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Objectives: To evaluate the efficacy and safety of heavy silicone oil as an endotamponade in patients with recurrent or complicated retinal detachment and macular hole., Materials and Methods: Nineteen eyes of 19 patients who underwent heavy silicone oil endotamponade for different indications were included in the study and evaluated by retrospective chart review. At each visit, patients underwent detailed ophthalmological examination and anatomical and functional outcomes, silicone oil emulsification, intraocular inflammation, presence of proliferative vitreoretinopathy, preoperative and postoperative visual acuity, and postoperative complications were recorded., Results: The study included 19 eyes of 19 consecutive patients: 13 women (68.4%) and 6 men (31.6%). The patients' median age was 60 years (interquartile range [IQR]: 44-70 years) and the median follow-up time was 19 months (IQR: 9-31 months). Indications for heavy silicone oil endotamponade were recurrent retinal detachment in 11 eyes (57.8%), inferior retinal detachment in 5 eyes (26.3%), inferior rhegmatogenous retinal detachment, recurrent macular hole in 2 patients (10.5%), and macular hole in 1 patient (5.2%). Median best corrected visual acuity was 2 logMAR (IQR: 1-2.6) preoperatively and 0.99 logMAR (IQR: 0.4-2) postoperatively (p<0.001). Postoperative anatomical success was achieved in all patients. Densiron 68 was used for endotamponade in 14 patients (73.7%), Densiron XTRA in 3 patients (15.8%), and AlaHeavy 1.07 in 2 patients. Heavy silicone oil emulsification was observed in only 3 patients (15.8%)., Conclusion: Although heavy silicone oil has limitations as an endotamponade, such as intraocular pressure increase, emulsification, intraocular inflammation, and the risk of complications during removal, it is a safe and effective alternative in eyes requiring inferior retinal tamponade for indications like proliferative vitreoretinopathy and recurrent macular holes., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2022 by Turkish Ophthalmological Association, Turkish Journal of Ophthalmology, published by Galenos Publishing House.)

Purpose: To report a case series of three patients with intractable uveal effusion syndrome (UES), treated with partial thickness sclerectomy and intravitreal anti-VEGF therapy., Methods: Three patients with intractable UES were included. All patients underwent intravitreal anti-VEGF therapy to facilitate resolution of uveal effusion. The concentrations of IL-1β, IL-6, IL-8, IL-10, IL-12p70, TNF and VEGF in aqueous humor were measured., Results: After the last intravitreal injection, all three eyes had total resolution of the chorioretinal detachment or subretinal fluid. One eye experienced improvement in visual acuity. All patients were free from recurrence during the follow-up period. Aqueous IL-6, IL-8 and VEGF concentrations were elevated in all cases., Conclusions: Our current data provided the evidence that VEGF was increased in eyes with intractable UES and anti-VEGF therapy was effective, suggesting that partial thickness sclerectomy and intravitreal anti-VEGF therapy could be a new choice for intractable UES.

Purpose: Outcomes and reoperation rates in infants with unilateral persistent fetal vasculature (PFV) with elongated or stretched ciliary processes have not been extensively studied and were excluded from the Infant Aphakia Treatment Study (IATS). The purpose of this study is to analyze the preoperative measurements, reoperation rates, and complications after surgery in unilateral anterior PFV with stretched processes., Design: Retrospective case series., Methods: Inclusion criteria consisted of unilateral cataract surgery prior to 7 months of age and anterior PFV with elongated ciliary processes. Eyes with posterior retinal involvement and less than 6 months of follow-up were excluded. All patients underwent lensectomy, posterior capsulectomy, and vitrectomy., Results: Eleven eyes of 11 patients were included. Patients had a mean age at surgery of 2.4 ± 1.4 months. Average follow-up was 4.5 ± 3.7years. Globe axial lengths were 18.6 ± 1.9 mm. Ten patients (91%) were initially left aphakic. Three patients (27%) later received a secondary intraocular lens (IOL), and 1 patient underwent an IOL exchange. Six out of 10 (60%) aphakic patients developed visual axis opacification. One aphakic patient required topical therapy for glaucoma. One additional patient developed neovascular glaucoma and retinal detachment. The eye was subsequently enucleated. Three patients underwent strabismus surgery. Two patients underwent pupilloplasty. Two patients (18.2%) had a final visual acuity better than 20/200., Conclusion: Eyes operated for PFV with elongated ciliary processes are unlikely to have a final visual acuity greater than 20/200 and many will need additional surgery. Postoperative visual axis opacification occurred in 60% and glaucoma developed in 18%., (Copyright © 2018 Elsevier Inc. All rights reserved.)

