1/33. Combined secondary capsulorhexis and vitreous surgery in a case of anterior capsule contraction and vitreous hemorrhage.A 59-year-old woman with diabetic vitreous hemorrhage and contracted anterior capsule opening received secondary capsulorhexis and trans pars plana vitrectomy in a single operation. The combined surgery was successful. In addition, the anterior capsule opening was enlarged by the procedure and no further vitreous hemorrhage occurred during the 6 month follow-up period in both eyes. When anterior capsule opening reduction is encountered in patients requiring vitreoretinal surgery, combining secondary capsulorhexis and vitreoretinal surgery together in a single operation maybe provide a good treatment alternative.- - - - - - - - - - ranking = 1keywords = diabetic (Clic here for more details about this article) |
2/33. 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 = 1keywords = diabetic (Clic here for more details about this article) |
3/33. 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 = 6keywords = diabetic (Clic here for more details about this article) |
4/33. Spontaneous luxation of encapsulated intraocular lens onto the retina after a triple procedure of vitrectomy, phacoemulsification, and intraocular lens implantation.PURPOSE: To report the clinical and histological findings of a luxated intraocular lens (IOL) in the capsular bag. methods: review of a case. RESULTS: Twenty-three months after a triple procedure of vitrectomy, phacoemulsification, and IOL implantation for diabetic vitreous hemorrhage and cataract, the encapsulated IOL spontaneously luxated. Scanning electron microscopy showed sparsely distributed anterior and equatorial zonules, with only a few posterior zonules on the surface of the removed capusular bag. CONCLUSION: The absence of the anterior hyaloid membrane and posterior zonules and contraction of the lens capsule may cause dialysis of the zonules. Therefore, the anterior hyaloid membrane should be left in place in patients at low risk for the development of postoperative proliferation to maintain the long-term stability of the IOL.- - - - - - - - - - ranking = 1keywords = diabetic (Clic here for more details about this article) |
5/33. Echographic evaluation of a patient with diabetes and dense vitreous hemorrhage: an avulsed retinal vessel may mimic a tractional retinal detachment.PURPOSE: To report that an avulsed retinal vessel may appear as a tractional retinal detachment on echographic evaluation. methods: Case report. RESULTS: A 57-year-old diabetic woman presented with a nonclearing vitreous hemorrhage of 2 months duration in the left eye. Echography was consistent with a localized tractional retinal detachment on longitudinal sections; transverse sections demonstrated a pinpoint opacity in the vitreous cavity. Intraoperatively, an avulsed retinal vessel was noted in the area of echographic abnormality. CONCLUSION: An avulsed retinal vessel may mimic tractional retinal detachment on echography. Although trained ophthalmic echographers routinely perform both longitudinal and transverse sections during an echographic evaluation, less skilled observers must be aware of the importance of performing both longitudinal and transverse sections for accurate echographic diagnosis.- - - - - - - - - - ranking = 1keywords = diabetic (Clic here for more details about this article) |
6/33. Nd:YAG laser treatment for premacular subhyaloid haemorrhage.PURPOSE: Premacular subhyaloid haemorrhage produces sudden, profound visual loss which may be prolonged if untreated. Nd:YAG laser treatment can create a posterior hyaloidotomy enabling rapid diffusion of subhyaloid haemorrhage into the vitreous gel. This study was performed to assess the results of Nd:YAG laser hyaloidotomy and to compare the outcome with similar conservatively managed cases. methods: Nd:YAG laser hyaloidotomy was performed in 6 patients with premacular subhyaloid haemorrhage. The aetiologies were Valsalva retinopathy, macroaneurysm, branch retinal vein occlusion, proliferative diabetic retinopathy (2 cases) and idiopathic. Four patients with premacular subhyaloid haemorrhage were managed conservatively. The aetiologies were Valsalva retinopathy (2 cases), macroaneurysm and proliferative diabetic retinopathy. RESULTS: Nd:YAG laser hyaloidotomy achieved rapid resolution of subhyaloid haemorrhage in all treated patients. visual acuity improved to 6/9 or better in 4 patients, but was limited by ischaemic diabetic retinopathy in 2 patients. No patient had evidence of damage to the retina or choroid from treatment. Among the conservatively managed cases, 3 patients had slow resolution of the subhyaloid haemorrhage over 3-6 months. One patient with diabetic retinopathy demonstrated little improvement at 18 months. CONCLUSION: Nd:YAG laser hyaloidotomy is a safe and effective procedure. It achieves rapid resolution of premacular subhyaloid haemorrhage with restoration of visual function, preventing the need for vitreoretinal surgery.- - - - - - - - - - ranking = 4keywords = diabetic (Clic here for more details about this article) |
