1/20. Retinal opacification after blunt non-perforating concussional injuries to the globe. A clinical and retinal fluorescein angiographic study.Fluorescein angiographic studies are reported on fifteen patients presenting with retinal opacification after blunt mechanical non-perforating injuries involving the eye. In patients who subsequently regained full visual function and in whom complete resolution of the retinal changes occurred, retinal fluorography carried out less than 24 hours after injury revealed no abnormal features. In cases with more prolonged visual disability, retinal fluorescein examinations may, however, reveal damage to the retinal pigment epithelium before this becomes apparent on routine ophthalmoscopy, or the existence of impaired perfusion through the retinal vessels. It is suggested, therefore, that retinal fluorescein angiography has a role in assessing the visual prognosis in patients presenting with traumatic retinal oedema.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
2/20. Sorsby's fundus dystrophy.BACKGROUND: Sorsby's fundus dystrophy describes the condition in which an autosomal-dominant inherited macular dystrophy with bilateral central visual loss is accompanied by progressive atrophy of the peripheral choroid and, subsequently, the outer retina. The first symptom of this condition is nyctalopia, whereas (typically) the first sign is the appearance of white-yellow deposits in the posterior pole. CASE REPORT: We report a case of Sorsby's fundus dystrophy, manifested with central visual loss in the fifth decade of life. A battery of tests--including ophthalmoscopy, electroretinography, color vision, Pelli-Robson contrast sensitivity, and fluorescein angiography--were used to evaluate the condition. CONCLUSIONS: While advances in understanding the etiology of Sorsby's fundus dystrophy have been made, the condition remains difficult to treat and the outcome is often devastating. The benefits of various methods of treatment, such as laser photocoagulation and dietary supplementation are unclear patients affected by this condition should be managed in a manner similar to that for end-stage sufferers of age-related macular degeneration.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
3/20. Polypoidal choroidal vasculopathy treated with macular translocation: clinical pathological correlation.AIMS: To report the histopathology of two specimens of polypoidal choroidal vasculopathy (PCV) obtained from two eyes of Japanese patients. methods: Specimens were obtained under direct visualisation during macular translocation surgery with 360 degree retinotomy. The clinical findings were correlated with the light microscopic findings of the two specimens. RESULTS: One specimen from a 77 year old man was the central portion of the lesion that lay under the sensory retina on the retinal pigment epithelium (RPE). The specimen was made up mainly of fibrous tissue with small, thin walled vessels. indocyanine green angiography after surgery revealed that active leaking polypoidal element remained under the RPE. Another specimen obtained from a 62 year old man was made up of a fibrovascular membrane situated within Bruch's membrane. The part of this specimen inferior to the foveal region included a collection of dilated, thin walled blood vessels without pericytes, surrounded by macrophages that stained positive for CD68. The dilated vessels appeared to be correlated with the orange coloured polyps observed by ophthalmoscopy, the polypoidal structure seen in indocyanine green angiograms, and the pyramidal elevation with intermediate reflectivity by optical coherence tomography. CONCLUSION: Polypoidal structures are located within Bruch's space. They are composed of clusters of dilated, thin walled blood vessels surrounded by macrophages and fibrin material. The positive immunohistochemical staining for vascular endothelial growth factor in the RPE and the vascular endothelial cells suggests that this fibrovascular complex is a subretinal choroidal neovascularisation.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
4/20. Macular phototrauma after cataract extraction and multifocal lens implantation: case report.PURPOSE: To report a patient who developed photic injury after cataract surgery and multifocal MF4 lens implantation methods: A 41-year-old caucasian woman without antecedents of interest was subjected to left catarct surgery involving phacoemulsification with capsular sac implantation of a new type of multifocal lens. A coaxial light microscope was used for surgery. The operation was filmed and anterior pole photographs were obtained. RESULTS: Two days after the operation, the patient noted a paracentral scotoma and hand movement visual acuity in the left eye. Indirect ophthalmoscopy revealed an oval, hyperpigmented macular lesion compatible with phototoxic maculopathy. CONCLUSIONS: Phototoxic injury to the macula may occur after cataract extraction. Implantation of an intraocular lens is an important factor in the producion of maculopathy, on account of its light-focusing effect on the retina. This effect was probably increased in our patient by the use of a new autofocus multifocal lens.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
5/20. Cancer-associated retinopathy associated with invasive thymoma.PURPOSE: To report a case of cancer-associated retinopathy associated with invasive thymoma. DESIGN: Interventional case report. METHOD: A 41-year-old Japanese woman was observed between February 1998 and May 2001. Ophthalmologic examinations and systemic examinations were performed. The patient received treatment including corticosteroid pulse therapy, plasmapheresis, and thymectomy. RESULTS: The patient developed progressive visual dysfunction including bilateral visual acuity loss, concentric contraction of visual fields, and color vision loss. In both eyes, retinal vessel attenuation and retinal pigment epithelium degeneration were observed with fundus ophthalmoscopy and fluorescein angiography. Response in electroretinogram was reduced, suggesting both rod and cone dysfunction. Autoantibody against 23-kD cancer-associated retinopathy (CAR) antigen (antirecoverin antibody) was detected in the patient's serum. A mediastinal tumor that was histopathologically diagnosed as invasive thymoma was detected and was surgically resected. During more than 3 years of follow-up, no other malignancy was detected despite extensive systemic evaluation. The patient also suffered from subclinical myasthenia gravis. Although temporary improvement of visual function was observed after treatment with steroid pulse therapy and plasmapheresis' light perception of each eye was lost in the end. CONCLUSIONS: The patient was diagnosed as having CAR. Invasive thymoma was considered to be the causative tumor because there had been no evidence that suggested other systemic malignancy during more than 3 years of follow-up.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