We aimed to present a novel case of sectoral ciliary body agenesis and complicated cataract as an embryogenic defect of eye development diagnosed by ultrasound biomicroscopy. A 20-year-old male patient presented with a complaint of visual impairment in his left eye since childhood. Slit-lamp examination of the left eye revealed pigment precipitation and focal lens opacities extending from the temporal quadrant through the posterior lens capsule, blocking the central optical axis. On ultrasound biomicroscopy examination, there was a hyperechoic reflection belonging to the rudimentary ciliary body structures between 2-5 o’clock in the temporal quadrant. The zonules could not be visualized in the same location. At all other quadrants of the anterior chamber angle, the ciliary body and zonules were normal. This is a very rare case of sectoral ciliary body agenesis complicated by cataract. Ultrasound biomicroscopy may be useful for detecting rare congenital anomalies of the anterior segment, anterior chamber angle, and ciliary body.

Congenital ectropion uveae (CEU) is a rare anomaly characterized by ectropion uveae, iris hypoplasia, iridotrabecular dysgenesis and glaucoma. The apparent ectropion uveae results from the spread of iris pigment epithelium beyond the iris ruff and onto the anterior surface of the iris. Conclusion Open-angle glaucoma results due to angle dysgenesis, so patients should be carefully examined periodically for its early detection.

The diagnosis of angle-closure glaucoma secondary to iridociliary cysts is challenging and lacks compiled literature support. We present a rare case of bilateral angle-closure glaucoma associated with pseudoplateau iris due to multiple ciliary cysts and conducted a systematic review of the literature to find similar case reports published between November 2006 and November 2016. Only 19 case reports present treatment modalities, and most cases required more than one therapeutic approach for controlling the intraocular pressure. Pseudoplateau iris attributed to iridociliary cysts should be considered in the differential diagnosis of patients with narrow angles, particularly those with ocular hypertension and glaucoma, in which management is complex. In addition to gonioscopy, ultrasound biomicroscopy is considered the conclusive method for accurate diagnosis.

Purpose: To report a case of choroidal neovascularization (CNV) in a patient with ocular sarcoidosis treated by intravitreal aflibercept., Methods: A 27-year old man was referred to our department because of sudden visual acuity decrease (best-corrected visual acuity (BCVA) was 20/80 LE). Fundus examination showed bilateral optic disk swelling, retinal pigment epithelium changes at the posterior pole, yellowish chorioretinal lesions in the periphery, and the presence of a prominent peripapillary neovascular complex., Results: The clinical diagnosis was most compatible with ocular sarcoidosis, later confirmed by mediastinal lymph node biopsy. Fluorescein and indocyanine green angiography confirmed the presence of active peripapillary type 2 (classic) CNV in both eyes. Given that the exudation of the peripapillary CNV harmed the fovea, the patient underwent a single intravitreal aflibercept injection LE. One month after the treatment, LE BCVA decreased to 20/125. Spectral-domain optical coherence tomography (SD-OCT) showed complete resolution of subretinal fluid but revealed outer retinal atrophy with complete loss of the ellipsoid zone (EZ) in the macula (possibly responsible for visual acuity worsening). Six months later, LE BCVA slightly increased to 20/100, and SD-OCT showed partial recovery of the EZ in the macula. No adverse events related to the treatment were recorded during follow-up., Conclusions: We report a case of CNV in a patient with ocular sarcoidosis treated with intravitreal aflibercept. In our experience, intravitreal aflibercept injection achieved morphologic resolution for sarcoid-related peripapillary CNV.

