Spontaneous retinal pigment epithelium tear in geographic atrophy.

PURPOSE: To report two cases of spontaneous retinal pigment epithelial (RPE) tears occurring in two patients affected with geographic atrophy (GA) due to non-exudative age-related macular degeneration (AMD). CASE REPORT: Two patients (a 79-year-old man and a 71-year-old woman) presented to our department with progressive visual loss. The man had a best-corrected visual acuity (BCVA) of 20/100 in the right eye (RE) and 20/50 in the left eye (LE); the woman had a BCVA of 20/200 in the RE and 20/160 in the LE. Upon complete ophthalmologic examination, revealing a large area of atrophy (>175 µm in diameter) along with pigmentary changes, calcified drusen and no choroidal neovascularization (CNV) in either eye, the patients were diagnosed with GA due to non-exudative AMD. Interestingly, the imaging modalities performed, including fluorescein angiography (FA), indocyanine green angiography (ICGA) and spectral-domain optical coherence tomography (SD-OCT), clearly highlighted the presence of spontaneous RPE tears in the context of non-exudative AMD, while in general, RPE tears are a well-recognized complication of exudative AMD. CONCLUSIONS: To our knowledge, this is the first description of spontaneous RPE tears as a possible complication of GA due to non-exudative AMD.

First Report of Stemphylium vesicarium as Causal Agent of Wilting and Root Rotting of Radish Sprouts in Italy.

A consistent contamination from a Stemphylium sp. was detected on radish (Raphanus sativus) seeds by a seed blotter test. Twenty-five percent of seed lots were contaminated. Stemphylium vesicarium (teleomorph Pleospora allii) was identified on the basis of morphological characters of conidia and conidiophores (4). Conidia were golden brown to dark drown, oblong to oval with one to four transverse and one to three longitudinal septa, constricted at one to three of the major transverse septa. Conidia dimensions ranged from 12 to 22 × 30 to 40 µm. Conidiophores were straight or occasionally one-branched with a swollen apex and one to four septate. Pseudothecia with asci and ascopores were observed on radish seeds. Asci were cylindrical to clavate with eight ascospores with up to six transverse septa and numerous longitudinal septa. Species identification was also confirmed after comparing the sequences of the internal transcribed spacer (ITS) region of rDNA and gpd (glyceraldehyde-3-phosphate dehydrogenase) (3) of four isolates with those of Stemphylium species already present in the NCBI database. Accessions Nos. AM 746020 to AM746023 and AM883174 to AM883177 were deposited for ITS and gpd, respectively. Artificial inoculations were carried out on radish seeds previously disinfected with 1% sodium hypochlorite for 10 min and then plated on S. vesicarium sporulating colonies grown on potato dextrose agar (PDA). The four sequenced isolates were tested for pathogenicity. Disinfected seeds were plated onto PDA only and used as a control. After 48 h of incubation, seeds were sown in sterilized soil in plastic plates. The emerging and the eventually dead plants were counted. Stem necrosis and root rotting developed on sprouts within the first week after sowing. On the surviving infected plantlets, wilting and death occurred on more than 70% of the plants within 4 weeks after sowing. Control plantlets obtained from disinfected seeds remained healthy. The fungus reisolated from wilted and dead plants was morphologically identical to the original isolates, thus confirming S. vesicarium as the causal agent. In Italy, this pathogen is common on asparagus (1), but it has also been reported on Allium spp., tomato, and pear. On European pear it is the causal agent of brown spot (2), a destructive disease in the Mediterranean area but also in the Netherlands and other continental European countries. On the basis of these results, seed contamination with S. vesicarium can represent a threat for the production of radish for sprout consumption. To our knowledge, this is the first report of S. vesicarium on radish plantlets in Italy. References: (1) F. Del Zan et al. L'informatore Agrario 11:95, 1989. (2) I. Llorente and E. Montesinos. Plant Dis. 90:1368, 2006. (3) B. M. Pryor and D. M. Bigelow. Mycologia 95:1141, 2003. (4) E. G. Simmons. Sydowia 38:284, 1985.

Internal carotid artery dissection in a patient with Behçet's syndrome.

The authors report a case of internal carotid artery dissection in a young woman with Behçet's syndrome. The authors postulate that a vasculitis of the vasa vasorum already suspected as the basis of aneurysm formation in course of Behçet's syndrome can account for occurrence of arterial dissection in this inflammatory condition.

Intracranial leiomyosarcoma: a neuro-oncological consequence of acquired immunodeficiency syndrome.

Leiomyosarcoma has recently been identified as an AIDS-related tumor, usually occurring in children in the chest or abdomen. We describe a case of intracranial leiomyosarcoma in an adult with AIDS. An enhancing mass adjacent to the right occipital cortical surface was diagnosed during a work-up for left arm weakness. Imaging characteristics were suggestive of a malignant neoplasm versus meningioma. The patient had a craniotomy for total excision of the lesion. Pathology showed a leiomyosarcoma. Metastatic work-up was negative. The patient refused radiation therapy, but is well without evidence of recurrence at 8 months follow-up. The differential diagnosis for intracranial lesions in AIDS should be expanded to include leiomyosarcoma. Surgical resection of the lesion is recommended.