Use of iodo-niacin for retinal or vitreous hemorrhages and vitreous floaters.
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Chlorobutanol↗
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Results for “RETINAL HEMORRHAGE”
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Retinal vein occlusion.
Retinal vein occlusion is a common form of retinal vascular disease, especially in middle-aged and older individuals. The diagnosis is based on the funduscopic finding of retinal vein dilatation in association with retinal hemorrhages and cotton-wool spots. The pathology can involve the entire venous system or can be limited to a branch of the central retinal vein. Retinal vein occlusion can be distinguished clinically from diabetic retinopathy and other retinal diseases. Treatment for the acute phase of retinal vein occlusion has been disappointing. However, some late complications, such as persistent macular edema and neovascularization of the iris and retina, respond well to retinal photocoagulation. The family physician has an important role in detecting and controlling risk factors for retinal vein occlusion, including hypertension, diabetes mellitus and hyperviscosity syndromes.
Adult↗
[Treatment of prepapillary neovascularization in the absence of an angiographically visible ischemic area].
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Fluorescein Angiography↗
[A case of cerebral hemorrhage associated with vitreous, retinal, subretinal and optic nerve shealth hemorrhages].
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Cerebral Hemorrhage↗
Shaken babies--some have no impact injuries.
One study has questioned the validity of shaking as a mechanism of head injury in children. A prospective, postmortem study investigated 80 deaths from head trauma to identify the roles of shaking and direct impacts. Evidence of shaking was defined as two or more of the following criteria: 1) finger marks and/or rib fractures, 2) subdural and/or subarachnoid hemorrhage, or 3) a history of vigorous shaking. Shaking to the exclusion of other head trauma was defined as the presence of two or more of the above criteria together with the complete absence of scalp or skull injuries. Nine (11.3%) of the 80 study deaths qualified as exclusively shaking injuries by this definition. Thirty (37.5%) of the deaths had direct injuries as well as two of the criteria of shaking; these deaths were classified as combined shaking and blunt trauma. Forty-one (51.3%) of the deaths had impact injuries without having two of the criteria of shaking. We reviewed the extent of ocular injuries in all the cases. We found ocular hemorrhages with increased frequency in cases with two or more of the criteria of shaking compared to cases with only impact mechanism of injury. Retinal hemorrhages continue to show themselves to be a good marker of infants injured by vigorous, intentional shaking. This study likewise confirms the observations of others that most, but not all, shaken babies have impact injuries as well.
Battered Child Syndrome↗
[Partial closure of the central artery and vein of the retina in retrobulbar optic neuritis (author's transl)].
The changes in the fundus of a 57-year-old patient (perimacular turbid retinal oedema, cloudy peripapillary exsudates and peripheral retinal hemorrhages) could not be interpreted satisfactorly on a clinical basis. Histologic examination revealed a retrobulbar optic neuritis associated with round cell infiltrates around the central retinal blood vessels impeding their blood flow.
Fluorescein Angiography↗
Ocular microangiopathy in familial amyloidotic polyneuropathy, type I.
To obtain precise information on ophthalmological manifestations in patients with familial amyloidotic polyneuropathy (FAP), we performed ophthalmological and histopathological studies on 18 FAP patients and 6 asymptomatic individuals with a mutant transthyretin (TTR) gene. The incidence of vascular abnormalities of the conjunctiva and retina was surprisingly high in FAP patients. Abnormal conjunctival vessels were found mainly in the limbal area of FAP patients, but not in asymptomatic individuals with a mutant TTR gene. Conjunctival biopsy of 5 FAP patients and autopsy of another 2 FAP patients revealed that a significant amyloid deposit could be recognized in the superficial substantia propria of the conjunctiva and wall and perivascular area of the conjunctival vessels in all cases, a finding that is of diagnostic value. As for the retinal vessels, an abnormal arteriovenous ratio (A/V ratio), tortuous retinal vessels, cotton wool exudates and retinal hemorrhages were found in FAP patients. However, histopathological analysis of the retina in two autopsied cases revealed only a trace amount of amyloid deposit around the retinal vessels. Ophthalmological examination of three patients with pandysautonomia revealed that the appearance of both the conjunctival and retinal vessels of these patients was similar to that in FAP patients. These results indicate that in FAP patients ocular microangiopathy may be related to autonomic dysfunction as well as amyloid deposit.