Purpose: To reconsider the pathogenesis of traumatic myopia by describing two cases and literature review., Methods: Refraction was measured, A-scan ultrasonography was performed, and ultrasound biomicroscopy (UBM) was used to observe the ciliary body in the acute and recovery stages., Results: The first patient had a myopic shift of -6.12 diopters (D) on the initial examination (day 2) compared with the recovered stage. UBM showed ciliochoroidal effusion in one half of the circumference and severe edema in three eighths of the ciliary body, which led to an anterior rotation of the ciliary body. Immediately after the cycloplegia, the myopic shift decreased by -3.9 D. On day 11, the refraction was -0.63 D, and the UBM findings were normalized. The second patient had a myopic shift of -4.38 D on the first examination compared with the recovered stage. UBM showed an annular ciliochoroidal effusion leading to anterior rotation of the ciliary body. Immediately after the cycloplegia, there was a decrease of -2.75 D. Biometric measurements showed an increased anterior chamber depth and a decreased thickness of the lens. On day 16, the refraction was -1.0 D, and the UBM findings were normalized. In both cases, biometric measurements in the acute phase suggested a anterior chamber shallowing, a thickening of the lens, and an anterior shift of the lens-iris diaphragm, Conclusions: Cycloplegia decreased the myopic shift by more than 60 %. These findings indicate a significant contribution of ciliary spasm combined with ciliochoroidal effusion, anterior shift of the lens-iris diaphragm, and thickening of the lens.

Case Report: An 18-year-old man, presented a lower vitreous hemorrhage of unknown cause. Multiple tests are performed, including Ophthalmic Ultrasound and Fluorescein Angioghaphy (FA), they did not find justification of bleeding. Finally, we decide to do a Biomocroscopía Ultrasonic (UBM) showing an iridociliary cyst., Discussion: The iridociliary cysts are single or multiple, primary or secondary. The primaries are usually benign so, they do not require treatment. When the cyst has a considerable size, it may produce a focal plateau iris with or without angle-closure. Our case reveals an unusual complication that should take notice of when you have an unknown vitreous hemorrhage., (Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To describe aqueocentesis cytopathology results from dogs and cats presenting for uveitis investigation and to determine whether this is a useful and safe procedure., Animal Studied: Dogs and cats presenting for investigation of anterior uveitis (April 2008-December 2013)., Procedures: Aqueous was collected via limbal entry under sedation/general anesthesia, for cytopathology and occasionally bacterial culture or polymerase chain reaction (PCR) testing. Further workup included blood testing (hematology, biochemistry, and serology), diagnostic imaging, nonocular cytopathology, and available histopathology., Results: Fifty-six dogs and 39 cats were included in the study. An aqueous cytopathologic diagnosis of lymphoma (or discrete cell neoplasia) was made in six dogs and seven cats, and a diagnosis of large cell carcinoma made in one dog. This diagnosis of lymphoma was confirmed by ocular histopathology in two dogs and one cat; nonocular cytopathology corroborated lymphoma in another three dogs and five cats. Lymphoma was not evident on aqueous cytopathology but confirmed on nonocular histopathology in two dogs and by cytopathology in one cat. Additionally, aqueous cytopathology in three cats suggested, but was not considered diagnostic of, lymphoma; one of these cats had a confirmatory diagnosis of lymphoma on subsequent clinical investigation. Aqueous humor cytopathology alone was not diagnostic in non-neoplastic anterior uveitis cases, but supplemented the clinical picture with other systemic diagnostic tests. No clinically important complications were reported in association with aqueocentesis., Conclusions: Aqueocentesis is performed readily with minimal risk. The results were primarily useful in aiding a diagnosis of lymphoma in both dogs and cats., (© 2014 American College of Veterinary Ophthalmologists.)

