1/77. Elastic cord-induced cyclodialysis cleft and hypotony maculopathy.We describe a case of hypotony maculopathy in which hypotony was due to a cyclodialysis cleft produced by an elastic cord injury. Sixteen months after being hit with an elastic cord, a 43-year-old white male presented with progressive loss of vision in the right eye. The visual acuity in the right eye was 1/200 due, in part, to a subluxated and cataractous lens. The intraocular pressure (IOP) was 4 mm Hg. gonioscopy revealed a cyclodialysis cleft at the 2 o'clock position, and fundus examination showed hypotony maculopathy. The patient underwent pars plana vitrectomy, pars plana lensectomy, repair of the cyclodialysis cleft, placement of an anterior chamber intraocular lens, and tightly sutured trabeculectomy without antimetabolite. Sixteen months following surgery, visual acuity was stable at 20/60 and IOP was 11 mm Hg but the chorioretinal folds persisted.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/77. Combination of autologous blood injection and bleb compression sutures to treat hypotony maculopathy.PURPOSE: To report successful use of a combination of autologous blood injection and bleb compression sutures to treat overfiltration with hypotony maculopathy after trabeculectomy with mitomycin C. methods: Two patients underwent the combined procedure and were followed until visual acuity and intraocular pressure (IOP) were stable over three consecutive visits (4 to 9 months). RESULTS: Both patients experienced improvement in visual acuity both subjectively and objectively, and both patients had an elevation in IOP that persisted over three consecutive visits. CONCLUSIONS: Combination autologous blood injection and bleb compression suture placement may be an effective means of treating hypotony maculopathy after trabeculectomy with mitomycin C.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/77. Single isolated cotton-wool spots.The presence of isolated cotton-wool spots in normal fundi may indicate serious systemic disease. In this presentation 4 patients were examined for blurred vision or scotomas with sudden onset. Two of them were pregnant. Funduscopic examination revealed soft-appearing white spots in the temporal arcades in 3 patients and in the papillomacular bundle in 1 patient. Due to the lack of other fundus lesions 3 of the patients were initially treated for toxoplasmosis. The patients were seronegative for typical viral (hiv), antinuclear antibodies, bacterial infections, or toxoplasmosis. Blood pressures, glycosylated hemoglobin and blood counts were in the normal range. At the follow-up examinations subjective symptoms had improved and the spots disappeared or were smaller and showed more distinct borders, and no new lesions were detected. These cases suggest that isolated cotton-wool spots may occur without serious systemic disease in otherwise healthy subjects and the spots may be misinterpreted as acute inflammatory retinochoroidal lesions.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/77. indocyanine green angiographic findings in 3 patients with traumatic hypotony maculopathy.PURPOSE: Little is known about the choroidal circulation in human eyes with ocular hypotony. Recently, indocyanine green angiography (IA) became a useful method for examining choroidal circulation. The present study using IA was designed to determine choroidal circulatory disturbances in patients with traumatic hypotony maculopathy. methods: indocyanine green angiography was performed on 3 consecutive patients (3 eyes) with traumatic hypotony. One patient underwent IA using an infrared fundus camera only during the hypotony stage. The other 2 patients underwent IA using a scanning laser ophthalmoscope before and after recovery of intraocular pressure (IOP). RESULTS: During the hypotony stage, IA revealed multiple hypofluorescent spots in many parts of the fundus, sector hypofluorescent areas, dilatation, and tortuosity of the choroidal vessels in the posterior pole. These findings had not been detected by fluorescein angiography. After surgical treatment, IOP returned to the normal range and visual acuity improved. indocyanine green angiography showed improvement of the sector hypofluorescent areas, and dilatation and tortuosity of choroidal vessels in the posterior pole. However, most of the hypofluorescent spots and regional delay of choroidal filling remained. CONCLUSIONS: indocyanine green angiography revealed that choroidal circulatory disturbances occurred during the hypotony stage and that some remained during the recovery stage.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/77. Neovascular glaucoma as a complication of retinal vasculitis in crohn disease.PURPOSE: To report a case of neovascular glaucoma as a complication of retinal vasculitis in crohn disease. methods: Case report with fluorescein angiogram. RESULTS: A 62-year-old man with biopsy-proven crohn disease presented with bilateral uveitis, bilateral iris new vessels, and neovascular glaucoma in the left eye. fluorescein angiography revealed signs of retinal vasculitis and capillary nonperfusion in both eyes. CONCLUSION: crohn disease may be associated with retinal vasculitis and, thus, neovascular glaucoma. A satisfactory result can be achieved by using corticosteroids to control the retinal vascular inflammation, by applying panretinal photocoagulation and by controlling the increased intraocular pressure surgically.