Masahiko Sakurai

Optic disk pallor and retinal atrophy in Sotos syndrome (cerebral gigantism)

PURPOSE To report a case of Sotos syndrome (cerebral gigantism) with megalophthalmos, optic disk pallor, and retinal atrophy. METHODS Case report. RESULTS A 22-year-old man was diagnosed with Sotos syndrome with optic atrophy. His corneal diameters were 13 mm horizontally, and his optic disks were pale. His retinal vessels were attenuate in diameter, and small white spots were found on the retina. The results of a Goldmann visual field test were normal. His visually evoked potential to flash stimuli showed extended latent times and normal amplitudes. Keratometry was 40.5 diopters (8.33 mm) in both eyes. The axial length was 25.9 mm in the right eye and 25.4 mm in the left eye. CONCLUSION Sotos syndrome may be associated with optic disk pallor and retinal atrophy.

Bilateral choroidal metastases secondary to uterocervical carcinoma of the squamous cell type.

PURPOSE To report a patient with bilateral choroidal metastases secondary to uterocervical carcinoma of the squamous cell type. METHODS Case report. RESULTS A 55-year-old woman complained of visual field loss and decreasing vision. Seven months earlier, uterocervical carcinoma of the squamous cell type was diagnosed and treated with chemotherapy and irradiation. Serous retinal detachment and choroidal masses were present in both eyes. Retinal detachment was lessened in both eyes after radiotherapy. The patient died of respiratory insufficiency 3 months after the appearance of choroidal metastases. At autopsy, there was no second cancer to cause the choroidal metastases. Tumor embolization was present in the choriocapillaries. CONCLUSION Choroidal metastasis may develop from hematogenous spread of uterocervical squamous cell carcinoma.

Effect of systemic acetazolamide on the fluid movement across the aqueous-vitreous interface

In an attempt to study the effect of systemic acetazolamide on the fluid flow between the aqueous and vitreous in normal eyes, 50 mg kg(-1) acetazolamide was given intravenously every hour for 3 hr and the time change of the aqueous flow rate was calculated in two groups of rabbits, applying one of the following two different methods to each: the fluorescein method II of Jones and Maurice, a classical fluorometric method, or the more recently developed Johnson-Maurice method which entails intravitreal injection of FITC-dextran and measurements of its concentration in the anterior chamber many days after the injection. The flow rate after acetazolamide calculated by the fluorescein method II of Jones and Maurice in one group of rabbits was reduced to 55 +/- 5% (mean +/- S.E. n = 9) of the control on the average. When calculated by the Johnson-Maurice method in another group of rabbits, the reduction was to 80 +/- 4% (n = 11) of the control rate. The difference between the above figures was significant (P less than 0.005). Furthermore, the effect of acetazolamide calculated by the first procedure was significantly greater than that calculated by the second at 1 and 2.33 hr and at later times after the acetazolamide injection (P less than 0.05-0.01). On the other hand, the outflow pressure was reduced by 53-60% in both groups. The difference between the flow rates after acetazolamide determined by the above two methods was best explained by assuming that the FITC-dextran movement from the vitreous into the aqueous was reduced by about 25% after acetazolamide administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Proliferative vitreoretinopathy developed in HLA-B27-associated uveitis.

features but rarely extend deeper than the sweat coils, and mitoses should only be present in the outer-most layers. Invasion has been described and some have suggested that keratoacanthoma is a variant of squamous cell carcinoma. Our case emphasizes the need for a histological diagnosis to be made as the occurrence of keratoacanthoma on mucosal sites and in non-Caucasians is rare, and furthermore cannot be easily differentiated from malignant tumours such as squamous cell carcinoma clinically. Unlike cutaneous lesions, the natural history of conjunctival keratoacanthoma is obscure because they are excised early. Whether these lesions would regress like their cutaneous counterparts or go on to become invasive is unknown. Of the six or so previously documented cases of definite conjunctival keratoacanthoma, there have been no reports of recurrence after excision with follow-up ranging from 4 to 24 months. However, a noteworthy case, described by Grossniklaus et al, of a rapidly growing limbal lesion with keratoacanthoma features was excised after 3 weeks with evidence of invasion on histology. There was subsequent rapid recurrence with intraocular invasion requiring enucleation. It is unclear whether the lesion in their report was a keratoacanthoma or a very rapidly growing squamous carcinoma, but clearly early excision of a suspected conjunctival keratoacanthoma is recommended in light of this particular case. References