Repair of Traumatic Rhegmatogenous Retinal Detachment Combined with Congenital Falciform Retinal Detachment

Purpose: To report a case of surgical repair of traumatic rhegmatogenous retinal detachment combined with congenital falciform retinal detachment (FRD). Methods: A retrospective case report. Results: A 36-year-old man with traumatic rhegmatogenous retinal detachment complicating a previously known FRD was successfully treated despite residual FRD following pars plana lensectomy, vitrectomy, and encircling scleral buckling. His best corrected visual acuity improved from hand motion at 50 cm to 20/1,000. Conclusion: We concluded that the root of the FRD is susceptible to trauma because of the contraction of fibrovascular tissue. The early intervention of modern vitrectomy to traumatic rhegmatogenous retinal detachment complicating a previously known FRD is an important consideration for enhanced quality of care and optimal patient outcomes

Multimodal imaging of retinal metastasis masquerading as an acute retinal necrosis

Abstract Background To report the multimodal imaging and histology of a case of metastatic esophageal cancer with vitreoretinal involvement resembling acute retinal necrosis (ARN) in a patient receiving systemic chemotherapy. Case presentation A 69-year-old Japanese man with a history of stage 4 esophageal carcinoma, treated with three cycles of 5-fluorouracil (5-FU) and cisplatin (CDDP) chemotherapy as well as 30 sessions of radiation therapy, presented with new onset of blurry vision in the right eye (OD). Visual acuity was 20/200 OD. Fundus examination OD revealed 2+ nuclear cataract, veil-like vitreous opacity, a tractional retinal detachment, and white retinal lesions in the macula and periphery masquerading as an ARN. Due to the poor view and uncertainty regarding diagnosis, combined cataract extraction and 25 gauge pars plana vitrectomy was performed. Polymerase chain reaction and cytologic analysis were performed on the vitreous samples, which was negative for all infectious entities but positive for poorly differentiated malignant cells. The vitreous biopsy was consistent with the primary endoscopic esophageal biopsy. Ultra-wide view fundus imaging revealed multifocal white intraretinal lesions in the macula and periphery. Optical coherence tomography through these white opacities displayed hyper-reflective inner retinal lesions with no choroidal involvement, suggestive of retinal metastasis. Observation and palliative support was continued until the patient passed away 3 months after diagnosis. Conclusion Retinal metastasis may mimic infectious syndromes such as ARN and are associated with a very poor prognosis. Outside of the retina, no further central nervous system metastasis was found. 5-FU is known to cross the blood–brain-barrier but may be inadequate in preventing retinal metastasis

5-HT2 Receptor-Mediated Phosphoinositide Hydrolysis in Bovine Ciliary Epithelium

The serotonin 2 (5-HT2) receptor antagonists, MCI-9042 (Anplag®) and ketanserin, have been shown to lower intraocular pressure in rabbits (1) and humans (2). The mechanism of action of these drugs has not been determined, but it is hypothesized that 5-HT2 receptors, and possibly α-adrenergic receptors, (3) may regulate in part aqueous humor production via an intracellular signal transduction pathway in the ciliary body. We therefore examined whether 5-HT2 receptors were coupled to phosphoinositide hydrolysis in an organ culture system of isolated bovine ciliary epithelium. 5-HT stimulated [3H]inositol phosphates ([3H]InsPs) accumulation in a dose-dependent manner with a maximum increase approximately twice over the basal level. The mean EC50 value was 1.1 μM, which was calculated from four dose-response curves. The 5-HT stimulated accumulation of [3H]InsPs was inhibited by spiperone (5-HT2A/1A and dopamine 2 (D2) antagonists), M-1 (a major metabolite of MCI-9042), ketanserin (5-HT2A antagonist), SB-206553 (5- HT2B/2C antagonist), and mesulergine (5-HT2C antagonist and D2 agonist). It was not inhibited by chlorpromazine, which is a D2 receptor antagonist. Accordingly, our study demonstrates that 5-HT2 receptors are coupled to phospholipase C in bovine ciliary epithelium.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63244/1/108076803762718114.pd