Imaging of Dalen-Fuchs Nodules in a Likely Case of Sympathetic Ophthalmia by Fluorescein Angiography and OCT.

Sympathetic ophthalmia (SO) is a well-known but rare autoimmune disease in which the sympathizing eye suffers granulomatous panuveitis after trauma to the fellow eye. An unusual case of SO occurring 32 years after trauma to the fellow eye, and 1 year after unsuccessful vitrectomy/scleral buckle repair of an acute retinal detachment in the inciting eye was presented. An optical coherence tomography imagery of Dalen-Fuchs nodules, not previously reported, and rare angiographic imaging of SO in its acute phase was demonstrated.

Choroiditis in a patient with multiple sclerosis.

PURPOSE: To describe choroiditis in multiple sclerosis (MS). DESIGN: Case report. METHODS: Clinical findings, fluorescein angiography, optical coherence tomography, and treatment are presented. A 50-year-old man with MS presented with vitritis and multiple choroidal lesions in the fovea and periphery in both eyes. Fluorescein angiography (FA) revealed early hyperfluorescence and late leakage of the lesions. Optical coherence tomography showed subretinal fluid in the right eye. One month post-treatment, visual acuity returned to the baseline with complete resolution of subretinal fluid and decreased leakage on FA. CONCLUSIONS: Choroiditis might be related to MS, but may also be a chance occurrence.

Intracameral triamcinolone acetonide as treatment for endothelial allograft rejection after penetrating keratoplasty.

PURPOSE: Intracameral injection of triamcinolone acetonide as treatment of therapy-resistant endothelial allograft rejection after penetrating keratoplasty is reported. METHODS: A 32-year-old patient showed conventional therapy-resistant endothelial allograft rejection 2 months after penetrating keratoplasty. The patient received an intracameral injection of 4 mg in 0.1 mL of triamcinolone acetonide. Preinjection visual acuity was count fingers at 3 ft, and the graft showed diffuse haze and multiple endothelial rejection lines. RESULTS: Within 2 weeks after injection, marked resolution of the microcystic edema and reversal of the endothelial rejection was noted. Fourteen months after injection, best-corrected visual acuity was 20/20, and intraocular pressure was 17 mm Hg without antiglaucoma therapy. CONCLUSIONS: Intracameral injection of triamcinolone acetonide may be an additional treatment modality in the treatment of endothelial allograft rejection when traditional steroid therapies have failed.

Comparison of optic nerve head assessment with a digital stereoscopic camera (discam), scanning laser ophthalmoscopy, and stereophotography.

PURPOSE: To compare computer-assisted planimetry using the Discam system (Marcher Enterprises Ltd., Hereford, UK), confocal scanning laser ophthalmoscopy (CSLO), and stereoscopic disc photography with respect to optic nerve head (ONH) measurements and glaucoma status. DESIGN: Comparative, observational case series and interobserver variability study. METHODS: Three hundred eighty-six eyes of 233 consecutive subjects were imaged with the Discam, and a subset underwent ONH evaluation with CSLO (n = 297), stereoscopic photography (n = 233), or both. Subjects were classified into normal, glaucoma suspect, and glaucoma groups based on clinical findings of slit-lamp disc examination and visual field testing. Agreement of cup-to-disc ratio measurements among the three technologies was assessed by the intraclass correlation coefficient (ICC) and areas under the receiver operator characteristic (AROC) curves. MAIN OUTCOME MEASURES: Cup-to-disc ratio as measured by Discam, CSLO, and stereography. RESULTS: Intraclass correlation coefficients calculated using the two-way random effects model for comparing Discam, CSLO, and stereography among cup-to-disc area ratio, vertical cup-to-disc ratio, and horizontal cup-to-disc ratio were 0.46 to 0.53. The ICC was higher for eyes with larger optic discs (0.51) than those with smaller ones (0.32). The ICC calculated using the fixed effects model for the Discam and CSLO comparison was 0.72. Areas under the receiver operator characteristic curves were 0.67 to 0.80 among the three technologies comparing normal with glaucomatous eyes. In general, there was no statistically significant difference between techniques with respect to sensitivity and specificity of glaucoma detection. CONCLUSIONS: There is good agreement between ONH measurements obtained by Discam, CSLO, and stereography; however, the results are not interchangeable. Similar AROC curve values among all three techniques imply that the Discam, CSLO, and stereography perform equally for the determination of glaucoma status.