1/5. Central retinal vascular obstruction secondary to melanocytoma of the optic disc.A 35-year-old black man developed abrupt visual loss in his left eye. Ophthalmic examination revealed a deeply pigmented mass obscuring the optic disc, hemorrhagic retinopathy, and signs of central retinal vascular obstruction. fluorescein angiography disclosed sluggish filling of the retinal blood vessels; ultrasonography disclosed an acoustically solid mass in the optic nerve head. Cytopathologic findings of a fine needle aspiration biopsy specimen demonstrated probable benign tumor cells, but melanoma could not be excluded. Histopathologic findings in the enucleated eye revealed a large, necrotic melanocytoma of the optic disc and hemorrhagic necrosis of the retina secondary to obstruction of the central retinal artery and vein. Melanocytoma of the optic nerve can undergo spontaneous necrosis and induce central retinal vascular obstruction. Abrupt visual loss in a patient with a melanocytoma does not necessarily imply malignant transformation.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. Systemic non-Hodgkin's lymphoma with optic nerve infiltration in a patient with AIDS.PURPOSE: To report the clinicopathologic features of a patient with AIDS and clinically regressed systemic non-Hodgkin's lymphoma who subsequently developed lymphomatous infiltration of the optic nerve and occlusion of the central retinal vein in both eyes. methods: The eyes of this patient were examined ophthalmologically and by fluorescein angiography. The eyes, brain, and body were obtained after death and studied by light microscopy. RESULTS: Ophthalmic examination and fluorescein angiography revealed optic nerve swelling and central retinal vein occlusion first in the left eye and shortly thereafter in the right eye. Postmortem histopathologic examination showed dense infiltration of both optic nerves by lymphoma as well as necrotizing vasculitis involving the retinal vessels near the left optic nerve head. Examination of the brain revealed lymphomatous involvement in the paraventricular region with associated necrosis and inflammation. No bone marrow recurrence or other residual systemic lymphoma was present. CONCLUSION: This case demonstrates that infiltrative optic neuropathy may occur as the sole ocular manifestation of disease recurrence in a patient with systemic non-Hodgkin's lymphoma otherwise thought to be in clinical remission.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/5. Benefits and complications of photodynamic therapy of papillary capillary hemangiomas.OBJECTIVE: To evaluate the potential benefit and risks of photodynamic therapy (PDT) in the treatment of papillary capillary hemangioma. DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Five patients with solitary capillary hemangioma on the temporal portion of the optic nerve presenting with exudative decompensation and decrease in visual acuity (VA). methods: All eyes received a standardized PDT treatment with 6 mg/kg body surface area verteporfin and application of 100 J/cm(2) light at 692 nm. One to three PDT courses were performed until resolution of exudation was achieved. A continuous follow-up was provided with documentation 1 week before and at 4 to 6 weeks, 3 months, and 12 months after the last treatment application. MAIN OUTCOME MEASURES: Functional parameters included best-refracted VA (Early Treatment diabetic retinopathy Study), and central scanning laser ophthalmoscope (SLO) scotometry and peripheral (automated perimetry) visual fields; anatomic parameters were presence of retinal edema or serous detachment (ophthalmoscopy) and tumor size (ultrasonography). RESULTS: Pretreatment VA levels ranged from 20/40 to 20/800; posttreatment levels ranged from 20/64 to 20/2000. Tumor regression with resolution of macular exudate and serous retinal detachment was obtained in all eyes. A decline in VA of 1, 3, and 10 lines, respectively, was documented in three patients. Complications included transient decompensation of vascular permeability, occlusion of retinal vessels, and ischemia of the optic nerve. CONCLUSIONS: PDT is successful in reducing tumor size and exudative activity. Vaso-occlusive effects at the level of the retina and optic nerve compromise the functional benefit. Parameters proven safe in choroidal neovascularization may be inappropriate in retinal capillary lesions of the optic nerve.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. Involution of retinochoroidal shunt vessel after radiotherapy for optic nerve sheath meningioma.PURPOSE: To illustrate the development and involution of retinochoroidal shunt vessel of the optic disc in a patient with primary optic nerve sheath meningioma. CASE REPORT: A 38-year-old woman presented with gradual onset of blurred vision in her right eye. Examination revealed a right relative afferent pupillary defect and mild edema of the right optic disc. Computed tomography (CT) showed changes consistent with a primary optic nerve sheath meningioma affecting the orbital portion of the right optic nerve. Patient was observed without treatment and subsequently developed a retinochoroidal shunt vessel on her right optic disc. With progression of the meningioma towards the optic chiasm, treatment with stereotactic radiosurgery was done. Following treatment, the optic disc gradually became pale and the retinochoroidal shunt vessel decreased in caliber with complete involution three years after radiotherapy.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
5/5. Optociliary veins in optic nerve sheath meningioma. indocyanine green videoangiography findings.OBJECTIVE: To report the indocyanine green videoangiography (ICG-V) characteristics of optociliary veins (OV) in optic nerve sheath meningioma (ONSM). DESIGN: Case series. PARTICIPANTS: Four eyes (patients) with OV and ONSM were examined. INTERVENTION: indocyanine green videoangiography and intravenous fluorescein angiography (IVFA) were prospectively performed. MAIN OUTCOME MEASURES: The course of OV in ONSM cases was observed with ICG-V and IVFA. RESULTS: On ICG-V, the course of OV was followed from their origin at small tributaries of the central retinal vein, their junction with choroidal veins, and finally to their drainage in the vortex venous system. The authors found an inverse relationship between the degree of optic disc edema and the development and ease of visualization of the optociliary veins and their draining course through the choroidal circulation. The mean time from the injection of indocyanine green to the visualization of OV's draining choroidal vessels was 35.4 seconds (range, 25.4-50 seconds). Intravenous fluorescein angiography allowed visualization of OV only at the margins of the optic disc in all cases. CONCLUSION: indocyanine green videoangiography provides important and new information in cases with OV and ONSM that is not obtained with IVFA. Such information may provide important knowledge regarding the hemodynamics of the choroidal circulation in normal and pathologic states.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |