1/22. Delayed mustard gas keratopathy: clinical findings and confocal microscopy.PURPOSE: To describe the clinical manifestations and confocal microscopic findings in a patient with delayed mustard gas keratopathy. METHOD: Case report. A 32-year-old veteran who had participated in the iran iraq conflict was exposed to mustard gas in 1988. Ocular abnormalities in 1996 and 1998 and corneal confocal microscopic findings in 1998 are presented. RESULTS: In 1996, slit-lamp examination disclosed bilateral limbal changes with tortuous blood vessels and full-thickness corneal alterations. In 1998, the right eye had porcelain-white episcleral changes and adjacent peripheral ulcerative keratopathy. Confocal microscopy demonstrated irregular-appearing epithelial and basal epithelial cells. The anterior stroma was remarkable for spindle-like keratocytes, diffuse fibrillar inhomogeneities and the presence of highly reflective material. CONCLUSIONS: mustard gas keratopathy is a uncommon cause of ocular damage, but it may lead to delayed ocular damage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/22. Autoimmune keratolysis in a patient with leukocytoclastic vasculitis: unusual erythema elevatum diutinum with granulomatous pattern.PURPOSE: Leukocytoclastic vasculitis (LCCV) is an immune complex-mediated, small vessel disease that is clinically characterized by the presence of palpable purpuric lesions, most often in association with rheumatic diseases. Ocular manifestations of LCCV are rare. methods: We describe a patient with an unusual granulomatous pattern of erythema elevatum diutinum (EED) associated with autoimmune keratolysis. RESULTS: We studied a 64-year-old man with decreased visual acuity and nodular lesions in both hands. Ocular examination revealed bilateral superior corneal melting with perforation in the left eye and conjunctival thickening in both eyes, in association with a severe inflammatory reaction. Histopathologic examination of the conjunctiva revealed granulomatous vasculitis with neutrophilic infiltrate, giant cells, and fibroblastic proliferation. A punch biopsy taken from his skin showed similar characteristics that suggested EED; however, there were no giant cells. CONCLUSION: To our knowledge, autoimmune keratolysis secondary to cutaneous LCCV (EED) has not been described previously, and there has been no description of granulomatous reaction (in the conjunctiva) in EED.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/22. Photodynamic therapy of corneal neovascularization with verteporfin.PURPOSE: To describe the effect of photodynamic therapy (PDT) using verteporfin (Visudyne) on corneal neovascularization (CNV) in two patients. methods: Two patients with corneal neovascularization were treated with a nonthermal laser light at 689 nm delivered 15 min after an intravenous infusion of verteporfin. Postoperative outcome of neovascularization was followed clinically (inflammation, intraocular pressure, and visual acuity) and photographically [color photographs and corneal fluorescein and indocyanine green (ICG) angiography] for a minimum of 6 months. RESULTS: Successful photothrombosis of corneal neovascularization was obtained immediately after treatment in the two patients, and regression was verified by corneal fluorescein and ICG angiography. In one case, partial vessel recanalization was observed after 1 month, and treatment was repeated, with complete regression of new vessels. No relevant side effects were observed in our cases. CONCLUSIONS: PDT with verteporfin is an effective and safe procedure indicated for patients with corneal neovascularization; however, multiple sessions may be required.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/22. Subepithelial intracorneal hemorrhage in a soft contact lens user.PURPOSE: To describe a case of spontaneous subepithelial hemorrhage in a soft contact lens user. methods: A 45-year-old man with irritation and decreased vision had four-quadrant pannus and corneal subepithelial hemorrhage in an annular pattern. RESULTS: The subepithelial hemorrhage was drained and the feeder vessel coagulated. The hemorrhage subsequently absorbed with time. CONCLUSIONS: Soft contact lens users should be monitored for the development of significant neovascularization.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/22. Structural alteration and destructive corneal disease.There is good evidence that maintenance of the structural integrity of the human cornea carries with it significant advantages over and above the preservation of normal function. The breakdown in the protective layers of the cornea and invasion by blood vessels and lymphatics would seem to add greatly to the risk of recurrent inflammatory disease. There is a solid rationale, therefore, for the development of therapeutic principles aimed at preventing these structural changes from occurring.