A method for performing full-thickness, orthotopic, penetrating keratoplasty in the mouse.

In an attempt to overcome the lack of well characterized, inbred, and congenic strains, as well as a paucity of immunological reagents, in rabbit and rat models, we have developed a procedure for performing full-thickness, penetrating keratoplasty in the mouse. One hundred percent of isografts (BALB/c onto BALB/c) were successful, while 83.3% of allografts (C3H onto BALB/c) failed. The use of a mouse model to study corneal graft failure will allow a critical evaluation of the role of a variety of immunological mediators in causing graft failure.

Pseudotumor cerebri and macular disease.

The most common indications for treatment of patients with pseudotumor cerebri are the presence of severe intractable headaches and evidence of optic neuropathy. The role of the ophthalmologist in following patients with pseudotumor cerebri has been to document optic nerve dysfunction in terms of visual field abnormalities or loss of visual acuity. Macular changes have been described in association with papilledema. A case of pseudotumor cerebri and associated macular disease is reviewed to call attention to the need for the ophthalmologist to differentiate between visual loss secondary to optic neuropathy from that of macular disease. The case illustrates how quickly macular disease can develop. The management of patients with pseudotumor cerebri is discussed.

Endolaser photocoagulation of toxoplasmosis.

Traditional medical treatment regimens for toxoplasmosis using such agents as sulfadiazine, clindamycin, pyrimethamine, and prednisone may not be effective always. Alternative methods of treatment such as diathermy and cryotherapy have been advocated. Photocoagulation has been used with some effect. In advanced cases vitreous opacification may preclude external photocoagulation technique. Two cases are presented in which vitrectomy and endolaser photocoagulation techniques were used. Endolaser treatment may be done in situations where vitreous opacification may preclude other methods.

Sarcoidosis and peripheral neovascularization.

Twenty-eight patients with sarcoidosis were examined. Four of the patients had a history of uveitis. Retinal periphlebitis was noted in one case, and peripheral retinal neovascularization was found in two non-sickle cell black patients. Vitreous hemorrhage developed in one of the patients with neovascularization, prior to laser treatment and this patient eventually required vitreous surgery. The other patient was treated with prophylactic laser. Peripheral retinal neovascularization may be a noteworthy finding that will be found in larger numbers with attention to the retinal periphery in cases of sarcoidosis.

Laser treatment of a subretinal neovascular membrane associated with retinochoroidal coloboma.

Subretinal neovascularization associated with retinochoroidal coloboma is a rare finding. Only two other cases have been reported in the literature, neither of which were treated with photocoagulation. Here, the author reports a case of subretinal neovascular net associated with a retinochoroidal coloboma, which was treated with laser photocoagulation. The patient's vision improved from 20/200 to 20/30-1 following two argon green laser treatments, with a 33-month follow-up since the initial treatment.

An unusual case of retinoschisis and retinal detachment.

An unusual case of retinoschisis and associated retinal detachment in a 61-year-old man is reported. The case involved a retinoschisis area with 22 outer-layer retinal holes and two inner-layer retinal holes in the superior nasal quadrant of the left eye. The retinal detachment extended posteriorly beyond the schisis area. The patient's condition was managed with a combination of cryotherapy and a scleral buckle. Postoperatively, the did well despite the presence of a choroidal detachment that resolved in one month. Cases previously reported have not precisely listed the number of retinal holes. This case is unusual in that there are an unusually large number of retinal holes.

A colobomatous optic disc anomaly and associated retinal detachement.

A case is presented of a two-year-old white female with an optic nerve anomaly and an associated retinal detachment. A unilateral colobomatous disc was noted to be surrounded by a chorioretinal pigmentary alteration in the form of an annulus. A clear zone with absence pigmentation ringed the more central gray-black area. The retinal vessels were noted to come directly out of the deeply colobomatous disc area and to run between the cystic convolutions of the adiacent retinal tissue. A surrounding area of retinal detachment extended for a distance of three disc diameters from the disc. This case is one of a few yet reported in the literature.

Steroid treatment of an orbital or periocular hemangioma.

Orbital hemangiomas may cause deviation of the visual axis with amblyopia and loss of fusion in the infant as a result. Prior methods of treatment include radiation, injection of sclerosing solutions, surgery and ligation of feeding vessels and systemic steroids. A case is presented of an infant treated at five months of age with systemic prednisone over a six-week period with rapid resolution of an orbital hemangioma.