1/39. Venous collateral remodeling in a patient with posttraumatic glaucoma.PURPOSE: To photographically document venous collateral development, remodeling, and regression in a patient with traumatic glaucoma. methods: Consecutive fundus photographs were evaluated, labeled, and correlated with the clinical history of a patient with unilateral posttraumatic glaucoma. RESULTS: This report photographically documents the appearance, remodeling, and subsequent disappearance of collateral vessels from venous occlusion on the surface of the optic disk in an eye with increased intraocular pressure and progressive glaucomatous cupping. CONCLUSIONS: Asymptomatic chronic obstruction of a branch retinal vein on the optic disk may cause venous collaterals to develop in the absence of retinal hemorrhages or other signs of venous occlusive disease. Increased intraocular pressure, arteriolarsclerosis, and glaucomatous cupping are risk factors for these occlusions.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/39. Central retinal vein occlusion: report of two familial cases.The authors report a 46-year-old father and 17-year-old son who each presented with unilateral central retinal vein occlusion (CRVO) and bilateral abnormalities of retinal vascular perfusion. The son presented with a nonperfused CRVO in the left eye, developed traction-rhegmatogenous retinal detachment treated with vitreous surgery, and developed prolonged arteriovenous filling in the retina of the fellow eye. The father presented with progressive CRVO in the right eye, developed choroido-vitreal neovascularization following laser treatment to create a chorioretinal anastomosis, underwent vitrectomy for retinal detachment and vitreous hemorrhage in that eye, and developed prolonged arm-eye and retinal arteriovenous circulation times in the fellow eye. An extensive evaluation (including hematological studies and imaging of the major vessels of the neck) failed to reveal a predisposing cause in either patient although echocardiography disclosed a mitral valve thrombus in the father. After institution of coumadin therapy, the circulatory parameters in the fellow eye of each patient improved.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/39. The diagnostic challenge of occult large vessel ischemia of the retina and choroid.Vascular occlusions of the retina and choroid can cause severe visual loss. These occlusions can occur as a result of systemic disease or after surgery. In most cases, the retinal appearance provides evidence of ischemia as the cause of visual loss. On occasion, however, clinical examination shows no objective signs of vascular occlusion, and this can lead the clinician to suspect optic nerve pathology as the cause of visual loss. This paper outlines some of the diagnostic criteria, clinical findings, and ancillary studies that can be used to differentiate between occult occlusion of the retina or choroid and optic nerve disease.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
4/39. Central retinal vein occlusion combined with cilioretinal artery occlusion.A healthy 65-year-old man with sudden profound visual loss in his right eye presented with clinical signs of central retinal venous occlusion and retinal whitening, indicative of a cilioretinal arterial obstruction. He had been diagnosed with cilioretinal artery occlusion at a private ophthalmology clinic three days before being referred to our department. On fluorescein angiogram of the affected eye, the proximal portion of the retinal arteries filled with dye 27.3 seconds after injection, indicating a delay in retinal arterial filling. Moreover, the cilioretinal artery did not fill at that phase, but went on to fill 45.1 seconds after injection. Over 63.4 seconds after the filling of the retinal arteries, the laminar flow of the retinal venous vessels appeared. This was not until 90.7 seconds after injection. This patient was elderly, had no systemic diseases, and showed non-ischemic CRVO, prolonged retinal arterial filling on fluorescein angiography, and poor prognosis in visual acuity. His clinical course seemed to favor the pathogenetic hypothesis of a primary arterial affection.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/39. Case report: indocyanine green dye leakage from retinal artery in branch retinal vein occlusion.BACKGROUND: Little is known about retinal vascular lesions underlying hemorrhage in the acute phase of branch retinal vein occlusion (BRVO). CASE: A 64-year-old woman presented with a decrease in visual acuity of ten-day duration in her left eye. OBSERVATIONS: At the initial examination, her left fundus showed the typical appearance of BRVO, including retinal bleeding and soft exudates in the lower half of the fundus, after the arteriovenous crossing. fluorescein angiography showed no detail in the retinal vessels, which were occluded by retinal bleeding. However, in the early phase of indocyanine green (ICG) angiography, ICG dye leaked from the retinal artery at a point proximal to the first bifurcation. In the late phase of ICG angiography, the dye pooled along the retinal artery in a fusiform fashion. One year after laser photocoagulation was performed in the area of the BRVO, ICG dye leakage from the retinal artery had completely disappeared. CONCLUSIONS: These findings suggest that the changes in the retina detected by ICG angiography may have been associated with the onset of BRVO. In patients with acute BRVO, ICG angiography may be used to evaluate retinal arterial lesions covered by hemorrhage and provide useful information.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/39. 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) |