Vitreous block (VB), a rare secondary angle-closure caused by anterior rotation of the ciliary body, occurs in a variety of settings, but most frequently after glaucoma filtering surgery. The etiology remains unclear, but choroidal expansion and anterior vitreous abnormalities have been proposed. In the past, treatment of VB has yielded high rates of failure and recurrence. Advancements in surgical techniques, however, have led to improved visual outcomes. We review the history of this condition and present a stepwise approach to its diagnosis and treatment using modern imaging modalities and surgical techniques., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: To report a case of acute glaucoma due to complete ring cyst of the ciliary body., Patients and Methods: A 33-year-old woman experienced blurred vision in her left eye. Intraocular pressure of the left eye was elevated accompanied with a very shallow anterior chamber. Anterior segment-optical coherence tomography and ultrasound biomicroscopy detected ring-shaped ciliary masses in the both eyes. Myopic change and contact between the ciliary mass and lens in the left eye suggested the presence of aqueous misdirection resulting in forward displacement of the lens-iris diaphragm. Because elevated intraocular pressure was refractory to conservative management, the left eye underwent clear lens aspiration and implantation of intraocular lens., Results: Although the anterior chamber became deep in the left eye initially after lens extraction in conjunction with core vitrectomy, possible aqueous misdirection recurred. Second vitrectomy in the left eye together with posterior and anterior capsulotomies, to establish humoral communication between the anterior and posterior chambers, deepened the anterior chamber and lowered the intraocular pressure. The anterior chamber in the fellow right eye remained deep a year after the episode., Conclusions: This is the first reported case of bilateral ring cysts of the ciliary body. The manifestation caused secondary glaucoma, which was resolved by lensectomy and vitrectomy.

Importance: Bilateral diffuse uveal melanocytic proliferation (BDUMP) is a rare paraneoplastic syndrome with characteristic findings, including exudative retinal detachment, rapid cataract formation, and uveal melanocytic tumors. We report a case notable for bilateral iris and ciliary body cysts--a rare presentation of the disease., Observations: A woman in her 50s presented with bilateral decreased vision. Her medical history was significant for clear cell adenocarcinoma of the endometrium. Slitlamp examination revealed a contiguous ring of pigmented translucent iris cysts at the pupillary margin of each eye, confirmed with ultrasound biomicroscopy. Ophthalmoscopic examination of the left eye showed a geographic patch of subretinal fluid temporal to the macula that was associated with orange polygonal pigment. The patient underwent periocular injection of triamcinolone acetonide, with resolution of the subretinal fluid. Recurrent fluid was treated successfully with a second injection of triamcinolone., Conclusions and Relevance: Our case of BDUMP appears to be the first to demonstrate multiple iris and ciliary body cysts with high-quality color photography and ultrasound biomicroscopy. Involvement of the anterior uveal tract may be more common than reported in the literature because of its occult nature. Ultrasound biomicroscopy and anterior segment optical coherence tomography may be useful in patients with suspected BDUMP to identify anterior uveal tract involvement.

Purpose: To report on severe HLA B27-associated anterior uveitis complicated by vitritis, hypotony, and serous retinal detachment., Methods: Retrospective case series., Results: Five patients with HLA B27-associated uveitis presented with an acute anterior uveitis complicated by vitritis, hypotony, serous retinal detachment, and ciliochoroidal effusion. Two patients had previously acute anterior uveitis and two suffered from HLA B27-associated systemic disease. Laboratory and imaging examinations did not reveal another cause of uveitis. Despite the aggressive treatment a prolonged and slow recovery followed. Four patients developed macular edema and one additional patient developed a macular pucker. Finally, 3 eyes improved, 2 eyes developed atrophy, and 1 was lost at 4-month follow-up with visual acuity of hand movements., Conclusions: The authors conclude that severe uveitis with a serous retinal detachment might develop in HLA B27-positive patients and may be complicated by protracted hypotony, macular edema, and poor visual outcome.

We present a series of three American Bulldogs with clinical signs of glaucoma and intraocular inflammation accompanied by bilateral uveal cysts and abnormal gonioscopic findings. All dogs proved refractory to medical management and were enucleated. Histopathologic findings were similar in all three and included significant preiridal fibrovascular membranes and mononuclear inflammatory infiltrates in the anterior uvea. On microscopic evaluation, cysts appeared to arise primarily from the ciliary body and iridociliary sulcus, with smaller cysts also budding from the posterior iris. Pigment dispersion was variable but consistent, involving deposition of a small number of pigment-laden cells in the dependent trabecular meshwork. Cataract formation was not noted. Glaucoma associated with uveal cysts has been described previously in Golden Retrievers and Great Danes, although clinical and histopathologic findings in those breeds are not identical to those described here. American Bulldogs with uveal cysts should have gonioscopy performed and should be monitored carefully for signs of increased intraocular pressure and intraocular inflammation. Furthermore, documentation of cyst-associated glaucoma in a third breed suggests clinicians should exercise caution in dismissing uveal cysts in dogs as incidental findings., (© 2012 American College of Veterinary Ophthalmologists.)

