1/14. Asymptomatic unilateral microembolic retinopathy secondary to percutaneous transluminal coronary angioplasty.BACKGROUND: Percutaneous transluminal coronary angioplasty (PTCA) for the treatment of coronary artery disease has increased in frequency as technological advances have made the procedure more effective and cost-efficient. In spite of the number of procedures that have been performed, ocular complications have rarely been reported. CASE REPORT: A case of asymptomatic unilateral microembolic retinopathy one month after PTCA is presented. Embolic events to the retinal circulation and their relationship to invasive cardiac procedures is discussed. CONCLUSIONS: The embolic ocular complications of PTCA is probably underestimated due to the lack of symptoms from the partial occlusion of the larger retinal arteries and the total occlusion of the remote smaller vessels.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/14. Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization secondary to toxoplasmic chorioretinal scar.BACKGROUND: To assess the effect of photodynamic therapy in the treatment of subfoveal choroidal neovascularization consecutive to a toxoplasmic chorioretinal scar. history AND SIGNS: Three patients with a previous history of toxoplasmic chorioretinal scar noticed a decrease in visual acuity and metamorphopsia. Fundus examination and fluorescein angiography revealed the presence of subfoveal choroidal neovascularization at the edge of the toxoplasmic chorioretinal scar. THERAPY AND OUTCOME: The first patient, aged 78, was treated by photodynamic therapy followed by three subsequent treatments of feeder vessel by laser photocoagulation. visual acuity decreased during follow-up in the presence of recurrence of choroidal neovascularization and subretinal fibrosis. The second patient, a 20-year-old lady, was treated with three sessions of photodynamic therapy for a subfoveal choroidal neovascularization related to a toxoplasmic scar. visual acuity was stabilized on the last follow-up visit at 0.3. The third patient, aged 53, received four treatments with photodynamic therapy at an interval of 3 - 4 months. choroidal neovascularization was stabilized and the last visual acuity was 0.2. CONCLUSIONS: This preliminary report suggests that photodynamic therapy with verteporfine may be an effective therapeutic modality for subfoveal choroidal neovascularization related to a toxoplasmic chorioretinal scar. Further assessment is needed in order to confirm this preliminary findings.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/14. Acute multifocal inner retinitis.Two patients developed acute changes in vision two to four weeks after a febrile illness. On ophthalmic examination, each patient had bilateral vitreitis without anterior segment inflammation and multiple, bilateral, round, yellow-white inner retinal lesions that were located in the posterior pole and midperiphery. Laboratory tests did not contribute to a diagnosis. Symptomatic visual loss was caused by neuroretinitis and serous retinal detachment in one patient and by an occluded branch retinal artery in the other. The multifocal retinal lesions resolved gradually without treatment over several months with minimal or no residual retinal changes. Acute multifocal inner retinal lesions may be associated with a preceding nonspecific viral illness and may cause a sudden change in vision if associated with neuroretinitis, serous retinal detachment, or retinal vessel occlusion. We have termed this constellation of ophthalmic findings acute multifocal inner retinitis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/14. Aspergillus necrotizing retinitis. A clinico-pathologic study and review.The authors describe a case of bilateral acute necrotizing retinitis caused by aspergillus fumigatus in an immunocompromised host. The patient rapidly lose useful vision and expired from progressive systemic disease while on parenteral amphotericin b. Postmortem aqueous cultures were negative whereas vitreous cultures were positive. light and electron microscopy demonstrated marked choroidal and retinal vascular occlusion by fungi and thrombi, hyphae extending through vessel walls and the internal limiting membrane of the retina, fungi accumulating in tissue spaces, hyphae on the iris surface, and necrosis of the retina. In view of the extensive vascular occlusion present in this disease, early diagnostic vitrectomy plus intravitreal amphotericin b is recommended to deliver adequate drug levels to infected sites.