Clinical findings in posterior uveitis [abstract]

Posterior uveitis which is an important cause of visual loss, needs careful work-up and aggressive management to minimize morbidity and reduce the incidence of blindness. Uveitis may be classified with regards to its presentation (acute or chronic) and also depending on its anatomic location. Patient symptoms are often helpful in determining the type of inflammation. It is important to carefully evaluate patients with posterior uveitis to determine the aetiology. Inflammation may be in the par plana (pars planitis), retina (retinitis) and the choroid (choroiditis). Some patients have inflammation in many layers (chorio-retinitis). In addition to specific agents to treat aetiologic factors (penicillin for syphilis), steroids are important agents for treating inflammation in these patients. Appropriate laboratory investigations help to determine systemic disorders. Chest X-rays are important to evaluate granulomatous diseases such as sarcoidosis and tuberculosis. Close follow-up is critical. (AU)

Ocular findings in elderly cases of homozygous sickle-cell disease in Jamaica

The ocular findings in 60 patients with homozygous sickle-cell disease over the age of 40 years have been described. Peripheral retinal vessel disease was common and appeared to increase with age. Retinitis proliferans was common among older patients in the group. Angioid streaks occurred in 13 (22 percent) patients. (Summary)

Photocoagulation and diathermy in the treatment of proliferative sickle retinopathy

The O'Malley Log II portable photocoagulator was used to treat the worse eye of 36 patients with proliferative sickle cell retinopathy flat on the retinal surface. The technique involved direct coagulation of the feeder arterioles before treatment of the new vessels themselves. The photocoagulator was most successful in treating the lesions and 131 of 137 retinitis proliferans (RP) lesions were occluded. In only one RP lesion did the photocoagulator have insufficient power to occlude the lesion. Vitreous haemorrhage occurred in only one patient and small round localized retinal haemorrhages in five. The Manchester portable diathermy machine successfully occluded all 29 raised RP lesions and fifty feeder arterioles in thirteen patients. Anterior segment ischaemia occurred in only one patient who had advanced traction retinopathy involving 360 degrees of arc of the retinal circumference before treatment. No recurrence of retinopathy over a 2-year follow-up period was seen in seven patients and in the remainder there was no recurrence in the 2 months after treatment. (Summary)

Ocular findings in children with sickle cell haemoglobin C disease in Jamaica

The ophthalmological findings in 54 Jamaican children with SC disease are reported. Evidence of peripheral retinal vessel disease was present in 94 percent and retinitis proliferans in 11 percent. Retinitis proliferans was noted as early as 7 years of age and was more common in patients with high haemoglobin levels. There was an unequivocal progression in severity of retinopathy in eight out of eleven children examined 2 years previously. The pathological processes leading to sickle cell proliferative retinopathy are well established in childhood and attempts at prophylactic therapy should be instituted at an early age. (Summary)

Ocular findings in homozygous sickle cell anemia in Jamaica

Retinal detachment, brown mottled areas and microcapillary abnormalities at the posterior pole are previous undescribed retinal features of sickle cell anemia that were found in a series of 76 Jamaicans with homozygous sickle cell anemia. These subjects were consecutive patients in a sickle cell clinic during a one-month period; thus, the series is unique in that bias in selective inclusion of cases with ocular pathology was avoided. Tortuosity of the major retinal vessels, previously reported as a major feature of the retinopathy was found in unaffected relatives of SS patients in the same family with normal hemoglobin genotype. Angioid streaks were not seen in this series. (AU)