RESUMO
OBJECTIVE: To investigate outcomes of vitreoretinal surgery for complications of branch retinal vein occlusion (BRVO). DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: The medical records of all patients who underwent vitreoretinal surgery for complications of BRVO at Bascom Palmer Eye Institute between January 1, 1991 and December 31, 1998 were reviewed. Thirty-six eyes from 36 consecutive patients were identified. MAIN OUTCOME MEASURES: Visual acuity outcomes include preservation of preoperative visual acuity and visual acuity greater than or equal to 20/40, 20/200 and 5/200. When preoperative retinal detachment was present, the anatomic outcome assessed was complete retinal attachment. Postoperative event rates of retinal detachment, vitreous hemorrhage, epiretinal membrane (ERM), and cataract were tabulated. All outcomes were assessed at 6 months. RESULTS: Surgical indications included nonclearing vitreous hemorrhage (17 patients), traction retinal detachment involving the macula (15), and ERM (4). Mean follow-up was 19 months. Preoperatively, best-corrected vision was greater than or equal to 20/200 in 19/36 (53%) eyes. Six months postoperatively, best-corrected vision was greater than or equal to 20/40 in 12/36 (33%) eyes, greater than or equal to 20/200 in 27/36 (75%) eyes, and greater than or equal to 5/200 in 31/36 (86%) eyes. Postoperative complications included retinal detachment (2/36; 6% eyes), ERM (3; 8%), vitreous hemorrhage (2; 6%), suprachoroidal hemorrhage (1; 3%), central retinal vein occlusion (1; 3%), and central retinal artery occlusion (1; 3%). Clinical features associated with better visual outcome include better preoperative visual acuity (P: = 0.05), absence of preoperative afferent pupillary defect (P: = 0.01), and absence of preoperative macular edema (P: = 0.08). CONCLUSIONS: Following surgery, retinal attachment and improved visual acuity were achieved in the majority of patients. Pre-existing pathology and postoperative complications may limit final vision in eyes with BRVO.
Assuntos
Membrana Epirretiniana/cirurgia , Descolamento Retiniano/cirurgia , Oclusão da Veia Retiniana/complicações , Vitrectomia , Hemorragia Vítrea/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Membrana Epirretiniana/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Acuidade Visual , Hemorragia Vítrea/etiologiaAssuntos
Neoplasias da Coroide/diagnóstico , Esotropia/diagnóstico , Hemangioma/diagnóstico , Hiperopia/diagnóstico , Síndrome de Sturge-Weber/diagnóstico , Criança , Neoplasias da Coroide/diagnóstico por imagem , Neoplasias da Coroide/radioterapia , Hemangioma/diagnóstico por imagem , Hemangioma/radioterapia , Humanos , Masculino , Síndrome de Sturge-Weber/diagnóstico por imagem , Síndrome de Sturge-Weber/radioterapia , UltrassonografiaRESUMO
PURPOSE: To report bilateral choroidal hemangiomas associated with unilateral facial nevus flammeus in Sturge-Weber syndrome. METHODS: Case report. RESULTS: A 6-year-old male with a left facial nevus flammeus and a history of a left cerebral angioma had been followed 2 years for increasing esotropia. Examination demonstrated bilateral diffuse choroidal hemangiomas with overlying exudative retinal detachments. After bilateral external beam radiotherapy, the retinal detachments resolved and vision improved. CONCLUSION: Patients with Sturge-Weber syndrome and unilateral facial nevus flammeus may harbor bilateral choroidal hemangiomas. Clinical manifestations of the Sturge-Weber syndrome are characteristically unilateral and ipsilateral to the facial nevus flammeus. Bilateral choroidal hemangiomas associated with bilateral facial nevus flammeus are rare. 1,2 We report bilateral diffuse choroidal hemangiomas associated with unilateral facial nevus flammeus in Sturge-Weber syndrome.
