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The present study deals with the retinal vascular involvement in 64 patients with toxoplasmic retinochoroiditis during the acute phase of the disease and its evolution. Vascular involvement was noted in all 64 eyes during the acute phase of the disease. In 59 (92%) out of 64 cases the vascular involvement was located in the same retinal quadrant as the active toxoplasmic lesion. In the remaining 5 eyes (8%) the vascular participation was found in all four retinal quadrants. In 3 (5%) out of 64 cases, the vascular infiltration was extremely severe and resulted in retinal vascular obstruction. In all three cases the vessel traversed the active toxoplasmic lesion. In 35 (55%) out of 64 patients the initial vascular picture changed in the course of the acute phase of the disease. In these patients, the lesions had extended to the adjacent vessels or to other parts of the involved vessel. In the further course of the evolution of the active toxoplasmic lesion, the vascular involvement did not persist indiscriminately. It was noted that in 14 (22%) out of 64 cases the vascular lesions gradually regressed and eventually disappeared together with the active toxoplasmic lesion and the formation of the retinochoroidal scar. In the remaining 50 (78%) out of 64 cases the vascular involvement either disappeared after the establishment of the retinochoroidal scar in 3-12 months (29 cases) or remained permanently (21 cases).

Just before inclusion in the study, each patient underwent ophthalmic assessment of both eyes; it included best corrected Snellen visual acuity, biomicroscopy, and applanation tonometry (baseline IOP). One hour before laser capsulotomy patients received orally either 125 mg of acetazolamide sodium (28 patients) or placebo (26 patients) in a randomised, double-masked fashion. IOPs were measured before capsulotomy, and at 1, 3, and 24 hours after capsulotomy.All posterior capsulotomies were performed by one of the authors (IDL), after topical anaesthesia with one drop of 0 5% proparacaine hydrochloride. A Peyman wide field YAG laser contact lens was used in each case.Before capsulotomy the eyes of all patients were dilated with one drop of a mixture of 5% phenylephrine and 1% tropicamide. We used a Q-switched Nd-YAG laser (Pegasus 3002, Rodenstock) with the Nd-YAG laser beam retrofocused approximately 0 3 mm behind the helium-neon beam focused on the capsule. A single application technique was used and the burst mode was not employed. Our intention was to create a 3-4 mm diameter opening in the centre of the opacified capsule using the least amount of total laser energy.After the capsulotomy, all eyes received one drop of 0 1% dexamethasone sodium phosphate three times daily for 3 days. No additional medical therapy was given to any patient for a period of 24 hours, unless the measured IOP was greater than 35 mm Hg. If the IOP exceeded 35 mm Hg, the patient was treated with one drop 0-5% timolol maleate twice daily and 250 mg of oral acetazolamide four times daily. The patient was then observed until the IOP decreased to below 25 mm Hg.Numerical data were recorded as mean (SD). Statistical significance for data comparison between patient groups was analysed using analysis of variance or XI analysis; p values of less than 0-01 were considered significant.

No abstract

Although the chorioretinal damage produced by PDT is minimal, it is enough to create, directly or indirectly, the basis for the formation of a lacquer crack in an eye with pathologic myopia.