1/244. Peripheral choriovitreal neovascularization in proliferative diabetic retinopathy: histopathologic and ultrastructural study.We describe the histopathologic and ultrastructural evidence of choriovitreal neovascularization in the peripheral fundus of a non-vitrectomized eye with proliferative diabetic retinopathy (PDR). One eye with PDR was surgically enucleated because of neovascular glaucoma and studied with light and electron microscopy. The eye had neovascular membranes at the ora serrata of the peripheral fundus. The newly formed vessels originated from the choroid, passed through Bruch's membrane and the retina, and extended into the vitreous. These vessels had either developing or mature characteristics. The endothelial cells of the developing vessels contained a bulky cytoplasm with many intracytoplasmic filaments, ribosomes and rough endoplasmic reticulum. Budding endothelial cells were frequently found in the developing vessels. The endothelial cells of the mature vessels had attenuated cytoplasm and fenestrations with diaphragms. These observations suggest that choriovitreal neovascularization in the peripheral fundus is one of the features of PDR.- - - - - - - - - - ranking = 1keywords = retinopathy (Clic here for more details about this article) |
2/244. Providing timely and ongoing vision rehabilitation services for the diabetic patient with irreversible vision loss from diabetic retinopathy.BACKGROUND: diabetic retinopathy (DR) remains the leading contributor to severe vision loss in the united states among persons 20 to 70 years of age. Despite advances in disease management and treatment, patients with vision loss from DR continue to constitute a significant portion of patients served in vision rehabilitation service (VRS) settings. These patients present special challenges to VRS providers because of early onset, fluctuations in and the complex nature of vision loss, unique visual demands of disease management, and associated multi-system losses. case reports: After introductory epidemiologic review, a case presentation format is used to illustrate solutions a multidisciplinary VRS can offer the special visual challenges of the person with diabetes with vision loss from DR. Four patients are presented--ages 30 to 70 years--with varying degrees and types of vision loss, with different lifestyle demands and disease management needs. The cases address vocational issues, vision fluctuation, coordinating adaptive solutions to complex visual losses, and meeting diabetic needs to measure medication, insulin, and blood glucose levels, to maintain skin care, diet, exercise, transportation, family roles, and support systems. CONCLUSIONS: The unique and complex needs of people with diabetes who experience vision loss can be well addressed through timely and ongoing VRS consultations, in conjunction with medical/ocular disease management.- - - - - - - - - - ranking = 1keywords = retinopathy (Clic here for more details about this article) |
3/244. Preservation of vision through Weiss ring after dense vitreous hemorrhage.PURPOSE: To report an unusual case of retained vision through a Weiss ring in the setting of dense vitreous hemorrhage. METHOD: Case report of a 55-year-old woman with a 23-year history of type 1 diabetes mellitus who presented with new onset of blurred vision in the left eye as a result of a dense vitreous hemorrhage. RESULTS: The patient had received full scatter laser photocoagulation for proliferative diabetic retinopathy in the right eye several years earlier and reported previous resolving episodes of vitreous hemorrhage in the left eye. Best-corrected visual acuity in the left eye was hand motions at 3 feet. However, with careful head positioning visual acuity improved to 20/40 through a small clear central island. Examination of the left fundus showed a dense vitreous hemorrhage with a clear, mobile opening in the posterior hyaloid corresponding to the Weiss ring. The retina could be partially visualized only through the area of the Weiss ring. CONCLUSIONS: This unusual case demonstrates the anatomical relationship between the posterior hyaloid and Weiss ring.- - - - - - - - - - ranking = 0.2keywords = retinopathy (Clic here for more details about this article) |
4/244. Treatment of severe proliferative retinopathy and diabetic maculopathy.Strict blood glucose control, early detection and surveillance of diabetic retinopathy by means of validated screening programmes, and judicious use of laser photocoagulation can greatly reduce the risk of visual loss in diabetes. Some patients however, have aggressive neovascular disease resistant to laser treatment, or present at a late stage with advanced fibroproliferative disease, and may progress rapidly to blindness. In the elderly with Type 2 disease, diabetic maculopathy is more common and requires a different therapeutic approach. The present article describes two diabetic patients and discusses the management of patients with severe proliferative retinopathy or diabetic maculopathy.- - - - - - - - - - ranking = 1.2keywords = retinopathy (Clic here for more details about this article) |
