Transient vertical diplopia and silent sinus disorder.

A 57-year-old man had isolated transient recurrent vertical diplopia. Left hypoglobus and enophthalmos were present. Investigations revealed an otherwise asymptomatic left maxillary chronic aspecific sinusitis, with 8 mm lowering of the left orbital floor. Transient diplopia was thought to be secondary to transient fusion impairment. Orbital floor reconstruction cured the patient

Indocyanine green angiography anomalies in ocular syphilis

Objective: to report indocyanine green (ICG) angiography anomalies in ocular syphilis. Design: interventional non-comparative case series. Participants: eight patients (16 eyes) affected by ocular syphilis. Methods: from January 1994 to October 2001, all patients presenting with a diagnosis of active ocular syphilis were evaluated by a standard fluorescein and ICG angiographic protocol. The ICG angiography was repeated after completion of a systemic antitreponemal and antinflammatory treatment. Results: ICG angiography anomalies were detected in 12/16 eyes (75%). Two types of anomalies have been observed: a) late phase scattered hyperfluorescent spots (11 eyes), b) a persistent staining of retinal vessels (1 eye). In 4 of these 12 eyes no alteration was recordable at the concomitant fluorescein angiography. When ICG angiography was repeated (5 ± 1 week after the beginning of treatment), the mentioned ICG anomalies disappeared. Conclusions: ICG angiography might be valuable when assessing patients with active ocular syphilis. First, it can disclose retinal and choroidal vascular anomalies that are not detectable by funduscopy and/or fluorescein angiography. Second, it can be useful to monitor the efficacy of antitreponemal therapy

Visual disturbances and trans-urethral resection of the prostate : The TURP syndrome.

A 73-year-old man with a history of a cerebral and a cardiac vascular disease and atrial flutter developed visual disturbances characterized by vision being dark in both eyes and by seeing as through a color photographic negative immediately after an uncomplicated transurethral resection of the prostate (TURP) for prostatic hyperplasia under spinal anesthesia. There was complete remission of the symptomatology after 2.5 h. A cerebrovascular workup was negative. Considering postoperative hyponatremia and hypoosmality, we discuss the possible role of glycine-induced visual disturbances as described in the TURP reaction syndrome, to our knowledge an entity almost unknown in the neurologic literature. Glycine-induced visual disturbances should therefore be considered in the differential diagnosis of bilateral transient visual loss