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Background: Optical coherence tomography(OCT) permits the noninvasive analysis of cross-sectional tomograms of ocular tissue in vivo., Case: A 67-year-old woman presented with abnormal feeling in the left eye. An ophthalmoscopic examination revealed retinal edema in the macular vascular arcades and radial folds on the fovea. Optic disc pits were not demonstrated ophthalmoscopically or by fluorescein angiography(FAG). OCT disclosed separations in the inner and outer layers of the edematous retina, retinal detachment on the fovea, and cystic schisis(pseudo-pits) beneath the inner limiting membrane of the disc which seemed to be connected with the separation of the inner layers of the retina., Conclusion: OCT demonstrated cystic schisis-like pits(pseudo-pits) which were not recognized ophthalmoscopically or by FAG, and the cystic schisis seemed to communicate with the inner separation of the retina. Therefore, we prefer to call such cases pseudo-disc-pits macular syndrome instead of optic disc pit macular syndrome.

An intravitreal injection of a small amount of 1-ornithine hydrochloride damages the retinal pigment epithelium (RPE) selectively in monkey eyes. In this paper, we examined the rat eye and observed similar results. Clinically, retinal edema appeared immediately after injection and showed hyperfluorescence on a fluorescein angiograph after 3 days. Histopathologically, RPE showed marked swelling 3 hours after injection, then became necrotic and disappeared gradually. One month after injection, retinal structure was maintained in the area where RPE regenerated to cover Bruch's membrane, but in the area where RPE cells disappeared, the photoreceptor cells and choriocapillaris degenerated and finally disappeared. In the eyes injected intravitreally with NaCl solution of equivalent osmosis microvacuoles were seen but no necrotic change in RPE. Thus, a small amount of ornithine damaged RPE selectively, and induced disappearance of the photoreceptors and choriocapillaris secondarily.

For objective evaluation of elevated changes in the optic nerve head, volumetric measurement of optic nerve heads in normal eyes, and in eyes with optic neuritis and papilledema was performed using a three-dimensional computerized digital image analyzer. To determine the reliability of the data, both intraphotographic and interphotographic error variance was studied. The reproducibility of the data was good, because the coefficient variation of elevated volume was small, 1.0 to 8.3% (mean; 4.5%) on intraphotographic study and 0.8 to 11.5% (mean; 6.5%) on interphotographic study in the optic neuritis and papilledema. The accuracy of the data was good enough for clinical use, presuming a change of less than 0.05 mm as measuring error.

In a 53-year-old woman with papilledema and idiopathic thrombocytopenic purpura (ITP) brain CT examinations failed to detect the cause of papilledema, pseudotumor cerebri was suspected and lumbo-peritoneal shunt operation was performed to decrease the intracranial pressure. Unfortunately the patient died of intracerebral hemorrhage. The autopsy revealed superior sagittal sinus thrombosis to be the cause of papilledema, which indicate that sinus thrombosis can develop with such a hemorrhagic disease as ITP.

A case of ganglioglioma associated with choked disc is reported. A 19-year-old girl was admitted to our hospital because of blurred vision. Neurologically, the patient had nothing but choked disc. The CT showed a large cystic mass with calcification in the left parieto-occipital lobe. The MRI revealed that the cyst was delineated by a membrane and that its dorsal side was solid, showing enhancement by Gd-DTPA. Cerebral angiography showed no tumor stain. Left parieto-temporo-occipital craniotomy was performed and the tumor was removed subtotally. Histopathological examination demonstrated the typical pattern of ganglioglioma. The most common symptom of ganglioglioma is convulsions. Symptoms of increased intracranial pressure have been reported sporadically in the literature. It was clinically noted that the cause of the increased intracranial pressure in this patient was enlargement of the cyst associated with ganglioglioma.