Assuntos
Antivirais/efeitos adversos , Diabetes Mellitus Tipo 1/complicações , Hepatite B/tratamento farmacológico , Interferon-alfa/efeitos adversos , Doenças Retinianas/induzido quimicamente , Adolescente , Antivirais/uso terapêutico , Angiofluoresceinografia , Fundo de Olho , Hepatite B/complicações , Humanos , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Masculino , Proteínas Recombinantes , Doenças Retinianas/diagnóstico , Acuidade VisualRESUMO
PURPOSE: To investigate the possible association of presumed macular choroidal watershed vascular filling (PMWF), choroidal neovascularization, and systemic vascular disease in patients with age-related macular degeneration. METHODS: In a retrospective study, we evaluated 74 randomly selected indocyanine green videoangiograms of 74 patients with age-related macular degeneration. We also reviewed the charts of 20 randomly selected, age-matched control patients without age-related macular degeneration, initially referred for uniocular conditions, and subsequently performed indocyanine green videoangiography on their normal fellow eyes. We evaluated these videoangiograms for the presence of PMWF, manifesting as characteristic early choroidal hypofluorescence and its relation to choroidal neovascularization when present. Additionally, the incidence of hypertension, coronary artery disease, peripheral vascular disease, and diabetes mellitus was determined. RESULTS: Forty-one (55.4%) of 74 patients with age-related macular degeneration vs three (15.0%) of 20 normal control patients exhibited PMWF on indocyanine green videoangiography (P = .0014). Of the 61 patients with age-related macular degeneration and choroidal neovascularization, 36 (59.0%) exhibited PMWF on videoangiography. Associated choroidal neovascularization arose from the PMWF zone in 33 (91.7%) of these cases. Hypertension was observed in 24 (58.5%) of 41 patients with age-related macular degeneration and PMWF vs nine (27.3%) of 33 patients with age-related macular degeneration who did not exhibit PMWF (P = .007). CONCLUSIONS: An increased incidence of PMWF occurs in patients with age-related macular degeneration with a possible predisposition for the development of associated choroidal neovascularization. Additionally, PMWF may be accentuated by associated hypertensive choroidal microvascular insult.
Assuntos
Corioide/irrigação sanguínea , Macula Lutea/irrigação sanguínea , Degeneração Macular/complicações , Neovascularização Patológica/complicações , Doenças Vasculares/complicações , Idoso , Idoso de 80 Anos ou mais , Corioide/patologia , Corantes , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Incidência , Verde de Indocianina , Macula Lutea/patologia , Degeneração Macular/patologia , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/patologia , Distribuição Aleatória , Estudos Retrospectivos , Doenças Vasculares/patologiaRESUMO
BACKGROUND: Idiopathic polypoidal choroidal vasculopathy (IPCV), the posterior uveal bleeding syndrome, and multiple recurrent serosanguineous pigment epithelial detachments in black women are a heterogeneous group of related entities seen in elderly hypertensive females. Similar associations are known for retinal arterial macroaneurysm (RAM). METHODS: This report documents the clinical, fluorescein, and indocyanine green videoangiographic findings of two elderly black female hypertensive patients who presented with IPCV, RAM, and hypertensive retinopathy. RESULTS: Clinical, fluorescein, and indocyanine green videoangiographic analysis of these two patients revealed hypertensive retinopathy, RAM, and anomalous polypoidal vascular networks associated with focal "bead-string" constrictions, terminal vascular loops, and polypoidal and pinpoint choroidal nodules. CONCLUSION: Certain subgroups of IPCV and related entities and RAM may be pathophysiologically related as analogous hypertensive insults to the choroidal and retinal vascular beds.