Adolescent↗
Ocular features of west nile virus infection in North America: a study of 14 eyes.
PURPOSE: To present a case series of ocular findings of West Nile virus infection (WNVI) in North America. DESIGN: Retrospective, noncomparative, observational case series. PARTICIPANTS: All patients were referred to the authors for WNVI with ocular involvement between the years 2002 and 2005. METHODS: Chart review was performed on all participants. All participants underwent complete ophthalmic evaluation during each examination, including best-corrected Snellen visual acuity measurement, tonometry, slit-lamp biomicroscopy of the anterior and posterior segments, and dilated fundus examination with indirect ophthalmoscopy. Fundus photography and fluorescein angiography were also performed on all eyes. Relevant ocular findings associated with WNVI were recorded and tabulated. MAIN OUTCOME MEASURES: The authors studied the characteristics, frequency, and locations of ocular lesions found in participants' eyes. RESULTS: There were 14 eyes (7 patients) with ocular West Nile virus lesions from 2002 to 2005. Average patient age was 58.4 years (range, 32-85 years). Ocular findings in descending order of frequency included multifocal chorioretinal target lesions in 12 eyes (85.7%), retinal hemorrhages in 7 eyes (50.0%), vitritis in 6 eyes (42.9%), chorioretinal linear streaks in 4 eyes (28.6%), perivascular sheathing and vasculitis in 4 eyes (28.6%), narrowed retinal vessels in 4 eyes (28.6%), disc edema in 4 eyes (28.6%), optic atrophy in 2 eyes (14.3%), vascular occlusion in 2 eyes (14.3%), and VIth nerve palsy in 1 eye (7.1%). Peripheral fundus lesions were found in all 14 eyes (100%), whereas posterior fundus lesions were found in 8 eyes (57.1%). Five patients (71.4%) were diabetic. Diabetic retinopathy was present in 7 eyes (70%). CONCLUSIONS: Multifocal choroiditis is the most common ocular manifestation associated with WNVI, with a typically benign clinical course. Less frequent ocular lesions, including optic neuritis and occlusive vasculitis, frequently induce persistent and likely permanent visual deficit. Diabetic patients and those older than 50 years of age are more vulnerable to the more severe features of WNVI, including more serious ocular lesions.
Adult↗
Isolated metastases to the retina or optic nerve.
Isolated metastases to the retina or optic nerve are extremely rare. Retinal metastases arise from cutaneous malignant melanoma and carcinomas (lung, gastrointestinal, genitourinary, and breast). Most patients present with reduced vision. The clinical appearance of these metastases is variable. Melanoma metastases are brown or black, whereas carcinoma metastases are white. Frequently, retinal hemorrhages and exudates are seen. Optic nerve metastases arise from carcinomas (lung, breast, and gastrointestinal) in adults and acute leukemias in children. As is true of retinal metastases, most patients present with reduced vision. Though in most cases there is a visible optic nerve mass, some patients have optic disc edema only. Investigations are directed by a known history of malignancy in many patients and by physical examination. Cytological workup of vitreous may be required. Treatment options include observation, radiotherapy in eyes with visual potential, and enucleation for pain control. The visual prognosis is poor. In patients with retinal or optic nerve metastases, median survival is approximately 9 months after the onset of visual symptoms, but is slightly longer in cases in which the primary lesion is breast carcinoma.
Adult↗
Vitreous hemorrhage as an ophthalmic complication of galactosemia.
