1/42. Successful treatment of acute subretinal hemorrhage in age-related macular degeneration by combined intravitreal injection of recombinant tissue plasminogen activator and gas.Subretinal hemorrhage secondary to age-related macular degeneration (AMD) has a poor visual prognosis. Surgical drainage of the blood improves visual acuity only in selected patients. We report on two elderly patients with spontaneous subretinal hemorrhage from AMD. In one eye, recombinant tissue plasminogen activator (rTPA), combined with a long-acting gas (SF6), was injected into the vitreous cavity. The other eye was treated first by gas instillation followed 3 days later by rTPA injection. Both treatments led to nearly complete displacement of the subretinal hemorrhage from the macular region. In both eyes, an inferior exudative retinal detachment reabsorbed spontaneously within 2 weeks. Bilateral vitreous opacities after rTPA injection resolved without further treatment. Postoperative visual acuity increased to 0.3 and 0.4. The combined treatment is a valuable method for management of acute subretinal hemorrhage. Rapid displacement of this abnormality can minimize clot-induced damage of the highly sensitive macula and increase visual acuity.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/42. A case of presumed ocular toxocariasis in a 28-year old woman.This is a case of presumed ocular toxocariasis in a 28-year old woman complaining of a sudden onset of nasal side field defect of the right eye. The patient had been suffering from uveitis for ten months. Fundoscopic examination of the right eye showed a rhegmatogenous retinal detachment. Furthermore, a retinochoroidal granulomatous lesion was observed nearby the tear site. scleral buckling, cryotherapy, and gas injection(SF6, pure gas, 0.7 cc) were conducted. mebendazole was prescribed for one month at 25 mg/kg per body weight daily. Even though the interventions resulted in the recovery of the field defect, anti-toxocara IgG and IgE titer levels did not decrease when checked three months after the treatment ended. This is the first confirmed serological ocular toxocariasis case in korea. uveitis may be a clinical presentation prior to retinal detachment of a person with toxocariasis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/42. Serous retinal detachment in patients under systemic corticosteroid treatment.PURPOSE: To understand the pathophysiology of central serous chorioretinopathy or bullous retinal detachment in patients under systemic corticosteroid treatment. Little is understood about the mechanism of the development of serous retinal detachment. methods: Three patients who had developed central serous chorioretinopathy or bullous retinal detachment during systemic corticosteroid administration were examined by fluorescein angiography and indocyanine green angiography. RESULTS: indocyanine green angiography revealed dilated choroidal veins, delayed choroidal filling, intrachoroidal hyperfluorescence, and patchy hypofluorescence at or near the sites of dye leakage examined by fluorescein angiography. CONCLUSIONS: The primary change caused by central serous chorioretinopathy is thought to occur in the choroid, followed by the breakdown of the outer blood-retinal barrier in the pigment epithelium, resulting in the development of serous retinal detachment.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/42. Retinal hemorrhages in posterior vitreous detachment.Detachment of the posterior vitreous can cause clinically significant retinal hemorrhage. Two patients with acute posterior vitreous detachment had massive retinal hemorrhages overlying the optic disks. These absorbed in time without sequealae. A third patient had numerous small blot hemorrhages scattered near the optic disk and macula. A fourth patient presented with a small macular hemorrhage causing temporary visual loss. All patients had moderately severe myopia and were in good health without hypertension or diabetes. There was no history of trauma or valsalva maneuver. Hematologic and coagulation studies were normal. These cases indicate that retinal hemorrhages due to posterior vitreous detachment may be strikingly large, multiple, and, when involving the macula, cause temporary visual loss.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/42. Endoillumination-assisted cataract surgery in a patient with corneal opacity.We present a technique to better visualize cataracts through corneal opacity. A 70-year-old Japanese woman with retinal detachment, cataract, and corneal opacity in the left eye was treated with phacoemulsification, 3-port vitrectomy, and intraocular lens implantation. To circumvent the difficulty of performing continuous curvilinear capsulorhexis (CCC) and subsequent cataract surgery through a hazy cornea, we used an endoilluminator as a light source outside the cornea for CCC and inside the anterior chamber for phacoemulsification. As a result, CCC and subsequent cataract surgery were successfully and easily performed despite potentially troublesome corneal opacity. The use of an endoilluminator can be an effective supportive measure for cataract surgery in patients with corneal opacity.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/42. Massive epithelium-lined inclusion cysts after scleral buckling.Two patients with massive epithelium-lined inclusion cysts of the orbit became symptomatic five and 16 years after scleral buckling. Each patient described diplopia and displacement of the previously treated eye. An orbitotomy in the first patient disclosed a loculated epithelium-lined inclusion cyst that extended posteriorly from the insertion of the inferior rectus muscle nearly to the apex of the orbit. In the second patient, a loculated epithelium-lined inclusion cyst extended into the superior nasal portion of the orbit from its origin near the insertions of the superior and medial recti muscles. We speculated that epithelial cells of the conjunctiva were shed at the time of scleral buckling and became lodged in the exposed sulcus created by the surgical retraction of Tenon's capsule. Here they proliferated and formed the large epithelium-lined cysts. In each patient, removal of the cyst was followed by a decrease in diplopia as the displaced globe returned toward its normal position.- - - - - - - - - - ranking = 2keywords = near (Clic here for more details about this article) |
