RESUMO
PURPOSE: To report macular anatomic abnormalities in eyes with stage 4A retinopathy of prematurity (ROP) that may account for poor visual outcome despite an ophthalmoscopically normal-appearing posterior pole. DESIGN: Retrospective case series. PARTICIPANTS: Nine patients (14 eyes). METHODS: Nine patients (14 eyes) diagnosed with stage 4A retinal detachments were imaged with optical coherence tomography (OCT) before repair by lens-sparing pars plana vitrectomy. One patient (2 eyes) 2 years after successful lens-sparing vitrectomy for stage 4A detachment with reduced visual acuity underwent fluorescein angiography, fundus photography, and imaging with OCT. MAIN OUTCOME MEASURE: Optical coherence tomography findings. RESULTS: Preoperative OCT confirmed absence of macular involvement in 12 of 14 eyes. Two eyes demonstrated diffuse intraretinal posterior pole changes. Both eyes of a 2-year-old infant demonstrated a lack of normal foveal architecture on OCT scanning and an absent foveal avascular zone on angiography. CONCLUSIONS: Anatomic macular abnormalities--not immediately apparent ophthalmoscopically--may explain the variability in visual outcome after lens-sparing vitrectomy for stage 4A ROP.
Assuntos
Técnicas de Diagnóstico Oftalmológico , Macula Lutea/patologia , Retinopatia da Prematuridade/diagnóstico , Tomografia de Coerência Óptica , Angiofluoresceinografia , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Descolamento Retiniano/cirurgia , Retinopatia da Prematuridade/classificação , Retinopatia da Prematuridade/cirurgia , Estudos Retrospectivos , Acuidade Visual/fisiologia , VitrectomiaRESUMO
PURPOSE: To report a case of spontaneous resolution of traumatic macular hole-related retinal detachment. DESIGN: Observational case report. METHODS: Clinical examination and optical coherence tomographic (OCT) evaluation of a patient who experienced spontaneous resolution of a retinal detachment resulting from a traumatic macular hole. RESULTS: A 12-year-old boy developed a macular hole and retinal detachment after blunt ocular trauma. Spontaneous reattachment of the retina and closure of the macular hole were documented at clinical examination and by OCT three weeks after presentation. CONCLUSIONS: Spontaneous closure of traumatic macular hole and resolution of associated retinal detachment can occur.
Assuntos
Traumatismos Oculares/fisiopatologia , Descolamento Retiniano/fisiopatologia , Perfurações Retinianas/fisiopatologia , Futebol/lesões , Ferimentos não Penetrantes/fisiopatologia , Criança , Traumatismos Oculares/diagnóstico , Angiofluoresceinografia , Humanos , Masculino , Remissão Espontânea , Descolamento Retiniano/diagnóstico , Perfurações Retinianas/diagnóstico , Tomografia de Coerência Óptica , Acuidade Visual , Cicatrização , Ferimentos não Penetrantes/diagnósticoAssuntos
Antineoplásicos Fitogênicos/efeitos adversos , Edema Macular/induzido quimicamente , Paclitaxel/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Quimioterapia Combinada , Feminino , Angiofluoresceinografia , Humanos , Edema Macular/diagnóstico , Pessoa de Meia-Idade , Tomografia de Coerência Óptica , TrastuzumabRESUMO
BACKGROUND: Retinal detachment in pediatric vasoproliferative disorders such as retinopathy of prematurity (ROP) and familial exudative vitreoretinopathy (FEVR) have an exudative and tractional component. Younger eyes have an especially adherent posterior hyaloid. Contraction of the posterior hyaloid interface may lead to tractional retinal detachment. METHODS: Retrospective chart review of six eyes (four ROP, two FEVR) with diffuse contraction of the posterior hyaloid resulting in retinal detachment. Fundus photographs and optical coherence tomography findings (one eye) are presented. RESULTS: Diffuse proliferation along the posterior hyaloid required extensive lamellar dissection at times aided by autologous plasmin enzyme. A diffuse, taut posterior hyaloid resulted in marked tractional component to retinal detachment. CONCLUSIONS: Recognition of hyaloid contracture will aid in the proper diagnosis and surgical planning and repair of eyes with pediatric vasoproliferative disorders.
Assuntos
Retinopatia da Prematuridade/patologia , Vitreorretinopatia Proliferativa/patologia , Corpo Vítreo/patologia , Adolescente , Exsudatos e Transudatos , Seguimentos , Humanos , Recém-Nascido , Fotocoagulação a Laser , Masculino , Prognóstico , Retinopatia da Prematuridade/cirurgia , Índice de Gravidade de Doença , Vitrectomia , Vitreorretinopatia Proliferativa/cirurgiaRESUMO
PURPOSE: To describe the intraschisis cavity protein composition in congenital X-linked retinoschisis (CXLRS) from two eyes of one child. METHODS: The authors present a child with complex, Type 3 CXLRS who underwent bilateral surgical repair with autologous plasmin enzyme-assisted lens-sparing vitrectomy. Undiluted samples of intraschisis fluid and vitreous fluid from two eyes (one child) were obtained and used for protein analysis. RESULTS: The patient underwent successful schisis repair with plasmin-assisted lens-sparing vitrectomy and silicone oil. Two unique protein bands were identified in the intraschisis cavity sample of each eye by gel electrophoresis. The proteins were identified as tenascin-C, an extracellular matrix protein involved in wound healing, and cystatin C, a ubiquitous cysteine protease inhibitor implicated in inflammation. CONCLUSIONS: Tenascin-C has previously been described in its complex relationship with decorin and fibronectin in normal wound healing. Tenascin's upregulation in sites of inflammation and tenascin's role as an antiadhesive molecule may contribute to the pathogenesis of CXLRS. To the authors' knowledge, this is the first description of intraschisis cavity fluid.