Retinal vasculitis and uveitis--an adverse reaction to intravenous immunoglobulins?
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Biomedical subjects
J M Schmidbauer
Publications and source records attributed to J M Schmidbauer.
[Melanoma of the iris with recurrent hyphema--course over 32 years].
BACKGROUND: The differential diagnosis of melanocytic iris tumours is very difficult. Signs of malignancy such as pupil distortion, ectropium uveae, secondary cataract and secondary glaucoma can also occur with benign iris nevi. However, spontaneous hyphemata occur in 6.9% to 13% of melanomas, while anterior chamber hemorrhages are extremely rare with nevi. PATIENT AND METHOD: A 69 year old man with a pigmented iris tumor of the right eye strictly refused surgical treatment. Therefore the tumor was followed clinically over 32 years. Over this period the tumor showed a very slow increase in size. Twenty-seven years after the initial presentation for the first time a spontaneous anterior chamber hemorrhage occurred. In the following period, the patient experienced recurrent hyphemata at last approximately every two months. An excisional biopsy consisting of a sector-iridectomy and localized excision of Descemet's membrane was performed. Histologically, the tumor was classified as a melanoma of the iris. CONCLUSION: A careful documentation cannot be overemphasized in the follow up of patients with pigmented iris lesions. In case of spontaneous hyphema histological evaluation is required even in the absence of evident tumor growth.
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[Krypton laser therapy. Use in secondary serous detachment of the retinal pigment epithelium and in multiple idiopathic serous detachments of the retinal pigment epithelium].
Two variants of serious detachments of the retinal pigment epithelium (RPE) are demonstrated with reports of typical cases: (1) secondary serous detachment of the RPE; (2) idiopathic serous detachment of the RPE (pigment epithelium detachment not associated with any other retinal or choroidal disease). Fluorescein angiographic criteria for differential diagnosis and the resulting different techniques of krypton laser coagulation are portrayed: (a) focal krypton laser coagulation of the total area of the pigment epithelium detachment; (b) circular, one-row laser coagulation at the detachment borders. The advantages of circular, one-row laser coagulation of idiopathic serous RPE detachment over coagulation of the total area of the RPE detachment are described: first, these are fewer scotomas following coagulation; second, fewer laser foci are required; and third, the risk of subretinal bleeding is lower. These findings emphasize the efficiency of circular, one-row laser coagulation at the detachment borders in the treatment of idiopathic serous RPE detachments.
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