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PURPOSE: To present a rare case of central retinal vein occlusion in conjunction with the HELLP syndrome. METHODS: A 30-year-old woman presented in the 28th week of her second pregnancy with severe pre-eclampsia with HELLP syndrome; delivery by caesarean section was recommended. Ten days later, the patient complained of severely decreased visual acuity in her right eye. RESULTS: Ophthalmoscopy revealed a central retinal vein occlusion with venous engorgement and tortuosity, multiple flame hemorrhages, and disc and macular edema. Electroretinography revealed a reduction of b-wave/a-wave ratio. Fluorescein-angiography showed a blockage due to extensive retinal hemorrhages with late mild staining of the walls of veins. The patient presented a spontaneous improvement in visual acuity (0.8 two months after) and a complete resolution of ophthalmoscopic findings. CONCLUSION: Ophthalmic complications are possible during and soon after this syndrome. This is the first description of a patient suffering a central retinal vein occlusion during puerperium after the HELLP syndrome.

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BACKGROUND: The use of pneumatic retinopexy is controversial because 1) intraocular gas could increase the risk of proliferate vitreoretinopathy and 2) it has been reported to achieve low rates of success after a single procedure. METHODS: A total of 219 consecutive cases of SF6 pneumatic retinopexy were reviewed retrospectively. The follow-up period ranged from 2 to 5 years. RESULTS: A total of 179 (81.73%) of 219 eyes were treated successfully with a single procedure. The success rate increased with reoperations to 98.89%. Preoperative factors related to primary failure or redetachment were aphakia or pseudophakia (P = 0.0058) and breaks localized on horizontal meridia (P = 0.0305). Cryopexy was significantly associated with failure (P = 0.0007). A total of 31.05% of eyes showed early complications. The most frequent incidence was delay in subretinal fluid reabsorption (36.76%), followed by new breaks (26.47%). Late complications were observed in 6.84% of the eyes (six eyes with macular pucker, three with new retinal detachments, three with cataracts, and three with new breaks without detachment). CONCLUSIONS: Failures of pneumatic retinopexy were related to lens status, localization of the break, and cryopexy. The occurrence of early and late complications was similar to that in other procedures.

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PURPOSE: To investigate the demographic characteristics, clinical findings and long-term outcome of central serous chorioretinopathy (CSC). METHODS: This study examined retrospectively the clinical stories and fluorescein angiographies of 113 patients with CSC and a minimum follow-up of 12 months. RESULTS: A total of 113 patients was examined; 90 were men and 23 women. Bilateral involvement was found in 13 cases. In 85.7% of the eyes (Group I) resolution was completed in months and mean final visual acuity (VA) was 79.3/100, while 14.3% of the eyes (Group II) showed a chronic evolution, with diffuse retinal pigment epithelipathy and mean final VA of 47.2/100. The mean age of the patients in Group II was significantly higher; male:female ratio was also higher in this Group. Bilateral involvement occurred in 6% of patients from Group I and in 46.6% in Group II. CONCLUSIONS: Chronic CSC affected less than 15% of the patients. Mean age in this group of patients was higher than in patients with a classic CSC, most of the cases were men, bilateral involvement was present in nearly 50% of the cases and 50% of them suffered a significant visual permanent impairment.

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BACKGROUND: A case of mixed carcinoma of the parotid gland (an epidermoid carcinoma located in a pleomorphic adenoma) metastatic to the choroid is presented. The histopathology of the tumor is discussed. METHODS: A 65-year-old man was admitted complaining of blurred vision in his right eye for 1 day. He underwent parotidectomy for mixed carcinoma of the parotid gland (an epidermoid carcinoma located in a pleomorphic adenoma that was completely excised) 6 months before. Funduscopic examination showed a nasal retinal detachment, with gray-whitish, minimally elevated nodular choroidal lesions. Fluorescein angiography and contact B-scan ultrasonography confirmed the presence of an underlying mass. RESULTS: The right eye was enucleated and an epidermoid infiltrating carcinoma was identified. CONCLUSIONS: Metastatic tumors are the most common intraocular malignancies, and the choroid is by far the most common location for intraocular metastases. There are few cases reported of parotid tumors metastatic to the orbit. To the best of our knowledge, no histological examination of an ocular metastatic mixed carcinoma of the parotid gland has yet been reported.

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The ophthalmology radioactive phosphorus uptake test has been utilized in the differential diagnosis of intra ocular lesions in 21 patients. In the majority of the cases the diagnosis was histologically confirmed. When the lesion is located in the anterior part of the globe, it is not necessary to make an incision of the conjunctiva to perform the test. If the lesion is located in the posterior segment, the test is performed by the transscleral route, with surgical incision of the conjunctiva and with indirect ophthalmoscopy control when possible. In 3 patients with choroidal hemangioma were results false-positives, observed with inferior P32 uptake to that in patients with choroidal melanomas. One false-negative result was obtained in a patient with a clinical diagnosis of uveal malignant melanoma, histologically confirmed after enucleation of the globe. In all others patients with uveal malignant melanoma results were highly positive.

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