Cases reported "vitreous hemorrhage"

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11/235. optic nerve avulsion from a golfing injury.

    PURPOSE: To describe a patient with optic nerve avulsion after being struck in the eye with a golf club. methods: A 10-year-old male was hit in the left eye by a golf club. The patient underwent full ophthalmoscopic evaluation and neuroimaging. RESULTS: The patient had no light perception in the left eye when first seen. Avulsion of the optic nerve with vitreous hemorrhage was apparent on examination. Computed tomographic imaging of the brain and orbits revealed no abnormalities. CONCLUSIONS: optic nerve avulsion from golf-related injury is more likely to occur when the impact site is between the globe and the orbital rim. rupture of the globe is more likely to occur with direct impact to it. ( info)

12/235. incidence of vitreoretinal pathologic conditions within 24 months after laser in situ keratomileusis.

    OBJECTIVE: To report for the first time a case series of vitreoretinal pathologic conditions after laser in situ keratomileusis (LASIK) and to determine its incidence. DESIGN: Case series. PARTICIPANTS: Five refractive surgeons and 29,916 eyes that underwent surgical correction of ametropia (83.2% were myopic) ranging from -0.75 to -29.00 diopters (D; mean: -6.19 D) and from 1.00 to 6.00 D (mean: 3.23 D) participated in this retrospective study. MAIN OUTCOME MEASURES: Vitreoretinal complications after LASIK. RESULTS: The clinical findings of 20 eyes (17 patients) with LASIK-related vitreoretinal pathologic conditions are presented. Fourteen eyes experienced rhegmatogenous retinal detachments (RDs). Two eyes experienced corneoscleral perforations with the surgical microkeratome when a corneal flap was being performed (one experienced a vitreous hemorrhage and the other later experienced an RD). In four eyes, retinal tears without RDs were found. In one eye, a juxtafoveal choroidal neovascular membrane (CNVM) developed. Retinal tears were treated with argon laser retinopexy or cryotherapy. Corneoscleral perforations were sutured, and the RD was managed with vitrectomy. The remaining RDs were managed with vitrectomy, cryoretinopexy, scleral buckling, argon laser retinopexy, or pneumatic retinopexy techniques. The CNVM was surgically removed. The incidence of vitreoretinal pathologic conditions determined in our study was 0.06%. CONCLUSIONS: Serious complications after LASIK are infrequent. Vitreoretinal pathologic conditions, if managed promptly, will still result in good vision. It is very important to inform patients that LASIK only corrects the refractive aspect of myopia. Complications of the myopic eye will persist. ( info)

13/235. 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. ( info)

14/235. The acoustic lighthouse effect. An ultrasonic response met in eyes after vitreoretinal surgery with silicone oil.

    PURPOSE: To discuss and possibly explain the ultrasonic lighthouse effect, a metaphor suggested for an artifact-like phenomenon sometimes found by B-scan in eyes having had intra-ocular perfluorocarbon and/or silicone oil injected as part of vitreoretinal surgery. METHOD: Analysis of the ultrasonic findings with a view to the specific gravities of the above injected substances. Compared to water, perfluorocarbon has a higher and silicone oil a lower gravity; they are heavy and light, respectively. RESULTS: The elicited lighthouse effect may appear localized or 'mobile'. When evoked only from specific positions on the globe, most likely it is explained by a lens-like accumulation of material trapped at the vitreous base just under the transducer. When mobile it depends on head position; there is a gravitational shift in position of the material, as evident in particular when becoming visible in the anterior chamber. CONCLUSIONS: In case reports in literature slit-lamp verified anterior segment perfluorocarbon remnants have caused acoustic disturbances of a similar nature. In this study we found evidence that also silicone oil can underlie the acoustic lighthouse effect. ( info)

15/235. Spontaneous involution of a large retinal arterial macroaneurysm.

