OUTCOMES OF RETINAL DETACHMENT REPAIR AFTER POSTERIOR OPEN GLOBE INJURY.

PURPOSE: To report outcomes of retinal detachment (RD) repair following posterior open globe injury. METHODS: This retrospective, consecutive case series examined patients who underwent RD repair following Zone II and/or III open globe injury repair between January 1, 2007 and October 31, 2013. Patients with <3 months of follow-up since their last vitreoretinal surgery, and those who underwent pars plana vitrectomy (e.g., for intraocular foreign body) during their initial open globe injury repair were excluded. RESULTS: Of 30 patients who met inclusion criteria, reattachment of the retina was achieved in 25 (83%) during the first vitreoretinal surgical procedure and 5 (17%) were deemed inoperable intraoperatively. Ten patients (30%) developed recurrent RD, and 8 underwent additional surgery. At last follow-up, reattachment was observed in 4 of these 8. The overall rate of final reattachment was 63% (19 patients). The mean number of surgeries for RD was 1.5 (range, 1-3). Fifteen patients (50%) achieved final visual acuity of counting fingers or better. Mean follow-up from the last vitreoretinal surgery was 23 months (range, 3-52). CONCLUSION: Although RD following posterior open globe injury confers a grave prognosis, successful anatomic reattachment of the retina was achieved in the majority of patients in this series, with half achieving ambulatory vision.

Quality and Diagnostic Utility of Mydriatic Smartphone Photography: The Smartphone Ophthalmoscopy Reliability Trial.

BACKGROUND AND OBJECTIVE: Establish quality and diagnostic utility of mydriatic smartphone ophthalmoscopy (SO) fundus images compared to fundus camera (FC) images. PATIENTS AND METHODS: In this prospective, cross-sectional study, 94 consecutive patients in an urban eye emergency department underwent SO and FC fundus imaging via one of three study arms: medical student 1 (MS1), medical student 2 (MS2), and ophthalmology resident (OR). Images of 188 eyes were graded for overall quality by two masked reviewers, and observed critical fundus findings were compared to dilated fundus examination documentation. RESULTS: SO images were higher quality in the OR arm than in the MS1 and MS2 arms (P < .017). There were no differences in FC image quality between photographers (all P > .328). In the OR arm, SO images detected 74.3% of critical fundus findings, whereas FC images detected 77.1%. CONCLUSION: SO produces fundus images approaching the quality and diagnostic utility of traditional FC photographs.

Bilateral Straatsma syndrome with nystagmus.

PURPOSE: This case report presents a rare case of bilateral Straatsma syndrome with nystagmus and documents additional findings related to spectral domain optical coherence tomography and ocular fundus images. METHODS: Case report with fundus photography, fluorescein angiography, indocyanine green angiography, and spectral domain optical coherence tomography correlations. RESULTS: A 22-year-old man presented with extensive bilateral myelination of the retinal nerve fiber layer that encompassed both posterior poles. The patient had concomitant ocular findings of high myopia, strabismus, amblyopia, and congenital nystagmus. CONCLUSION: This case describes an unusual presentation of Straatsma syndrome and investigates the clinical features of this disease. The patient's constellation of findings is most easily explained as bilateral myelination serving as the catalyst for the associated findings of myopia and nystagmus.

Ocular anomalies in an infant with Klinefelter Syndrome.

Klinefelter syndrome is caused by the presence of one or more additional X chromosomes in an affected male. Patients often exhibit gynecomastia, small testes, and infertility. Though the characteristics of Klinefelter have been well-documented, associated ocular abnormalities have been only occasionally reported. Here we present a 2-month-old infant with Klinefelter syndrome and a unique combination of ocular abnormalities including microphthalmia, cataracts, and malformed pupils.