BILATERAL SPONTANEOUS VITREOUS BASE DETACHMENT IN A FEMALE PATIENT WITH NEUROFIBROMATOSIS TYPE 1.

PURPOSE: We describe a unique case of bilateral spontaneous vitreous base detachment in a female patient with neurofibromatosis Type 1 and no known history of ocular injury. This serves to add further to the medical literature. DISCUSSION: Vitreous base detachments usually occur after significant ocular trauma. There is only one other published case of this occurring spontaneously also in a female patient with neurofibromatosis Type 1. CONCLUSION: This suggests a rare association between neurofibromatosis Type 1 and spontaneous detachment of the vitreous base.

Large, Spontaneous Macular Hole with Posterior Pole Detachment in a Patient with Best Vitelliform Macular Dystrophy.

PURPOSE: To describe the visual and anatomical outcomes in a patient with a full-thickness macular hole and Best vitelliform macular dystrophy. METHODS: The authors present a case of a large spontaneous macular hole with associated posterior pole detachment in a patient with a history of Best vitelliform macular dystrophy including clinical course and surgical outcome. PATIENT: The patient presented with a history of blurred central vision. He was known to have Best vitelliform macular dystrophy. Examination revealed BCVA 6/36 (0.78 logMAR) and a full-thickness macular hole (1,102 µm) with a shallow posterior pole detachment extending to the vascular arcades. He underwent phacovitrectomy with silicone oil tamponade. Internal limiting membrane (ILM) peel was prohibited due to a very adherent posterior hyaloid membrane (PHM). RESULTS: The patient developed type 2 closure. He had oil removal in 14 months combined with PHM and ILM peel. Two months postoperatively, he had further reduction of the foveal defect and the retina remained flat. Final BCVA was 6/24 (0.60 logMAR). CONCLUSION: Macular holes with Best disease are rare and are thought to be due to rupture of a cyst in the vitelliform stage or atrophy in later stages. This case outlines that closure of the macular hole, flattening of the detachment, and improvement in visual acuity is possible with vitrectomy and ILM peeling.

Is there an association between Vogt-Koyonagi-Harada syndrome and intracranial meningioma?

The authors report a case of Vogt-Koyonagi-Harada syndrome associated with intracranial meningioma. The authors discuss the HLA-DR4 gene as a common and causative factor in both conditions. This case report draws attention to the possibility of a causative association between intracranial meningioma and Vogt-Koyonagi-Harada syndrome, a rare but potentially blinding condition if not detected and treated early.

Registration of visual impairment due to diabetic retinopathy in a subpopulation of Cambridgeshire.

BACKGROUND/AIMS: The UK National Screening Committee (NSC) has set 18 standards for diabetic retinopathy (DR) screening services in England and Wales, the first of which is to reduce new visual impairment (VI) due to DR by 10% within 5 years. This study examined the incidence of VI due to DR in Cambridgeshire (City, South, and Huntingdonshire) in order to establish a baseline rate of VI registration. METHODS: A retrospective review of all certificates of visual impairment (CVI) for 2004 and 2005 was conducted. Hospital records of patients registered due to DR were reviewed to ascertain conformity to NSC Standards. The incidence of VI registration due to DR was calculated. RESULTS: The number of registrations predominantly due to DR was 18; 13 visually impaired and 5 with severe VI. The rates of VI and severe VI predominantly due to DR were 17.1 and 6.5 per million per year, respectively. The VI and severe VI registration rates in the diabetic population were 600 and 230 per million per year, respectively. CONCLUSION: The severe VI registration rate due to DR lies within the national standard. The VI registration rate exceeds 1990-1991 national standards but lies within 1999-2000 national figures.