1/28. Blurred vision and high blood pressure in a young woman.A 41-year-old woman presented with a short history of blurred vision. She had a 6-year history of refractory hypertension which had been treated with a variety of drug regimens. She was found to have bilateral branch retinal vein occlusion. retinal vein occlusion is a recognised complication of hypertension but simultaneous involvement of both eyes is extremely rare. Following this episode, blood pressure control has improved without change in drug therapy, suggesting that treatment compliance may partly explain the previous difficulties.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/28. Venous collateral remodeling in a patient with posttraumatic glaucoma.PURPOSE: To photographically document venous collateral development, remodeling, and regression in a patient with traumatic glaucoma. methods: Consecutive fundus photographs were evaluated, labeled, and correlated with the clinical history of a patient with unilateral posttraumatic glaucoma. RESULTS: This report photographically documents the appearance, remodeling, and subsequent disappearance of collateral vessels from venous occlusion on the surface of the optic disk in an eye with increased intraocular pressure and progressive glaucomatous cupping. CONCLUSIONS: Asymptomatic chronic obstruction of a branch retinal vein on the optic disk may cause venous collaterals to develop in the absence of retinal hemorrhages or other signs of venous occlusive disease. Increased intraocular pressure, arteriolarsclerosis, and glaucomatous cupping are risk factors for these occlusions.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |
3/28. Cilioretinal artery occlusion with central retinal vein occlusion.BACKGROUND: Combined cilioretinal artery and retinal vein occlusions are infrequently documented retinal vascular disorders of speculative origin. Occlusion of the cilioretinal artery is believed to result from either mechanical compression of the artery as a result of an increase in venous pressure or from a reduction in perfusion pressure in both the cilioretinal and retinal arteries. The ophthalmoscopic and angiographic features of this condition are reviewed. case reports: Two cases of cilioretinal artery occlusion after central retinal vein occlusion are presented, one of which evolved to the development of iris neovascularization. DISCUSSION: The incidence of cilioretinal artery occlusions due to central retinal vein occlusions is infrequently reported in the literature. Excluding those with chronic cystoid macular edema, most patients have a favorable visual outcome. It is possible that the incidence of combined cilioretinal artery and central retinal vein occlusions is grossly underestimated.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |
4/28. Familial primary pulmonary hypertension and associated ocular findings.BACKGROUND: Familial primary pulmonary hypertension (PPH) is a rare, fatal, autosomal dominant disease that results in right heart failure from idiopathic obliteration of the pulmonary arteries. patients develop stagnation of venous blood flow and elevated venous pressure. methods: The authors retrospectively reviewed the clinical records of three patients diagnosed with PPH that was confirmed on the basis of physical examination, chest X-ray, electrocardiogram, and echocardiogram. cardiac catheterization excluded cardiac shunt and other secondary causes of pulmonary hypertension. RESULTS: Two patients presented with a clinical picture resembling venous stasis retinopathy, and one with bilateral choroidal detachments. Two patients had delayed choroidal filling on fluorescein angiography, which was confirmed in one patient with indocyanine green videoangiography. CONCLUSIONS: Elevated venous pressure found in PPH is responsible for the delayed choroidal perfusion and the reduced venous blood outflow. This explains the clinical findings of venous stasis retinopathy and choroidal detachments seen in these patients.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |
5/28. Hemiretinal vein occlusion associated with membranous glomerulonephritis.PURPOSE: To report a patient in whom the finding of hemiretinal vein occlusion led to the diagnosis of membranous glomerulonephritis. DESIGN: Interventional case report. methods: A 44-year-old tennis instructor presented with a 1-week history of blurred vision in the left eye. Examination of the left eye demonstrated a best-corrected visual acuity of 20/40 and an inferior hemiretinal vein occlusion. RESULTS: blood pressure was normal, and the patient was referred for a medical examination, which revealed membranous glomerulonephritis. The patient was treated with oral prednisone and cyclosporine. Four months after presentation, the left eye demonstrated resolution of the vascular abnormalities and had a best-corrected visual acuity of 20/20. CONCLUSION: retinal vein occlusion may be associated with membranous glomerulonephritis. Treatment of the systemic disease may be associated with regression of the retinal vascular abnormalities.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
6/28. Intravitreal triamcinolone acetonide in eyes with cystoid macular edema associated with central retinal vein occlusion.PURPOSE: To evaluate treatment of cystoid macular edema associated with central retinal vein occlusion with intravitreal triamcinolone acetonide. methods: This study included 10 eyes of nine patients with perfused central retinal vein occlusion with visual acuity of 20/50 or worse. Following baseline evaluation, including best-corrected visual acuity, intraocular pressure (IOP), fluorescein angiography, and volumetric optical coherence tomography (VOCT), triamcinolone acetonide (4 mg in 0.1 ml) was injected into the vitreous cavity. RESULTS: Mean duration from the time of diagnosis to the intravitreal injection was 15.4 months. All 10 eyes demonstrated biomicroscopic improvement in cystoid macular edema with corresponding improvement in VOCT measurements from a mean of 4.2 mm(3) preinjection to a mean of 2.6 mm(3) at last follow-up (P <.001). Mean best-corrected visual acuity improved from 58 letters (range, 37-72) at baseline to 78 letters (range, 50-100 letters) at last follow-up (average, 4.8 months). The visual acuity improvement was statistically significant (P =.01). Six eyes (60%) were > or =20/50. There were no significant complications. Three eyes (30%) without previous history of glaucoma required initiation of topical aqueous suppressant therapy for IOP elevation at last follow-up. One eye with a previous history of open-angle glaucoma required a trabeculectomy. CONCLUSIONS: Intravitreal injection of triamcinolone acetonide appears to be effective in reducing cystoid macular edema associated with central retinal vein occlusion. This reduction often corresponded to an improvement in visual acuity. Further evaluation is warranted to assess its safety and efficacy in these eyes.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