Assuntos
Neoplasias da Coroide/complicações , Hemangioma/complicações , Mancha Vinho do Porto/complicações , Síndrome de Sturge-Weber/complicações , Criança , Neoplasias da Coroide/diagnóstico , Neoplasias da Coroide/radioterapia , Face , Hemangioma/diagnóstico , Hemangioma/radioterapia , Humanos , Masculino , Mancha Vinho do Porto/diagnóstico , Mancha Vinho do Porto/radioterapia , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico por imagem , Descolamento Retiniano/radioterapia , Síndrome de Sturge-Weber/diagnóstico , Síndrome de Sturge-Weber/radioterapia , Ultrassonografia , Acuidade VisualRESUMO
The authors report a photodocumented case of improved retinal capillary perfusion accompanied by visual acuity improvement after treatment of severe proliferative diabetic retinopathy.
Assuntos
Retinopatia Diabética/cirurgia , Fotocoagulação a Laser , Vasos Retinianos/fisiologia , Adulto , Capilares/fisiologia , Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/etiologia , Retinopatia Diabética/fisiopatologia , Angiofluoresceinografia , Fundo de Olho , Humanos , Masculino , Perfusão , Descolamento Retiniano/etiologia , Descolamento Retiniano/fisiopatologia , Descolamento Retiniano/cirurgia , Acuidade Visual , VitrectomiaAssuntos
Cegueira/etiologia , Endoscopia/efeitos adversos , Espaço Epidural , Hemorragia Retiniana/etiologia , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Cegueira/patologia , Pressão do Líquido Cefalorraquidiano , Feminino , Angiofluoresceinografia , Humanos , Pressão Intraocular , Hemorragia Retiniana/patologia , Acuidade VisualRESUMO
OBJECTIVE: To assess the potential of optical coherence tomography (OCT) to differentiate retinoschisis from retinal detachment. Optical coherence tomography is a noninvasive, noncontact imaging method that produces high-resolution, cross-sectional images of ocular tissue. DESIGN: Retrospective case series. PARTICIPANTS: Thirteen eyes of 12 patients with the differential diagnosis of retinoschisis versus retinal detachment. METHODS: Differentiation between retinoschisis and retinal detachment was established from both ophthalmoscopic and OCT examinations. MAIN OUTCOME MEASURE: Ability of OCT to differentiate retinoschisis from retinal detachment was measured. RESULTS: Thirteen eyes of 12 patients with retinal elevation were examined with OCT. The cross-sectional view produced by OCT was effective in distinguishing retinoschisis from retinal detachment. Optical coherence tomography images of retinoschisis show a splitting of the neurosensory retina. The OCT images of retinal detachment show separation of full-thickness neurosensory retina from the retinal pigment epithelium band. The OCT images correlated with the clinical impression in all 13 cases. CONCLUSIONS: Based on this series of cases, OCT is a potentially useful new test that may be used to distinguish retinoschisis from rhegmatogenous retinal detachment.
Assuntos
Técnicas de Diagnóstico Oftalmológico/instrumentação , Retina/patologia , Degeneração Retiniana/diagnóstico , Descolamento Retiniano/diagnóstico , Tomografia/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Fundo de Olho , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
OBJECTIVES: To review a large experience with extracorporeal life support in patients with congenital heart disease. To determine the major causes of mortality and morbidity in order to improve the results of using this technology in this patient population. DESIGN: Retrospective chart review. PATIENTS: Twenty-five patients between the ages of 1 day and 8 yrs. These patients had congenital heart disease and were clinically felt to be at high risk for death caused by cardiac failure or by respiratory failure complicated by congenital heart disease. INTERVENTIONS: All patients in this report were placed on extracorporeal life support to allow recovery of myocardial or pulmonary function. MEASUREMENTS AND MAIN RESULTS: Of these 25 patients, 52% were weaned from bypass support and 40% survived to discharge. Patients who were not weaned from extracorporeal life support characteristically suffered from irreversible neurologic injury, multiple organ failure, or bleeding complications. Only one patient died of irreversible cardiac failure. CONCLUSIONS: Extracorporeal life support can be useful in supporting patients with congenital heart disease with life-threatening cardiac or pulmonary failure. Improvements in limiting neurologic and bleeding complications may lead to improvements in the use of extracorporeal life support for this indication. However, prospective, randomized studies are needed to appreciate the role of extracorporeal life support in these patients.