Assuntos
Aneurisma/complicações , Corioide/irrigação sanguínea , Hipertensão Ocular/complicações , Artéria Retiniana , Idoso , Idoso de 80 Anos ou mais , Aneurisma/diagnóstico por imagem , Corioide/diagnóstico por imagem , Doenças da Coroide/complicações , Doenças da Coroide/diagnóstico por imagem , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Verde de Indocianina , Hipertensão Ocular/diagnóstico por imagem , Radiografia , Artéria Retiniana/diagnóstico por imagem , Doenças Retinianas/complicações , Doenças Retinianas/diagnóstico por imagem , TelevisãoRESUMO
PURPOSE: We studied the indocyanine green videoangiographic characteristics of eyes in patients with Stargardt's flavimaculatus and fluorescein angiographic evidence of a dark choroid. METHODS: Affected individuals underwent ophthalmic examination and fluorescein angiographic examination. Indocyanine green videoangiography was performed on eight patients with classic Stargardt's flavimaculatus. Two additional asymptomatic patients with mild manifestations of Stargardt's flavimaculatus, both of whom were related to one patient with the classic phenotype, were also examined with indocyanine green videoangiography. RESULTS: Choroidal detail was evident in all patients examined with indocyanine green videoangiography, and varying degrees of choroidal vascular closure were documented in the maculas of eight patients. Retinal pigment epithelial flecks were found to block indocyanine green videoangiographic fluoresence progressively. Late indocyanine green videoangiographic imaes frequently showed retinal pigment epithelial involvement in areas of retina thought to be uninvolved clinically and by fluorescein angiography. Peripapillary crescents of hypofluorescence, which in some patients were not noted clinically or by fluorescein angiography, were observed in all ten patients examined with indocyanine green videoangiography. In one asymptomatic patient, retinal pigment epithelial flecks could be identified only with indocyanine green videoangiography. CONCLUSIONS: Indocyanine green videoangiography in conjunction with fluorescein angiography can be a valuable tool in the recognition and further understanding of Stargardt's flavimaculatus.
Assuntos
Angiofluoresceinografia , Verde de Indocianina , Macula Lutea/patologia , Degeneração Retiniana/genética , Degeneração Retiniana/patologia , Adolescente , Adulto , Idoso , Atrofia , Corioide/irrigação sanguínea , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Epitélio Pigmentado Ocular/patologia , Degeneração Retiniana/fisiopatologia , Gravação em VídeoRESUMO
In patients with subretinal neovascular membranes (SRNVM), persistence of the SRNVM after laser treatment is a major cause of decreased visual acuity. Persistence is associated with inadequate initial laser treatment. A technique using a digitized fluorescein angiogram (DFA) system is presented that allows immediate evaluation of the adequacy of laser treatment for SRNVM. This involves overlaying a red-free photograph taken after treatment on a fluorescein angiogram taken before treatment using a digital angiogram system that evaluates the adequacy of treatment. A protocol for augmentation of laser treatment has been developed that will aid in the reduction of persistence after laser treatment of SRNVM.
Assuntos
Angiofluoresceinografia/métodos , Processamento de Imagem Assistida por Computador/métodos , Terapia a Laser , Neovascularização Retiniana/cirurgia , Idoso , Idoso de 80 Anos ou mais , Estudos de Avaliação como Assunto , Feminino , Fundo de Olho , Humanos , Fotografação , Prognóstico , Reoperação , Reprodutibilidade dos TestesRESUMO
A study was conducted using the digitized fluorescein angiogram (DFA) system to evaluate adequacy of coverage of laser treatment for subretinal neovascular membranes (SRNVM) and to confirm that complete coverage lowers the incidence of persistent SRNVMs. Ten consecutive cases were evaluated with the DFA system after undergoing a single laser treatment. Three cases were judged to be adequately treated, and the remaining seven cases were judged to be inadequately treated. The DFA system was then used during photocoagulation in 16 consecutive cases to verify complete coverage of the SRNVM or to indicate the need for photocoagulation augmentation. Despite augmentation, 2 of the 16 cases remained inadequately treated. Overall, the cases that were adequately treated had a 12% (2/17) persistence rate, whereas those that were inadequately treated had a persistence rate of 67% (6/9). The data indicate that adequate coverage of SRNVMs is essential to prevent persistence.