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/77. Management of hypotony maculopathy and a large filtering bleb after trabeculectomy with mitomycin C: success with argon laser therapy.We report a patient with postkeratoplasty glaucoma that developed a large, filtering bleb following trabeculectomy with intraoperative antimetabolite treatment. The hypotony and the bleb were managed using argon laser photocoagulation. A 26-year-old female patient underwent penetrating keratoplasty in the left eye for keratoconus. Postoperatively, her elevated intraocular pressure could not be controlled medically, and the patient underwent a trabeculectomy with intraoperative antimetabolite application. Two months later, hypotony maculopathy, optic disc edema, and choroidal folds developed, and her vision dropped. Steroid treatment and soft contact lenses did not help. Photocoagulation was applied twice to the surface of the bleb and the surrounding area. After the photocoagulation therapy, the patient's vision improved, intraocular pressure increased, and the optic disc edema and macular folds had resolved. argon laser photocoagulation applied to a large filtering bleb associated with hypotony maculopathy is a useful treatment for bleb remodeling and elevating intraocular pressure.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
7/77. Reversible hypertensive retinopathy in a child with bilateral pheochromocytoma after tumor resection.pheochromocytoma is very rare in children. We report a case of bilateral pheochromocytoma in a 12-year-old boy who had blurred vision due to hypertensive retinopathy. Abdominal ultrasound and computed tomography revealed bilateral suprarenal tumors. Resection of the bilateral tumors along with right total and left subtotal adrenalectomy were performed. blood pressure and visual acuity returned to normal after surgery.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/77. 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 = 1keywords = pressure (Clic here for more details about this article) |
9/77. Multiple arterial ectasias in patients with sarcoidosis and uveitis.PURPOSE: To describe and evaluate the cause of a clinical entity characterized by bilateral intraocular inflammation, multiple arterial ectasias including beading, macroaneurysms, comma-like ectasias and kinking, with vasculitis, staining of the optic disk and multiple peripheral round punched-out hypopigmented chorioretinal scars in elderly patients. The formation and the course of the arterial ectasias is analyzed. methods: Seven patients with this syndrome were evaluated by clinical examination, fluorescein angiography, and systemic investigations. RESULTS: Three of the seven patients had a biopsy characteristic of sarcoidosis, two others showed positive bronchoalveolar lavage, as well as other analyses and tests suggesting sarcoidosis, and two showed other findings suggestive of sarcoidosis. The patients were all over 60 years of age and had arterial hypertension. In two patients, an arterial ectasia developed at the site of previous focal inflammation. The macroaneurysms either remained unchanged, became comma-like ectasias, arterial kinks, or completely vanished. CONCLUSION: Elderly patients with multiple arterial ectasias, uveitis, disk staining, and peripheral chorioretinitis should be thoroughly investigated for sarcoidosis. We suggest that sarcoidosis may cause some degree of arteritis, which may weaken the arterial wall, with resulting ectasia. Arterial hypertension may play a role in the formation of the ectasias by increasing the pressure on the arterial wall weakened by inflammation.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/77. Autologous blood injection for marked overfiltration early after trabeculectomy with mitomycin C.PURPOSE: After trabeculectomy with mitomycin C, extremely low intraocular pressure (IOP) with excess filtration may cause hypotonous maculopathy in the early postoperative period. We evaluated the effect of injecting autologous blood on reversing early postoperative marked hypotony after trabeculectomy with mitomycin C. methods: trabeculectomy with mitomycin C was performed in 258 eyes between 1994 and 1998. Peribleb autologous blood injection was performed in five eyes in which pressure patches were ineffective in reversing excess filtration. Approximately 0.1 to 0.3 ml of whole unclotted blood was slowly injected at least 3 mm from the edge of the flap using a sterile 27-gauge needle. RESULTS: None of these eyes developed hypotonous maculopathy after injection. After a mean 31-month follow-up, all eyes had well-controlled IOP and visual acuity in three eyes was much improved. postoperative complications included mild IOP elevation in one eye treated with laser suturelysis, and fibrinous pupillary membrane in one eye. CONCLUSION: In the early postoperative period, autologous blood injection is effective in reversing excess filtration.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
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