[Retinal bleeding and venous stasis in a 10-month-old infant after a fall?]. / Retinale Blutungen und venöse Stase bei einem 10 Monate alten Säugling nach Sturz?

This report describes the case of a 10-month-old infant, who was delivered to our hospital by the emergency physician intubated and in an unclear unconscious state. The father reported that the child had fallen from the couch to the ground. The consulted ophthalmologist reported venous stasis in both eyes including intraretinal and preretinal bleeding in all four quadrants, a diffuse vitreous hemorrhage in the right eye and temporal retinal wrinkling in both eyes. Based on these particular clinical findings a shaken baby syndrome was suspected. This report demonstrates the importance of recognizing and correctly interpreting the typical ophthalmological signs of physical child abuse in order to detect and prevent further mistreatment of children; moreover, the increasing importance of photographic documentation and histological work-up of the findings for forensic reasons are emphasized.

[Three cases--one diagnosis: ocular manifestations of sarcoidosis]. / Drei Fälle--eine Diagnose: okuläre Manifestationsformen der Sarkoidose.

INTRODUCTION: Sarcoidosis can manifest itself in a variety of affection patterns in the eye. Early diagnosis and treatment are of crucial importance. Therefore the following three cases present occular symptoms associated with sarcoidosis. METHODS: Three case reports are described. RESULTS: We report three cases with panuveitis but different anamneses. A 14-year-old boy suffered initially from a medically refractory sinusitis, followed by panuveitis with a distinct pattern of chorioretinal involvement. Furthermore, there was a facial palsy, swelling of the parotid glands, fever, and a deterioration of his general condition. The histological examination of a turbinectomy revealed a granulomatous inflammation with non-caseating granulomas. The second patient, a 66-year-old female, presented with the suspected diagnosis of paraneoplastic syndrome and positive anamnesis for sigma carcinoma. One of her main symptoms was significant uveitis with a pronounced inflammation in the anterior chamber. The suspicious lesions in thoracic CT yielded to the diagnosis of sarcoidosis. The third patient, a 51-year-old male, seemed to be generally healthy. He described a loss of visual acuity, which was explained by vitritis and a pronounced macular oedema. As part of the search for underlying diseases the chest radiography showed abnormal structures. DISCUSSION: In all patients the diagnosis was sarcoidosis. Moreover, in the first case Heerfordt syndrome, a special form of sarcoidosis, was diagnosed. In all three patients a significant improvement of visual acuity occurred under systemic prednisolone therapy. These cases demonstrate the broad spectrum of manifestations of sarcoidosis in ophthalmology. Moreover, the early diagnosis and implementation of therapy were decisive for the prognosis.

[A rare manifestation of sarcoidosis]. / Seltene Manifestation einer Sarkoidose.

This article reports the case of a 14-year-old boy who was presented in the case conference with symptoms of decreased visual acuity, scintillating scotomas and photophobia. Physical examination revealed right facial paralysis, parotid gland swelling, high fever and poor general condition. Ophthalmoscopy revealed anterior and posterior uveitis including macular edema and chorioretinal infiltrates. Angiography revealed a dense pattern of hyperfluorescent lesions and these observations resulted in the diagnosis of Heerfordt syndrome. Under systemic prednisolone therapy, symptoms were reduced and visual acuity recovered.