Assuntos
Angiofluoresceinografia/métodos , Processamento de Imagem Assistida por Computador/métodos , Neovascularização Retiniana/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Fundo de Olho , Humanos , Incidência , Fotocoagulação a Laser , Masculino , Pessoa de Meia-Idade , Fotografação , Recidiva , Neovascularização Retiniana/cirurgiaRESUMO
A young woman was followed for over 20 years with a macular combined hamartoma of the retina and retinal pigment epithelium. When vision deteriorated due to contracture of an overlying epiretinal membrane, a pars plana vitrectomy with removal of the membrane was performed. Decreased vascular tortuosity and retinal vascular leakage resulted in postoperative improvement of visual acuity. Selected patients with combined retinal and retinal pigment epithelial hamartomas may benefit from removal of epiretinal membranes.
Assuntos
Neoplasias Oculares/cirurgia , Hamartoma/cirurgia , Epitélio Pigmentado Ocular/cirurgia , Retina/cirurgia , Doenças Retinianas/cirurgia , Criança , Neoplasias Oculares/patologia , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Hamartoma/patologia , Humanos , Membranas/cirurgia , Epitélio Pigmentado Ocular/patologia , Retina/patologia , Doenças Retinianas/patologia , Acuidade Visual , VitrectomiaAssuntos
Umidade , Lentes Intraoculares , Oftalmoscopia , Humanos , Injeções , Complicações Intraoperatórias , Masculino , Pessoa de Meia-Idade , Cloreto de SódioRESUMO
The leukemias commonly involve the eyes and adnexae. It is unusual, however, for leukemia to present with visual complaints. Furthermore, there are only rare case reports of leukemic patients presenting with bilateral exudative retinal detachments. We report a unique case of a boy who presented with visual loss due to a unilateral exudative retinal detachment. A systemic evaluation discovered acute lymphocytic leukemia (ALL). There was rapid settling of the exudative detachment and improvement in vision while the patient received chemotherapy and radiotherapy for the ALL.
Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Descolamento Retiniano/etiologia , Biópsia , Contagem de Células Sanguíneas , Exame de Medula Óssea , Criança , Citarabina/uso terapêutico , Angiofluoresceinografia , Humanos , Hidrocortisona/uso terapêutico , Injeções Espinhais , Masculino , Metotrexato/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Acuidade VisualRESUMO
We report a case of visual loss following intranasal injection of triamcinolone acetonide and phenylephrine hydrochloride in a 22-year-old female with chronic sinusitis. Clinical examination and fluorescein angiography revealed vascular occlusions which involved multiple small branches of both the choroidal and retinal circulations. The mechanism of such a complication probably involves inadvertent intra-arterial injection into the anterior or the posterior ethmoidal artery, with retrograde flow into the opthalmic arterial system. Precautions can be taken to avoid such complications.
Assuntos
Corioide/irrigação sanguínea , Embolia/induzido quimicamente , Vasos Retinianos , Triancinolona Acetonida/efeitos adversos , Adulto , Feminino , Angiofluoresceinografia , Humanos , Injeções/efeitos adversos , Fenilefrina/administração & dosagem , Doenças Retinianas/induzido quimicamente , Sinusite/tratamento farmacológico , Triancinolona Acetonida/administração & dosagem , Doenças da Úvea/induzido quimicamenteRESUMO
Four affected family members in two generations demonstrated an unusual, probably autosomal dominant, retinal vascular disorder called inherited retinal venous beading. The proband had retinal neovascularization, exudation, and vitreous hemorrhage. The other three affected family members had significant venous beading and varying degrees of arteriolar tortuosity. Family members with venous beading had low to normal leukocyte and neutrophil counts, which differed significantly from unaffected family members.
