1/12. Focal retinal pigment epithelial dysplasia associated with fundus flavimaculatus.BACKGROUND: One or more focal dysplastic lesions of the retinal pigment epithelium (RPE) occurred in 15 eyes of 10 patients with fundus flavimaculatus. methods: review of patient records including an attempt to obtain follow-up information concerning a history of previous ocular trauma. RESULTS: Mild antecedent ocular trauma occurred to the eye with a dysplastic lesion in two patients. Dysplastic lesions were most frequently solitary and located temporal to the macula. Subretinal neovascularization accompanied two of the dysplastic lesions. The lesions were multifocal and present bilaterally in two patients. CONCLUSIONS: In fundus flavimaculatus, progressive lipofuscin storage is responsible for engorgement and hypertrophy of the RPE. Dysplastic lesions of the RPE probably result from reactive hyperplasia and fibrous metaplasia of RPE cells in response to acute disruption of fragile, hypertrophied RPE cells that may be enormously enlarged in the area of yellow flecks. This disruption may occur in response to trauma, focal inflammation, or other localized stimuli. patients with fundus flavimaculatus should be cautioned concerning the possible role of trauma in causing dysplastic changes in the RPE and visual loss.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
2/12. Macular injury by a military range finder.OBJECTIVE: The authors report the clinical findings of a civilian patient who unintentionally looked into the laser beam of a military range finder. Detailed information on the range finder is given. The objective is to illustrate the potential danger of such devices and to give detailed information on the device, the clinical findings associated with exposure, and the laser-tissue interaction mechanism. methods: The patient was examined with fluorescein angiography, indocyanine green angiography, microperimetry, and optical coherence tomography, both in the acute stage (2 hours) and 4 weeks later. fluorescein angiography was performed again 4 months later. A total of 100 mg prednisone tapered over 9 days was prescribed. Additionally, 50 microg tissue plasminogen activator (TPA) and 0.5 mL pure C2F6 were injected in the vitreous. RESULTS: In the acute phase, hemorrhage was located beneath the retina, primarily beneath the retinal pigment epithelium. Retinal defects as seen initially over the subretinal blood were reduced after 4 weeks, but a retinal defect ranging from the lasered site toward the fovea remained. visual acuity slightly increased from 20/100 to 20/63 after 4 weeks. indocyanine green angiography showed a large hypofluorescent spot in the macula. Four months after the accident, a classic choroidal neovascularization developed, originating from the lasered site. The technical parameters of the range finder were: Nd:YAG laser (1,064 nm), pulse duration 10 ns, beam divergence 1.5 mrad, energy 10 mJ. CONCLUSION: A range finder can produce severe macular injury. The primary laser-tissue interaction mechanism seems to be explosive disruption of choroidal tissue. Intravitreal injection of TPA and C2F6 did not show a clear benefit to such laser lesions. A late complication can be secondary choroidal neovascularization.- - - - - - - - - - ranking = 2keywords = neovascularization (Clic here for more details about this article) |
3/12. Best's vitelliform macular dystrophy.A patient with Best's vitelliform macular dystrophy in his right eye had an intact vitelliform disk and drusen of the optic papilla. Although the foveola elevated by a few tenths of a millimeter, resolution was only slightly affected and the retinal receptors remained remarkably well-aligned, suggesting that mechanisms subserving receptor alignment still functioned. Hue discrimination and visual acuity were only slightly affected and the electroretinogram and visually evoked response showed essentially normal values. The vitelliform disk in the left eye ruptured by direct, blunt trauma. This same eye later developed subretinal macular neovascularization, as its visual acuity reduced, retinal sensitivity decreased, receptor orientation showed abnormalities, and hue discrimination became less efficient; the electroretinogram and visually evoked response remained normal.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
4/12. Latent proliferative sickle cell retinopathy in sickle cell trait.PURPOSE: To describe a patient with sickle cell trait who developed latent proliferative sickle cell retinopathy after mild blunt trauma. METHOD: Case Report. A 20-year-old man with unilateral Stage 3 sickle retinopathy associated with an ischaemic ridge presenting three years after the initial mild blunt ocular trauma. RESULTS: Fundus examination of the left eye showed an ischaemic ridge delineating avascular from vascular retina. fluorescein angiography of the left eye showed an avascular peripheral retina and multiple sea fan neovascularization. blood studies showed him to be Hb AS. CONCLUSIONS: In our patient the proliferative changes were the result of his initial mild trauma associated with an increase in the intraocular pressure. The latent development of the sea-fan neovascularization associated with an ischaemic ridge is unusual. Advice about potential complications to patients with Hb AS after ocular trauma is advocated.- - - - - - - - - - ranking = 2keywords = neovascularization (Clic here for more details about this article) |
5/12. Retinal pigment epithelial tear after transpupillary thermotherapy for choroidal neovascularization.PURPOSE: To describe two patients who developed a retinal pigment epithelial tear after transpupillary thermotherapy for choroidal neovascularization. METHOD: case reports. RESULTS: Retinal pigment epithelial (retinal pigment epithelium) tear developed in 2 (8%) of 25 eyes after transpupillary thermotherapy for occult choroidal neovascularization associated with age-related macular degeneration. In both eyes, the retinal pigment epithelium tear developed between the treatment session and first post-treatment examination. In both eyes, the visual acuity was unchanged, but the complication of retinal pigment epithelium tear may result in decreased visual acuity when transpupillary thermotherapy is performed in an eye with good initial visual acuity. CONCLUSION: retinal pigment epithelium tear appears to occur more frequently after transpupillary thermotherapy for poorly defined choroidal neovascularization than after conventional laser photocoagulation for poorly defined choroidal neovascularization.- - - - - - - - - - ranking = 8keywords = neovascularization (Clic here for more details about this article) |
