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PURPOSE: Hypofluorescent spots were seen in indocyanine green (ICG) angiography of peau d'orange fundus in eyes with angioid streaks. Origin of the hypofluorescent spots were examined with attention to their correlation with a peau d'orange appearance of the central fundus using a computer-assisted image comparison system. METHODS: ICG angiography was performed in 5 patients having peau d'orange appearance of fundus using a scanning laser ophthalmoscope (SLO) and a digital video-fundus camera. The same central fundus areas corresponding to hypofluorescent spots in an ICG angiogram were then digitally identified in a fluorescein angiogram and in a red-free picture in all 10 eyes of the 5 patients. Monochromatic light observation was also performed with a dark field observation using an SLO to see subretinal or intrachoroidal pigment clumping. RESULTS: In no patient, the areas identified with hypofluorescent spots did show relevant changes in fluorescein angiogram or red-free picture. SLO examination revealed no perfusion defect at the same areas. The dark field observation showed no pigment clumping at the peripapillary and papillomacular bundle regions where hypofluorescent spots were seen. CONCLUSIONS: Hypofluorescent spots seen in ICG angiograms did not show exact consistency with peau d'orange changes in their location and shape. Perfusion defects or blocking by pigments were not a cause of hypofluorescent spots. The scattered hypofluorescent spots were considered to be relevant with irregular affinity of the fundus to ICG dye.

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In 43 men who required further examination of erectile function, we analyzed the relationship between the various factors including hormone levels, penile blood pressure index (PBPI), shape of the arterial wave, erection period after prostaglandin E1 injection and dynamic cavernosography/metry, as well as the patterns of nocturnal penile tumescence (NPT) with rigidity. Normal, dissociation, short episode, low amplitude and flat trace patterns, which were classified by Kaneko, were observed in 11, 8, 11, 2 and 11 men, respectively. Uncoupling was not observed in any men. There were no differences in the levels of prolactin and LH among the 6 patterns. A high FSH level was seen in men with a flat trace pattern; a low level of free testosterone ( < 12.2 pg/ml) was seen in men with dissociation, low amplitude and flat trace patterns, and low PBPI ( < 0.75) in men with flat trace pattern; and an arteriosclerotic shape of the arterial wave was seen in men with short episode and flat trace patterns. Each erection period immediately after prostaglandin E1 injection in men with dissociation, short episode, low amplitude and flat trace was shorter compared with cases with a normal pattern. Venoocclusive dysfunction was observed in 5 men with a dissociation pattern and 6 men with a flat trace pattern. In conclusion, an integral analysis of pattern of NPT with rigidity and other examinations are useful for differentiating organic impotence from psychogenic impotence and for accurately diagnosing pathophysiological disorders of organic impotence and underlying diseases.

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Fenestration of the choriocapillaris may be lost and regained in various pathologic conditions. The purpose of this study was to observe the gradual disappearance of fenestrae with the scanning electron microscope. Pigmented rats were treated with an intravenous injection of sodium iodate. Changes in the choriocapillaris were produced by damaging retinal pigment epithelium. The eyes were processed for styrene embedded cracking on the third, fifth, and seventh days. Dense clusters of fenestrae were seen at the luminal surface facing retina on the third day. These clusters were surrounded by protrusion of cellular surface. The clusters of fenestrae were smaller with some variation in size on the fifth and seventh days. The protrusion between the clusters became flatter and wider. Some endothelial cells had a flat surface with tiny clusters of fenestrae. Although there was loss of fenestrae with smaller clusters and some variation in size, the tendency of the fenestrae to cluster was sustained in the same way as during the reformation of fenestrae in the choriocapillaris after laser photocoagulation.

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A neonatal pneumonia caused by Chlamydia trachomatis (C. trachomatis) is well-known. But it is uncertain whether C. trachomatis causes pneumonia in a patient over 1 year of age. Therefore, a search for serologic and cultural evidence of C. trachomatis infection in patients suffering from acute pneumonia over 1 year of age was made. We studied 183 children ages 1 to 5 year-old suffering from acute pneumonia admitted to Kousei General Hospital to assess the relation between acute pneumonia and C. trachomatis. We investigated the serologic evidence of acute C. trachomatis infections in 73 children with a persistent cough and wheezing, detecting specific IgG antibodies and IgM antibodies by microimmunofluorescence test. Serologic results signifying acute infection were observed in 4 cases (2.2%). Then we tried to isolate C. trachomatis from the cultures of nasopharyngeal swabs, specific inclusion bodies of C. trachomatis in 2 cases (1.1%) were found. Our study suggests that C. trachomatis might cause pneumonia in children over 1 year of age.

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Interferon-alpha was effective for the treatment of retinal vasculitis and vitreous opacity in a patient with human T-lymphotropic virus type I associated myelopathy (HAM). The patient was a 40-year-old male with retinal vasculitis, vitreous opacity and Koeppe's iris nodules. Systemic administration of corticosteroid hormone was not fully effective for the treatment of ocular involvements except for iris nodules. After Interferon-alpha treatment, given 3 million IU/day as the intramuscular injection for 4 weeks, the retinal vasculitis subsided and vitreous opacity disappeared.

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