1/17. 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) |
2/17. Retinal arteriovenous communication.BACKGROUND: Disturbances in development of the embryonic vascular system, though uncommon, may cause formation of retinal arteriovenous communications (RAC). Such anomalies may also involve the intracranial, orbital, and maxillofacial blood vessels. Field loss, neovascular glaucoma, optic atrophy, Parinaud syndrome, hemiparesis, hemiplegia, and proptosis may be associated with RAC. CASE REPORT: A 27-year-old woman was referred for photography of a vascular anomaly in her left eye. I noted a large arteriovenous malformation joining major temporal branches of the left central retinal artery and vein. External and internal examination of both eyes was otherwise unremarkable. Visual-field testing revealed nasal field disturbances for the left eye, but none for the right eye. CT scan showed no obvious intracranial abnormalities. CONCLUSIONS: Visual-field testing may show scotomas associated with retinal arteriovenous communications. It is possible for patients with RAC to have no associated vascular abnormalities elsewhere in the circulation of the head.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/17. Acute macular neuroretinopathy.An unrecognized acute macular affection occurred in four women, 24 to 35 years old, using oral contraceptives who complained of a sudden decrease of visual acuity or paracentral scotomas. Three patients had bilateral lesions and one patient had unilateral lesions. These lesions consisted of darkish brown-red, wedge-shaped dots in the macula pointing to the fovea. These dots were located mostly on the nasal side to the macula. Biomicroscoby showed these lesions were located in the superficial layers of the retina. The retinal vessels, pigment epithelium, and optic disk showed no distinct pathologic features. fluorescein angiography, performed repeatedly, showed some questionably dilated perimacular capillaries without leakage in two cases. Static perimetry delineated dense paracentral scotomas. Recovery was slow or absent, confirmed py perimetric observation. Ophthalmoscopic, fluorescein angiography, and perimetric details excluded an affection of the pigment epithelium, the nerve fiber layer, and the optic disk. Since the affection appears to be localized superficially in the retina, we called this specific entity acute macular neuroretinopathy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/17. Junctional scotoma in giant cerebral aneurysm.A brain lesion located at the lateral side of the sella turcica can produce a junctional scotoma by compressing the ipsilateral optic nerve and the contralateral inferonasal nerve fiber. This study reports a female patient with a junctional scotoma caused by a cerebral aneurysm. At the initial visit, she complained of visual disturbance in both eyes and the right optic disc was atrophied. The visual field showed right blindness and left superotemporal quadrantopsia. A brain CT indicated an approximately 3 cm sized brain mass located superolateral to the sella turcica. The brain MRI showed the lesion to be more like an aneurysm than a pituitary adenoma. Therefore, 4 vessels angiography was done, and this lesion was confirmed to be a sellar variant of an aneurysm located at the right carotid siphon. Like a tumor of the optic chiasm, a cerebral aneurysm can cause visual disturbance and visual field defects. Therefore, an early differential diagnosis is important because the prognosis and treatment of an aneurysm differ.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/17. Congenital retinal macrovessel causes reduced retinal sensitivity at the macula.PURPOSE: To report a case of reduced macular sensitivity at the macula due to congenital retinal macrovessel as measured by liquid crystal display (LCD) microperimetry. methods: Case report. RESULTS: We present a patient with normal visual acuity OU, with fundus OS revealing a congenital retinal macrovessel. LCD microperimetry of the macular area OS revealed reduced sensitivity of the superior retina (median sensitivity, 13.0 dB) compared to the inferior retina (median sensitivity, 15.0 dB) based on numerical values of the sensitivity. Such a difference of sensitivity was not found in OD which had a normal fundus ezamination. CONCLUSIONS: The patient's congenital macrovessel may be causing a relative angioscotoma with reduced retinal sensitivity in the superior half of the macula as compared to the inferior half.- - - - - - - - - - ranking = 7keywords = vessel (Clic here for more details about this article) |
6/17. Ocular ichemia syndrome - a malignant course of giant cell arteritis.PURPOSE: To call attention to a malignant course of ocular ischemic syndrome in patients with giant cell arteritis (GCA). methods/PATIENT: A 84-year-old woman developed severe headache for about 3 (1/2) months prior to myocardial infarction and visual disturbances. RESULTS: An anterior ischemic optic neuropathy (AION) in the right eye with a distinct reduction in visual acuity was found. The retina revealed several cotton-wool spots in both eyes. Serologic examinations showed inflammatory signs. Despite treatment with prednisolone, eye pressure decreased to 2 mm Hg in the right eye and 4 mm Hg in the left eye in a few days. An ischemic iritis developed in the right eye. visual acuity worsened to detection of hand motions in the right eye and to 0.1 in the left eye. Approximately 8 (1/2) months after her initial headache, a biopsy was carried out. The patient was treated continuously with corticosteroids. histology of the superficial temporal artery indicated inflammatory cells in the vessel wall. - The patients daughter developed symptoms of GCA at the age of 54 years. CONCLUSION: An ocular ischemic syndrome points to a malignant course of the disease. A cardiac infarction can develop in GCA. A biopsy of the temporal artery can reveal inflammatory changes even after 8 (1/2) months.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/17. Photofield mapping in the evaluation and management of subretinal neovascularization.Photofield mapping is a useful method for classifying subretinal neovascularization based on its area and location. Careful central field mapping is performed to delineate scotomata during evaluation of patients with subretinal new vessels. A photofield map is then constructed by projecting 35 mm fundus photographs and angiograms onto an appropriately-oriented central visual field map. The composite map (photofield) documents the location and relationship of scotomata, subretinal neovascularization, foveal avascular zone, and retinal blood vessels. The areas of subretinal neovascularization and scotomata are measured in square millimeters with a planimeter. The distance between their closest edge and the center of the foveal avascular zone is measured in millimeters. This method permits quantitative comparison of results with different photocoagulation protocols and instrumentation. Such comparative analysis may help improve the technique and instrumentation used in laser photocoagulation of subretinal neovascularization.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
8/17. Retinal ultrastructural findings in cone degeneration.We studied an eye from a 73-year-old man with a sporadic type of retinal cone degeneration and choroidal melanoma. Histologic and ultrastructural studies of the nasal retina unaffected by the choroidal melanoma showed alterations at the outer retina predominantly involving the photoreceptors and retinal pigment epithelium. A wide spectrum of pathologic changes were observed, ranging from near normal retina showing only photoreceptor outer segment disease (distortion and kinking) to grossly pathologic regions where photoreceptor cell bodies were sparse and their outer segments absent. The retinal pigment epithelium in minimally affected regions of the retina showed an increased proportion of the melanin complement of the cell within complex granules. In severe disease, many cells showed only giant complex granules with no free melanin. Retinal pigment epithelial cell migration and relocation around blood vessels was also noted in severe disease.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/17. Cilioretinal artery occlusion: a case report.A young man had an occlusion of the cilioretinal artery. Recirculation in the vessel was established within 48 hours. The retinal damage has been permanent with no improvement in visual acuity. fluorescein angiography during the stages of occlusion and established recirculation have been described. Vascular spasm of a short posterior ciliary artery due to smoking is the likely causal factor. The site of obstruction and the hemodynamic factors have been discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/17. X-recessive angiopathic opticopathy.A familial optic atrophy with X-recessive heredity, distinct from Leber's optic atrophy (loa), is described. The symptoms are: slight to moderate pallor of the papillomacular bundle at the disc possibly preceded by some hyperaemia of the disc, telangiectasia on the disc with normal retinal vessels, occurrence in the second decade of life, slow progression with often subclinical visual loss, a small relative central scotoma with an intact peripheral visual field, slight acquired tritanopia and deuteranopia, and vasomotor headaches. The disease may exhibit severe exacerbations with loss of vision to 1/60, provoked by vasoconstrictors and reacting favourably to vasodilators. This acute loss of vision is associated with ischaemia of the disc, a deep central scotoma with marked disturbance of colour vision in the form of an acquired deuteranopia, and sensoparalytic pupils. This is followed by increasing pallor of the disc, slow resolution of the central scotoma with a permanent reduction in the central light sensitivity, markedly disturbed Visual evoked potentials (VEP), acquired deuteranopia and normal ERG and EOG. In contrast to all hereditary opticopathies so far described, fluorescein angiography showed a disturbance of perfusion in the peripapillary choroid and the prelaminar part of the optic nerve. A similar disturbance of perfusion is described in anterior ischaemic optic neuropathy (AION) and low-tension glaucoma. To these acquired, non-hereditary recessive vascular opticopathies, which usually occur late in life, will have to be added the X-recessive vascular optic atrophy which we describe here, for which we propose the name: X-recessive angiopathic opticopathy. The differential diagnosis from some other hereditary, especially X-recessive, optic atrophies is discussed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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