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Villous processes from the inner segments of cones in the human macula lutea.

The cones of the human macula lutea were examined by scanning electron microscopy. It was found that each inner segment had about 15 thread-like processes which projected from the cell surface. They were arranged in a longitudinal straight line along the photoreceptor, and were directed away from or towards the fovea contralis. The villous processes may be analogous with the lateral fins of the inner segments of certain vertebrates. They may perhaps bridge the space between neighbouring photoreceptors and may establish contact and interaction between them.

Adult

The effect of ethyl apovincaminate on the circulation of the eyeground.

Ethyl apovincaminate (RGH-4405, Cavinton), contrary to the active vasodilators used up to the present, increases blood pressure of the eyeground. Dynamics of the eyeground circulation has been investigated with fluorescein angiography performed at certain points of time. Blood supply of the macula lutea was increased in the first place by Cavinton.

Blood Pressure

High altitude retinal hemorrhage.

The accessibility of high-altitude areas presents the risk of high altitude retinal hemorrhages (HARH). Four cases reported illustrate localized macular, diffuse, and familial incidence of HARH. Fluorescein angiography indicated no leakage, and a superficial retinal location of the hemorrhages. Marked retinal artery and vein dilation occurs. Ophthalmodynamometry showed retinal vascular hypertension in the presence of HARH. The complete resolution of hemorrhages occurs in most cases. Despite the return of visual acuity to normal, visual function studies indicate the persistance of defects.

Adult

Expandable silicone implants for scleral buckling. IV. Experiments with an explant for macular breaks.

A new expandable silicone rubber explant used to indent the sclera at the macula was tested experimentally in rabbits. The device consists of a Dacron-reinforced silicone rubber strip that has an expandable portion (or balloon) at its midpoint connected to a silicone filling tube. The explant was expanded with 0.03 to 0.06 ml of an antibiotic solution. Smooth, round buckles that exerted even indentation were produced. A decrease in height of 20% to 50% was observed ophthalmoscopically during six months of follow-up. The degree of buckling can be easily controlled during operation and may be modified postoperatively.

Animals

Retinal ischemia in diabetic retinopathy.

Eight patients with proliferative diabetic retinopathy developed extensive retinal arteriolar and capillary obstruction. Ophthalmoscopy showed many white, thread-like retinal arterioles associated with capillary and venous dilatation. Widespread retinal arteriolar and capillary nonperfusion was demonstrated by fluorescein angiography. Ischemic maculopathy resulted in severe loss of visual acuity in some eyes. The severe degree of retinal ischemia was accompanied by optic disc pallor and neovascularization and a high incidence of rubeosis iridis with neovascular glaucoma. Patients with this variety of diabetic retinopathy have a poor prognosis of retaining useful vision.

Adolescent

Optic nerve colobomas of autosomal-dominant heredity.

Fifteen members of a family had congenital colobomas of the optic nerves, all of which were bilateral. The bolobomas appeared as enlargement of the physiologic cup with severely affected eyes having huge cavities in the site of the disc. A variable amount of glial tissue was present within the colobomas. Either macular or extramacular serous detachment or sequelae were present in 21 of the 30 affected eyes, and often led to total blindness. Radioisotope cisternography in one patient failed to implicate cerebrospinal fluid as the source of the subretinal fluid. The disorder is apparently inherited as an autosomal dominant.

Adolescent

Cystoid maculopathy in diabetics.

Three patients with long-standing diabetes manifested reduced visual acuity and notable bilateral symmetrical cystoid maculopathy, with no other sign of meaningful background diabetic retinopathy, eg, minimal to no microaneurysms, hemorrhages, or exudates. Results of fluorescein angiography showed that the entire retinal capillary bed in the macula was dilated and leaked fluorescein diffusely and profusely, but also showed that there was excellent capillary perfusion. Argonlaser photocoagulation was applied to one eye of each patient in an attempt to resolve the cystoid maculopathy. The laser treatment effectively resolved the edema in the specific areas of treatment, but the foveal and perifoveal areas, which were not treated, showed no areas of resolution of the cystoid edema in two cases and no improvement (and no decrease) in visual acuity in all three cases.

Adult

Subretinal tracks in ophthalmomyiasis.

Three cases of presumed infestation of the human globe by the maggot of a true fly (order of Diptera) are presented. In each case, migration of the maggot through the subretinal space produced widespread ophthalmoscopic and fluorescein angiographic changes that are believed to be pathognomonic of subretinal ophthalmomyiasis. Despite extensive changes in the retinal pigment epithelium, each of the three patients expressed few symptoms and manifested minimal visual deficit.

Adolescent

Pseudovitelliform macular degeneration.

Three patients with vitelliform-like macular lesions had normal electroooculogram (EOG) light-peak/dark-trough ratios, unlike typical cases of vitelliform dystrophy (Best macular dystrophy). Leakage of fluorescein dye from perifoveal cappillaries implicated an increased permeability of these vessels as the probable cause for the vitelliform-appearing lesions. All patients with vitelliform lesions demonstrating normal EOG ratios should have an evaluation by fluorescein angiography to rule out a diagnosis of what we prefer to call pseudovitelliform macular degeneration.

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