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Background: We compared therapeutic outcomes in two cases of juxtapapillary capillary hemangiomas associated with von Hippel-Lindau disease., Cases: Case 1 was a 47-year-old man whose left eye was blind due to proliferative vitreoretinopathy. Visual acuity of the right eye was 1.2. No exudative change was found, but the juxtapapillary retinal hemangioma was enlarged. Three injections of intravitreal bevacizmab were not effective and laser photocoagulation was performed. Humphry microperimetry revealed a decreased sensitivity corresponding to the papillo-macular bundle damage. Vision was restored with regression of the retinal hemangioma. Case 2 was a 36-year-old woman with bilateral visual acuity of 1.2. The right eye had an inferior juxtapapillary retinal hemangioma at the optic disc surrounded by exudative retinal detachment. Laser photocoagulation, intravitreal injection of bevacizmab, transpapillary thermotherapy, photodynamic therapy, and vitrectomy were performed, but vision decreased to 0.02., Conclusions: Photocoagulation in the early stage of juxtapapillary hemangioma before development of exudative detachment may preserve visual acuity.

Objective: Recent data suggest that the concentration of interleukin-10 (IL-10) is higher than that of interleukin-6 (IL-6) in the vitreous of eyes of patients with non-Hodgkin's lymphoma. In this study, we evaluated the utility of measuring intravitreal IL-10 and IL-6 concentrations in the diagnosis of intraocular lymphoma., Methods: Specimens of undiluted vitreous were collected at the time of pars plana vitrectomy and IL-10 and IL-6 concentrations were determined. Vitreous specimens were obtained from 5 patients with suspected intraocular lymphoma and 10 patients with uveitis presumed to be unrelated to a neoplasm., Results: In all 5 patients eventually diagnosed with intraocular lymphoma, the vitreous IL-10 concentration ranged from 3,040 to 11,200 pg/ml, and was higher than the vitreous IL-6 concentration in all cases. In 9 of the 10 patients with uveitis, the vitreous IL-10 concentrations ranged from less than 2 to 97 pg/ml, with an IL-10/IL-6 ratio of less than 0.11. However, in the remaining case diagnosed as uveitis of unknown etiology, the vitreous IL-10/IL-6 ratio was greater than 1., Conclusion: Our data suggest that the measurement of vitreous IL-10 concentrations would aid in the diagnosis of intraocular lymphoma.

Background: A case of Sweet syndrome mimicking orbital cellulitis is reported., Case: A 17-year-old girl presented with painful eyelid swelling, limited ocular movement in the right eye, and an increased white cell count. The patient was initially diagnosed as having infectious orbital cellulitis, but her symptoms did not improve with administration of intravenous carbanpenem and cefzon. Systemic examination revealed erythema of the extremities, and blood tests showed elevated C-reactive protein. These findings are consistent with a diagnosis of Sweet syndrome, and the patient was treated with 30 mg of oral prednisone. The eyelid swelling and erythema of the extremities decreased one day after the initiation of corticosteroid therapy. Skin biopsy showed infiltration of neutrophils and histiocytes in the dermis, confirming the diagnosis of Sweet syndrome., Conclusion: Sweet syndrome with eyelid and orbital involvement may mimic infectious orbital cellulitis.

Purpose: To identify risk factors of poor visual outcome with vitrectomy for early-onset endophthalmitis after cataract surgery., Patients and Methods: Clinical records of 29 consecutive eyes with endophthalmitis developing within 6 weeks after cataract surgery and that underwent therapeutic vitrectomy between June 1996 and April 2001 were retrospectively reviewed. Twenty-two of the eyes received intravitreal injections of vancomycin and ceftazidime at the time of vitrectomy, and all patients received intravenous antibiotics. Eyes were divided into two groups; group A consisted of 22 eyes with a final visual acuity of 0.2 or greater, and group B consisted of 7 eyes with a final visual acuity of less than 0.2., Results: Fifteen eyes (52%) in group A achieved a visual acuity of 0.5 or better and 8(28%) achieved a visual acuity of 1.0, while 4 eyes in group B developed phthisis bulbi. For eyes with a preoperative visual acuity of hand motions or worse, there was no correlation between final visual acuity and preoperative visual acuity. The overall culture-positive rate was 57%. In group A, methicillin-resistant Staphylococcus epidermidis was identified in 6 eyes, methicillin-resistant Staphylococcus aureus (MRSA) in 3 eyes and enterococcus in 2 eyes. In group B, alpha-hemolytic streptococcus (AHS) was identified in 4 eyes, aspergillus in 1 eye, and MRSA in 1 eye. All isolates were sensitive to vancomycin with the exception of the aspergillus. AHS infection appeared to be associated with wound failure from the initial cataract surgery and a poor visual outcome. Among 3 of the eyes that developed phthisis bulbi, intravitreal injection of antibiotics was not performed., Conclusion: Early vitrectomy and intravitreal injection of vancomycin may improve visual outcomes, but infection with AHS may be associated with cataract surgery wound failure and poor visual outcomes.