Birdshot retinochoroiditis in Brazil: a multicenter review of 40 patients.

BACKGROUND: Birdshot retinochoroiditis (BRC) is a rare and chronic bilateral uveitis mostly found in Caucasians. As few data are available about the clinical course of BRC in Hispanic patients, we aimed to report the clinical findings and the evolution of BRC in Brazilian patients. METHODS: This retrospective cohort multicenter nationwide study was performed by analyzing the records of patients with BRC diagnoses from Brazilian ophthalmological centers from April 1995 to May 2020. RESULTS: Forty patients (80 eyes) with a diagnosis of BRC were evaluated. The mean age was 53 years, and there was no sex predominance. All tested patients (34/40) were positive for HLA-A29. The diagnosis of BRC was made following the Levinson et al. criteria, and all ancillary tests were performed to exclude differential diagnoses. Clinical signs and symptoms, such as complications and treatment, were described. CONCLUSIONS: BRC evolution in Brazilian patients seems to have some peculiarities that diverge from the published literature available about Caucasians, as AS inflammation is higher in this population.

Histopathological study of 49 cases of keratoconus.

AIMS: Keratoconus is a bilateral and asymmetrical corneal ectasia. The pathophysiology of this disorder has yet to be fully elucidated. The purpose of our study was to document the prevalence of the most common morphological features of keratoconic corneas. METHODS: A retrospective analysis of 49 cases diagnosed as keratoconus between 2001 and 2006 was undertaken. Histopathological reports were reviewed to obtain data such as age and gender. Specimens were fixed in 10% buffered paraformaldehyde solution for 24 h, bisected through the centre of the button, and embedded in paraffin. Sections were stained with haematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) for light microscopic examination. RESULTS: The studied group was composed of 29 men and 20 women. Age at the time of the penetrating keratoplasty was 39 +/- 14 years (mean +/- standard deviation). Forty of the 49 specimens (82%) presented with epithelial thinning. Other common features of keratoconus included breaks in Bowman's layer in 35 (71%), compaction of the stromal collagen fibres in 31 (63%), and folds in Descemet's membrane in 31 (63%) cases. Other less common histopathological findings were: presence of superficial iron deposits in 14 (29%), deep stromal scarring in 12 (24%), epithelial scarring in 11 (22%), endothelial cell loss in 11 (22%), and breaks in Descemet's membrane in nine (18%) cases. CONCLUSIONS: Some of the histopathological findings associated with keratoconus are subtle. It is important to be aware of them in order to properly confirm the clinical diagnosis.

Localized retinal ischemia as an ocular manifestation of primary antiphospholipid syndrome.

CASE REPORT: Herein, a case of an unusual ocular presentation of primary antiphospholipid syndrome. The patient disclosed localized retinal ischemia due to branch retinal artery occlusion, confirmed by fluorescein angiography and manual perimetry. COMMENTS: The ocular manifestation led to the diagnosis and successful treatment of the systemic disease.

Clinical-histopathological correlation in a case of Coats' disease.

BACKGROUND: Coats' disease is a non-hereditary ocular disease, with no systemic manifestation, first described by Coats in 1908. It occurs more commonly in children and has a clear male predominance. Most patients present clinically with unilateral decreased vision, strabismus or leukocoria. The most important differential diagnosis is unilateral retinoblastoma, which occurs in the same age group and has some overlapping clinical manifestations. CASE PRESENTATION: A 4 year-old girl presented with a blind and painful right eye. Ocular examination revealed neovascular glaucoma, cataract and posterior synechiae. Although viewing of the fundus was impossible, computed tomography disclosed total exudative retinal detachment in the affected eye. The eye was enucleated and subsequent histopathological evaluation confirmed the diagnosis of Coats' disease. CONCLUSION: General pathologists usually do not have the opportunity to receive and study specimens from patients with Coats' disease. Coats' disease is one of the most important differential diagnoses of retinoblastoma. Therefore, it is crucial for the pathologist to be familiar with the histopathological features of the former, and distinguish it from the latter.

Retinite rubeólica: indocianina verde e eletrorretinografia / Rubeolic retinitis

Os autores descrevem um caso de retinite rubeólica em uma criança de 10 anos, mostrando as diversas alteraçöes decorrentes da patologia, assim como aspectos angiofluoresceinográficos e com indocianina verde, além de eletrorretinografia. Os mesmos comentam sobre a importância do conhecimento das alteraçöes causadas pela síndrome para melhor acompanhamento e prevençäo de alteraçöes graves