The presence of 'ghost' could be an independent predictor of mortality after TLE, thus identifying a subgroup of patients who need closer clinical surveillance to promptly detect any complications.

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BackgroundNeurofibromatosis type 1 (NF1) is an autosomal dominant disorder involving aberrant proliferation of multiple tissues of neural crest origin. Retinal vascular alterations in NF1 have rarely been reported in the literature and their nature is not clear. This study describes distinctive retinal microvascular alterations and their relationship to choroidal nodules in patients with neurofibromatosis type 1.MethodsThis was a retrospective study where records of seventeen consecutive patients with diagnosis of NF1, presenting Lisch nodules and choroidal alterations, and 17 age and gender-matched healthy control patients were evaluated. Fundus photographs, near infrared reflectance and enhanced depth imaging - optical coherence tomography images were reviewed. Retinal microvascular abnormalities and choroidal and retinal alterations in proximity of the retinal microvacular alterations were carefully noted.Results6 patients (35%) presented distinctive microvascular abnormalities. These consisted of small, tortuous vessels with a “spiral” or “corckscrew” aspect. They were second or third order, small tributaries of the superior or inferior temporal vein. These vessels were all located overlying choroidal alterations as observed with near infrared reflectance. Enhanced depth imaging - optical coherence tomography showed alteration of choroidal vasculature due to the presence of choroidal nodules but otherwise retinal and choroidal cross-sections were unremarkable for morphology.ConclusionsRetinal microvascular alterations overlying choroidal nodules in patients with NF1 can be considered another distinctive characteristic of the disease. Although the nature of these alterations is not clear, the authors speculate that functional disorders of vasomotor nerve cells, which originate in the embryonal neural crest can lead to their formation.

Purpose To determine the ocular alterations occurring in alopecia areata with regard to the lens and fundus.Methods Seventy-five patients with alopecia areata were examined. Seventy healthy control patients unaffected by skin, ocular or systemic disorders were also studied.Results Symptomless punctate lens opacities were found in 38 (51%) patients, whereas only 2 (3%) control patients had similar lens changes. Fundus alterations were found in 31 (41 %) cases of alopecia areata and in only 16 (23%) controls. this study was to investigate the prevalence and appearance of the ocular changes occurring in AA. Conclusions Patients and methodsSeventy-five patients (25 men, 50 women; age range 7-61 years) with AA who were seen for dermatological reasons at the Dermatology Institute of the University of Rome 'La Sapienza' were referred for ophthalmological examination as part of the study and solely because of the presence of AA. All patients were subjected to the following tests: visual acuity, applanation tonometry, anterior segment biomicroscopy with study of the lens and fundus ophthalmoscopy after full pharmacological mydriasis. Seventy healthy control patients (25 men, 45 women; chosen to be comparable in age to the AA patients) unaffected by skin, ocular or systemic disorders were also studied. The cases of AA were divided into groups designated as: universalis (complete loss of scalp and body hair), totalis (complete loss of scalp hair) and areata (incomplete loss of the hair from the scalp, beard or other body areas). ResultsThe personal history of various diseases in the AA patients is shown in Table 1. In 24 (32%) there was thyroid pathology and in 17 (23%) there was a history of atopic dermatitis. Two patients suffered from vitiligo, 3 had anaemia (microcytaemia), 3 were affected with diabetes mellitus, 1 had Down's syndrome and 15 patients (20%) had neuropsychiatric problems. The patients in the control group were unaffected by skin, ocular or systemic disorders. Even though they were chosen to be of ages comparable to the patients with AA, statistical analysis with Student's t-test showed a lower (t = 2.3; d.f. = 144; p = 0.02) mean age in the AA group (30.4 years, SD = 13.1) compared with the control group (36.2 years, SD = 17.2), Table 2 shows the various modalities of treatment undergone by the AA patients in the past.Eye (1999) 13. 643-M6