We examined fundus photographs of 5,789 patients (11,578 eyes) and found 39 patches of myelinated nerve fibers in 35 eyes of 33 patients. The prevalence was 0.57%. The lesion was more frequent in females than in males. The patch occurred more often at the superior sectors of the nerve head and in the inferotemporal retina than in other areas. No myelinated nerve fibers were discovered in the macula. One patient (case 1) had 3 patches in 1 eye. Two patients (cases 2 and 3) had unilateral myelinated nerve fibers, bilateral myopia and ipsilateral amblyopia. In case 3, the patch was associated with an epiretinal membrane. Another patient (case 4) had branch vein occlusion and neovascularization from the patch of myelinated nerve fibers. The fundus conditions observed in our cases 1–4 may be uncommon.

The temporal inverted internal limiting membrane flap technique, which is a simple surgical strategy to treat macular holes, provides scaffolding for retinal gliosis and may facilitate bridge formation between the walls of the macular hole beneath the flap. The procedure may be a good option to achieve macular hole closure without postoperative prone positioning.

ABSTRACT. A 33-year-old Japanese woman had bilateral eyelid swelling and soft tumor of the right orbit. Increased serum IgE and eosinophilia in the peripheral blood was observed. Magnetic resonance imaging of the lesion showed hypointense orbital fat on T1-weighted image and isointense orbital fat on T2-weighted image. Gd-DTPA T1-weighted images demonstrated marked enhancement. The histopathological appearance of the tumor was consistent with Kimura's disease. On a regimen of 60 mg of prednisone per day, the orbital mass reduced in size. A review of the recent literature indicated that corticosteroids rather than surgery might be tried at least initially as treatment.

A 72-year-old female complained of acute pain on left eye movement followed by progressive exophthalmos. Neuroimaging revealed a large well-demarcated lesion consisting of solid and cystic parts, as well as bone destruction and hemorrhage, within the left orbital cavity. The preoperative diagnosis was pleomorphic adenoma with or without malignant transformation, or cavernous angioma. En bloc excision including adjacent tissues was planned to resolve the progressive symptoms and to obtain a histological diagnosis. The transcranial route was chosen since tumor invasion to the cranial base was possible. The histological diagnosis was pleomorphic adenoma. Pathological and preoperative radiological examinations indicated that repeated intratumoral hemorrhage had caused the orbital bone destruction and acute orbital pain. Neoplasms should be differentiated from a wide spectrum of other possible pathologies. Accurate clinical diagnosis of neoplasm in the orbital cavity is important for correct therapeutic management. Malignancy is generally suspected if painful and progressive signs and symptoms are associated with an orbital mass lesion. The present case suggests that pleomorphic adenoma should also be considered in the differential diagnosis. The therapeutic strategy for lacrimal gland tumors remains controversial, so a flexible management approach is required.

ABSTRACT.Purpose: To clarify the prevalence and clinical profile of neuroretinitis associated with cat-scratch disease (CSD) in Japan. Methods: Japanese patients were searched using a computer web site, Japana Centra Revuo Medicina. Location of patients, medical history, systemic and intraocular findings, treatments and visual outcome were examined. Results: We reviewed 15 eyes of 14 patients, including our own case. Incidences of the disease were more common in summer than in winter and presented in the warmer parts of Japan. All patients had been previously healthy and had been exposed to cats or flea bites. Of the 14 patients, 13 (93%) had febrile illness and seven of these (54%) had lymphadenopathy. Uveitis and macular stars were observed in 11 of 15 eyes (73%). Most patients were treated with antibiotics and systemic steroids and visual prognoses were good. Conclusions: The clinical features of CSD-associated neuroretinitis in Japan are similar to those in other countries. Its distribution may correlate with the prevalence of Bartonella henselae-seropositive cats in Japan.