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/22. Deep corneal neovascularization after implantation with intrastromal corneal ring segments.PURPOSE: To demonstrate the development of deep corneal neovascularization after intrastromal corneal ring segment (ICRS) implantation, and to demonstrate complete regression after treatment with surgical removal and anti-inflammatory therapy. DESIGN: Observational case report. methods: A 29-year-old man developed deep stromal neovascularization after ICRS implantation for post-laser-assisted in situ keratomileusis ectasia that was not associated with the surgical wound. RESULTS: After surgical removal of the ICRS and treatment with topical prednisolone acetate 1.0% and cyclosporine A 1.0%, complete vessel regression occurred in 2 weeks. CONCLUSIONS: ICRS can induce deep corneal neovascularization that is not associated with the surgical wound. Surgical removal of the intrastromal ring and treatment with topical anti-inflammatory agents can induce vessel regression.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
7/22. Cutting and pasting corneas: combination of a corneal allograft with relocation of a crescent of autologous corneal tissue in therapeutic penetrating keratoplasty.PURPOSE: A therapeutic penetrating keratoplasty (TPKP) technique that achieves satisfactory visual rehabilitation with a minimal risk of rejection is described. methods: A patient presented with a central corneal perforation in the left eye extending to the temporal limbus. We performed a novel surgical procedure, in which a corneal allograft was combined with relocation of a crescent of autologous corneal tissue. RESULTS: The TPKP placed the optical zone of the donor cornea over the center of the entrance pupil. The chances of an immunologic rejection were minimized by intercalating a crescent of autologous tissue between the allograft and the limbal vessels. CONCLUSION: The combination of an allograft with a crescent of autologous corneal tissue minimizes the disadvantages associated with eccentric or oversized trephination.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/22. Cutis marmorata telangiectatica congenita associated with bilateral congenital retinal detachment.Cutis marmorata telangiectatica congenita is a rare congenital vascular disorder of the skin, characterized by persistent telangiectasia of the cutaneous blood vessels often associated with cutaneous ulcers. The only previously recognized ophthalmic association with this condition has been rare instances of unilateral congenital open angle glaucoma. The authors report their observations in a child in whom this cutaneous disorder was associated with congenital bilateral total retinal detachments and secondary neovascular glaucoma. The retinal detachments produced bilateral leukocoria simulating retinoblastoma. The cutaneous disorder and the ocular findings were confirmed histopathologically.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/22. Idiopathic bilateral lipid keratopathy.A 52-year-old Mexican man presented with asymptomatic, bilaterally symmetrical lipid infiltrates of the cornea and adjacent limbus. No evidence of previous ocular disease or systemic disorder of lipid metabolism could be detected. Penetrating keratoplasty of the right eye was required. The cornea was rigid and thick, with posterior bulging into the anterior chamber. light microscopy revealed deep corneal lipid granules, foamy histiocytes, vascularisation, and chronic non-granulomatous inflammation. Transmission electron microscopy showed extracellular lipid spaces and numerous intracytoplasmic lipid vacuoles in histiocytes, keratocytes, conjunctival epithelium, and the endothelium of blood vessels in the corneal stroma and adjacent limbal conjunctiva. Histochemical analysis revealed the presence of neutral fats, free fatty acids, cholesterol, and phospholipids.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/22. Spontaneous hyphaema and corneal haemorrhage as complications of microbial keratitis.Hyphaema developed spontaneously in 16 of 458 patients with microbial keratitis treated at two centres on the East and West Coasts of the united states. Chronic corneal conditions were often present, and three cases had rubeosis iridis. Inflamed iris vessels were assumed to be the source of the haemorrhage. The hyphaemas tended to persist longer than is usual, particularly when coincident with a hypopyon. Recurrent hyphaemas are reported in two patients from outside this series. Spontaneous corneal haemorrhage was seen in three cases. Subepithelial bleeding settled rapidly, but a combined midstromal and pre-Descemet's haematoma cleared more slowly. Anterior segment bleeding was significantly associated with advanced age, female sex, infection with Gram-positive organisms, and hypopyon.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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