Assuntos
Doenças Retinianas/genética , Veia Retiniana , Adulto , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/genética , Neovascularização Patológica/patologia , Linhagem , Doenças Retinianas/complicações , Doenças Retinianas/patologia , Veia Retiniana/patologia , Vasos Retinianos , Transtornos da Visão/etiologia , Hemorragia Vítrea/genética , Hemorragia Vítrea/patologiaAssuntos
Degeneração Macular , Idoso , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Degeneração Macular/diagnóstico , Degeneração Macular/etiologia , Degeneração Macular/patologia , Degeneração Macular/terapia , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/patologia , Drusas Retinianas/diagnóstico , Drusas Retinianas/etiologia , Drusas Retinianas/patologia , Fatores de RiscoRESUMO
The authors describe six complications, of retrobulbar injections documented by fundus photography and fluorescein angiography. These include (1) injection of corticosteroid into the posterior ciliary arterial circulation resulting in emboli in the vasculature of the choroid and the optic nerve head; (2) injection of corticosteroid into the ophthalmic artery resulting in emboli in both the choroidal and retinal circulations; (3) presumed injection of lidocaine and air into the optic nerve sheath adjacent to the globe with extension anteriorly into the subretinal space and the space between the posterior vitreous and the internal limiting membrane; (4) occlusion of the central retinal artery without an associated retrobulbar hemorrhage; (5) trauma to and partial injection of lidocaine in the central retinal artery with embolization into the retinal circulation; and (6) presumed injection of lidocaine into the optic nerve sheath producing a combined central retinal vein and artery occlusion. Alternative techniques that might decrease the incidence of complications associated with retrobulbar injections are discussed.
Assuntos
Oftalmopatias/etiologia , Injeções/efeitos adversos , Adulto , Arteriopatias Oclusivas/etiologia , Corioide/irrigação sanguínea , Embolia/etiologia , Embolia Aérea/etiologia , Feminino , Hemorragia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nervo Óptico/irrigação sanguínea , Artéria Retiniana , Oclusão da Veia Retiniana/etiologia , Vasos RetinianosRESUMO
We observed choroidal neovascularization with associated macular detachment in three cases of benign choroidal nevi. Successful obliteration of the neovascular membranes was performed with argon laser photocoagulation with maintenance of good central visual acuity.
Assuntos
Neoplasias da Coroide/diagnóstico por imagem , Corioide/irrigação sanguínea , Nevo/diagnóstico por imagem , Adulto , Idoso , Argônio , Neoplasias da Coroide/cirurgia , Feminino , Angiofluoresceinografia , Humanos , Terapia a Laser , Pessoa de Meia-Idade , Nevo/cirurgia , RadiografiaAssuntos
Corioide/cirurgia , Terapia a Laser , Lasers/efeitos adversos , Descolamento Retiniano/cirurgia , Doenças Retinianas , Vasos Retinianos , Adulto , Argônio , Diagnóstico Diferencial , Feminino , Humanos , Macula Lutea , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Descolamento Retiniano/diagnóstico , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Doenças da Úvea/cirurgiaRESUMO
This 14-year-old patient with bilateral simultaneous papillitis experienced no light perception in either eye for 24 hours and had a complete recovery of central and peripheral vision 3 weeks later. Fluorescein angiography confirmed the diagnosis. Although her hospital work-up was negative except for a mildly elevated CSF protein, it seems most likely that this was a postviral syndrome based on the bilaterality, rapid recovery of vision, and the age group.
Assuntos
Disco Óptico , Nervo Óptico , Neurite Óptica/diagnóstico , Adolescente , Corticosteroides/uso terapêutico , Feminino , Angiofluoresceinografia , Humanos , Hidrocortisona/uso terapêutico , Luz , Neurite Óptica/tratamento farmacológico , Fatores de TempoRESUMO
A 19-year-old black man with acute posterior multifocal placoid pigment epitheliopathy had concurrent positive viral cultures and rising antibodies to adenovirus type 5. This finding, considered together with earlier reports of viral-like syndromes accompanying the disease, supports the implication of a respiratory virus as a possible etiologic factor.