1/10. Histopathological findings in proliferative membrane from a patient with sarcoid uveitis.BACKGROUND: Sarcoid uveitis is occasionally accompanied by proliferative changes, such as retinal neovascularization and vitreous hemorrhage. Steroid administration, retinal photocoagulation, and vitrectomy may be indicated in such proliferative cases. CASE: A 19-year-old woman presented with proliferative sarcoid uveitis accompanied by recurrent vitreous hemorrhage. OBSERVATIONS: At the initial examination, bilateral vitreous opacity, retinal exudates, mild vitreous hemorrhage, retinal vasculitis, and neovascularization of the retina and optic disc were observed. Although prednisolone was administered and panretinal photocoagulation was performed several times, recurrent vitreous hemorrhage continued. Since the vitreous hemorrhage was not absorbed, pars plana vitrectomy and lensectomy were performed. After surgery, neovascularization and intraocular inflammation decreased, and the corrected visual acuity in the right eye improved to 20/50. Histopathologic analysis of the proliferative membrane removed during surgery revealed substantial neovascularization and numerous neutrophils in the vessels. CONCLUSIONS: Based on these findings, an inflammatory reaction as well as retinal ischemia were thought to be involved in the proliferative changes in this patient.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/10. Opacification of a hydrophilic acrylic intraocular lens with exacerbation of Behcet's uveitis.Behcet's disease is 1 of the most common causes of uveitis in the Eastern world. Its common ocular complications are uveitis, cataract, and obliteration of retinal vessels. phacoemulsification with intraocular lens (IOL) implantation in patients with Behcet's disease is known to be a safe procedure. We managed a patient with Behcet's disease who had aggravated uveitis and opacification of a hydrophilic acrylic IOL (ACRL-C160, Ophthalmed) 4 months after cataract surgery. Recalcitrant uveitis despite maximum tolerable medication and IOL opacification with vitreous opacity necessitated an IOL exchange and trans pars plana vitrectomy. After the procedure, the eye became quiescent. However, the visual acuity was 20/200 because of the obliteration of retinal vessels.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
3/10. Anterior uveitis in a child with Takayasu's arteritis.Takayasu's arteritis is a rare idiopathic arteriopathy that produces narrowing and eventually closure of affected blood vessels. Ocular symptoms typically occur late in the disease process in those individuals who have severe involvement of the aortic arch and the carotid arteries. Visual loss typically occurs as a result of either systemic hypertension or concomitant ocular hypo-perfusion. We describe an unusual case of Takayasu's arteritis presenting in a child who complained of painful blurred vision. In this individual, no carotid artery disease was identified on vascular imaging and no evidence of impairment of ocular perfusion was demonstrable. Vision loss in this instance was due to anterior uveitis and cystoid maculopathy. These are atypical and rarely described features of Takayasu's arteritis. The patient responded well to anti-inflammatory treatment and his symptoms resolved. The clinical significance of these findings are discussed and the relevant literature reviewed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/10. Multiple retinal hemorrhage following anterior chamber paracentesis in uveitic glaucoma.PURPOSE: We describe the occurrence of a massive retinal hemorrhage following anterior chamber paracentesis in uveitic glaucoma. methods: A 33-year-old man who suffered from uveitic glaucoma was transferred to our hospital. The lOP in both his eyes was documented to vary between 11 mmHg and 43 mmHg and remained at a continuously high level for 7 months despite maximally tolerable medical treatment. A paracentesis was performed bilaterally to lower the IOP. RESULTS: Immediately after the paracentesis, massive retinal hemorrhages occurred in the left eye. Multiple round blot retinal hemorrhages with white centers occurred in the equator and peripheral retina, and small slit hemorrhages were observed in the peripapillary area. A fluorescence angiography(FAG) showed no obstruction of retinal vessels but a slightly delayed arteriovenous time in the left eye. CONCLUSIONS: It is important to be aware that patients who have a persistent relatively high IOP are at an increased risk of developing decompression retinopathy due to paracentesis and filtering surgery.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/10. Clinical and immunopathological studies of pars planitis in a family.We examined a family in which two brothers with identical HLA typing have pars planitis with snowbanking. Immunopathological studies of one of their eyes showed that in the area of snowbanking over the pars plana there was mild to moderate inflammatory cell infiltration, consisting of mostly Pan T (Leu 4 ) lymphocytes. The ratio of T helper/inducer to T suppressor/cytotoxic cells was approximately 10:1. Few macrophages (OKM1 ) were identified. Very few B cells and no NK cells were observed. Some retinal vessels had a perivascular infiltration consisting of mostly T lymphocytes. Most of the inflammatory cells bore class II antigens (HLA-DR ), while T cells bore few IL-2 receptors (anti-TAC ). The snowbank consisted mainly of glial elements (GFAP ) and basement membrane components (type IV collagen and laminin) with the predominant cell the Muller cell (Mu ). A site of inflammation at the iris-ciliary body junction also stained for B cells (Leu 14 ). These findings suggest that the snowbank could be formed by the glial elements of the peripheral retina. The chronic inflammation in pars planitis appears to consist of helper T cells, both in the pars plana, and the retinal vasculature.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/10. Delayed hypersensitivity to retrobulbar injections of methylprednisolone acetate.A patient with chronic cyclitis developed hyperemia of the episcleral and bulbar conjunctival vessels after retrobulbar injections of methylprednisolone acetate suspension. Intradermal testing revealed the responsible allergen to be methylprednisolone acetate; hypersensitivity could not be demonstrated by patch testing, despite use of increased concentrations.