ABSTRACT
Chloroquine retinopathy can result in devastating loss of vision. To date, there are no effective and reliable methods of detecting the toxicity at an early stage when retinopathy may be reversible. Chloroquine is deposited in the retinal pigment epithelium, which forms part of the blood-retinal barrier (BRB). By vitreous fluorophotometry we have shown that there is breakdown of the BRB in chloroquine retinopathy. However, in asymptomatic patients who had received varying amounts of hydroxychloroquine (up to 1067 g), the BRB remained intact.
Subject(s)
Blood-Retinal Barrier/drug effects , Chloroquine/adverse effects , Retinal Diseases/chemically induced , Aged , Female , Fluorescein Angiography , Fluorometry , Humans , Hydroxychloroquine/adverse effects , Male , Middle Aged , Pigment Epithelium of Eye/drug effects , Retinal Diseases/pathology , Vision Tests , Visual AcuityABSTRACT
We have described a complex abnormality of retinal pigment epithelium, Bruch's membrane, and choriocapillaris in mesangiocapillary glomerulonephritis (MCGN) type II. Patients with MCGN type II were examined by vitreous fluorophotometry which reveals that there is a breakdown of the blood retinal barrier (BRB) in those patients with the typical fundus lesions. The function of this barrier was calculated as a penetration ratio and was statistically greater in these patients when compared with a group of (a) normal persons, (b) patients with drusen, and (c) patients with other forms of glomerulonephritis.
Subject(s)
Blood-Retinal Barrier , Choroid/pathology , Glomerulonephritis, Membranoproliferative/pathology , Fluoresceins , Fluorometry , Humans , Lipodystrophy/pathology , Photometry , Pigment Epithelium of Eye/pathologyABSTRACT
Previously we have demonstrated a deposit in Bruch's membrane in a single case of mesangiocapillary glomerulonephritis type II. We studied a group of patients with this disease and described extensive clinical and fluorescein angiographic abnormalities, which were in marked contrast to the findings in a group of patients with other forms of glomerulonephritis. This finding contributes to our understanding of the pathophysiology of the complex of the retinal pigment epithelium, Bruch's membrane, and choriocapillaris.
Subject(s)
Choroid/pathology , Glomerulonephritis, Membranoproliferative/pathology , Adult , Basement Membrane/pathology , Female , Fluorescein Angiography , Glomerulonephritis, Membranoproliferative/physiopathology , Humans , Lipodystrophy/pathology , Lipodystrophy/physiopathology , Male , Middle Aged , Pigment Epithelium of Eye/pathology , Visual AcuitySubject(s)
Eye Diseases/diagnosis , Fluorometry/methods , Fluorescein , Fluoresceins , Humans , Vitreous BodyABSTRACT
The blood retinal barrier was investigated in a group of patients with angioid streaks and pseudoxanthoma elasticum, using the technique of vitreous fluorophotometry. Angioid streaks are breaks in the elastic layer of Bruch's membrane with atrophy of the adjacent pigment epithelium. The retinal pigment epithelial cells and their intercellular junctions form part of the blood retinal barrier. In this study, it was found that despite the presence of angioid streaks and extensive areas of pigment epithelial atrophy the blood retinal barrier was intact. In contrast, when disciform degeneration had occurred the blood retinal barrier was abnormal. It is proposed that vitreous fluorophotometry could be used to identify those patients developing disciform degeneration at an early and therefore potentially treatable stage.
Subject(s)
Angioid Streaks/physiopathology , Blood-Retinal Barrier , Pseudoxanthoma Elasticum/complications , Adolescent , Adult , Angioid Streaks/etiology , Female , Fluorescein Angiography , Humans , Macular Degeneration/physiopathology , Male , Middle Aged , PedigreeABSTRACT
Methods of interpreting data obtained by vitreous fluorophotometry vary between institutions. One important difference in these methods is the use of total plasma fluorescein or only free fluorescein in the calculation of the plasma fluorescein curve used in the analysis of the blood retinal barrier. We examined 16 diabetic patients (32 eyes) with documented background retinopathy using vitreous fluorophotometry. We compared two methods of analysis: (1) using total plasma fluorescein, and (2) using plasma-'free' fluorescein. Both methods were equally efficient at detecting breakdown of the blood retinal barrier and were highly comparable (R = 0.84; p less than 0.001). 43.75% of eyes with documented background retinopathy had a normal blood retinal barrier as measured by these techniques.
Subject(s)
Blood-Retinal Barrier , Diabetic Retinopathy/physiopathology , Fluorophotometry/methods , Adolescent , Adult , Data Interpretation, Statistical , Fluorescein Angiography , Humans , Middle AgedABSTRACT
It is important when photographing ocular movements or the bulbar conjunctiva that the full visualizations of the eye positions can be seen. This will require the upper eyelids to be retracted. The most common method is the use of fingers to retract the eyelids. A much improved technique is described using either cotton wool buds or orange sticks. It is simple and painless and makes the photographs superior in quality.
Subject(s)
Eye Diseases/physiopathology , Eye Movements , Eyelids , Photography/methods , HumansABSTRACT
Sixty-eight patients (76 eyes) who had undergone standard intercapsular cataract extraction and posterior chamber lens implantation were reviewed for the presence of posterior synechiae between the anterior capsule remnants and the iris. Thirty-five eyes (46%) had such synechiae, the characteristics of which are described. Risk factors for the development of posterior synechiae in this type of surgery include intraoperative trauma, postoperative inflammation, and the size of the anterior capsulectomy.