Obstruction of a major temporal branch vein, or one of its macular tributaries, presents a significant threat to vision. Visual acuity may be reduced by macular edema or the consequences of retinal neovascularization, and these afflictions frequently become irreversible. Since the complicating macular edema and retinal neovascularization respond, at least in part, to argon laser therapy in some other conditions, some investigators have begun to treat branch vein occlusions with this modality. However, since the pathogenesis and natural history of the disorder have not yet been elucidated by prospective studies, it is not clear whether such treatment is indicated. Clinical and experimental studies are reviewed, and treatment rationale and techniques are discussed. The authors emphasize the need for well-controlled randomized studies to evaluate the natural history of branch vein occlusion and the efficacy of photocoagulation in its treatment.

Diagnosis, Differential↗

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The evaluation of patients with Eales' disease.

Thirty-two patients with documented Eales' disease who have been followed-up at Johns Hopkins Hospital for periods of as long as 37 years were investigated. The previously reported association of Eales' disease with tuberculoprotein hypersensitivity was confirmed in 10 of 21 patients tested. For the first time, associated vestibuloauditory dysfunction is described. The previously reported association with multiple sclerosis was not confirmed. Eales' disease is a specific vasculopathy that can affect both the retinal and vestibuloauditory circulations. Patients with suspected Eales' disease should also be examined to rule out other diseases such as diabetes, sarcoidosis, and connective tissue diseases including systemic lupus erythematosus. This can be done by obtaining such tests as fasting blood glucose, chest radiograph, erythrocyte sedimentation rate, antinuclear antibody, rheumatoid factor, and LE cell preparation. Tuberculoprotein sensitivity status should be ascertained and active tuberculosis should be ruled out. The patient should be questioned regarding hearing or balance problems, and if a history suggestive of abnormalities is elicited, referral for vestibuloauditory function testing should be made.

Adult↗

PubMedDate not supplied

Transient delay in choroidal filling after krypton red laser photocoagulation for choroidal neovascular membranes.

The authors report four patients who were treated with krypton red laser photocoagulation for neovascular membrane in the papillomacular bundle. In each patient, from 1 to 7 days following photocoagulation, there was a transient delay in filling of the choroid in a localized area beyond the treatment site. No patient suffered permanent visual loss as a result of this complication. Each patient regained normal choroidal filling (except for the treatment site) within two to four weeks. This angiographic observation may be explained by the increased uptake of the krypton red wavelength in the deep choroid.

Adult↗

PubMedDate not supplied

Macular hole and retinal detachment in Best's disease.

The authors report a family with Best's vitelliform macular dystrophy in which one member developed a macular hole and retinal detachment. The retinal detachment was repaired by resultant extensive rhegmatogenous pars plana vitrectomy, fluid-air exchange, and photocoagulation. Examination of the vitreous specimen disclosed numerous large macrophages with abundant cytoplasm distended by lipofuscin.

Adolescent↗

PubMedDate not supplied