1/64. 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 = diabetic (Clic here for more details about this article) |
2/64. Ultrasound biomicroscopy in a case of anterior hyaloidal fibrovascular proliferation.The authors describe the use of ultrasound biomicroscopy for the diagnosis and preoperative evaluation of anterior hyaloidal fibrovascular proliferation (AHFVP). Ultrasound biomicroscopy was performed on a 62-year-old man who presented after diabetic vitrectomy with a hyphema, vitreous hemorrhage, and hypotony. Images in the temporal and nasal meridians revealed thickened tissue bands extending from the peripheral retina to the ciliary body, and from the pars plicata to the posterior surface of the iris. A ciliary body epithelium detachment was seen in the nasal meridian. Ultrasound biomicroscopy demonstrated to be a potential tool in the diagnosis and surgical management of AHFVP.- - - - - - - - - - ranking = 0.2keywords = diabetic (Clic here for more details about this article) |
3/64. Intravitreal triamcinolone acetonide for cataract surgery with iris neovascularization.A 73-year-old patient with proliferative diabetic retinopathy presented with marked iris neovascularization and dense cataract that prevented retinal laser coagulation. To prevent postoperative progression of the iris neovascularization, the patient had standard cataract surgery with implantation of a foldable posterior chamber lens in combination with an intravitreal injection of 25 mg triamcinolone acetonide. During the 5.5-month follow-up, visual acuity increased from 0.10 to 0.20. With no additional retinal ablative treatment, the iris neovascularization markedly regressed within the first 5 postoperative weeks, after which a peripheral retinal laser treatment was performed, resolving the iris neovascularization. intraocular pressure was within the normal range.- - - - - - - - - - ranking = 0.2keywords = diabetic (Clic here for more details about this article) |
4/64. Preretinal neovascularization in diabetic retinopathy: a preliminary investigation using contrast-enhanced magnetic resonance imaging.Preretinal neovascularization is a well-described feature of advanced diabetic retinopathy. In this study, contrast-enhanced magnetic resonance imaging was used to examine blood-retinal barrier breakdown associated with preretinal neovascularization in three subjects with proliferative diabetic retinopathy. Using a standard imaging protocol, a varying degree of vitreous enhancement was observed in these eyes. The location and severity of enhancement, judged by visual inspection of the images, corresponded to the fluorescein angiographic and/or clinical appearance of preretinal neovascularization. This result suggests that contrast-enhanced magnetic resonance imaging may prove a reasonable approach to the identification of preretinal neovascularization in eyes with significant media opacities.- - - - - - - - - - ranking = 1.2keywords = diabetic (Clic here for more details about this article) |
5/64. Acute onset of rubeosis iridis after diabetic vitrectomy can indicate peripheral traction retinal detachment.Acute onset or exacerbation of rubeosis iridis associated with peripheral retinal detachment after vitrectomy represents a rare but serious complication of advanced diabetic retinopathy that indicates a poor prognosis. The clinical features, surgical procedures, and anatomical and functional results for a series of 13 eyes presenting with this complication are reported. In addition to rubeosis iridis and peripheral retinal detachment, anterior hyaloidal fibrovascular proliferation (APH) was also present in 10 eyes. All eyes had undergone one or more previous vitrectomies for diabetic complications such as nonclearing vitreous hemorrhage and traction retinal detachment. Treatment modalities for iris neovascularization and peripheral retinal detachment included reattachment procedures with an encircling band, peripheral membrane peeling, and, if necessary, peripheral retinectomy. Peripheral coagulation therapy was performed in all eyes. Eight eyes received an intraocular silicone-oil tamponade. Early results (4 weeks post-surgery) showed regression or stabilization of rubeosis iridis in all eyes. Later results (mean, 9 months post-surgery) revealed nine eyes with stabilized anterior ocular neovascularization and reattachment of the retina. Four eyes were anatomic failures due to recurrent rubeosis iridis/AHP or traction retinal detachment, and three of them also developed ocular hypotony. None of the eyes has thus far been lost as a result of neovascular glaucoma or painful phthisis. Ambulatory vision was retained in ten eyes, but function was limited to a low level as a result of the underlying ischemic disease. Immediate reattachment surgery in combination with anterior/peripheral coagulation therapy was shown to be an effective measure for controlling iris neovascular activity in eyes afflicted with acute anterior ocular neovascularization.- - - - - - - - - - ranking = 1.2keywords = diabetic (Clic here for more details about this article) |
6/64. Occlusion of the central retinal artery and ocular neovascularisation: an indirect association?Ocular neovascularisation is recognised as an uncommon complication of central retinal artery occlusion (CRAO) but has been associated most frequently in those patients suffering from carotid artery occlusive disease. We report the finding of neovascularisation after CRAO in a group of 8 patients, who have presented over the previous 6 years. Four showed no evidence of atherosclerotic carotid disease and only 2 were diabetic. Although the group numbers are necessarily small, it is suggested that these cases support the assertion that ocular neovascularisation may occur following CRAO in the absence of any underlying and predisposing ischaemic or inflammatory condition.- - - - - - - - - - ranking = 0.2keywords = diabetic (Clic here for more details about this article) |
