To study the evolution of the retinal pigment epithelial lesions in the central serous retinopathy, the authors studied 150 patients with ages between 20 and 49 years at the first examination, during periods varying between 6 months and 14 years. It was found a greater incidence of the disease in the males (83.3%); bilaterality in 23.3%; only one point of leakage in 62.7%; 3 different types of diffusion (inkblot 71.4%; mushroom 23.8%; with serous pigment epithelial detachment 4.9%). The final visual acuity was < 20/40 in a quarter of the cases and the frequency of the recurrences was 30%. The laser treatment did not influence the recurrences. In 50 patients with a follow-up superior to 3 years, 8 (16%) developed lesions similar to those described as diffuse retinal pigment epitheliopathy with visual field defects and subnormal EOG. Actuarial calculus suggests that 50% of the patients may get the most severe and extensive form of the disease after 12 years of evolution. The results allow to conclude that the diffuse retinal pigment epitheliopathy is only the terminal state of the most severe cases of central serous retinopathy.

During the past four years 450 patients (247 female - mean age 36 years and 203 male - mean age 34 years) with intraocular inflammation were evaluated using standard diagnostic criteria, to establish a uveitis survey profile. Patients were divided into four anatomic groups: anterior uveitis (270 cases = 60%), posterior uveitis (108 cases = 24%), panuveitis (54 cases = 12%) and intermediate uveitis (18 cases = 4%). A probable aetiological diagnosis was made in 232 cases (51.5%). Rheumatic diseases were diagnosed most commonly (55 cases = 12.2%), mainly ankylosing spondylitis, as is true for other European countries. Ocular toxoplasmosis was a frequent cause of uveitis, as in Brazil and West Africa, thus requiring a prompt diagnosis and treatment. Behçet's syndrome was associated with HLA B5 (65%) as in Japanese and Mediterranean populations. In our area AIDS retinitis is becoming an important differential diagnosis.

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To outline the severity and long-term sequelae of eye injuries in soccer.Design: Prospective observational study of 163 patients who sustained soccer-related ocular injuries between April 1, 1992, and March 31, 2000 (8 years). Methods:Patients were observed at a sports ophthalmology unit located in the largest university hospital of the northern region of the country and central to all major soccer fields in town. The data were recorded using the United States Eye Injury Registry report forms for initial and follow-up observation. Main Outcome Measures:(1) Self-reported history surrounding the ocular trauma, initial visual acuity, diagnosis, and operations and (2) final visual acuity, late diagnosis, and additional operations.Results: Injuries occurred predominantly in young men (mean±SD age, 23.2 ± 8.8 years) practicing indoor soccer (50.9%) or outdoor soccer (47.2%), and most re-sulted from a kicked ball (79.1%) near the goalpost (60.1%). Angle recession and peripheral vitreoretinal lesions were more likely to occur in the superotemporal quadrant (54.7%; 95% confidence interval, 44.2%-65.0%; and 57.6%; 95% confidence interval, 48.4%-66.4%; respectively). Vitreoretinal lesions were present in 42.2% (95% confidence interval, 33.1%-51.8%) of patients with "normal" visual acuity (Ն20/40) and in 50.0% (95% confidence interval, 38.1%-61.8%) of patients without hyphema. No significant association was found between severity of injury and age, sex, type of soccer, level of athletic expertise, or player position.Conclusions: Severe ocular lesions can occur in soccer players without symptoms and at all skill levels. The development of laboratory models will be essential to explain the tendency for lesions to be in the superotemporal quadrant. The data support the need for protective eyewear designed specifically for soccer.

Familial amyloidotic polyneuropathy (FAP) is a hereditary disease which may present a wide range of ocular manifestations. Glaucoma is amongst the most serious complications of FAP. We report the results of ultrastructural study of the trabecular meshwork in a glaucomatous patient with the Portuguese form of FAP. This study showed that there was marked anatomical disruption of the uveoscleral, cornoscleral meshworks and juxtacanalicular tissue characterized by (a) accumulation of amyloid fibrils in the intertrabecular spaces; (b) degeneration of the endothelial cells; (c) homogeneous and/or multilayered plaques of basement membrane-like material loading the intertrabecular spaces or protruding to the lumen of the Schlemm's canal; and (d) degeneration of unmyelinated nerve fibres. These morphological changes and an analysis of the literature suggest that mechanical and neuropathic events can be co-existing factors which enhance the resistance to aqueous humour outflow, leading to increased intraocular pressure and glaucoma in the Portuguese form of FAP.

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