NONHEREDITARY IDIOPATHIC FOVEAL RETINOSCHISIS ASSOCIATED WITH NEW-ONSET PROLIFERATIVE DIABETIC RETINOPATHY.

PURPOSE: To present a case of idiopathic foveal retinoschisis in a patient with new-onset proliferative diabetic retinopathy. METHODS: Single case report. RESULTS: A 64-year-old African American man with Type 2 diabetes mellitus presented for a routine annual diabetic eye examination with mildly blurred vision at near and distance in the right eye. Fluorescein angiography demonstrated optic nerve leakage consistent with neovascularization of the disk but no leakage on or around the macula in the right eye. Optical coherence tomography demonstrated peripapillary macular retinoschisis within the outer plexiform layer without optic disk pit, epiretinal membrane, or diabetic tractional membrane. He underwent pan-retinal photocoagulation in the right eye; his acuity and schisis remained unchanged at 6-month follow-up. CONCLUSION: This is the first reported case of idiopathic acquired macular schisis with new-onset nontractional proliferative diabetic retinopathy in the same eye.

Optic neuritis caused by the re-emerging great masquerader.

A 49-year-old Caucasian woman presented with subacute headache and right eye pain associated with scotoma, blurred vision and photophobia. MRI was suggestive of optic neuritis of the right optic nerve and she was treated with steroids. Due to persistent symptoms, a lumbar puncture was performed and cerebrospinal fluid analysis was positive for venereal disease research laboratory and rapid plasma reagin titres. On further history, she recalled experiencing an illness associated with diffuse rash, likely secondary syphilis, 1-2 months prior. She tested negative for HIV. She was treated with intravenous penicillin for 2 weeks following which she experienced improvement in symptoms.

Chronic Traumatic Giant Macular Hole Repair with Autologous Platelets.

We report on the closure of a chronic posttraumatic giant macular hole. The patient presented with decreased vision in the left eye following blunt trauma 20 years prior. His dilated fundus examination revealed a 3000 um base-diameter full thickness macular hole. Surgical repair was performed with pars plana vitrectomy (PPV), internal limiting membrane peeling and autologous platelet concentrate (APC) injected over the macular hole. At one month follow-up, the macular hole had closed on exam and optical coherence tomography (OCT), and the patient reported subjective visual improvement. To our knowledge, this report presents the first case of a chronic giant macular hole successfully closed after undergoing surgery with adjuvant platelets therapy.

Utilization of Portable Radios to Improve Ophthalmology Clinic Efficiency in an Academic Setting.

Improvement in clinic efficiency in the ambulatory setting is often looked at as an area for development of lean management strategies to deliver a higher quality of healthcare while reducing errors, costs, and delays. To examine the benefits of improving team communication and its impact on clinic flow and efficiency, we describe a time-motion study performed in an academic outpatient Ophthalmology clinic and its objective and subjective results. Compared to clinic encounters without the use of the portable radios, objective data demonstrated an overall significant decreases in mean workup time (15.18 vs. 13.10), room wait (13.10 vs. 10.47), and decreased the total time needed with an MD per encounter (9.45 vs. 6.63). Subjectively, significant improvements were seen in careprovider scores for patient flow (60.78 vs. 84.29), getting assistance (61.89 vs. 88.57), moving patient charts (54.44 vs. 85.71), teamwork (69.56 vs. 91.0), communications (62.33 vs. 90.43), providing quality patient care (76.22 vs. 89.57), and receiving input on the ability to see walk-in patients (80.11 vs. 90.43). For academic purposes, an improvement in engagement in patient care and learning opportunities was noted by the clinic resident-in-training during the pilot study. Portable radios in our pilot study were preferred over the previous method of communication and demonstrates significant improvements in certain areas of clinical efficiency, subjective perception of teamwork and communications, and academic learning.