7/64. genetic linkage of autosomal dominant neovascular inflammatory vitreoretinopathy to chromosome 11q13.Autosomal dominant neovascular inflammatory vitreoretinopathy (ADNIV) is an inherited eye disease characterized by retinal and iris neovascularization, abnormal retinal pigmentation, anterior chamber and vitreous inflammation, cystoid macular edema, vitreous hemorrhage, and traction retinal detachment. Some of these clinical features are shared by more common, potentially blinding, conditions including diabetic retinopathy, uveitis, and retinitis pigmentosa. Elucidation of the molecular pathogenesis of ADNIV has the potential to provide insight into the mechanisms of these common disorders. One hundred and sixteen members of an eight generation family affected with ADNIV were examined. A combination of slit lamp biomicroscopy, ophthalmoscopy, and electroretinography was used to establish the diagnosis and 34 family members were found to be affected. Blood samples were obtained from thirty-three of these individuals and nine spouses and used for chromosome linkage analysis with denaturing gradient gel and short tandem repeat polymorphisms. Two markers that map to chromosome 11q13 were found to be significantly linked to the ADNIV phenotype. There were no recombinants between the disease phenotype and marker D11S527 and multipoint analysis yielded a maximum lod score of 11.9 centered on this marker.- - - - - - - - - - ranking = 0.2keywords = diabetic (Clic here for more details about this article) |
8/64. iris neovascularization in proliferative vitreoretinopathy.PURPOSE: The purpose of this study is to report on the prevalence, incidence, and associated risk factors of iris neovascularization in nondiabetic patients undergoing vitrectomy for retinal detachment complicated by proliferative vitreoretinopathy (PVR). methods: The authors conducted a retrospective review of 141 consecutive non-diabetic patients undergoing vitrectomy for recurrent retinal detachment resulting from PVR. Univariate and multivariate analyses were performed on all patients to determine which preoperative, intraoperative, and postoperative factors were associated with the development of postoperative iris neovascularization. RESULTS: Twenty-seven of the 141 (19%) patients were noted with preoperative and/or postoperative iris neovascularization. Four of eight patients presenting with preoperative iris neovascularization had complete regression after successful reattachment of the retina. Results of analysis of the remaining 133 patients without iris neovascularization preoperatively showed residual retinal detachment as the most significant risk factor for postoperative iris neovascularization. In the absence of panretinal photocoagulation, none of the 27 patients developed neovascular glaucoma. CONCLUSIONS: The development of iris neovascularization preoperatively or post-operatively is not necessarily a predictor of a poor anatomic and/or visual result. iris neovascularization in PVR rarely if ever progresses to neovascular glaucoma. Panretinal photocoagulation is not indicated in these patients. Retinal reattachment is the most important factor in the prevention and/or resolution of postoperative iris neovascularization. The development of iris neovascularization in PVR appears to be a multifactorial process requiring multiple variables acting in concert.- - - - - - - - - - ranking = 0.4keywords = diabetic (Clic here for more details about this article) |
9/64. Idiopathic choriovitreal membrane--a case report.A case of a macular idiopathic choriovitreal membrane is described which developed in a diabetic man. On initial examination the patient was found to have a pigment epithelial detachment with a choroidal neovascular membrane (CNVM) in the right eye. Two months after the first visit the CNVM was seen to have penetrated the retina and presented as a choriovitreal membrane. Panretinal photocoagulation was applied after which the choriovitreal membrane demonstrated fibrotic involution. This case is unusual in that the choriovitreal membrane developed in the absence of a choroidal or retinal pigment epithelial disease process that may be associated with a CNVM as well as in the absence of previous macular laser treatment.- - - - - - - - - - ranking = 0.2keywords = diabetic (Clic here for more details about this article) |
10/64. diabetic retinopathy in two patients with congenital IGF-I deficiency (laron syndrome).OBJECTIVE: Animal and clinical studies have shown that excessive amounts of growth hormone or insulin-like growth factor-I (IGF-I) promote the development of diabetes and diabetic retinopathy. Forthwith, we present two patients with congenital IGF-I deficiency who developed type II diabetes and subsequently retinopathy. methods: Eighteen adult patients with classical laron syndrome (8 males, 10 females, aged 20-62 years) were followed by us since childhood or underwent fundus photography with a Nikon NF 505 instrument. Three had been treated in childhood with IGF-I, the rest were never treated, including the two patients reported. RESULTS: Two never-treated patients were diagnosed with type II diabetes (DM) at ages 39 and 41 respectively. There was no diabetes in the families. Oral treatment was followed by insulin injections. Metabolic control was not optimal and one patient developed proliferative diabetic retinopathy, necessitating laser surgery. He also has nephropathy and severe neuropathy. The other patient has background diabetic retinopathy and has developed, progressively, exudates, microaneurisms, hemorrhages and clinically significant macular edema. He also has subacute ischemic heart disease. CONCLUSIONS: Our findings show that congenital IGF-I deficiency, similar to excess, causes vascular complications of DM, denoting also that vascular endothelial growth factor can induce neovascularization in the presence of congenital IGF-I deficiency.- - - - - - - - - - ranking = 0.6keywords = diabetic (Clic here for more details about this article) |
| | Next -> |