The uveal effusion syndrome is a rare disease characterized by serous choroidal detachment. The pathogenesis of idiopathic uveal effusion syndrome has not yet been conclusively established. One hypothesis is an abnormality of diffusion of extravascular proteins in the choroid leading to decompensation of the pigment epithelium pumping capacity. Fluid then accumulates in the subretinal space leading to retinal detachment which results in loss of visual acuity. It typically affects males and hypermetropia is another risk factor. When looking at the fundus a circular serous detachment of the choroid and choroidal puckering is typical. The fluorescein angiography shows hyperfluorescence in the form of a leopard-spot pattern. Space-occupying lesions have to be excluded with the help of ultrasound or magnetic resonance tomography. The uveal effusion syndrome is a diagnosis by exclusion. Treatment varies because of the different hypotheses for the pathogenesis. An intraocular tamponade in combination with laser coagulation may for example be an effective treatment.

Purpose: Neurofibromatosis 1 (NF1) is an autosomal dominant, multisystem disorder that also effects the eye. Herein, we aimed to investigate the posterior iris surface and ciliary body morphology of NF1 patients by ultrasonic biomicroscopy (UB)., Materials & Methods: Nine consecutive unrelated subjects with NF1, and as a control group 25 healthy subjects, were included in the study. All patients underwent ophthalmic examination including visual acuity testing, slit-lamp biomicroscopy, tonometry, gonioscopy (Schaffer classification), and dilated ophthalmoscopy, UB., Results: Mean age was 35.1 ± 16.2 (range, 11-57) and 34.5 ± 15.6 (range, 9-60) for NF1 and control groups respectively (p>0.05). Lisch nodules were present in 16 of 18 eyes (88.8%) in NF1 group. Fundoscopic examination of the control group and 15 eyes of NF1 (83.3%) patients was normal, whereas hypoplastic and tilted optic nerve were present in three eyes, and temporally-located bone-spicule-like lesions was present in one eye of the NF1 group. UB revealed ciliary body cyst in 77.7% (14/18) of the eyes among NF1 group, and 8% (4/50) among control group (p<0.05). The mean size of the cysts were 520 ± 191 μ (range, 220-860 μ) and 495 ± 231 μ (range, 300-830 μ) at NF1 and control groups, respectively. Gonioscopic evaluation revealed that 55% of the NF1 patients have an unoccludable anterior chamber angle (Grade 3 or 4), 45% occludable angle (Grade 1 or 2), and 78% irregular pigment patches. However, occludable angle rate was just 4% in the control group, and none of the patients had irregular pigment patches., Conclusion: The coexistence of ciliary body cysts and NF1, and the effect of these cysts in the eye should be enlightened with further studies.

We present the case of a 41-year-old female patient with acute onset of nyctalopia, xanthopsia and impairment of visual field. The ophthalmologic examination revealed peripheral choroidal elevation with accompanying retinal detachment. Due to the the presence of a nanophthalmic eye without any evidence of inflammation or malignant growth, the diagnosis uveal effusion syndrome could be made.

Purpose: To investigate why myotonic dystrophy type 1 (DM1) patients have low intraocular pressure (IOP)., Design: Prospective, comparative case series., Participants: One hundred two eyes of 51 patients with DM1 (age range, 21-64 years) and 44 eyes of 22 healthy subjects of similar age (21-64 years)., Methods: All participants underwent IOP measurement with Goldmann applanation tonometry and an in vivo examination of the ciliary body with a 35-MHz high-resolution B-scan. The findings were compared between the 2 groups. In both groups, only patients with no history of ocular trauma or surgery were included. The differences were evaluated using the unpaired Student t test., Main Outcome Measurements: Intraocular pressure, central corneal thickness (CCT), and echographic evidence of ciliary body detachment., Results: The mean ± standard deviation (SD) IOP in patients with DM1 was 10.9 ± 3.1 mmHg and that in the control patients was 15.4 ± 2.2 mmHg, a difference that reached significance (P<0.01). The mean ± SD CCT (measured at the pupillary center) was 574.4 ± 37.9 μm in the patients with DM1 and 557.8 ± 39.2 μm in the controls (P = 0.02). Detachment of the ciliary body was identified in all DM1 subjects. Size was variable and the detachment involved 1 or more quadrants. The number of quadrants affected by the detachment was not correlated with the IOP (R(2) = 0.088) or the size of the CTG expansion. No detachments were found in the healthy controls., Conclusions: Detachment of the ciliary body may explain the low IOP values in patients with DM1. The finding of a ciliary body detachment in an individual who has not had recent eye surgery or trauma raises the possibility of a DM1 diagnosis., (Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.)