    BACKGROUND: Acquired retinal macroaneurysms are round dilatations of retinal arterioles that occur in the posterior fundus. They tend to rupture before they grow large and cause a visual decrease. The average diameter of macroaneurysms in the previous reports is 281 micrometer. methods: A 63-year-old man complained of a sudden decrease of visual acuity in the left eye. Fundus examination of his left eye revealed a large protruded mass, 2 disc diameters in size, at the first bifurcation of the inferotemporal retinal artery. Preretinal vitreous bleeding and serous retinal detachment were observed around the lesion. indocyanine green (ICG) angiography showed this mass to be continuous with the inferotemporal retinal artery and ICG dye leaked from the retinal artery into the lumen of the mass, with pulsation. RESULTS: Six months later, the large macroaneurysm underwent spontaneous involution. CONCLUSION: As shown in this patient, retinal macroaneurysms may grow extremely large. ICG angiography was useful to diagnose this large retinal arterial macroaneurysm. ( info)

16/235. vitreous hemorrhage after intravitreal tissue plasminogen activator (t-PA) and pneumatic displacement of submacular hemorrhage.

    PURPOSE: To report the immediate complication of dense vitreous hemorrhage after intravitreal injection of tissue plasminogen activator and gas for treatment of two cases of sudden submacular hemorrhage associated with retinal arterial macroaneurysm. methods: case reports. RESULTS: Two patients, a 67-year-old woman and a 92-year-old man, presented with sudden vision loss related to submacular hemorrhage from a retinal macroaneurysm. tissue plasminogen activator at a dose of 50 microg to 75 microg and a sulfur hexafluoride (SF(6)) gas bubble were injected intravitreally under local anesthesia. Dense vitreous hemorrhage was noted on the first postoperative day in both cases, which subsequently required pars plana vitrectomy removal. CONCLUSION: Sudden severe vitreous hemorrhage may be an immediate complication after intravitreal injection of tissue plasminogen activator and gas for treatment of submacular hemorrhage associated with retinal arterial macroaneurysm. ( info)

17/235. Congenital retinal arterial loops and spontaneous vitreous haemorrhage: a case report.

    This report describes a case of unilateral spontaneous vitreous haemorrhage associated with congenital retinal arterial loops. ( info)

18/235. Inadvertent topical exposure to isocyanates caused damage to the entire eyeball.

    isocyanates are part of a group of important chemicals necessary in the production of adhesives, synthetic rubbers, and a variety of plastics. They are known to have minimal toxic effects when administered locally. However, we experienced a case of damage involving the entire eyeball in a person who accidentally exposed his eye to isocyanates. The patient presented with inflamed conjunctiva, and shrunken cornea and sclera, with focal atrophic changes in the iris. The lens and vitreous were opacified. After removal of the lens and vitreous, there were large areas of atrophic retina and areas of retinal necrosis with holes. We found that locally absorbed isocyanates can cause damage to the entire eyeball. Therefore, we recommend that if there is any evidence of isocyanate penetration, early vitrectomy should be performed to help in determining the extent of retina damage and to decrease the amount of toxic substance in the vitreous. ( info)

19/235. Removing silicone oil droplets from the posterior surface of silicone intraocular lenses.

    A 67-year-old woman had droplets of silicone oil adhering to her silicone intraocular lens (IOL) resulting from a previous silicone oil tamponade. A lens hook and intraocular irrigation were used in conjunction by inserting an infusion cannula to remove the droplets. This restored clarity of the visual axis, improved visual acuity, and eliminated the need for IOL replacement. The technique is simple and less invasive than IOL exchange and may become the preferred way to remove silicone droplets from an IOL. ( info)

20/235. Combined cataract extraction and submacular blood clot evacuation for globe perforation caused by retrobulbar injection.

    A 45-year-old woman, originally scheduled for cataract surgery in the left eye, was referred for management of a globe perforation noticed after the retrobulbar injection of an anesthetic solution. There was a moderate degree of vitreous hemorrhage, and initial visual acuity was hand movement. A submacular blood clot of about 4-disc diameter was detected when the vitreous hemorrhage gradually cleared. One week after the incident, combined phacoemulsification, intraocular lens implantation, pars plana vitrectomy, and submacular clot removal using tissue plasminogen activator (tPA) as an adjunct were performed. Recovery was uneventful. At the last follow-up 6 months after surgery, best corrected visual acuity was 20/30. ( info)
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