1/6. Histopathological findings in proliferative membrane from a patient with sarcoid uveitis.BACKGROUND: Sarcoid uveitis is occasionally accompanied by proliferative changes, such as retinal neovascularization and vitreous hemorrhage. Steroid administration, retinal photocoagulation, and vitrectomy may be indicated in such proliferative cases. CASE: A 19-year-old woman presented with proliferative sarcoid uveitis accompanied by recurrent vitreous hemorrhage. OBSERVATIONS: At the initial examination, bilateral vitreous opacity, retinal exudates, mild vitreous hemorrhage, retinal vasculitis, and neovascularization of the retina and optic disc were observed. Although prednisolone was administered and panretinal photocoagulation was performed several times, recurrent vitreous hemorrhage continued. Since the vitreous hemorrhage was not absorbed, pars plana vitrectomy and lensectomy were performed. After surgery, neovascularization and intraocular inflammation decreased, and the corrected visual acuity in the right eye improved to 20/50. Histopathologic analysis of the proliferative membrane removed during surgery revealed substantial neovascularization and numerous neutrophils in the vessels. CONCLUSIONS: Based on these findings, an inflammatory reaction as well as retinal ischemia were thought to be involved in the proliferative changes in this patient.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/6. Surgical management of epiretinal membrane in young patients.PURPOSE: To report the outcome of epiretinal membrane (ERM) surgery in young patients. DESIGN: Interventional case series study. METHOD: A retrospective review of 20 young patients who had undergone vitrectomy and epiretinal membrane removal. All patients had a preoperative examination, including fundus biomicroscopy, red free photographs, and fluorescein angiography. RESULTS: Nine patients were males and 11 females (age: 7-26 years; mean: 16.3 years). Follow up ranged from 4-96 months (mean: 21.2 months). The 20 patients comprised 13 cases of idiopathic ERM, six cases in which ERM was associated with ocular inflammation and one case of combined hamartoma of the retina and retinal pigment epithelium (RPE). In 13 cases, the ERM was especially white, thick, and opaque, with localized constriction and severe retinal distortion. Final best-corrected visual acuity (VA) was significantly better than preoperatively (20/50 vs. 20/112), (P = 0.0002). Mean improvement in VA was 4.25 lines and 17 patients gained two or more lines. This improvement was better in secondary than idiopathic ERM (6 lines vs. 3.3). During follow up, five cases of recurrence were observed (25%). In another case, postoperative persistent ocular hypertension required filtering surgery. CONCLUSION: The characteristics of ERM in young patients are quite different in many cases from those in adults in terms of thickness and adherence. Removal of ERM in young patients is feasible and safe although the membrane may focally adhere strongly to retinal vessels. VA usually improves significantly after surgery, but recurrences are more frequent than in adults.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/6. Massive vascular endothelium growth factor (VEGF) expression in Eales' disease.BACKGROUND: Eales' disease is an idiopathic retinal vasculitic and vaso-occlusive process complicated by extensive retinal neovascularisation and vitreous hemorrhages. The great propensity to produce retinal neovessels is one of the particular aspects of the disease that deserves to be further investigated. We report a case of Eales' disease having evolved over more than three decades, with a typical clinical presentation in one eye, while the other eye had to be enucleated because of a terminal neovascular glaucoma, thus allowing pathological examination. methods: The functional right eye was treated by vitrectomy, cerclage, cryocoagulation and endolaser. The non-functional phthitic left eye was enucleated and submitted for histopathological and immunohistochemical examination using antibodies against vascular endothelial growth factor, T-cells, B-cells and Muller cells. RESULTS: Evolution was favourable in the operated right eye, following management of the inflammatory reaction. The histopathological examination of the left eye revealed an occlusion of the anterior chamber angle by rubeosis iridis, tractional retinal detachments, pre-, intra- and sub-retinal neovascular membranes, and vitrous hemorrhages. Diffuse positive anti-VEGF immunostaining was found at the level of the retinal neovascular membranes. The retina exhibited prominent Muller cell immunostaining, indicating extensive gliosis, and predominantly B cell infiltrates were found in the eye. CONCLUSION: The present study indicates a close relationship between the prominent neovascular proliferation in Eales' disease and the intense expression of VEGF. The increased expression of VEGF, when compared to other conditions inducing neovascularisation, might explain the severity of neovascular growth and the propensity of repeated vitrous hemorrhages in Eales' disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/6. epiretinal membrane formation is a late manifestation of shaken baby syndrome.shaken baby syndrome is a constellation of injuries resulting from the intentional shaking type movement of a child who is usually younger than 3-years-old. This rapid acceleration-deceleration movement of the head is responsible for lesions attributed to shearing forces placed on the vitreoretinal structures and meningeal vessels across the dura. The ophthalmic findings include intraocular hemorrhages, perimacular retinal folds, and peripheral retinoschisis in the presence of intracranial injuries such as subdural hematomas without obvious external signs of head trauma. We describe a case of late development of an epiretinal membrane in a child with a history of shaken baby syndrome and propose a differential diagnosis list for epiretinal membrane formation in the pediatric age group.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/6. Retinal contraction and metamorphopsia scores in eyes with idiopathic epiretinal membrane.PURPOSE: Using M-charts (Inami Co., tokyo, japan), which were developed by the authors to measure metamorphopsia, and image-analysis software, which was developed to quantify retinal contraction, the authors investigated the relationship between the degree of retinal contraction and the degree of metamorphopsia in eyes with idiopathic epiretinal membrane (ERM). methods: This study was conducted in 29 eyes with ERM (29 patients, 20 women; mean age, 62.1 /- 8.6 years) observed for at least 3 years (mean, 3.55 /- 0.6 years) after diagnosis. Horizontal (MH) and vertical (MV) metamorphopsia scores were obtained with the M-charts. Horizontal and vertical retinal contraction due to ERM was measured by using image-analysis software developed by the authors to calculate horizontal and vertical components of changes in the locations of retinal vessels on sequential fundus images. RESULTS: There was a significant (P < 0.01) positive correlation between the degree of retinal contraction and metamorphopsia score. In addition, there were significant positive correlations between horizontal contraction of the retina and the MV score (P < 0.01) and between vertical contraction of the retina and the MH score (P < 0.05). No significant correlations were found between change in the metamorphopsia score and change in visual acuity or mean defect. CONCLUSIONS: Metamorphopsia scores correlate well with measurements of retinal contraction due to idiopathic ERM. Using M-charts is a simple and useful method for quantitatively monitoring metamorphopsia in patients with ERM.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/6. Correlation study between optical coherence tomography and fluorescein angiography in post-membrane peeling recalcitrant macular oedema.Correlation between optical coherence tomography and fluorescein angiography in a post-membrane peeling patient indicated a surgically disturbed retinal vessel as the cause of recalcitrant macular oedema.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |