Merih Soylu

Sweet's syndrome associated with G-CSF

Summary. Sweets syndrome (SS) developed in two patients with acute myeloid leukaemia (AML) treated with granulocyte colony stimulating factor (G‐CSF) for febrile neutropenia due to AML chemotherapy. Fever, painful skin and conjunctival lesions developed and neutrophilic infiltration was detected at biopsy specimens. Neutrophilia was not detected. Skin lesions regressed within 1–2 weeks and conjunctival lesions within 4 weeks following the cessation of G‐CSF. We conclude that SS may be a complication of G‐CSF therapy and tender skin and/or conjunctival lesions developing during G‐CSF therapy should suggest the possibility of SS.

The association between HLA B5 and ocular involvement in Behçet's disease in southern Turkey

Abstract HLA B5 plays an important role in the aetiology of Behçets disease. The frequency of HLA B5 differs between racial groups and geographical regions. Ocular involvement, which could lead to serious complications, is a very important feature of Behçets disease. Various racial groups having different genetic properties live in the Čukurova region, located in southern Turkey. To investigate the role of HLA B5 in Behçets disease in Čukurova region, HLA B5 antigens were investigated by lymphocytotoxicity assay in 65 patients and 200 healthy controls. A significantly higher frequency was found in the patient group. Neither ocular involvement, nor the type of uveitis showed any correlation with HLA B5, but it was found that patients presenting with frequent ocular attacks had significantly higher HLA B5 positivity than the patients with rare attacks. This observation suggests that HLA B5 would be a negative factor in visual prognosis in Behçets disease.

Pars plana vitrectomy in ocular Behçet's disease

Purpose: To evaluate the results of pars plana vitrectomy in Behçet patients with dense vitreous opacities, and its effect on intraocular inflammatory episodes and visual prognosis. Methods: The study group consisted of nine patients (one eye in eight patients, both eyes in one) with Behçets disease who underwent pars plana vitrectomy because of dense vitreous opacification. The indications for vitrectomy, the effect of vitrectomy on the frequency of severe intraocular inflammatory episodes, and visual prognosis were investigated in these patients. All the patients were male, and their ages ranged between 28–45 years. Combined lensectomy was performed on those with complicated cataracts. The postoperative follow-up was between 12–66 months. Results: In all of the patients preoperative visual acuity was hand motions. Postoperatively there was no change in vision in five eyes, however visual acuity improvedin five eyes, between counting fingers and 0.4. None of the patients showed any severepostoperative intraocular inflammatory episodes, and phthisis did not develop in any ofthe patients. Conclusion: In this study, pars plana vitrectomy was found to have a beneficial effect on the prognosis of vision. There was also a decrease in the frequency of severe intraocular inflammatory episodes in patients with Behçets disease with severe vitreous opacities, who did not respond to maximum medical treatment. However, further studies on larger groups should be performed in order to confirm the findings of this study.

Haemodynamic changes in ocular Behçet's disease

Editor,—Behcet’s disease (BD) is an immune system related obstructive vasculitis characterised by recurrent inflammation that affects multiple systems. Posterior uveitis and retinal vasculitis are the common features of ocular involvement.1-3 Colour Doppler imaging (CDI) is a non-invasive ultrasonographic method which permits simultaneous grey scale imaging of structure and colour coded imaging of blood velocity. CDI has successfully demonstrated changes in orbital haemodynamics associated with a variety of pathological conditions.4-7In the present study the haemodynamic changes in ophthalmic (OA), central retinal (CRA), and posterior ciliary arteries (PCA) of the patients with BD were investigated by using CDI. ### CASE REPORT The study group consisted of 26 patients with BD (five females, 21 males), aged between 22 and 58 (mean 32.19 (SD 8.27)). Diagnosis was made according to the criteria recommended by International Study Group for Behcet’s disease.8 Control group consisted of 20 males, six females, aged between 21 and 58 (31.49 (8.60)), who had no ocular or systemic pathology other than presbyopia. After performing full ophthalmological evaluation, transocular CDI was performed in all the patients and controls with a colour Doppler sonographic unit (General Electric Sonochrome …

Bilateral choroidal infiltration from indolent non-Hodgkin's lymphoma: A rapid course with poor prognosis

A 42-year-old-woman, with a 2 year history of non-Hodgkins lymphoma suffered sudden bilateral visual loss. This unusual patient presented with an unifocal choroidal tumor in the superionasal quadrant in both eyes. Fluorescein angiography revealed early and late intense subretinal fluorescence. Cytological examination of the anterior chamber and vitreous tap material revealed abnormal lymphocytes compatible with NHL. Diffuse choroidal infiltration was diagnosed and treated with radiotherapy. Radiotherapy did not provide local control and preservation of the vision. Non-Hodgkins lymphoma can infiltrate to the choroid and radiotherapy may not be efffective in every case.

