A sphenoid en plaque meningioma aggravates exophthalmos in a patient with thyroid ophthalmopathy.

PURPOSE: To describe the rare case of a patient with thyroid ophthalmopathy whose unilateral aggravated exophthalmos was caused by the development of an ipsilateral sphenoid wing en plaque meningioma. METHODS: Case report. RESULTS: The ophthalmologic examination included visual acuity assessment, anterior segment examination, funduscopy, ocular motility examination, and exophthalmometry. Magnetic resonance imaging (MRI) of the brain and orbit revealed the existence of a sphenoid meningioma. Removal of the tumor through a pterional craniotomy was performed. The histologic examination showed that it was an en plaque meningioma. There were no postoperative complications and no recurrence of the tumor was revealed 24 months after the operation. CONCLUSIONS: Detailed ophthalmologic examination and MRI of the brain and orbit are necessary in every patient with deterioration of the exophthalmos even if the suggestive cause seems obvious.

Paraneoplastic optic neuropathy in a patient with a non-small cell lung carcinoma: a case report.

PURPOSE: To report a case and describe the clinical approach to a patient with a non-small cell lung carcinoma and paraneoplastic optic neuropathy. METHODS: Case report. RESULTS: A 79-year-old woman with known non-small cell lung carcinoma was admitted with a swollen optic disc in the right eye. After detailed clinical, laboratory, and imaging studies, the authors diagnosed paraneoplastic optic neuropathy, excluding other possible diagnosis. CONCLUSIONS: Paraneoplastic optic neuropathy is a clinical challenge and should be considered as a possible diagnosis in every cancer patient with optic disc edema.

Our experience with perfluorohexyloctane (F6H8) as a temporary endotamponade in vitreoretinal surgery.

PURPOSE: To evaluate the use of F6H8 as a temporary endotamponade for complicated and special cases of retinal detachment instead of silicone oil. METHODS: We have used F6H8 with 14 patients since February 1999. Eight suffered from rhegmatogenous retinal detachment (RRD) with multiple tears located inferiorly. Three presented inferior traction retinal detachment (TRD) under silicone oil, two suffered from ocular trauma with inferior TRD, and one had idiopathic macular hole. The substance was introduced into the eye after pars plana vitrectomy and membrane peeling if needed, and we tried to introduce as much as possible. RESULTS: With F6H8 the retina was easily reattached in all cases, like with perfluorocarbon liquids. The postoperative view was very good. F6H8 was removed in all cases after 3-8 weeks. Anatomical success was achieved in 12 out of 14 eyes. Two eyes presented severe PVR. F6H8 entered the anterior chamber in 4 cases, but no corneal complications occurred. In one case there was a marked IOP rise due to an anterior block, treated with superior iridotomy. In two cases retinal detachment (RD) occurred in the upper part and was treated with additional surgery, F6H8 removal and silicone oil injection. CONCLUSIONS: F6H8 seems to be a promising tamponade agent for special cases of RD.

Retinopathy of prematurity and other ocular problems in premature infants weighing less than 1500 g at birth.

PURPOSE: To estimate the incidence of retinopathy of prematurity and other ocular problems in a population of preterm infants. METHODS: This retrospective study included all infants with gestational age (GA) <32 weeks and birth weight (BW) <1500 g cared for in the neonatal intensive care unit (NICU) over a period of nine years (1992-2000). Ophthalmological examination was started the 4th week of life and included refractive examination, examination of the cornea and funduscopy under mydriasis. An ocular motility test was done after the 2nd month. RESULTS: The study included 194 infants. Stage I and II retinopathy occurred in 51 infants but regressed spontaneously. Five of the 194 (2.5%) had to undergo cryopexy. Optic disc atrophy was observed in association with peri-intraventricular hemorrhage (PIIVH) (grade IV) in seven infants. Fifteen infants (7.7%) had retinal hemorrhages which were absorbed by three months of age. Almost 20% of the study infants developed high refractive errors and 13.4% strabismus. CONCLUSIONS: Not only retinopathy of prematurity, but other serious ocular problems were observed in this population of preterm infants. The role of PIIVH III-IV in the pathogenesis of certain ocular problems needs further elucidation.