[A case of central retinal vein occlusion followed by branch retinal artery occlusion].

BACKGROUND: The influence of retinal artery circulation on central retinal vein occlusion (CRVO) is not well known. CASE: A 73-year-old man with hypertension complained of transient visual loss in his left eye. At initial examination, ophthalmoscopy of his left eye showed mild dilatation and tortuosity of the retinal vein and a few dot hemorrhages. Fluorescein angiography disclosed normal arm-to-retina circulation time and no leakage of dye, but delayed retinal circulation time. These findings indicated venous stasis retinopathy of CRVO. In spite of intravenous infusion of prostaglandin E1 and vasodilative treatment, four days after initial examination, the patient's left eyeground showed complication of branch retinal artery occlusion (BRAO). A fibrinolytic agent was given intravenously, but four weeks later, his left eyeground developed typical hemorrhagic retinopathy. The hemodynamics of retrobulbar arterial circulation were investigated by color Doppler imaging. CONCLUSION: We report a case of venous stasis retinopathy of CRVO associated with BRAO, that developed hemorrhagic retinopathy despite treatment with prostaglandin E1 and other vasodilative agents. We think that arterial insufficiency might be responsible for the conversion from venous stasis retinopathy to hemorrhagic retinopathy of CRVO.

The relationship between visual disability and visual scores in patients with retinitis pigmentosa.

PURPOSE: To evaluate the relationship between visual disability and visual scores in patients with retinitis pigmentosa. METHODS: The relationship between visual disability and visual scores (visual acuity and visual field) was investigated in 93 patients with retinitis pigmentosa. The visual disability of each patient was evaluated using a questionnaire (a total of 35 questions, in 7 sections, regarding daily life). The reproducibility and validity of the data obtained by the questionnaire had been established by a similar investigation in glaucoma patients. Mean (+/-SD) age of patients was 52.6 +/- 15.1 years, the mean visual acuity of the logarithm of the minimum angle of resolution (log10MAR) was 0.5 +/- 0.4, and the mean deviation of visual field with the Humphrey Field Analyzer program 30-2 was -22.0 +/- 10.9 dB. RESULTS: The visual acuity of log10MAR in the better eye (r = 0.66 to 0.81) and the mean sensitivity within the central 10 degrees of the visual field (r = -0.76 to -0.62) had a definite relationship to the visual disability index of each section and their sum (P < .0001). This relationship was also confirmed in multiple regression analysis, which showed a high correlation coefficient (R2 = 0.57 to 0.77, P < .0001). CONCLUSIONS: The retinal sensitivity within the central 10 degrees and the visual acuity of log10MAR in the better eye had a significant influence on a patient's daily life. We suggest that in patients with retinitis pigmentosa, visual disability in daily life can be precisely evaluated with the retinal sensitivity within the central 10 degrees and the visual acuity in the logarithm of the minimum angle of resolution in the better eye.

[The relationships between visual disability and visual scores in patients with retinitis pigmentosa].

PURPOSE: To evaluate the relationship between visual disability and visual scores in patients with retinitis pigmentosa. METHODS: The relationship between visual disability and visual scores (visual acuity and visual field) were investigated in 93 patients with retinitis pigmentosa. The visual disability of each patient was evaluated using a questionnaire (a total of 35 questions in 7 sections regarding daily life). Reproducibility and validity of the questionnaire had been established by an investigation in glaucoma patients. The mean (+/- standard deviation) age of patients was 52.6 +/- 15.1 years, the mean visual acuity (log10 MAR) was 0.6 +/- 0.4, and the mean deviation of visual field with Humphrey program 30-2 was -21.1 +/- 10.0 dB. RESULTS: The visual acuity in the better eye (r = 0.66-0.81) and the mean sensitivity within the central 10 degrees of the visual field (r = -0.76(-)-0.62) had a definite relationship to the visual disability index of each section (section DI) and their sum (total DI) (p < .0001). This relationship was also confirmed in stepwise multiple linear regression analysis which showed a high correlation coefficient (R2 = 0.57-0.77, p < .0001). CONCLUSIONS: Besides the visual acuity, the mean sensitivity within the central 10 degrees of the visual field is important in evaluating the visual disability of patients with retinitis pigmentosa.

[A case of chronic bronchitis with Pasteurella multocida possibly resulting from infection from a bird].

A 60-year-old woman was admitted to our division for further evaluation of fever and purulent sputa. In sputum cultures performed when the patient had complained of an increase in symptoms on three occasions during the previous 6 months, Pasteurella multicoida was usually detected. Based on the fact that the bacteria had been detected from the patient's sputa after feeding a macaw, but was not detected after treatment of the bird with OFLX, a diagnosis of respiratory tract infection by P. multocida was made. Clinical symptoms and laboratory data of the patient were markedly improved after treatment with cefaclor (750 mg/d). The bacteria in this case were sensitive toward many antibiotics. This case was considered to be the first case of bird-mediated Pasteurella infection.