man with recurrent ocular toxoplasmosis.

Reticular tapeto-retinal dystrophy. As a possible late stage of Sjögren's reticular dystrophy.

Findings from two patients with a reticular tapetoretinal dystrophy strongly suggested advanced stages of Sjögrens reticular dystrophy. These observations emphasize that, although initially a benign disease, advanced stages of Sjörgrens dystrophy may eventually manifest diffuse photoreceptor and retinal pigment epithelial disease.