1,720,968 research outputs found
Cystoid macular edema following cataract surgery.
No full textCYSTOID MACULAR EDEMA FOLLOWING CATARACT SURGERY
Alberto Rossetti and Daniele Doro
Cystoic macular edema (CME) is the most common cause of unexpected visual loss following cataract surgery. CME occurring in aphakic eyes with intraretinal fluorescein angiographic cystoid spaces has been termed the Irving-Gas syndrome. After extracapsular extraction chronic CME with permanent visual loss is estimated to occur in approximately 1% of patients.
The majority of cases occur between 4 and 12 week after cataract surgery. Predisposing factors are intraoperative complication ( e.g. vitreous loss or vitreous traction at the wound, severe iris trauma), diabetic retinopathy, and pre-existing epiretinal membrane.
The authors describe the pathogenesis , the diagnosis, the symptoms , the prevention and the medical therapy of CME
Ultrasound biomicroscopy examination of anterior uveal tumors: information on location and size only?
No full textThe aim of the study was to assess whether ultrasound biomicroscopy (UBM) examination of anterior uveal tumors could help in tissue differentiation. Five anterior uveal tumors in five patients underwent UBM (Paradigm P45, 50 MHz) examination prior to fine needle aspiration (FNA) of the lesion; two melanomas, one nevus, one metastatic carcinoma, and one bilateral iris lymphoma were cytologically diagnosed. Only UBM information was obtained from four small non-growing lesions consistent with iris nevi. Four ciliary body pigmented tumors elevated by 4 to 6 mm were examined both with UBM and immersion standardized echography (Cinescan S, Quantel Medical). UBM showed high reflective iris subsurface in all iris nevi. Of the FNA verified iridociliary pigmented tumors, the iris pigment epithelium was found to be indistinct in iridociliary melanoma only. Iridociliary melanoma, nevus and metastatic carcinoma showed angle invasion and similar acoustic pattern and reflectivity on UBM examination. Multiple iris masses were imaged in lymphoma and metastatic carcinoma. Two ciliary body low to medium reflective and two ciliary body high reflective tumors on standardized echography, consistent with ciliary body melanoma and melanocytoma, were plagued or observed for four and thirteen years; UBM was informative for superficial margins and angle invasion only. In conclusion, UBM was very useful for location and size of small anterior uveal tumors, but could not help in tissue differentiation of iridociliary tumors. Multiple iris lesions were found in iridociliary lymphoma or metastatic carcinoma only. Standardized echography allowed for tissue differentiation in at least 4-mm thick ciliary body pigmented tumors
Retained intravitreal lens fragments after phacoemulsification : complications and visual outcome in vitrectomized and non vitrectomized eyes
No full textI.F. 2.07
Intracorneal blood removal six weeks after canaplasty
No full textIn a 71-year-old patient with bilateral open-angle glaucoma, intracorneal blood was found after a canaloplasty procedure in the right eye. Six weeks after surgery on ultrasound biomicroscopy examination, liquified blood and blood clots could be observed nasally in the deep corneal stroma close to the Descemet's membrane. The intracorneal blood was washed out with balanced saline solution following deep corneal incision and lamellar dissection. Descemet's membrane was reattached with air injection into the anterior chamber. Two months later, visual acuity improved to 20/50, intraocular pressure was 16 mm Hg without medication and confocal microscopy showed deep stromal folds and limited endothelial cell loss. Viscoelastic entering the cornea at Schwalbe's line and reflux of blood from the collector channels to Schlemm's canal can account for corneal hematoma. Even six weeks after canaloplasty, successful blood removal could be fulfilled without rupturing the Descemet's membrane
Bilateral optic neuropathy and intraretinal deposits after pars plana vitrectomy in amyloidosis
No full textAbstract
Pathological examination of material from a nonextensive pars plana vitrectomy (PPV) in the right eye provided a diagnosis of nonfamilial amyloidosis in a 68-year-old woman, who presented with bilateral glass wool-like vitreous opacities. Genetic testing revealed a Tyr114Cys mutation in the transthyretin gene. Six months after PPV, perimetry showed intense constriction with a temporal island and central scotoma in the right eye. An extensive PPV was performed in the left eye. Spectral domain optical coherence tomography evidenced bilateral epimacular amyloid deposits and unreported reflective spots within the inner retina. One year later, visual acuity had decreased to 20/400 in the left eye, with mild vitreous opacity, pale cupped optic disc and inferior altitudinal field defect. Bilateral diurnal intraocular pressure, transiently increased after PPV, never exceeded 16 mmHg with medication. Our patient presented optic nerve blood supply impairment, due to amyloidosis, which caused optic atrophy. Epiretinal and intraretinal deposit detection could aid in diagnosing patients with suspected amyloidosis
High-resolution ultrasonography in central serous chorioretinopathy
No full textPURPOSE:
To investigate the use of high-resolution ultrasonography for detecting choroidal layer abnormalities in eyes with central serous chorioretinopathy (CSC).
DESIGN:
Prospective observational case series.
METHOD:
Optical coherence tomography (OCT) and high-resolution ultrasonography with a 20-MHz immersion probe were performed bilaterally in 10 patients, of whom 5 were affected by unilateral active CSC and 5 by unilateral cystoid macular edema (CME). Ten age-matched control subjects were also investigated.