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/14. Alteration of the blood-retina barriers in cases of viral retinitis.This paper presents three cases of serologically documented viral retinitis, and the great value of fluorescein angiography in outlining the structural abnormalities and the site of the lesions. Of our series in the case of influenza retinitis, the fluoroangiographic findings showed dye leakage from retinal vessels in the posterior pole. The dye leakage did not appear completely in the sites of macular edema. This edema was similar to the clinical appearance of cotton-wool spots and was arranged in a star-like pattern. One of the cases of cytomegalovirus retinitis (Case 3), a previously healthy adult with dysfunction of the cellular immune system, seems to be a further example of an inflammation in the inner retina presenting cotton-wool spots at the early stage. Case 2, a previously healthy adult, fulfilled the criteria for Vogt-Koyanagi-Harada syndrome. The patient had serologically documented cytomegalovirus infection with dysfunction of the cellular immune system. The fluorescein angiographic examination showed alteration both in the inner and outer blood-retina barriers as it is characteristic in cases of Harada syndrome. The cytomegalovirus infection might be assumed to play a role in the clinical picture as well as in the etiology of this disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/14. retinal neovascularization associated with acute retinal necrosis.Unilateral acute retinal necrosis (ARN), developed in a previously healthy 17-year-old boy. Neovascularization of the retina and optic disc was observed when the opaque vitreous was removed by pars plana vitrectomy. Following surgery there was a rapid resolution of neovascularization suggesting that intraocular inflammation, rather than retinal ischemia, was the cause of new vessel formation. Analysis of vitreous mononuclear cells with monoclonal antibodies and the fluorescence-activated cell sorter (FACS) revealed mostly T cells; a pattern consistent with intraocular infection as the cause of ARN. The pathogenesis of intraocular infection is complex and some patients with ARN may be helped by systemic immunosuppression (ie, corticosteroids).- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/14. Ocular candida with pale-centered hemorrhages.A 54-year-old man with severe thermal burns had candida corneal ulcers and candida septicemia develop, and he died 39 days after admission to the hospital. At autopsy examination, fungi were noted in the cornea to extend across the intact Descemet's membrane and were also found within foci of retinitis and choroiditis. Also, hemorrhages (some of which had pale centers) were present in both retinas. Histopathologic examination of these hemorrhages disclosed that the pale centers were comprised of a disrupted small blood vessel surrounded by an acellular material that most likely represented fibrin-platelet aggregates.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/14. Choroidoretinal vascular anastomosis.Vascular anastomoses between the retina and choroid may occur in different congenital and acquired conditions. It has been postulated that the direction of blood flow in these anastomoses follows a pressure gradient characterized as follows: choroidal artery greater than retinal artery greater than retinal vein greater than choroidal vein. Of the four possible directions of blood flow between the two circulations that this theory allows, only three have previously been reported. The fourth, described in this report, is a choroidoretinal vascular anastomosis with blood flow from a choroidal vessel into a retinal vein.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/14. Acute rubella retinal pigment epitheliitis in an adult.A 50-year-old man who had been taking betamethasone for 20 days experienced a slight bilateral decrease in visual acuity. There were localized dark-gray atrophic lesions at the posterior pole, accompanied by a diffuse detachment of the sensory retina. The retinal vessels appeared to be normal and only minimal anterior uveitis was present in the more severely affected eye. Fluorescein angiograms showed no masking of choroidal fluorescence in the early phase and late-phase fluorescein angiograms showed multifocal leakage of the dye into the subretinal space. Electro-oculographic findings were abnormal only during the acute stage in the more severely affected eye and returned to normal within three months. The retinal detachment spontaneously resolved within three months; visual acuity returned to normal but some atrophic areas remained in the retinal pigment epithelium. Because the antibody titer to rubella was 1:1,028 during the acute stage but decreased to 1:257 within one month, we believe this patient had rubella retinitis, a rare condition in adults. The betamethasone may have made him more susceptible to the viral infection.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/14. Acute retinal necrosis syndrome.Six patients with the acute retinal necrosis (ARN) syndrome are described. Ophthalmoscopic examination demonstrated occlusion of peripheral retinal vessels and patchy areas of peripheral retinal whitening spreading rapidly over a period of weeks to markedly decreased vision. In four patients, the disease was bilateral. Histologic examination of vitrectomy specimens from three cases and one enucleated eye revealed chronic granulomatous inflammation. Extensive medical evaluations were noncontributory, with no evidence of compromised immune systems. No patient demonstrated a response to any form of therapy. The etiology is unknown.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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