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 hemoglobin SC disease in Jamaica

In order to structure a series without bias, the retinal and chorioretinal lesions were recorded in a series of 70 Jamaicans with hemoglobin SC disease who were consecutive patients at a sickle cell clinic during a one-month period. By avoiding selective inclusion of cases with ocular pathology, a direct comparison with 76 SS cases studied earlier was possible. An analysis of both series, together indicated that peripheral retinal whitening was associated with mild grades of peripheral retinal vessel disease in 84.3 percent and with severe grades in 47.4 percent, giving rise to the postulation that peripheral whitening reflects an anoxic change, possibly edema, whereas a reddish brown appearance characterizes retinal atrophy associated with more severe vessel disease. Proliferative sickle retinopathy occurred in 63 percent SC paients compared with 26 percent SS patients. The incidence of retinitis proliferans in SC patients was related to hemoglobin level and occurred in 73 percent of patients with hemoglobin levels above 12.5 percent compared to 15 percent of those with hemoglobin below this level. This suggests that an increased blood viscosity may contribute to the development of retinitis proliferans. (Summary)