Acute retinal pigment epitheliitis.

PURPOSE: We examined a patient with acute retinal pigment epitheliitis before the development of the characteristic pigmentary retinopathy. METHODS: Three days after onset of blurred vision in her left eye, a 25-year-old woman had a visual acuity of L.E.: 20/40 -2. There were uniform outer retinal golden-colored vacuoles in the area of subsequent foveal pigmentary alterations. RESULTS: Two months after examination, visual acuity was L.E.: 20/25 -2, and fine subfoveal pigmentary clumping was present. CONCLUSION: The pigmentary maculopathy of acute retinal pigment epitheliitis may be secondary to primary inflammation of the neurosensory retina.

Photocoagulation treatment of radiation retinopathy.

We studied the visual and anatomic effects of focal photocoagulation for clinically significant radiation macular edema in five eyes of four patients and panretinal photocoagulation for proliferative radiation retinopathy in six eyes of three patients. Focal and limited scatter photocoagulation was successful in preventing further vision loss in all five eyes treated for macular edema. Three eyes treated with panretinal photocoagulation had regression of neovascularization. The other three eyes treated for proliferative retinopathy subsequently had dense vitreous hemorrhages that required vitrectomy for restoration of useful vision.

Acute retinal pigment epitheliitis.

Acute retinal pigment epitheliitis is an infrequently described macular disorder of unknown cause that affects healthy young adults. Acute symptoms include either reduced visual acuity or central scotoma. Ophthalmoscopy discloses discrete pigment clumps with surrounding hypopigmented halos in the center of the macula. Inflammatory signs are mild or absent. The hypopigmented areas show transmission hyperfluorescence without leakage on fluorescein angiography. Symptoms subside spontaneously although retinal pigment epithelial (RPE) changes are usually permanent. Central serous choroidopathy, macular edema, or permanently decreased vision have not developed in any of the eight patients we have followed for up to 8 years. Accurate identification of retinal pigment epitheliitis as a specific clinical entity is important because of the good prognosis without treatment.

Congenital iris cysts.

Unilateral, spontaneous, non-pigmented iris cysts appeared before the age of 2 years in four patients. Histopathological specimens obtained in three cases showed stratified to cuboidal, non-pigmented, epithelial lined cysts. Goblet cells were recognised in two of the three specimens. The clinical features and histopathological findings indicate that these cysts are derived from surface ectoderm and may be congenital.

Contamination of corneal tissue from infected donors.

Thirty-two corneas with scleral rims were cultured from the eyes of 17 cadavers that harbored systemic infection at the time of death. Twelve (71%) of 17 cadavers demonstrated corneal contamination from one or both corneas. Eleven (92%) of 12 donors with positive postmortem blood cultures had positive corneal cultures from at least one eye. Six of these 12 had the same organism isolated from both the blood and corneal tissue. Bacterial corneal cultures were negative in the five donors with negative postmortem blood cultures. Control cultures were obtained from 19 eyes of ten donors without evidence of infection at death. Four (21%) of 19 control eyes yielded Staphylococcus epidermidis. There was a significantly higher incidence of corneal contamination in donors who died with systemic infections. Eye banks should continue to screen donors carefully for documented or suspected sepsis in an effort to reduce the incidence of postkeratoplasty infections.