Case Report: We present a 37 year-old man with secondary angle closure by neuroepithelial ciliary body cysts. An argon laser peripherical iridoplasty was performed and ultrasound biomicroscopy (UBM) was employed to follow-up. Initially, the patient had a favorable response to treatment, but six months later the cysts and the secondary closed angle reappeared., Discussion: Argon laser peripheral iridoplasty has been proposed as treatment of plateau-like iris configuration resulting from neuroepithelial ciliary body cysts. However, the cysts and, the secondary closed angle could recur in a long-term (Arch Soc Esp Oftalmol 2009; 84: 569-572).

This report describes the association of developmental glaucoma with bilateral optic disc pits and uveal effusion. A case of developmental glaucoma (isolated trabeculodysgenesis) presented with bilateral optic disc pits and uveal effusion detected on ultrasound biomicroscopy. Uveal effusion and optic disc pits could be associated with bilateral developmental glaucoma. The constellation of symptoms reported here have not been previously described in the literature and thus merit exploration.

Purpose: To report the changes in corneal topography in 2 cases of ocular hypotony induced by cyclodialysis cleft after blunt trauma, which were successfully treated by argon laser photocoagulation., Methods: For both patients, a full ophthalmic clinical examination and corneal topography were performed before and after argon laser cleft closure., Results: In the first case, the corneal topography showed 3.81-D astigmatism at 96 degrees, which was reduced to 1.1 D at 124 degrees 1 week after treatment and 0.66 D at 122 degrees at 3 weeks after treatment. In the second case, the corneal astigmatism was 3.91 D at 104 degrees, which decreased to 1.44 D at 104 degrees and 0.35 D at 118 degrees at 1 week and 4 months after treatment, respectively., Conclusions: In both cases, the with-the-rule astigmatism reduced significantly after successful closure of the cleft and an increase in intraocular pressure.

Purpose: The aim of this study was to describe the findings of ultrasound biomicroscopy (UBM) in a case with bilateral, multilobulate primary iridociliary cysts presenting as chronic angle-closure glaucoma., History and Signs: An 82-year-old woman was admitted to a tertiary ophthalmological centre for a thorough exploration of the gradual deterioration of her visual fields and optic discs. Clinical evaluation of the patient revealed angle-closure glaucoma and cataract in both eyes. The use of UBM disclosed the presence of bilateral, multilobulate iridociliary cysts in all quadrants. The presence of multiple and bilateral iridociliary cysts was the cause of iris anterior displacement and the subsequent angle closure in this patient., Conclusions: Primary iridociliary cysts may rarely progress to a size that can compromise the angle. They are usually considered as benign and stationary lesions. The advent of UBM is an invaluable tool for the contemporary ophthalmologist in order to set the diagnosis and follow the evolution of those lesions.

Numerous surgical procedures have been proposed to close cyclodialysis clefts. We describe a novel technique, direct cyclopexy under microendoscopic view, in a patient with persistent hypotony despite previous attempts at both surgical repair and cryotherapy for her cyclodialysis cleft.

Purpose: To describe a patient with bilateral diffuse uveal melanocytic proliferation (BDUMP) and cancer-associated retinopathy (CAR)., Design: Interventional case report., Methods: A 66-year-old woman developed progressive vision loss 4 months after total hysterectomy. Ophthalmologic examination, Western blot test of sera and aqueous humor, and immunohistochemistry of carcinoma cells were performed., Results: Testing revealed BDUMP and severe retinal dysfunction. Autoantibodies against recoverin and heat shock cognate protein 70 (hsc 70) were detected in serum. Cytoplasmic immunoreactivity for recoverin and hsc 70 was observed in endometrioid carcinoma cells., Conclusions: Simultaneous cases of BDUMP and CAR are rare. Aberrantly expressed recoverin and hsc 70 triggered serum autoantibody production, which caused photoreceptor degeneration.