Serous retinal detachment in a case with chronic lymphocytic leukemia: no response to systemic and local treatment

Leukemias are systemic hematopoietic neoplasias and not infrequently cause ocular findings. Serous retinal detachment (SRD) is one of these manifestations and even may be the first sign of the underlying leukemia. Here we reported a case with chronic lymphocytic leukemia (CLL) presenting with SRD and discussed the clinical importance and therapeutic options.

NON-HODGKIN LYMPHOMA PRESENTING WITH UVEITIS OCCURRING AFTER BLUNT TRAUMA

We report here an unusual patient suffering from visual loss with refractory uveitis which was occured after a blunt trauma to her left eye. While in the hospital cervical lymph node and anterior chamber aspiration cytology with immunohistochemical staining were performed. The histopathologic diagnosis was highly malignant B-cell non-Hodgkin lymphoma. After the inflammation of the eye was regressed with chemotherapy, pars plana vitrectomy-lensectomy was performed. She was free of inflammation and the best corrected visual acuity was increased. However, she had a refractory inflammatory episode with clumps of cells in the anterior chamber 10 months after the operation. Local radiotherapy to the left eye was applied. Radiotherapy provided local control and preservation of the vision. The present case is presented in order to emphasize the importance of systemic evaluation in uveitis and possible role of trauma leading migration of atypical cells into the eye.

Basaloid large cell lung carcinoma presenting concurrently with metastatic uveal tumor

A 51-year-old man complaining of cough, hemoptysis, and decreased visual acuity was admitted to our hospital. Chest radiography revealed a left hilar mass and pleural effusion in the left hemithorax. In his ophtalmological examination, there was total retinal detachment in the left eye. Ultrasonographic examination and orbital magnetic resonance imaging (MRI) were reported as choroidal metastasis. A computed tomography (CT) confirmed the mass in the left hilum and multiple mass lesions consistent with metastasis in the liver and in the body of 12th thoracic vertebra. Bronchoscopic biopsies revealed large cell carcinoma with basaloid features. He died after 4 months with rapid progression of the disease in spite of combined chemotherapy. Although primary lung cancer with concurrent eye metastasis is an uncommon entity, it should always be kept in mind for patients with ocular symptoms.

Comparison of optical coherence tomographic findings between Behcet disease patients with and without ocular involvement and healthy subjects

Purpose: We aimed to compare the retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, and the choroid thickness between patients with Behcet disease and healthy subjects by using spectral domain optical coherence tomography (SD-OCT). Methods: Ninety eyes of 45 healthy subjects and 104 eyes of 52 patients with Behcet disease were included in this study. Rheumatoid factor and C-reactive protein levels were measured by blood testing in the patients. Results: The mean thickness of the retinal nerve fiber layer, ganglion cells layer, and inner plexiform layer were significantly lower in patients with Behcets disease than in the healthy subjects. The mean choroidal thickness was significantly higher in the patients than in the healthy subjects. Conclusions: SD-OCT was a useful and non-invasive tool for the detection of retinal nerve degeneration and choroidal changes in patients with Behcet disease even in the absence of ocular involvement.

Bilateral acute idiopathic frosted branch angiitis in a pregnant woman.

PURPOSE To present a case of frosted branch angiitis in a pregnant woman. METHODS A 27-week pregnant 18-year-old woman was presented with bilateral decreased visual acuity. Fundoscopy showed typical appearance of frosted branch angiitis. RESULTS A good spontaneous clinical improvement was observed during systemic evaluation. No treatment was started. CONCLUSION Frosted branch angiitis may be seen during pregnancy, without any associated underlying disease, and can be resolved without any intervention. The treatment may not be necessary for some cases.