7/39. Hemodynamic changes in two patients with retinal circulatory disturbances shown by fluorescein angiography using a scanning laser ophthalmoscope.PURPOSE: To assess hemodynamic changes in two patients with severely affected retinal circulation. methods: A 62-year-old man with central retinal artery occlusion and a 46-year-old woman with branch retinal vein occlusion were studied by fluorescein angiography with a scanning laser ophthalmoscope (SLO). fluorescein angiography with SLO revealed hypofluorescent clumps of different sizes and hyperfluorescent dots in large retinal vessels. The velocities of the hypofluorescent clumps were calculated between two points on the same vessel, and movements of the hypofluorescent clumps and the hyperfluorescent dots were investigated. RESULTS: The velocities of the hypofluorescent clumps were slow and varied in the same vessel. The velocities of the hypofluorescent clumps increased at the sites with narrow calibers. The hypofluorescent clumps occasionally changed size in the bloodstream. The hypofluorescent clumps flowed along the walls of retinal vessels. Distance between consecutive hypofluorescent clumps was wide. Some vessels filled with hypofluorescent clumps were also detected. Rolling hyperfluorescent dots were seen in fluorescent plasma. CONCLUSIONS: The hypofluorescent clumps were concluded to be packed erythrocytes and the hyperfluorescent dots corresponded to leukocytes and platelets moving in the vessels. fluorescein angiography with SLO is a useful method for evaluating hemodynamic changes using the hypofluorescent clumps in severely affected retinal circulation.- - - - - - - - - - ranking = 6keywords = vessel (Clic here for more details about this article) |
8/39. Unusual retinal vasculitis in a patient with protein s deficiency and systemic toxoplasmosis: a case report.A 28-year old female patient presented with unilateral dropped visual acuity and a central scotoma. Fundus examination and a fluorescein angiogram were suggestive for central retinal vein prethrombosis. Further tests revealed an isolated protein s deficiency for which oral anticoagulation therapy was initiated. Six months later she presented with new symptoms of a right retrobulbar pain on ocular movements. The retinal vessels had normalized with improved visual acuity. Re-evaluation of the fluorescein angiogram taken six months earlier showed an image compatible with unilateral vasculitis. During this six month period persisting high levels of IgG and IgM antibodies against toxoplasma were observed while no signs of other active infection could be found. This report illustrates that in cases of prethrombosis with vasculitis in a young patient, a full medical examination and a thorough investigation of infectious diseases are warranted.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/39. Analysis of retinal and choroidal circulation during central retinal vein occlusion using indocyanine green videoangiography.OBJECTIVE: To explore the hemodynamic changes and their correlation with clinical presentation during central retinal vein occlusion. MATERIALS AND methods: Retrospective, 2-center study. The medical records of 27 patients with central retinal vein occlusion were reviewed. For each patient, the plasma transit in central retinal vessels and in peripapillary choroidal vessels was analyzed using indocyanine green videoangiography. RESULTS: The incidence of alteration in retinal plasma transit, ie, pulsatile filling of arteries and/or veins and increased arteriovenous filling time, was inversely correlated to duration from the onset but not to funduscopic features. Among the 14 patients with less than 1 month's duration of symptoms, 3 developed chronic macular edema, and impairment of arterial flow preceded its onset. Among the 10 patients with opticociliary circulation, choroidal drainage routes were identified in 5 cases, with pulsatile filling in 3. CONCLUSIONS: Early in the course of central retinal vein occlusion, arterial and/or venous flow alterations are present, irrespective of visual acuity, vein dilation, or fundus hemorrhages. These alterations are less frequent in chronic than in recent-onset central retinal vein occlusion. The mechanisms of these alterations remain uncertain but may involve arterial constriction and/or intermittent venous compression. The relationship between these alterations in retinal flow and the secondary onset of macular edema or capillary nonperfusion deserves further investigation.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
10/39. Multiple retinal vein occlusions in essential thrombocythemia.PURPOSE: To report the ophthalmoscopic and angiographic evidence of both temporally and spatially independent multiple occlusions of the retinal veins in a patient with essential thrombocythemia. methods: Observational case report. Ophthalmic examinations, including fluorescein fundus angiogram, were performed on a 77-year-old male, who was found to have essential thrombocythemia. RESULTS: An acute impending central retinal vein occlusion in the left eye was diagnosed with coexisting old retinal vein occlusions evidenced by white vessels and capillary nonperfusion in both eyes. Peripheral retinal capillary dropout was also found angiographically in the right eye. CONCLUSION: Bilateral multiple occlusions of retinal veins in the present case suggest a prothrombotic tendency in retinal circulation in essential thrombocythemia.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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