Two sisters with macular dystrophy caused by the 3243A>G mitochondrial DNA mutation

CASE REPORT

Two sisters of 54 and 60years old, with a history of diabetes and deafness, consulted for decreased visual acuity (VA). Funduscopic examination revealed patchy areas of chorioretinal atrophy with annular arrangement around the fovea. Genetic study identified the heteroplasmic mutation 3243A>G in mitochondrial DNA, which supports syndrome maternally inherited diabetes and deafness (MIDD) or Ballinger-Wallace disease.

DISCUSSION

The finding of such macular disorders, especially in the presence of diabetes mellitus and deafness, should suggest the performing of a mitochondrial genome screening to identify this unusual syndrome.

[Atypical presentation of lacrimal gland pleomorphic adenoma with necrotic foci]

CLINICAL CASE

The case is presented of 48 year-old male complaining of a painful left upper eyelid and swelling of the lacrimal gland, with a suspicion of dacryoadenitis. Removal was decided after dacriops suspicion. Histopathology diagnosed a pleomorphic adenoma of the lacrimal gland, with areas of necrosis.

DISCUSSION

Lacrimal gland pleomorphic adenoma usually presents as a slowly progressive painless mass. However, painful presentation in this case might be related with necrotic foci found in the histopathological examination. Although not described in lacrimal glands, pleomorphic adenomas have already been reported in the major and minor salivary glands, and these patients also presented with a painful mass.

[Recurrent neurosensory macular detachment in carotid-cavernous fistula]

CASE REPORT

A 46 year-old man was seen in the emergency department complaining of vision loss and exophthalmos in his right eye. He also complained of headache, diplopia of 4 months onset, and neurosensory detachment that resolved spontaneously the month before. The study revealed tortuous conjunctival and episcleral vessels and neurosensory macular detachment in his right eye. A carotid-cavernous fistula was confirmed by computed tomography angiography. The fistula closed spontaneously during the hospitalization. One month later, the neurosensory detachment disappeared again.

DISCUSSION

Carotid-cavernous fistula should be included in the differential diagnosis of neurosensory macular detachments. These neurosensory detachments can resolve spontaneously 11 the fistula is closed.