7/28. Central retinal artery occlusion after radial optic neurotomy in a patient with central retinal vein occlusion.PURPOSE: To describe a patient with a central retinal vein occlusion (CRVO) who developed central retinal artery occlusion after radial optic neurotomy. DESIGN: Interventional case report. methods: A 70-year-old woman with CRVO underwent a radial optic neurotomy on her right eye. Her preoperative visual acuity in the affected eye was 20/400. RESULTS: Radial optic neurotomy was performed after phacoemulsification and aspiration for a cataract with intraocular lens implantation. At the insertion of a CRVO knife, pulsating bleeding occurred from the cup of the optic disk; the bleeding was stopped within 2 minutes by elevating the intraocular pressure to 80 mm Hg. On the following day, the patient noticed that she had lost light perception. fluorescein angiography showed a marked delay of arterial filling, indicating a central retinal artery occlusion. Retinal circulation returned to normal 2 months later; however, her vision was still no light perception. CONCLUSIONS: Ophthalmologists should be aware that severe complications such as central retinal artery occlusion can be associated with radial optic neurotomy, which is an unproven surgical procedure with a questionable pathophysiologic mechanism.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
8/28. Bilateral retinal venous occlusion in pigmentary glaucoma.BACKGROUND: The association of central retinal vein occlusion with primary open angle glaucoma is well known. This communication reports the occurrence of branch retinal vein occlusion and central retinal vein occlusion in a case of pigmentary glaucoma. methods: A 32-year-old man presented with old branch retinal vein occlusion in one eye and resolving central retinal vein occlusion in the other eye. Examination revealed bilateral Krukenberg's spindle and hyperpigmented trabecular meshwork. intraocular pressure was 30 mmHg OU. Topical antiglaucoma medication was prescribed. RESULTS: intraocular pressure was controlled with topical antiglaucoma medication. CONCLUSION: The present report suggests that intraocular pressure monitoring is important in eyes even with branch retinal vein occlusion. Pigment dispersion may be the underlying cause for bilateral retinal vein occlusion, especially in young patients.- - - - - - - - - - ranking = 0.6keywords = pressure (Clic here for more details about this article) |
9/28. vitrectomy with complete posterior hyaloid removal for ischemic central retinal vein occlusion: series of cases.BACKGROUND: Central retinal vein occlusion (CRVO) is a common retinal vascular disorder with potentially complications: (1) persistent macular edema and (2) neovascular glaucoma. No safe treatment exists that promotes the return of lost vision. Eyes with CRVO may be predisposed to vitreous degeneration. It has been suggested that if the vitreous remains attached to the macula owing to a firm vitreomacular adhesion, the resultant vitreous traction can cause inflammation with retinal capillary dilation, leakage and subsequent edema6. The roll of vitrectomy in ischemic CRVO surgical procedures has not been evaluated. CASE PRESENTATION: This is a non comparative, prospective, longitudinal, experimental and descriptive series of cases. Ten eyes with ischemic CRVO. vitrectomy with complete posterior hyaloid removal was performed. VA, rubeosis, intraocular pressure (IOP), and macular edema were evaluated clinically. Multifocal ERG (m-ERG), fluorescein angiography (FAG) and optic coherence tomography (OCT) were performed. Follow-up was at least 6 months. Moderate improvement of visual acuity was observed in 60% eyes and stabilized in 40%. IOP changed from 15.7 /- 3.05 mmHg to 14.9 /- 2.69 mmHg post-operative and macular edema from 976 /- 196 microm to 640 /- 191 microm to six month. The P1 wave amplitude changed from 25.46 /- 12.4 mV to 20.54 /- 11.2 mV. CONCLUSION: A solo PPV with posterior hyaloid removal may help to improve anatomic and functional retina conditions in some cases. These results should be considered when analyzing other surgical maneuvers.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
10/28. Intravitreal triamcinolone as primary treatment of cystoid macular edema secondary to branch retinal vein occlusion.PURPOSE: To describe six patients treated with intravitreal triamcinolone (IVT) as primary therapy for cystoid macular edema (CME) secondary to branch retinal vein occlusion (BRVO). methods: Retrospective case series. RESULTS: The age of the patients ranged from 53 years to 87 years (mean, 66 years). The time between BRVO and treatment with IVT ranged from 2.0 months to 4.7 months (mean, 3.5 months). Pretreatment visual acuity ranged from 20/40 to 6/200 (mean, 20/166). Length of follow-up ranged from 107 days to 175 days (mean, 149.5 days). Final visual acuity ranged from 20/40 to 3/200 (mean, 20/137). Three of six eyes showed improvement in vision. All three patients who did not have vision improvement were treated with a second injection. At the final follow-up visit, all six eyes had improved vision from baseline. Five (83.3%) of six eyes showed an improvement of > or = 2 lines of vision. One patient had a postoperative rise in intraocular pressure requiring a trabeculectomy. Final visual acuity in the 6 eyes ranged from 20/200 to 20/30 (mean, 20/106). CONCLUSION: IVT may be of potential use in treating CME due to BRVO, as either a primary or an adjunctive treatment modality. A prospective, randomized trial to clarify this role is warranted.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
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