Incidence of retinal detachment associated with atopic dermatitis in Japan: review of cases from 1992 to 2011.

PURPOSE: The present study aims to investigate the number and characteristics of retinal detachment with atopic dermatitis (AD) in these 20 years, and the number of the first visit AD outpatients in almost the same period. METHODS: A retrospective review of 101 consecutive surgically treated retinal detachments with AD patients from 1992 to 2011 was conducted. Retinal detachments were divided into two groups: eyes operated on from 1992 to 2001 (former AD group, n=63) and eyes operated on from 2002 to 2011 (recent AD group, n=38). We also reviewed the records of the first visit AD outpatients from 1993 to 2011 except 1998. RESULTS: The percentage of bilateral detachment was significantly higher in the former AD group (14/63) than that in the recent AD group (0/38) (P=0.0002). In addition, patients in the recent AD group were significantly older than those in the former AD group (P=0.0084). The annual cases with non-AD retinal detachment remained invariant for 20 years. The ratio of the retinal detachment with AD for the total retinal detachment was significantly lower in the recent (38/847) AD group than that in the former (63/796) AD group (P=0.0038). The number of the first visit AD outpatients linearly decreased in these 19 years (153 cases in 1993 and 65 cases in 2011). CONCLUSION: Our study indicates an apparent decrease in retinal detachment with AD in the recent 10 years, and might suggest the importance of dermatitis control for prevention of retinal detachment with AD.

Bilateral retinal detachment in Werner syndrome.

PURPOSE: To report the development of bilateral retinal detachment in a patient with Werner syndrome. METHODS: Retrospective chart review. A 44-year-old woman diagnosed with Werner syndrome developed bilateral retinal detachment. The fundus in both eyes showed patchy chorioretinal atrophy similar to that seen in high myopia, with the retinal detachment limited to the posterior pole. Two weeks after performing vitrectomy in the right eye, vitrectomy was performed in the left eye. RESULTS: After the surgeries, both retinas were reattached. During the surgeries, we observed an excessively liquefied vitreous and a posterior hyaloid membrane that was tightly attached to the retina. The retinal break was located along the superotemporal arcade and over an area of the patchy chorioretinal atrophy in both eyes. The chorioretinal atrophy and vitreous liquefaction appeared to be excessive for the patient's age and axial lengths (right: 26.66 mm, left: 27.04 mm). CONCLUSION: Vitreoretinal changes found in this case might have been partially because of the premature aging associated with Werner syndrome.

Retinal detachment because of macular hole and an additional break within the staphyloma.

PURPOSE: To report the finding of retinal detachment because of macular hole and an additional break within the posterior staphyloma. METHODS: A 63-year-old woman presented with progressive central scotoma of the right eye for 1-month duration. The fundus in the right eye showed retinal detachment that was localized within the posterior staphyloma and macular hole. An additional retinal break was observed within the staphyloma using ophthalmoscope, and optical coherence tomography confirmed that both the breaks were within the staphyloma. Macular buckling was scheduled because the two breaks were close enough to each other and the patient was unable to maintain a prone position. RESULTS: The retinal detachment was successfully reattached using macular buckling procedure. CONCLUSION: In the present case, optical coherence tomography proved to be very useful in helping to make the correct diagnosis of a full-thickness break before surgery.

Retrobulbar hemodynamic effects of nipradilol in normal and normal-tension glaucoma eyes.

Purpose. To investigate the effects of nipradilol on retrobulbar hemodynamics. Methods. We investigated normal and normal-tension glaucoma (NTG) eyes. Topical nipradilol (one eye) and placebo eye drops (fellow eye) were instilled for 1 week in volunteers. Nipradilol was also instilled in NTG patients. Ultrasound color Doppler imaging for the posterior vessels was performed before, 2 hr, 1 week (for normal), and at 4 weeks (for NTG). Results. In normal eyes, there were significant decreases in the resistance index (RI) for the temporal short posterior ciliary arteries (PCA) at 2 hr and for the ophthalmic arteries at 1 week. There were no significant changes in the placebo-treated eyes. In the NTG eyes, there was a significant decrease in the RI for the central retinal artery, nasal, and temporal PCA at 2 hr and 4 weeks. Conclusion. Short-term observations found that nipradilol increased the ocular blood flow in normal and NTG eyes.

[Case of systemic lupus erythematosus showing visual disturbances resulting from multiple ocular complications].

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown origins. We report a case of SLE retinopathy concurrent with macular edema and ischemic optic neuropathy. CASE: A 30-year-old women with SLE presented with sudden visual disturbances and SLE retinopathy with typical macular edema. We treated her with subconjunctival triamcinolone acetonide injections which providing a resolution of the edema within a few days, but her visual acuity did not improve. Scotoma, relative afferent papillary defect (RAPD) and optic nerve abnormality appeared on MRI during her clinical course. A diagnosis of hidden ischemic optic neuropathy was established. She was treated with corticosteroid pulse therapy and because of an antiphospholipid syndrome, antiplatelet and anticoagulation therapy were used to improve ocular circulation. Following therapy, her visual function recovered. CONCLUSION: Although the symptoms seemed complicated, circulatory insufficiency was the main cause of the complications and its improvement provided the key to the patient's recovery.

Time-dependent course of electroretinograms in the spontaneous diabetic Goto-Kakizaki rat.

PURPOSE: This study evaluates the relevance to human retinopathy of electroretinograms (ERGs) from the spontaneously diabetic Goto-Kakizaki (GK) rat. METHODS: Starting from 4 weeks of age, we obtained ERGs every 4 weeks from six GK rats and seven Wistar (control) rats, and from two GK and two Wistar rats at 14 days of age. The a-wave, b-wave, and oscillatory potentials (OPs) were recorded after stimulation with a single bright flash. We compared the amplitudes and implicit times and measured a-wave latencies to evaluate photoreceptor function. RESULTS: The amplitudes of the a-wave, b-wave, and OPs (O1 and O2) of the GK rats were reduced between 4 and 48 weeks of age. The time-dependent courses of change in a-wave, b-wave, and O2 amplitude did not differ between the two groups. The a-wave latencies in GK rats were significantly prolonged, but not the implicit times of OPs. At 14 days of age, the a-wave amplitudes were significantly smaller in GK than in Wistar rats. CONCLUSION: Functional abnormalities of photoreceptors might be induced by inheritable degeneration at an early age in the GK rat. Although hyperglycemia would cause retinal hypoxia, it would not be severe enough to disturb the generation of OPs.