Purpose: Acute zonal occult outer retinopathy (AZOOR) is one of the "white dot syndromes" a clinically heterogeneous group of inflammatory chorioretinopathies. The etiology is not yet clear. Methods: We present a 50 years female patient with a prior history of migraine. She experienced progressive visual loss and visual field defects in the last 3 years. Preceding each episode she experienced blue flickering photopsias. Results: Visual acuity was 0,3 in the right eye and 0,6 in the left eye. Biomicroscopy showed a normal anterior segment, fundus exam revealed pigment epithelial atrophy more pronounced in the worse eye. Electrophysiology showed a marked reduction in the photopic ERG in the more affected eye. MRI demonstrated multiple white matter lesions including a corpus callosum location. Lumbar puncture showed oligoclonal bands. Further tests demonstrated hearing impairment. Therapy was instituted during the three years course of the disease with steroids, immune suppressants and plasmapheresis with visual loss being progressive. New photopsia is currently present. Conclusions: The etiology of AZOOR remains unclear. With our patient being one of the few described in the literature with concomitant multiple sclerosis, the question remains on whether there is an underlying common process of inflammatory autoimmune reactions. Whether treatment is possible, remains to be evaluated.
Purpose: Impaired vascular regulation might contribute to glaucomatous damage. Whether retinal branch arteries and veins of healthy persons and primary open angle glaucoma (POAG) patients show different reactions in response to flickering light stimulation (FLS) is investigated. Methods: Retinal vessel reactions to FLS were examined in 28 POAG patients (stage I, 54,3±9,9 years old) after 4 week wash‐out of eye drops and in 28 age and gender matched medically healthy volunteers. Vessel diameters of retinal vessel segments were assessed by Dynamic Vessel Analyzer (DVA). After baseline measurement (50 s) monochromatic rectangular FLS (530‐600 nm, 12,5 Hz, 20 s) was applied. Results: In most subjects fast vessel dilation compared to baseline and an ensuing reactive arterial constriction were observed. In detail we found: ...........................................................................POAG.......control mean arterial dilation at the end of FLS, %...........3,3±2,7......3,4±2,7 time of max arterial constriction following FLS,s....49,9±26,7*.25,5±18,1 mean venous dilation at the end of FLS,%........... 2,9±1,9......3,8±2,2 area under the venous curve following FLS,s*%..‐1,1±16,9*...27,9±34,3 We found statistically significant differences between the two examined groups as marked with *(p<0,01) (U‐test). Conclusions: Functional retinal arterial and venous dilation in response to FLS does not differ between POAG patients and healthy subjects. Reactive arterial constriction following the FLS appeared later and venous restoration occurred faster in POAG. These findings might be an indication for alterations in the vascular endothelium and vessel wall rigidity in POAG, leading to impaired regulation following metabolic demand.
Bilateral stromal corneal opacity is a differential diagnostic challenge for ophthalmologists. In this article 2 female patients aged 30 and 36 years old, respectively, with different degrees of expression of stromal diffuse corneal opacity will be presented. Patient 1 was of short stature (114 cm) and patient 2 was 172 cm in size. Both patients exhibited altered joint structures of the hands and feet and diffuse stromal corneal opacity. Furthermore, patient 1 had both mitral and aortal insufficiencies and patient 2 an aorta insufficiency. The stromal diffuse corneal opacity was indicative of Schleie syndrome. For patients with reduced vision a lamellary keratoplasty is to be recommended.
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