Ocular aspects of cervical vascular disease.
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Biomedical subjects
Publications and source records attributed to D L Knox.
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A 60-year-old white man with recurrent nondeforming arthritis and no intestinal symptoms developed bilateral vitreous opacities strongly suggestive of Whipple's disease. He was successfully treated with tetracycline and erythromycin. Thirteen years later, a presumed diagnosis of Whipple's disease was established by histopathologic observation of macrophages that were distended by periodic acid-Schiff-positive material and the finding of bacilli by electron microscopy in a vitreous aspirate. The characteristics of ocular involvement in Whipple's disease are discussed.
Three patients with idiopathic exudative retinal detachment are presented. Fluorescein angiography and/or angioscopy was used in each case to demonstrate an area of leakage from the choroid into the subretinal space, accounting for the detachment. The leakage sites were treated by cryopexy or photocoagulation, resulting in reattachment of the retina in each case (four eyes). This method of examination and treatment should be considered in all cases of idiopathic exudative retinal detachment.
Four patients with primary intraocular reticulum-cell sarcoma were presented. All of the patients were followed at the Wilmer Institute for periods of up to ten years. All had decreased visual acuity and a uveitis that was refractory to standard forms of therapy. In one case, the correct diagnosis was made clinically. At autopsy, two of the patients had systemic reticulum-cell sarcoma, a third had intracranial reticulum-cell sarcoma, and in a fourth case the disease process was confined to the eye. The literature is reviewed and the clinico-pathologic features of the total of 14 cases are analyzed. It is emphasized that a recalcitrant uveitis was present in almost all of the cases reported. Differential diagnosis and methods of diagnosis are discussed.
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