6/12. Increased diode laser uptake in inner retinal layers after indocyanine green staining of the internal limiting membrane.Intraoperative use of indocyanine green to stain the internal limiting membrane assists in its visualization and removal. This article describes increased uptake of diode laser energy by the superficial layers of the retina after indocyanine green staining of the internal limiting membrane in a patient with diabetic macular edema and a taut, attached posterior hyaloid. The patient was undergoing pars plana vitrectomy, removal of the posterior hyaloid, and indocyanine green-assisted peeling of the internal limiting membrane. In addition, panretinal diode laser endophotocoagulation was performed after discovering retinal neovascularization. In areas that were more intensely stained with indocyanine green, the clinical appearance and optical coherence tomography scans demonstrated markedly increased laser energy uptake in the superficial layers of the retina. This case indicates near-infrared or infrared laser procedures performed in areas of indocyanine green-stained internal limiting membrane may necessitate adjustment of laser power and technique.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
7/12. choroidal neovascularization after accidental macular damage by laser.A 30-year-old male physics professor was examined 2 months after being accidentally hit by a laser beam in his left eye. He complained of abrupt vision loss and central scotoma after the laser accident,with stabilization of the vision thereafter. At presentation, he presented best-corrected visual acuity of 6/18 in the left eye. Fundoscopy disclosed a slightly elevated foveal brownish lesion,surrounded by a subtle subretinal haemorrhage. fluorescein angiography demonstrated a hyperfluorescent foveal lesion with staining and a slight leakage in the late phase, characterizing a fibrovascular choroidal neovascularization (CNV). Optical coherence tomography showed a discrete increase in retinal thickness and a subretinal fibrotic CNV. visual acuity remained stable during the follow up(4 months). CNV after laser injury is rare. The evolution of this case suggests that CNV, after an accidental laser injury,in a healthy macula of a young patient might have a self-limited course and a relatively good prognosis.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
8/12. Predictors of visual outcome and choroidal neovascular membrane formation after traumatic choroidal rupture.OBJECTIVE: To determine predictors of choroidal neovascularization (CNV) and visual outcome after traumatic choroidal rupture. methods: A retrospective review of patients with traumatic choroidal rupture diagnosed in the Retina Service, massachusetts eye and ear Infirmary, boston, between January 1993 and August 2001 was performed. Parametric and nonparametric statistical methods were used to evaluate visual prognosis, CNV, and retinal detachment after traumatic choroidal rupture. RESULTS: One hundred eleven cases were identified and reviewed. visual acuity (VA) changes were recorded in all of the cases. Thirty-eight (34%) of the 111 patients recovered driving vision (VA > or =20/40). rupture location was recorded in 107 cases. Recovery of driving vision was seen in 20 (59%) of 34 eyes with peripheral choroidal ruptures, 17 (22%) of 73 eyes with macular choroidal ruptures, 38 (38%) of 99 eyes without CNV, 1 (8%) of 12 eyes with CNV, 38 (40%) of 96 eyes without retinal detachment, and 1 (7%) of 15 eyes with retinal detachment. Older age and location of rupture within the arcades were positively associated with CNV formation (P = .04 and .03, respectively). Foveal location of rupture, multiple ruptures, and poor baseline VA were associated with failure to recover driving vision in univariate regression analyses. In multivariate analysis, rupture location and baseline VA were independently associated with visual outcome. Of 12 patients diagnosed with CNV, 5 were not treated, 4 were treated with argon laser photocoagulation, 1 was treated with surgery, 1 was treated with argon laser photocoagulation followed by surgery, and 1 was treated with verteporfin photodynamic therapy. CONCLUSIONS: Most patients with traumatic choroidal rupture do not achieve final VA of 20/40 or better. Poor visual outcome was most highly associated with a macular rupture and baseline VA of less than 20/40. The formation of CNV was most strongly associated with older age and macular choroidal rupture.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
9/12. choroidal neovascularization in a child with traumatic choroidal rupture: clinical and ultrastructural findings.choroidal neovascularization in children is uncommon and mostly associated with inflammation, infectious diseases or trauma. The clinical and histological findings of a choroidal neovascular membrane that developed in a 9-year-old boy after traumatic choroidal rupture are reported.- - - - - - - - - - ranking = 5keywords = neovascularization (Clic here for more details about this article) |
10/12. Indirect choroidal rupture secondary to blunt ocular trauma. A review of eight eyes.We retrospectively studied eight eyes of seven patients sustaining indirect choroidal rupture secondary to blunt trauma. Clinical and fluorescein angiographic findings were reviewed. The ruptures were single in five eyes and multiple in three eyes. Four eyes contained macular ruptures, and three eyes contained extramacular ruptures. Peripapillary ruptures were noted in three eyes. Three eyes developed subretinal neovascularization as a complication. Location of the rupture but not visual acuity at presentation was predictive of visual outcome. All ruptures were concentric with the optic nerve and vertically oriented, consistent with a break in Bruch's membrane and an associated tethering effect by the optic nerve.- - - - - - - - - - ranking = 1keywords = neovascularization (Clic here for more details about this article) |
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