Mutton fat-like subretinal precipitates associated with Vogt-Koyanagi-Harada disease.

PURPOSE: To report a case of Vogt-Koyanagi-Harada (VKH) disease presenting mutton fat like subretinal precipitates. DESIGN: Observational case report. METHODS: A 52-year-old Japanese woman developed bilateral uvetis with serous retinal detachment and mutton fat like subretinal precipitates. RESULTS: According to Opthalmologic, auditory, and systemic examination, we diagnosed the patient with VKH disease. Inflamation was controlled by three time steroid therapy and subretinal fluid and precipitates decreased and disappeared. CONCLUSIONS: Subretinal granulomatous lesion may present a manifestation of VKH and mean long standing subretinal fluid and inflammation.

Closure of a macular hole associated with a retinal arterial aneurysm without surgical intervention.

PURPOSE: To report a case in which a macular hole (MH) associated with a ruptured retinal arteriolar aneurysm (RAM) closed without surgical intervention. PATIENT AND RESULTS: A 65-year-old woman presented complaining of sudden visual loss due to vitreous hemorrhage in the left eye. Correctable visual acuity in the left eye was 2/100 at the initial visit. Three weeks later, the vitreous hemorrhage had resolved, revealing an MH, serous retinal detachment, and subretinal hemorrhage associated with a ruptured RAM. Laser photocoagulation was applied to the RAM to promote absorption of the subretinal fluid. Two months after onset, the MH closed with resolution of the exudative retinal lesions and recovery of vision to 20/60. CONCLUSIONS: The present case indicates that closure of an MH can take place within a couple of months without surgical intervention. This suggests that observation without surgical intervention may be advocated when an MH is associated with a ruptured RAM and massive subretinal hemorrhage spares the macula.

Alleviation of seasonal allergic symptoms with superfine beta-1,3-glucan: a randomized study.

BACKGROUND: The incidence of allergic symptoms to cedar pollen has reached epidemic proportions in Japan. Intravenous injection of beta-1,3-glucan in human subjects is known to induce a T(H)1 response, whereas oral uptake does not. OBJECTIVE: It was examined whether orally ingested, superfine dispersed beta-1,3-glucan (SDG), easily absorbed by intestinal mucosa, would alleviate allergic symptoms. METHODS: Allergic patients were orally administrated either SDG (n = 30) or nondispersed beta-1,3-glucan (n = 30), and allergic symptoms were assessed clinically in a double-blind, placebo-controlled randomized study. RESULTS: SDG alleviated ongoing symptoms of Japanese cedar pollen-induced rhinorrhea, sneezing, nasal congestion, and itchy watery eyes, and its oral uptake before symptom onset exhibited preventive effects. Alleviation of allergic symptoms was evident not only for seasonal allergy to cedar pollen but also for perennial allergy. Oral ingestion of beta-1,3-glucan in individuals with allergic tropism could reduce the spontaneous increase in both allergen-specific and total IgE titers. The clinical responses to treatment were well correlated with the capacity of monocytes to bind to beta-1,3-glucan. Although SDG reduced allergic symptoms, the oral uptake of nondispersed beta-1,3-glucan produced no clinical effects, despite the identical amount of beta-1,3-glucan in both preparations. CONCLUSION: We postulate that orally taken beta-1,3-glucan prepared in a form easily absorbed by intestinal mucosa is able to alleviate cedar pollen-induced allergic symptoms. CLINICAL IMPLICATIONS: Orally effective SDG might greatly contribute to the resolution of epidemic medical problems of seasonal cedar pollen-induced allergy.