7/33. vitreous hemorrhage as the initial presentation of postoperative endophthalmitis.PURPOSE: To describe a patient with postoperative endophthalmitis whose only abnormal finding at presentation was a vitreous hemorrhage. DESIGN: Interventional case report. methods: A 68-year-old diabetic woman underwent cataract extraction with intraocular lens implantation in the left eye. Three days after surgery, she had painless loss of vision, minimal anterior chamber inflammation, and dense vitreous hemorrhage in the left eye. RESULTS: On the fourth postoperative day, significant anterior chamber inflammation developed with fibrin and a hypopyon. During vitrectomy with intravitreal antibiotic injection, an area of retinitis surrounding an eroded retinal blood vessel was found. Cultures of undiluted vitreous fluid grew coagulase-negative staphylococcus organisms. The endophthalmitis resolved and 20 months later, her best-corrected visual acuity had improved to 20/40. CONCLUSION: Postoperative endophthalmitis may present as a vitreous hemorrhage, secondary to retinitis and erosion of a retinal blood vessel.- - - - - - - - - - ranking = 1keywords = diabetic (Clic here for more details about this article) |
8/33. Use of perfluorocarbon liquid during vitrectomy for severe proliferative diabetic retinopathy.AIM: To evaluate the value of using perfluorocarbon liquid (PFCL) during vitrectomy in eyes with proliferative diabetic retinopathy (PDR). methods: The surgical records of eyes with PDR (291 eyes of 228 patients) that underwent vitrectomy in the vitreoretinal service of Osaka Medical College (April 1999 to October 2001) were reviewed. From these, 18 eyes of 15 patients had PFCL used during vitrectomy, and the preoperative and postoperative findings of these eyes were analysed. RESULTS: All of the 18 eyes had advanced PDR with tractional and/or rhegmatogenous retinal detachment. PFCL enabled easier flattening of the retinal folds and effective endophotocoagulation. In two cases, PFCL was used to flatten a bullous retinal detachment that developed when a tight vitreoretinal adhesion was loosened. In two other cases with combined traction/rhegmatogenous retinal detachment, PFCL was used to tamponade the detached retina which then allowed successful membrane dissection. Anatomical success was obtained in 16 of the 18 cases (mean follow up time 13.3 months) with visual acuity of 20/200 or better in nine eyes (50%). CONCLUSIONS: PFCL is considered to be a useful adjunct during vitrectomy for the treatment of severe PDR.- - - - - - - - - - ranking = 5keywords = diabetic (Clic here for more details about this article) |
9/33. From minimal background diabetic retinopathy to profuse sight threatening vitreoretinal haemorrhage: management issues in a case of pregestational diabetes and pregnancy.Deterioration of retinopathy is a recognized complication of pregnancy in Type 1 diabetes. We discuss management issues relating to a case of rapid sight-threatening progression of retinopathy in pregnancy complicated by pregestational diabetes.- - - - - - - - - - ranking = 4keywords = diabetic (Clic here for more details about this article) |
10/33. Comparison between B-scan ultrasound and MRI in the detection of diabetic vitreous hemorrhage.The efficacy of proton magnetic resonance imaging (MRI) was evaluated and compared with that of B-scan ultrasound in the detection and differentiation of diabetic vitreous hemorrhage. Although conventional spin-echo MRI could not locate vitreous hemorrhages, gradient-recalled-echo (GRE) MRI readily did so. The aberrant signals appeared to originate from the interfacing between hemorrhages and the vitreous, and possibly also from the paramagnetic effect of the ferrous ion. The information provided by boundary/susceptibility detection, unique to the GRE sequence, is useful in delineating the extent of vitreous hemorrhage and hemolysis. However, for the diagnosis and follow up of diabetic vitreous hemorrhages, MRI appears no more informative than B-scan ultrasonography.- - - - - - - - - - ranking = 6keywords = diabetic (Clic here for more details about this article) |
| | Next -> |