7/42. Multifocal hypopigmented retinal pigment epithelial lesions in incontinentia pigmenti.BACKGROUND: incontinentia pigmenti (IP) can manifest with retinal detachment in children and can simulate retinoblastoma. The authors report a clinicopathologic correlation of IP and illustrate the retinal pigment epithelium (RPE) alterations that may be useful in establishing the diagnosis. methods: A 30-month-old reportedly healthy girl developed strabismus and was discovered to have total retinal detachment in the left eye. Intraocular calcification was found on ultrasonography and computed tomography, suggestive of retinoblastoma. RESULTS: ophthalmoscopy of the right eye revealed sector distribution of approximately 70 elongated, linear hypopigmented lesions of the RPE located in the peripheral superotemporal, inferotemporal, and superonasal quadrants and measuring 300 microm or less in basal dimension. The left eye had a total retinal detachment, vitreous traction, perivascular exudation, and iris neovascularization. Despite the lack of medical history in this patient, skin examination revealed classic cutaneous findings of IP The enucleated left globe displayed tractional retinal detachment with vitreoretinal neovascularization and nonspecific RPE papillary proliferation. Scattered minor foci of intraretinal calcification were observed. There was no sign of retinoblastoma. CONCLUSIONS: IP can closely simulate retinoblastoma with retinal detachment and minor intraocular calcification. In this case, the classic cutaneous manifestations combined with the fine linear hypopigmented RPE foci were important in suggesting the diagnosis of IP.- - - - - - - - - - ranking = 2keywords = near (Clic here for more details about this article) |
8/42. vitrectomy and silicone oil tamponade for serous macular detachment associated with an optic disk pit.PURPOSE: Description of the results of vitrectomy and silicone oil tamponade to repair serous macular detachment associated with optic disk pit. DESIGN: Interventional case report. methods: The authors report on a 17-year-old girl with serous macular detachment with a very thin layer near the fovea which clinically simulated a lamellar macular hole and macular schisis associated with an optic disk pit. The patient underwent pars plana vitrectomy with posterior hyaloid removal and silicone oil tamponade. RESULTS: Good anatomic and functional results were obtained after 1 year of follow-up. CONCLUSIONS: This surgical approach may be a valuable technique for the surgical management of serous macular detachment associated with an optic disk pit.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
9/42. Branch retinal vein occlusion associated with vitreoretinal traction.CASE REPORT: Branch retinal vein occlusion (BRVO) is believed to arise at arteriovenous crossing sites. Surgical dissection of the arteriovenous sheath has been proposed as a treatment option, yet induction of a posterior vitreous detachment may be as important in obtaining a successful surgical outcome, suggesting that vitreoretinal traction may play a role in the development of BRVO. A retrospective review of 3 patients presenting with clinical features of BRVO and evidence of vitreoretinal traction at the occlusion site was conducted. COMMENTS: All patients presented with mild vitreous hemorrhage. Intraretinal hemorrhages were distributed in an unusual linear pattern along the involved venous segment, suggesting the presence of vitreoretinal traction. fluorescein angiography demonstrated blocked fluorescence secondary to hemorrhage with delay of venous flow at the avulsion site. Partial avulsion of the involved venous segment was evident on clinical examination, B-scan ultrasound, or optical coherence tomography. Vitreoretinal traction may contribute to the pathogenesis of BRVO in some patients.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
10/42. Choroidal metastasis and rhegmatogenous retinal detachment.The association of a rhegmatogenous retinal detachment (RRD) with a uveal metastasis is an exceptional occurrence. In this article, the authors report the first successfully treated case (to their knowledge) of a patient with one eye in whom both the RRD and the metastasis is treated successfully. The RRD was operated on using a buckling procedure with cryopexy of the retinal break and drainage of the subretinal fluid. The metastasis, originating from an invasive canalicular carcinoma of the breast, was irradiated several days after surgery with a linear accelerator. The primary tumor was treated with systemic hormonotherapy. One and a half years after surgery, the patient is still alive. visual acuity in the eye is 20/30, the retina is flat and no signs of tumor recurrence have been observed.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
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