1/8. Thinning and small holes at an impending tear of a retinal pigment epithelial detachment.BACKGROUND: A tear of a retinal pigment epithelial detachment (PED) suddenly exposes a large area of bare Bruch's membrane. We report here the case of a patient whom we observed during the gradual, spontaneous development of a PED tear. METHOD: A 5.25-year case study of a 67-year-old woman with bilateral serous PEDs. RESULTS: Retinal pigment epithelial (RPE) thinning or small holes were seen along the PED margin in both eyes. Fluorescein angiograms showed intense hyperfluorescence without leakage, and indocyanine green angiography showed choroidal vessels through regions of RPE thinning or small holes. Optical coherence tomographs showed an interruption of a hyperreflective band corresponding to retinal pigment epithelium. A typical tear of the PED ensued later. CONCLUSION: Multiple, small regions of RPE thinning or holes along the margin of PED can be a sign of an impending PED tear.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/8. A macular hole in a female adult with bilateral coats disease.PURPOSE: To report a case of a macular hole in a female adult with bilateral Coats disease. methods: The fundus photograph, fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in two eyes, and observed theirs characters. RESULTS: Fundus photograph showed massive yellowish-white exudation in the temporal midperiphery of both eyes, but the degree was slighter in the right eye. There was 1/3 DD macular hole in left eye. FFA revealed general dilatation of capillaries, multiple aneurysms, and tortuous and closure of vessels in superotemporal midperiphery in both eyes, but the degree was slighter in the right eye. There was a one-third DD round transmitted fluorescence according the macula hole. ICGA revealed that hyperfluorescence of aneurysms in superotemporal midperiphery, the images of aneurysms were more clearly than in FFA. There was a 2/3 DD hypoflurescence of macula in the late phase of angiography. CONCLUSIONS: FFA and ICGA have respective advantage in revealing vascular abnormalities of Coats disease. Maybe there was some relationship between the abnormalities of retinal vascular and hypoperfusion of choroidial vascular in macula in this case.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/8. Treatment of an avulsed retinal vessel with infrared diode laser photocoagulation.PURPOSE: To report the use of the infrared diode laser with long-duration pulses to successfully treat a patient with recurrent vitreous hemorrhages due to an avulsed retinal arteriole. DESIGN: Interventional case report. methods: A 70-year-old man presented with repeated, visually significant vitreous hemorrhages due to an avulsed retinal arteriole. Infrared diode laser photocoagulation with long-duration, large, overlapping spots was performed on either side of the avulsed segment. RESULTS: Resolution of the hemorrhage occurred within 1 month, without further episodes of bleeding. Two-year follow-up with fluorescein angiography showed complete cessation of blood flow through the treated segment. CONCLUSIONS: Infrared diode laser photocoagulation with long-duration pulses may be an effective, minimally invasive treatment of the avulsed retinal vessel syndrome.- - - - - - - - - - ranking = 5keywords = vessel (Clic here for more details about this article) |
4/8. Nd:YAG laser photodisruption of the vitreous traction in avulsed retinal vessel syndrome.We applied Nd:YAG laser photodisruption to vitreous traction in three patients with avulsed retinal vessel syndrome. In every case the vitreous traction on the avulsed vessels was relieved and the vessel that had been avulsed in the vitreous cavity returned to the retinal surface postoperatively. There were no serious intraoperative and postoperative complications, nor was there any evidence of recurrence of vitreous hemorrhage after the treatment.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
5/8. The management of retinal detachment complicating degenerative retinoschisis.We repaired six retinal detachments complicating degenerative retinoschisis by using simultaneous external subretinal fluid drainage and intraocular gas injection without a scleral buckle or vitrectomy. The outer wall breaks were 30 to 135 degrees in size, and in three cases, extended close to the arcade vessels. We achieved retinal reattachment and collapse of the schisis cavity at surgery in all six cases. In one case, the retina redetached postoperatively, but it was repaired with a scleral buckle and gas injection. This technique simplified the management of retinal detachments complicating degenerative retinoschisis, particularly those with large or posterior outer-layer breaks.