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/10. psoriasis and intraocular inflammation.Presented in this series were seven men and three women. Ages when seen, ranged from 32 to 68 years (average 54). psoriasis had begun in childhood in the women and in the late 20's and 30's in the men. arthritis (ankylosing spondylitis) was present in only one. Their ocular inflammations began from ages 26 to 62 (average 41). The onset of the inflammation was acute iritis in four and in indolent iridocylcitis in six. All but one were bilateral and chronic. The vitreous had heavy debris in nine of the ten patients. The retina was normal in only three. Boggy congestion was present in two with cystoid edema. Patches of edema. fluorescein leaking, depigmentation of both maculae, pars plana exudate, and retinal vessel obliteration to grey-white, shaggy cords was present in at least one of the remaining five patients. Systemic corticosteroid therapy has been used in eight of the ten patients described in this report. Doses no higher than 30 mg of prednisone per day were used to initiate reversal of the inflammatory response. In case 10, knowledge of the sensitivity of the process to steroids led to the successful rapid reversal of a recalcitrant iritis with only 20 mg of prednisone as a first dose and 20 mg per day for less than three weeks. maintenance corticosteroid therapy ranged from 40 mg of prednisone every other day in case 9, prednisone 12.5 mg one day and 5 mg the next in case 8, to 8 mg of Aristocort or methylprednisolone acetate (M-edrol) daily in cases 1 and 2. In summary, these patients are older, have an indolent onset bilateral uveitis with dense vitreous debris, retinal abnormalites, and are extremely sensitive to systemic corticosteroids. Many of these patients had undergone the series of clinical evaluations known as a "uveitis survey." Many different systemic abnormalities were found and merited treatment which rarely made a difference in their ocular disease, though two improved after infected teeth were treated. Assuming that these ocular diseases were related to psoriasis, one can then challenge the value of anything found by a "uveitis survey." The author uses information gained from such studies to insure that the patient is in the best possible heatlh and then makes clinical correlations such as presented in this paper. The rarity of this combination of ocular inflammations in patients with psoriasis makes it risky to propose that this is a significant association. Arguments that this is a disease entity began with the clinical similarities: older age, indolent onset, vitreous and retinal involvement, and the extreme sensitivity to systemic corticosteroids. None of these patients had psoriatic arthritis and only one had ankylosing spondylitis. The best explanation for the fact that this disorder has not been emphasized in the past would be an attitude of ophthalmologists and physicians that the eye and skin disease were coincident.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/10. choroidal neovascularization in long-standing case of Vogt-Koyanagi-Harada disease.The eyes in a case of Vogt-Koyanagi-Harada disease (VKH) with long-standing uveitis for 26 years after the onset were studied histopathologically. It was found that typical granulomatous inflammation was persistent in the uveal tract and the choroidal neovascularization occurred in the peripheral fundus accompanied by proliferation of the retinal pigment epithelial cells (RPE). Some of the new vessels under the pigment epithelium extended into the vitreous. It was concluded that the ocular inflammation of VKH was essentially granulomatous even in this long-standing case. Disappearance of choroidal melanocytes, existence of epithelioid cells containing pigment granules, and accumulation of lymphocytes and plasma cells in the lesion indicated that the inflammation was an autoimmune reaction against uveal melanocytes, although the trigger initiating the disease remains unknown. It was further concluded that the peripheral fundus as well as the peripapillary and macular areas was a predilected site for choroidal neovascularization in chronic uveitis. The choroidal neovascularization may develop in such a way that the uveal inflammation damages the Bruch's membrane and choriocapillaris and consequently causes retinal ischemia, thus stimulating the endothelium of the choriocapillaris and the overlying RPE to proliferate. There is a close relation between choroidal neovascularization and proliferation of RPE. choroidal neovascularization may cause reactive proliferation of the RPE and vice versa.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/10. iridocyclitis and an iris mass associated with secondary syphilis.A 34-year-old white man developed iridocyclitis and an iris mass. The iridocyclitis was preceded by a nodular rash which spared the palms and soles. An anterior segment fluorescein angiogram was performed which showed numerous permeable vessels. An ultrasound examination of the mass showed that it extended to the ciliary body. He had both a positive RPRCT and FTA-Abs. A skin biopsy was done which disclosed the nodules to be a rare form of secondary syphilis. The patient was treated with topical steroids and a cycloplegic agent, and later prednisone and intravenous penicillin, with eventual resolution of iris mass, iridocyclitis and skin nodules.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/10. Secondary syphilis with iris papules.A 30-year-old man developed bilateral iridocyclitis with iris roseolae and papules three months after the rash of secondary syphilis. The inflammation resolved after treatment with penicillin, intramuscularly, topically given corticosteroids, and cycloplegics. The serum immune-complex levels were slightly increased. iris angiography showed leakage of fluorescein in the region of the papules and roseolae and from the vessels of the pupillary margin. When the eye was clinically uninflamed, a follow-up angiogram showed leakage of fluorescein from the same areas, suggesting that the inflammatory effect on the iris vessels persisted in the region of the roseolae, the papules, and the sphincter vessels.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
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