SD-OCT imaging of idiopathic macular holes with spontaneous closure.

Spectral-domain optical coherence tomography serial changes in three cases of spontaneous closure of idiopathic macular hole at stages II, III, and IV are described. Initial and serial spectral-domain optical coherence tomography images document the progressive closure. Macular holes apparently resolved spontaneously through two different mechanisms: posterior hyaloid detachment in case 1 and a contraction of epiretinal macular membrane in cases 2 and 3. The spontaneous closure of idiopathic full-thickness macular holes may occur in any stage of idiopathic macular hole; the small size of the hole is a common feature in all cases of spontaneous closure reported.

Role of the intravitreal growth factors in the pathogenesis of idiopathic epiretinal membrane.

PURPOSE: The aim of the present study is to evaluate the roles of TGFs ß1 and ß2, glial cell line-derived neurotrophic factor (GDNF), and nerve growth factor (NGF) in the pathogenesis of idiopathic epiretinal membrane (ERM). METHODS: Eight patients, six males and two females, with an average age of 60.25 ± 17.16 years (range, 33-75 years) who were affected by idiopathic ERM were enrolled in the study. All patients underwent standard pars plana vitrectomy surgery with membrane removal and specific ELISA was performed to evaluate TGFß1, TGFß2, GDNF, and NGF in the vitreous samples. This was repeated after acidification of the samples with hydrochloric acid. RESULTS: Before acidification, ELISA analysis revealed a significant increase of TGFß2 in the samples with idiopathic ERM (327.98 ± 99.58 pg/mL; range, 206.864-466.235 pg/mL) compared to the control group (187.17 ± 58.20 pg/mL; range, 132.758-271.707 pg/mL; t = 3.4; P < 0.05). A statistically significant difference was also obtained after acidification of the samples (618.15 ± 201.43 pg/mL; range, 409.795-866.215 pg/mL compared to 265.04 ± 98.15 pg/mL; range, 152.478-352.101 pg/mL; t = 4.5; P < 0.05). Notably, before acidification the differences in NGF between the two groups were not statistically significant (t = 0.79; P = 0.46), while after acidification a significant increase of the NGF levels in ERM samples was found in comparison with the control group (723.41 ± 235.4 vs. 242.84 ± 104.61; t = 3; P < 0.05). CONCLUSIONS: The present study reveals that TGFß2 and NGF are associated with idiopathic ERMs, suggesting a novel compensatory mechanism so far never proposed.

Vogt-Koyanagi-Harada syndrome and keratoconjunctivitis sicca.

PURPOSE: To discover a relationship between Vogt-Koyanagi-Harada (VKH) syndrome and Sjögren syndrome. DESIGN: Observational case-control study. METHODS: Sixteen Italian patients with VKH syndrome and 16 controls with diffuse uveitis underwent tear analysis and rheumatologic evaluation. Biopsy specimens of the minor salivary glands were obtained or salivary gland scintigraphy was performed in patients with xerostomia. RESULTS: The Schirmer test (P <.0001), break-up time (P <.0001), the Ferning test (P <.001), and fluorescein and rose bengal staining (P <.0001) resulted in changes in VKH. Biopsy was positive in two patients and scintigraphy in four. Human leukocyte antigen DR4 was found in 68.75% of VKH cases and in 83.3% of the cases with Schirmer test less than 3 mm. CONCLUSIONS: The incidence of keratoconjunctivitis sicca was higher in VKH syndrome patients than in controls. Two patients satisfied the criteria for Sjögren syndrome, and two others had scintigraphy indicative of salivary gland involvement. The association of these two autoimmune disorders is suggested by the low incidence of VKH syndrome in Italy and might be related to HLA DR4.