5/244. Reduced expression of the adherens junction protein cadherin-5 in a diabetic retina.PURPOSE: Transvascular leakage occurs in diabetic retinopathy. The tight junction proteins occludin and zonula occludens-1 (ZO-1) and adherens junction protein cadherin-5 are critical to the maintenance of endothelial barrier. We report a comparison of junction protein expression in the normal and diabetic retina. METHOD: Case report. Postmortem retinal cryosections were prepared from the left eye of a 73-year-old woman with diabetic retinopathy. Cryosections were immunostained for cadherin-5, occludin, and ZO-1 and compared with retinal cryosections from the right eye of a 72-year-old man with no progression of retinal disease. RESULTS: Immunofluorescence showed positive retinal vessel staining for occludin and ZO-1 in both eyes and cadherin-5 in the normal eye but reduced cadherin-5 staining in the retinal vessels of the diabetic eye. CONCLUSION: Increases in transvascular leakage observed in diabetic retinal vasculature may be associated with reduction in the expression of the critical adherens junction protein, cadherin-5.- - - - - - - - - - ranking = 0.4keywords = retinopathy (Clic here for more details about this article) |
6/244. Ultrasound biomicroscopy for examination of the sclerotomy site in eyes with proliferative diabetic retinopathy after vitrectomy.PURPOSE: We evaluated the capability of ultrasound biomicroscopy (UBM) to predict fibrovascular proliferation at sclerotomy sites in eyes with postoperative vitreous hemorrhage due to proliferative diabetic retinopathy (PDR). methods: Ultrasound biomicroscopy was used for examining the sclerotomy sites in 13 eyes of 11 patients with PDR experiencing postoperative vitreous hemorrhage (PDR group). Thirty-nine sclerotomy sites (all entry sites of each eye) were examined before reoperation, and the UBM images were compared with findings obtained during revision of the vitrectomy. Thirteen eyes of 13 patients undergoing vitrectomy for nondiabetic diseases were used as controls and examined after vitrectomy. RESULTS: The UBM images were classified into the following four categories: A, tent; B, spheroid; C, trapezoid; and N, none. The findings were distributed as follows in the PDR group: category A, 18%; B, 5%; C, 56%; and N, 21 %; and as follows in the control group: category A, 28%; B, 5%; C, 5%; and N, 62%. In the PDR group, 11 of 12 sclerotomy sites disclosing fibrovascular proliferation possessed the trapezoidal image. Mean length of trapezoidal base was 2.49 /-0.97 mm and 1.51 /-0.75 mm in the groups with and without fibrovascular proliferation, respectively (P<0.01). The average relative reflectivity of the trapezoidal image against the sclera was 0.501 /-0.169 in the fibrovascular proliferation group and 0.891 /-0.183 in the fibrous ingrowth group (P<0.01). CONCLUSION: Ultrasound biomicroscopy is useful in detecting fibrovascular proliferation at sclerotomy sites because a large and low-reflecting trapezoidal UBM image is highly correlated to its presence.- - - - - - - - - - ranking = 1keywords = retinopathy (Clic here for more details about this article) |
7/244. Improved retinal capillary perfusion following treatment of severe proliferative diabetic retinopathy.The authors report a photodocumented case of improved retinal capillary perfusion accompanied by visual acuity improvement after treatment of severe proliferative diabetic retinopathy.- - - - - - - - - - ranking = 1keywords = retinopathy (Clic here for more details about this article) |
8/244. Difficult therapeutic decisions in the management of diabetic retinopathy.Management decisions for patients with diabetic eye disease can remain difficult despite the presence of guidelines. The cases below illustrate the dilemmas about the timing of instituting insulin in patients needing laser photocoagulation for improvement of glycaemic control. The use of angiotensin-converting enzyme inhibitors for diabetic eye disease is also discussed.- - - - - - - - - - ranking = 0.8keywords = retinopathy (Clic here for more details about this article) |
9/244. qi-promoting and phlegm-resolving method for treatment of diabetic microvascular complications.OBJECTIVE: To evaluate the effects of qi-promoting and phlegm-resolving approach in treatment of diabetic microvascular complications. METHODOLOGY: Clinical observation of cases given modified Wen Dan Tang ([symbol: see text] gallbladder-warming Decoction). RESULT: Favorable results obtained in cases of diabetic microvascular complications of the type of stagnancy of qi and phlegm (diabetic retinopathy, diabetic nephropathy and diabetic foot). CONCLUSION: Wen Dan Tang is effective for diabetic microvascular complications of the type of stagnancy of qi and phlegm.- - - - - - - - - - ranking = 0.2keywords = retinopathy (Clic here for more details about this article) |
10/244. Rapid onset retinopathy in a diabetic patient following bone marrow transplantation.We report a 38-year-old man who presented in 1998 with advanced multiple myeloma and newly diagnosed diabetes mellitus (DM). Subsequent BMT has been successful after conditioning with melphalan and total body irradiation, but significant ischaemic retinopathy has developed. Chemotherapeutic agents, total body irradiation, and DM are likely to have been co-factors in precipitating the rapid onset of retinopathy. Routine ophthalmic surveillance is recommended for all patients after BMT, particularly for those with additional risk factors for the development of retinopathy such as DM.- - - - - - - - - - ranking = 1.4keywords = retinopathy (Clic here for more details about this article) |
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