Mano Swartz

Clofazimine-induced bull's-eye retinopathy.

Bulls-eye retinopathy has multiple associations. We report a case of bulls-eye retinopathy presumed to be secondary to clofazimine (Lamprene®) treatment of a 30-year-old patient with acquired immunodeficiency syndrome (AIDS). Pretreatment baseline eye exam of this patient was normal except for bilateral cotton-wool spots. However, follow-up exam 5 months later revealed bilateral anterior pigmentary corneal deposits in a whorl pattern, a presumed infectious retinitis in the left eye, and bilateral annular macular pigmentary abnormalities. The patient was taken off clofazimine treatment, but died 1 month later. The authors suggest that patients being treated with clofazimine be examined for drug-related corneal and retinal lesions.

Dominant optic atrophy, deafness, ptosis, ophthalmoplegia, dystaxia, and myopathy. A new syndrome.

Twenty-three members of a 96-member family exhibited an autosomal dominant disorder which has not previously been described. This disorder involves progressive optic atrophy, abnormal electroretinography without retinal pigment changes, and progressive sensorineural hearing loss usually evident in the first or second decade of life. In midlife, ptosis, ophthalmoplegia, dystaxia, and a nonspecific myopathy occur.

Acute leukemic infiltration of the vitreous diagnosed by pars plana aspiration.

A 30-year-old man with acute lymphoblastic leukemia, null cell, L2 type developed a unilateral dense cellular vitreous infiltrate while in apparent remission. Cytopathologic examination of material aspirated from the vitreous established the diagnosis of lymphoblastic infiltration. Prompt radiotherapy and chemotherapy rapidly reduced the vitreous infiltration and cleared cells from the cerebrospiral fluid. Intraocular involvement by the leukemic process was the initial sign of central nervous system involvement. Acute lymphoblastic leukemia should be added to the list of lymphoproliferative disorders capable of vitreous infiltration, and which can be identified by vitreous aspiration and cytopathologic examination.

Histology of macular photocoagulation

The histology of macular photocoagulation is reviewed. This information may be helpful in selecting the best available laser for retinal vascular and choroidal disorders in the macular region, as providing an experimental method to better understand the effects of photocoagulation on retinal disease processes.

Hyperopic Shift Induced by High Altitude after Radial Keratotomy

BACKGROUND The collagen fibrils embedded in the ground substance of the stromal lamellae provide the structural support for the cornea. When the stromal lamellae are cut in a radial keratotomy surgical procedure, the remaining uncut lamellae carry the tensile forces. METHODS We studied two expert climbers who had bilateral radial keratotomy before participating in six climbs of extreme altitude, including Mount McKinley and above 7500 m (24,606 ft) on Mount Everest. RESULTS Whenever either climber was exposed to altitudes greater than approximately 5000 m (16,405 ft) for more than a day, their refraction would become +3.00 D or more hyperopic and remain so al long as they were at or above this altitude. Visual acuity slowly returned to normal after descent. CONCLUSION It appears that in the presence of significantly reduced atmospheric pressure and/or oxygen there is a greater effect of radial keratotomy in some patients, making the cornea more vulnerable to changes in shape. The cornea appears to respond by further flattening, exacerbating the intended surgical effect and producing a refractive shift toward hyperopia.

Posteriorly dislocated anterior chamber intraocular lens

A case of a posteriorly dislocated anterior chamber intraocular lens (IOL) is reported.