6/20. Unilateral acute idiopathic maculopathy.PURPOSE: To discuss the fluorescein angiographic features and diagnosis as well as differential diagnosis. methods: In our hospital, we have found three cases of UAIM, one of them has eccentric maculopathy, another has papillitis, and the third associates with pregnancy. Each has characteristic clinical findings. We have made the diagnosis base on ophthalmoscopy and fluorescein angiography (FA). RESULTS: Three patients with UAIM have been experienced sudden unilateral decreased visual acuity. The significant changes on fundus are retinal pigment epithelium (RPE) thickening with neurosensory retinal detachment with in the macular area. FA showed early patchy hypofluorescence and hyperfluorescence at the level of the RPE. 'Bull's eye appearance may occur in the macular area after the acute stage of the disease. The clinical findings are similar to what the foreign report described. But there were no previous reports in china. CONCLUSION: We can establish the diagnosis on the base of clinical and fundus features associated with fluorescein angiographic findings. However, the etiology and pathology could not be identified. It required further research.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
7/20. Optical coherence tomography findings in nicotinic acid maculopathy.PURPOSE: To report optical coherence tomography findings in nicotinic acid maculopathy. DESIGN: Observational case report. METHOD: The patient was examined with ophthalmoscopy, fluorescein angiography, and optical coherence tomography. RESULTS: A 71-year-old man presented with bilateral decreased visual acuity with metamorphopsia. Optical coherence tomography demonstrated cystoid spaces in the outer plexiform layer and inner nuclear layer. fluorescein angiography did not show leakage. Two weeks after stopping the nicotinic acid, the cystoid spaces resolved. CONCLUSIONS: niacin maculopathy causes cystoid spaces in the inner nuclear and outer plexiform layers that resolve with discontinuation of the drug.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
8/20. Retinal and optic disc atrophy associated with a CACNA1F mutation in a Japanese family.OBJECTIVE: To describe retinal and optic disc atrophy and a progressive decrease of visual function in 2 Japanese brothers. Both had a mutation in the CACNA1F gene, the causative gene of incomplete congenital stationary night blindness (CSNB). methods: We studied observational case reports and performed comprehensive ophthalmologic examinations including best-corrected visual acuity, biomicroscopy, ophthalmoscopy, fundus photography, and electroretinography. Genomic dna was extracted from the peripheral blood, and all 48 exons of the CACNA1F gene were directly sequenced. RESULTS: The 2 brothers had retinal and optic disc atrophy and a progressive reduction of visual acuity with increasing age. Although these clinical features are not typical of previous patients with incomplete CSNB, both patients had an in-frame mutation with deletion and insertion in exon 4 of the CACNA1F gene. In both patients, the bright-flash, mixed rod-cone electroretinogram had a negative configuration, a characteristic of incomplete CSNB. However, the full-field scotopic and photopic electroretinograms were nonrecordable, indicating severe, diffuse retinal malfunction, which is not typical in incomplete CSNB. CONCLUSION: These findings indicate that a mutation of the CACNA1F gene may be associated with retinal and optic disc atrophy with a progressive decline of visual function.Clinical Relevance In patients with retinal and optic disc atrophy associated with negative-type electroretinograms, a CACNA1F gene mutation should be considered.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
9/20. Visual field testing in the management of cytomegalovirus retinitis.BACKGROUND: Sequential visual field testing is an extremely helpful adjunct to ophthalmoscopy and fundus photography in the management of cytomegalovirus (CMV) retinitis with the antiviral agents ganciclovir or foscarnet in patients with the acquired immune deficiency syndrome (AIDS). The authors studied the visual field defects found in a series of 110 patients with AIDS and CMV retinitis. methods: ophthalmoscopy and fundus photography were performed on all patients. Visual field analysis was performed with either tangent screen, Goldmann kinetic, or Humphrey automated static perimetry. RESULTS: Of 166 eyes in 110 patients with CMV retinitis, visual field defects were present initially in 92 (55%) eyes of 78 (70%) patients, and ultimately in 97 (53%) eyes of 90 patients in whom follow-up was available. Stabilization of visual field defects was indicative of controlled retinitis. CONCLUSION: Sequential visual field testing will confirm ophthalmoscopic evidence of successful antiviral treatment of CMV retinitis and will corroborate very early progression of previously controlled retinitis.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
10/20. Ocular filariasis due to wuchereria bancrofti presenting as panuveitis: a case report.PURPOSE: To report a case of ocular filariasis due to wuchereria bancrofti manifesting as panuveitis. DESIGN/methods: Observational case report. RESULT: A 30-year-old, healthy, Asian, Indian male presented with decreased vision and panuveitis with secondary glaucoma in the right eye. Careful slit-lamp examination revealed multiple, tiny, motile larvae in the anterior chamber. Indirect ophthalmoscopy showed vitritis with plenty of vitreous membranes, and subretinal yellow lesions in the peripheral retina along with retinal pigment epithelial tracts. An aqueous tap and a peripheral blood smear isolated microfilariae of W. bancrofti. Therapy with diethyl carbamazine citrate along with systemic steroids provided symptomatic relief. CONCLUSIONS: Ocular filariasis due to W. bancrofti is very rare. It can present in an otherwise asymptomatic patient without any constitutional symptoms. Careful examination, prompt diagnosis, and early treatment can reduce ocular morbidity.- - - - - - - - - - ranking = 1keywords = ophthalmoscopy (Clic here for more details about this article) |
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