RESULTS:
Both OCT and high-resolution ultrasonography showed a macular elevation in eyes with CSC and CME. High-resolution ultrasonography has shown evidence of a nonechogenic linear band under the retinal pigment epithelium in patients affected by CSC. This could be found in neither patients with CME or in control subjects.
CONCLUSION:
High-resolution ultrasonography can detect a nonechogenic space consistent with hyperpermeability of choroidal capillaries in eyes with active CSC. Shadowing by an altered retinal pigment epithelium cannot be ruled out, however
Long-term follow-up with optical coherence tomography and microperimetry in eyes with metamorphopsia after macula-off retinal detachment repair
No full textPURPOSE: to report the long-term sequential morphological and functional results in eyes with metamorphopsia after retinal detachment (RD) repair.
PATIENTS AND METHODS: in six eyes of six patients aged 58.7 ± 11.0 years with metamorphopsia after successful buckling surgery for macula-off RD, best-corrected visual acuity (BCVA), fundus biomicroscopy, Amsler grid test, time-domain optical coherence tomography (TD-OCT) and central 12° microperimetry (MP-1) were performed at months 1, 3, 6, 12, and 18. At 5 to 6 years after surgery all patients underwent also spectral domain (SD)-OCT.
RESULTS: three eyes slowly recovered pre-RD BCVA. In the remaining three eyes-with good final BCVA-the interrupted junction line between photoreceptor cell inner and outer segments (IS/OS) was progressively less evident after RD surgery; and the external limiting membrane was preserved on SD-OCT examination. In all eyes post-operative metamorphopsia faded with time, but fully disappeared in 6 years only in two eyes without photoreceptor abnormalities. One of the two eyes with subretinal fluid up to 6 months and IS/OS disruption had central dense scotoma with relatively unstable fixation on MP-1 and persistent metamorphopsia. Macular sensitivity (MS) increased from 9.7 ± 7.1 at month 1 to 13.5 ± 5.6 dB at the final check, and was weakly (r=0.33) correlated with post-operative BCVA and OCT abnormalities.
CONCLUSION: long-standing metamorphopsia can occur after successful macula-off RD repair even without detectable photoreceptor disruption on OCT. Post-operative BCVA recovery weakly correlates with increasing MS, and late restoration of the photoreceptor layer may be observed.
PMID: 20948555 [PubMed - indexed for MEDLINE
Combined 50-and 20-MHz frequency ultrasound imaging in intermediate uveitis
No full textPURPOSE:
To evaluate the information provided by multifrequency ultrasound examination in patients with intermediate uveitis.
DESIGN:
Prospective observational case series.
METHOD:
High-resolution ultrasonography with 50- and 20-MHz frequency immersion probes was performed in seven eyes of five young patients with clinical diagnosis of intermediate uveitis.
RESULTS:
Exudative material over the inferior pars plana and peripheral retina (snowbank) was found in all eyes with 50- and 20-MHz probe, although resolution of the latter was poorer. The 50-MHz imaging was superior for visualization of angle structures and details of pars planitis; the anterior vitreous involvement and cyclitic bands were better shown with the 20-MHz probe, which could also evidence cystoid macular edema.
CONCLUSIONS:
Ultrasound examination with both 50- and 20-MHz frequency probes can detect the typical snowbank in intermediate uveitis and be useful in eyes with small pupil, dense vitreitis, or both, especially before pars plana vitrectomy or cataract surgery
Choroidal vascular changes after transpupillary thermotherapy for choroidal melanoma
No full textAbstract
OBJECTIVE: To evaluate choroidal vascular alterations after transpupillary thermotherapy used as the sole treatment for choroidal melanoma.
DESIGN: Prospective noncomparative interventional case series.
PARTICIPANTS: Forty-five eyes of 45 patients affected by malignant choroidal melanoma treated with transpupillary thermotherapy alone with more than 1 year of follow-up.
INTERVENTION: Transpupillary thermotherapy was performed through a panfunduscopic contact lens using an 810-nm diode laser.
MAIN OUTCOME MEASURES: Dynamic/static fluorescein and indocyanine green angiography were performed at scheduled intervals (24 hours, at 3-month intervals during the first year, and every 6 months thereafter) after transpupillary thermotherapy. Visual acuity, clinical evaluation, fundus photographs, and ultrasonographic examination were also performed.
RESULTS: The mean follow-up was 30.5 months (range, 12-54 months). Changes in the choroidal circulation were always confined within the treatment margins (except in one case) and characterized by occlusion of choriocapillaris (100%), patent medium and/or large choroidal vessels (76%), retinochoroidal anastomosis (11%), and progressive choroidal vascular remodeling (42%). Forty-one cases (91%) showed persistent clinical regression, and four cases (9%) recurred; recurrent cases showed retinochoroidal anastomosis.
CONCLUSIONS: Transpupillary thermotherapy is suggested as a new single therapeutic modality in the treatment of selected choroidal melanomas, but more precise eligibility criteria and longer follow-up are mandatory. Patent choroidal circulation, choroidal vascular remodeling, and anastomosis after transpupillary thermotherapy might be helpful to detect recurrent tumors
Protrusione della protesi da rabdomiosarcoma delll'orbita in bambina con anoftalmia congenita bilaterale
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