Purpose: To measure scleral thickness in patients with and without uveal effusion syndrome using ultrasound biomicroscopy (UBM) and magnetic resonance imaging (MRI)., Design: Prospective case-control study., Methods: UBM was used to measure scleral thickness in five subjects with uveal effusion syndrome and five matched controls. We also used MRI to measure scleral thickness in three subjects., Results: The mean thicknesses for eyes with uveal effusion syndrome versus control eyes were 0.65 +/- 0.08 mm and 0.55 +/- 0.05 mm, respectively (mean difference 0.10, P value = .13). MRI measurements of three subjects showed abnormally thick sclera but were imprecise., Conclusions: UBM can be used to measure scleral thickness, and our results support the finding that patients with uveal effusion syndrome have abnormally thick sclera. Compared with MRI, UBM may be a more accurate and precise method of measuring scleral thickness. UBM can be a useful adjunctive test in the management of uveal effusion syndrome.

Purpose: To report the use of argon laser peripheral iridoplasty in the treatment of plateau-like iris configuration as a result of iris and ciliary body cysts., Design: Case report., Methods: A 43-year-old male with plateau iris syndrome was demonstrated by high frequency ultrasound biomicroscopy (UBM), to have numerous iris and ciliary body cysts. Bilateral argon laser peripheral iridoplasty was performed., Results: Argon laser iridoplasty opened the drainage angle in both eyes., Conclusion: Argon laser iridoplasty is an effective and safe treatment for plateau iris syndrome and may also prove valuable in the treatment of plateau-like iris configuration resulting from iridociliary cysts.

Purpose: In colobomatous eyes, the risk of retinal detachment increases with age. This study elucidates the anatomic conditions and pathologic process of retinal detachment associated with colobomas., Methods: The records, including histologic slides, of 14 children (1 day to 17 months old) and 7 adults (17 to 78 years old) with colobomas were examined., Results: In children, colobomas were associated with lethal malformations. The extracolobomatous inner retinal layers extended centrally, forming the intercalary membrane. Duplication of the outer retinal layers and a horizontal shift of Müllerian glia created a triangle and a locus minoris resistentiae adjacent to the laterally displaced pigment epithelium. Part of the locus was an incomplete layer of photoreceptors excluding Müllerian glia. In adults, atrophy of the intercalary membrane, manifested as central schisis, thinning of the neuroepithelium, and hole formation, was related to a paucity of blood vessels within and underneath the intercalary membrane and the size of colobomas. The margins featured blood vessels, pigment epithelial hypertrophy, and choroidal and scleral thickening in a compact, intertwined arrangement., Conclusions: Glial atrophy, schisis, and hole formation in the intercalary membrane and separation of the locus minoris resistentiae from the pigment epithelium can disrupt barriers to fluid flow and set the stage for rhegmatogenous retinal detachment. That process is exacerbated by scleral ectasia, increasing vitreous traction at the margin, and retinovascular ischemia within the intercalary membrane. A vascularized, compact margin resembling a laser barrier, found predominantly in adults, may protect against retinal detachment.

Serous choroidal detachment is characterized by exudative detachment of the retina and choroid following leakage of fluid from the choriocapillaris into suprachoroidal space. This accumulation of fluid has been known to be a complication of various intraocular surgeries (cataract, glaucoma and retinal detachment surgery), where hypotony is combined with postoperative inflammation. Among other non surgical conditions associated with uveal effusion are idiopathic (uveal effusion syndrome, microphthalmia) and inflammatory diseases (scleritis, sympathic ophthalmia, pars planitis, Harada's disease). Idiopathic serous detachment of choroids is caused by scleral abnormalities associated with hypoplasia or partial absence of the vortex venous system. The most cases of postoperative choroidal detachment resolve spontaneously. Resolution is usually associated with rapid normalization of the intraocular pressure and reduction of intraocular inflammation. The natural course of idiopathic condition is variable but tends to be prolonged with remissions and exacerbations. Surgical management involving vortex vein decompression and/or sclerotomy is the most effective treatment in this patients.