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/8. retinal detachment with tear in the posterior fundus following ocular contusion.Two unusual cases of rhegmatogenous retinal detachment following contusion to the eyeball showed retinal tears at the posterior fundus close to the optic disc and the large retinal blood vessels. In both cases, the tears were not detected immediately after the injury due to a coexisting vitreous hemorrhage. Both patients were successfully treated by pars plana vitrectomy, air-fluid exchange, and endolaser photocoagulation. During vitrectomies, an adhesion of the vitreous to the flap or the operculum of the tear was observed, with detachment of the remainder of the posterior vitreous from the retina. vitrectomy allowed a more complete resolution of posterior tractional forces than scleral buckling, and eliminated the vitreous hemorrhage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/8. Visual field loss following vitreous surgery.OBJECTIVE: To assess possible causes of visual field loss following vitreous surgery. DESIGN: charts of 8 patients prospectively identified, who developed visual field loss following vitreous surgery, were reviewed to characterize this newly recognized syndrome and assess possible causes. RESULTS: Two patients had preexisting chronic open-angle glaucoma and 1 had ocular hypertension. Indications for surgery included 4 eyes with macular holes, 1 eye with epiretinal membrane, 2 eyes with rhegmatogenous retinal detachment, and 1 eye with retinal detachment and giant retinal tear. All patients received retrobulbar anesthesia. Seven of 8 patients had fluid/gas exchange with installation of long-acting bubbles. In 1 patient with a macular hole, a small hemorrhage was noted along a vessel coming off the nerve superotemporally while attempting to engage the posterior cortical vitreous intraoperatively. This patient developed an inferior visual field defect. No intraocular pressure (IOP) measurements greater than 26 mm Hg were recorded in any eye perioperatively. Visual field defects included 4 eyes with inferotemporal defects, 2 eyes with inferior altitudinal defects, 1 eye with a cecocentral scotoma, and 1 eye with a superonasal defect. Only 1 patient had worsened visual acuity. A relative afferent pupillary defect was observed in 4 eyes and disc pallor in 5 eyes. CONCLUSIONS: Central or peripheral visual field loss can now be recognized as a possible complication of vitreous surgery. In some cases, a relative afferent pupillary defect and optic disc pallor are present, suggesting that the optic nerve is the site of injury. Possible mechanisms include ischemia due to elevated IOP or fluctuations in IOP, optic nerve damage from retrobulbar injection, direct intraoperative mechanical trauma to the optic nerve, indirect injury from vigorous suction near the optic nerve leading to shearing of peripapillary axons or vessels, or a combination of these. Certain optic nerves may be more susceptible to injury because of preexisting compromise from glaucoma or vascular disease.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
8/8. Visual field defects after macular hole surgery.PURPOSE: To describe a group of patients with dense visual field defects following macular hole surgery. methods: Nine (7%) of 125 patients reviewed noted onset of dense visual field defects following uncomplicated vitrectomy with gas-fluid exchange for the treatment of macular hole. Patient records were reviewed to investigate the etiology of these defects. RESULTS: Eight (89%) of nine eyes that had surgery for macular hole developed dense, wedge-shaped visual field defects in the temporal periphery. One eye had an inferonasal wedge-shaped defect extending to fixation. Seven (78%) of nine eyes had generalized or focal narrowing of the retinal arteriole extending into the area of retina corresponding to the visual field defect, and five (56%) of nine eyes developed mild to moderate segmental nasal optic disk pallor. Postoperative fluorescein angiography disclosed one eye with delayed filling of the retinal arteriole extending into the area of retina corresponding to the visual field defect. vitrectomy specimens showed no evidence of nerve fiber layer or internal limiting membrane in eight (89%) of nine eyes. CONCLUSIONS: Visual field defects can occur following vitrectomy and gas-fluid exchange for macular hole. The most common visual field defect is dense and wedge-shaped and involves the temporal visual field. Although unclear, the etiology may involve trauma to the peripapillary retinal vasculature or nerve fiber layer during elevation of the posterior hyaloid or during aspiration at the time of air-fluid exchange, followed by compression and occlusion of the retinal peripapillary vessels during gas tamponade.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |