1/15. Long-term posterior and anterior segment complications of immune recovery uveitis associated with cytomegalovirus retinitis.PURPOSE: To identify and describe long-term posterior and anterior segment complications of immune recovery uveitis in patients with inactive cytomegalovirus retinitis who are undergoing highly active antiretroviral therapy-mediated recovery of immune function.methods: A prospective cohort study at a university medical center. Twenty-nine eyes of 21 patients with immune recovery uveitis and inactive cytomegalovirus retinitis were followed for 14.5 to 116 weeks (median, 43 weeks) after diagnosis of immune recovery uveitis. RESULTS: Nine eyes of nine patients developed visually important complications involving the posterior segment, anterior segment, or a combination of both. Posterior segment complications included severe proliferative vitreoretinopathy in three eyes and spontaneous vitreous hemorrhage from avulsion of a blood vessel secondary to contraction of the inflamed vitreous in one eye. Proliferative vitreoretinopathy recurred in all cases after surgery, severely compromising the visual outcome. Anterior segment complications included posterior subcapsular cataracts with vision decrease in five eyes and persistent anterior chamber inflammation after cataract extraction, resulting in posterior synechiae and large visually important lens deposits in three eyes.CONCLUSION: Persistent inflammation in immune recovery uveitis may lead to vision-threatening complications, such as proliferative vitreoretinopathy, posterior subcapsular cataracts, and severe postoperative inflammation. Immune recovery uveitis is a chronic inflammatory syndrome that may result in complications months to years after the onset of inflammation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/15. Recurrent hyphema in an aphakic child: Swan syndrome.In 1973, Swan described 3 patients who developed hyphema months to years after uncomplicated cataract surgery. He noted focal vascularization from an ingrowth of episcleral vessels at the cataract wound site, resulting in recurrent intraocular bleeding. Swan syndrome has been reported following intracapsular cataract extraction, extracapsular cataract extraction (including clear corneal incisions), iridocyclectomy, and glaucoma filtering procedures. patients typically present with sudden painless blurred vision, often upon awakening, which may or may not be preceded by physical strain or trauma. Other patients are asymptomatic and diagnosed with hyphema or anterior chamber red blood cells on routine examination. The hyphema often resolve spontaneously, making later diagnosis difficult. Gonioscopic visualization of the abnormal wound vessels is necessary for diagnosis. Without active bleeding, however, the fibrovascular tuft may be easily overlooked. We report a case of Swan syndrome in a 16-month-old boy after cataract extraction was performed. To our knowledge, Swan syndrome has not been reported in the pediatric population. Children represent a significant proportion of patients undergoing anterior segment surgery and Swan syndrome should be considered in the differential diagnosis of hyphema in this population.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
3/15. anterior chamber hemorrhage during cataract surgery in Lowe syndrome.This article reports a spontaneous intracameral bleeding at the end of cataract surgery in both eyes of two patients with Lowe syndrome. Extracapsular cataract extraction with anterior vitrectomy and posterior capsulotomy, using the anterior chamber maintainer (ACM), was performed in both eyes of two patients. At the conclusion of the surgery, when the ACM was removed, spontaneous bleeding occurred into the anterior chamber and spread into the vitreous cavity. The hemorrhage resolved spontaneously over varying periods of time. We propose that bleeding occurred from damage to iris vessels in the abnormal angle in our patients with Lowe syndrome when the ACM was removed with a concomitant decrease in intraocular pressure.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/15. Posttraumatic neovascularization in a cataractous crystalline lens.A 73-year-old woman presented with a dense traumatic cataract and intralens angiogenesis. Slitlamp examination showed abundant blood vessels in the lens stroma. Microscopic examination confirmed the presence of blood cells in the lumen. The angiogenesis represented an ingrowth into the lens from posterior synechias. Pathologic angiogenesis is frequently seen in the retina, vitreous, iris, and cornea but is rarely seen in the crystalline lens. This is the first well-documented case of angiogenesis in the lens stroma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/15. Multifocal choroiditis in patients with familial juvenile systemic granulomatosis.PURPOSE: To document clinical features of uveitis in patients with familial juvenile systemic granulomatosis. DESIGN: Retrospective chart review. methods: Ophthalmologic examination, medical history, and clinical course in 16 patients from eight families examined at six academic medical centers. RESULTS: Of the 16 patients, 15 had evidence of panuveitis with multifocal choroiditis. One patient had only an anterior uveitis. Ischemic optic neuropathy, presumably due to a small vessel vasculopathy, and retinal vasculopathy each occurred in one patient. Ocular complications were common, including cataracts in 11, glaucoma in six, band keratopathy in six, cystoid macular edema in six, and optic disk edema in six. All 16 patients had polyarthritis, and at least nine had skin rash. Often patients were misdiagnosed initially as having either juvenile rheumatoid arthritis or sarcoidosis. CONCLUSIONS: Familial juvenile systemic granulomatosis is an uncommon genetic disease characterized by polyarthritis and uveitis. panuveitis and multifocal choroiditis often may be present. patients with a diagnosis of juvenile rheumatoid arthritis but having a family history of the disease and multifocal choroiditis should be suspected of having familial juvenile systemic granulomatosis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/15. Bleeding during gonioscopy after deep sclerectomy.PURPOSE: To show a new complication after deep sclerectomy (DS). methods: We described two eyes of two patients with open-angle glaucoma and cataract who were operated on of an uneventful phacoemulsification and DS with SK-gel implantation. RESULTS: Bleeding during gonioscopic examination occurred in both eyes 7 and 8 months after combined surgery. The blood originated from the vessels around the Descemet window, and was probably due to manipulation or rocking of the goniolens. Pressure was immediately applied to the gonioscopic lens and the hyphema was interrupted. CONCLUSION: These cases show the presence of new vessels around the Descemet window after DS with SK-gel. Bleeding from the Descemet window vessels can occur during gonioscopy even months after DS. We recommend conducting a careful gonioscopic examination in patients who have undergone DS to avoid this complication.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
7/15. Coats' disease and bilateral cataract in a child with turner syndrome: a case report.PURPOSE: To report the first case in which Coats' disease was observed with infantile cataract in a girl with turner syndrome (TS). MATERIALS AND methods: We examined a 4-year-old female infant with TS who was referred with a diagnosis of leukocoria in the left eye. RESULTS AND DISCUSSION: Examination under anaesthesia revealed a bilateral punctate cataract and left eye fundus showed vascular retinal abnormalities typical of Coats' disease. cryotherapy was performed on the telangiectatic vessels and the child was followed up for a period of 12 months. Despite cryotherapy resulting in regression of the peripheral exudates, an exudative maculopathy persisted with poor visual outcome. We suggest that Coats' disease should be considered as a rare ocular manifestation in TS.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/15. Clinical ocular abnormalities in infants with trisomy 13.PURPOSE: Previous reports of ocular abnormalities associated with trisomy 13 have described pathologic abnormalities, with minimal descriptions of clinical findings. This report describes the clinical findings in four infants with trisomy 13. DESIGN: Retrospective noncomparative case series. methods: review of medical records of four infants with trisomy 13. One patient underwent cataract surgery and treatment of Coats disease. RESULTS: All four infants had inferonasal iris colobomas with unilateral inferonasal cataracts, primarily involving the posterior lens surface. Two patients had pigmented tissue associated with the cataracts. Cataract surgery was performed in one of the patients with good results. This patient also developed a unilateral exudative retinal detachment with peripheral telangiectatic vessels. This resolved after treatment with cryotherapy. CONCLUSIONS: The cataracts in these infants with trisomy 13 had similar clinical features, which were different than those seen in other types of cataracts in infants. In addition, one patient had Coats disease, which has not been previously described in association with trisomy 13. The presence of inferonasal iris colobomas and adjacent sectoral cataracts in patients with other dysmorphic findings should prompt chromosomal analysis for trisomy 13.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/15. Retinal changes in myotonic dystrophy: a clinicomorphological study.This report appears to be the first ultrastructural study of the maculopathy and peripheral pigmentary retinopathy in myotonic dystrophy. Nine eyes from five patients observed during life are described. The findings were similar in all eyes, the retinal pigment epithelium in the macular region containing an accumulation of lipofuscin in large hyperpigmented cells. Pigment-laden profiles found in the subpigment epithelial space or subretinal space were interpreted as an attempt to discharge the pigment. Stress fibres of actin microfilaments were thrown into prominence by the irregularity of the pigment epithelium. In the periphery migration of retinal pigment cells into the retina occasionally resulted in the formation of bone corpuscles around occluded vessels, as occurs in retinitis pigmentosa; but more often the clumps were coarser and surrounded basement membrane material. Central and peripheral epiretinal membranes were also observed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/15. retinitis pigmentosa and exudative vasculopathy.A patient with bilateral retinitis pigmentosa and exudative vasculopathy was initially seen with a blind and painful left eye, which was enucleated. Results of clinical study of the right eye and histopathologic and ultrastructural study of the enucleated left eye showed the abnormal vessels to be derived from the choroidal circulation. Previous clinical reports of retinitis pigmentosa with exudative vasculopathy have described retinal vascular abnormalities similar to those found in Coats' disease. From the comparison of our case with those previously reported, we conclude that different types of exudative vasculopathy may develop in the setting of retinitis pigmentosa.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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