Purpose: We describe a 39-year-old Japanese woman with chronic angle closure glaucoma secondary to spherophakia and frail zonular fibres. The patient was 143 cm in height with short fingers and had no family history of eye problems. High intraocular pressure, total optic disc cupping and severe visual field constriction were found in the right eye., Methods: The patient was treated successfully with trabeculectomy in the right eye and laser iridotomy in the left eye., Conclusion: The clinical findings imply that this was a borderline case of Weil-Marchesani syndrome.

Objective: To report the occurrence of angle-closure glaucoma in 2 teenagers., Design: Observational case reports, review of literature., Methods: Review of case histories, examinations, biometries, visual fields, and ultrasound biomicroscopy findings in 2 teenagers with angle-closure glaucoma., Main Outcome Measures: Intraocular pressure, gonioscopy, Humphrey 24-2 visual field (SITA Standard), and ultrasound biomicroscopy., Results: The first case involved a 15-year-old white male who presented with an intraocular pressure of 60 mm Hg in the right eye and 24 mm Hg in the left eye and 360-degree appositional closure in both eyes. Ultrasound biomicroscopy revealed prominent bilateral ciliary pigment epithelial cysts pushing the iris anteriorly towards the angle. The second case involved a 14-year-old white male with a strong family history of primary angle-closure glaucoma. The patient had pupillary block and an intraocular pressure of 24 mm Hg in the right eye and 40 mm Hg in the left eye on routine eye examination. Gonioscopy and ultrasound biomicroscopy revealed appositional closure of the angle in all 4 quadrants bilaterally., Conclusion: Primary angle-closure glaucoma is uncommon in younger individuals. Therefore, the finding of angle-closure glaucoma in a young individual should alert the physician to the possibility of a secondary cause of angle closure, such as iris pigment epithelial cysts. In addition, special attention to family history is important as the configuration of an occludable anterior chamber angle may, in some instances, be inherited.

We report two cases clinically diagnosed as idiopathic uveal effusion syndrome, where indocyanine green angiogram suggest non-specific choroidal inflammation as the underlying cause. Treatment with non-steroidal anti-inflammatory drugs was beneficial.

Background: Juvenile xanthogranuloma is a rare non-Langerhans cell histiocytosis that could occasionally produce diffuse systemic disease in young children, but associated posterior uveal lesions are very uncommon., Methods: Case report of an 8-month-old boy with macrocephaly who presented with chronic subdural haematoma and intracranial hypertension. A combination of nodular skin lesions and bilateral yellowish choroidal infiltration with limited retinal involvement suggested juvenile xanthogranuloma., Results: The diagnosis was confirmed by a skin biopsy, and oral corticosteroid therapy was introduced. Progression of the disease to involve an anterior uveitis with hypopyon and numerous other systemic lesions, including the central nervous system, lung, liver, spleen, kidney and testis, was also suggestive of Letterer-Siwe disease. Histiocytes were negative for Langerhans cell markers (S-100 and CD1a) and positive for macrophage marker (CD68). Electron microscopy failed to show Birbeck granules. Ocular lesions regressed under prolonged corticosteroid treatment, but resurgence of the other lesions required chemotherapy with vinblastine., Conclusion: In this atypical systemic variant of juvenile xanthogranuloma with bilateral uveal involvement, the immunohistochemical and ultrastructural findings were crucial in distinguishing juvenile xanthogranuloma from Langerhans cell histiocytosis.

Purpose: To report a case of vitreous hemorrhage from ciliary granuloma in Wegener granulomatosis., Methods: Interventional case report. An 18-year-old woman with Wegener granulomatosis and episcleral granuloma in her LE had ultrasound biomicroscopy findings of a mass in the pars plana of the ciliary body in the meridian corresponding to the episcleral granuloma., Results: The patient underwent vitrectomy in the LE for subsequent vitreous hemorrhage. Intraoperatively, the mass was diagnosed as a ciliary granuloma at the pars plana. Dense blood clotting around the ciliary granuloma and subretinal exudation at the ora serrata were observed, with no other changes causative for the vitreous hemorrhage., Conclusions: We report a case of vitreous hemorrhage associated with a ciliary granuloma that was revealed by ultrasound biomicroscopy. Careful observation is necessary in eyes with persistent inflammation in Wegener granulomatosis.