A major complication of galactosemia is cataracts. This is usually considered to be the sole ophthalmic feature of this disorder. However, we have encountered vitreous hemorrhage, a very rare ophthalmic finding, in five neonates with galactosemia and have found four probable additional cases in the literature. All of these infants had severe neonatal manifestations of galactosemia and were discovered to have vitreous hemorrhage by ophthalmologic examination initiated by the observation of clouding of the eye or on a routine basis. The infants lost most or all vision from the affected eye. Retinal abnormalities were present in the involved eyes of the five neonates of whom we have direct knowledge. Thus we believe that retinal hemorrhage is the most likely source of the vitreous hemorrhage and that the coagulopathy associated with neonatal disease in galactosemia leads to vitreous hemorrhage. Prompt recognition and therapy for the coagulopathy would likely prevent vitreous hemorrhage in galactosemia.
Female↗
The ocular ischemic syndrome. Clinical, fluorescein angiographic and carotid angiographic features.
The records of 43 consecutive patients (51 eyes) with the ocular ischemic syndrome (ocular symptoms and signs attributable to severe carotid artery obstruction) were studied in a retrospective fashion. Men comprised 67% of the group and the mean age at presentation was 64.5 years. In the anterior segment, neovascularization of the iris was observed in 66% of eyes and iritis was noted in 18%. Posterior segment signs included narrowed retinal arteries and dilated, but not tortuous, retinal veins. Mid-peripheral retinal hemorrhages were seen in 80% of eyes, posterior segment neovascularization was observed in 37%, and a cherry red spot was noted in 12%. Fluorescein angiography commonly revealed delayed choroidal and retinal filling, while electroretinography generally demonstrated a reduction in the amplitude of both the a- and b-waves.
Aged↗
Choroidal neovascular membrane associated with optic nerve coloboma in a patient with CHARGE association.
PURPOSE: To report a patient with CHARGE association (coloboma, heart disease, choanal atresia, growth retardation, genital hypoplasia, and ear abnormalities) who developed a choroidal neovascular membrane in association with an optic nerve coloboma. DESIGN: Interventional/observational case report. METHOD: A 21-month-old boy with CHARGE association developed a grayish choroidal neovascular membrane associated with lipid exudation, subretinal fluid, and retinal hemorrhage at the temporal edge of his right optic nerve coloboma. RESULTS: The patient underwent transpupillary diode laser of the choroidal neovascular membrane. Five months later, it and the serous retinal detachment had resolved. CONCLUSIONS: Patients with CHARGE association may develop choroidal neovascular membrane with serous retinal detachments in association with optic nerve colobomas. These neovascular membranes may be treated successfully with transpupillary diode laser.
Abnormalities, Multiple↗
Ophthalmoscopic findings in malignant hypertension.
Malignant hypertension may present with retinopathy, choroidopathy, and optic neuropathy. Flame-shaped retinal hemorrhages, an early finding, are due to smooth muscle necrosis and bleeding along the nerve fiber layer. Cotton-wool spots, or cytoid bodies, are not exudates, but rather are retinal infarcts. Hypertensive optic neuropathy is a late finding. Optical coherence tomography is a relatively new imaging technique for evaluating retinal thickness and the location of pathology in patients with malignant hypertension.
Adult↗
Massive vitreous hemorrhage and senile macular choroidal degeneration.
In the elderly patient with a massive vitreous hemorrhage in one eye and senile macular choroidal degenerative changes in the fellow eye, a hemorrhagic disciform detachment causing this massive vitreous hemorrhage must be considered in the differential diagnosis. Ultrasonography selectively combined with radioactive phosphorus (32P) testing differentiates between a hemorrhagic disciform detachment or disciform scar and a malignant melanoma of the choroid. The ultrasonographic findings of a hemorrhagic disciform detachment may vary, but usually the posterior pole lesion is relatively flat and broad-based with a fairly homogeneous pattern without choroidal excavation. Posterior polar lesions secondary to senile macular choroidal degeneration do not grow. The vitreous hemorrhage clears in about three fourths of the patients, eventually allowing visualization of the posterior pole and ophthalmoscopic confirmation of a disciform scar. Almost one half of the eyes may be expected to lose all light perception because of the development of an initially hemorrhagic retinal detachment.
Age Factors↗
[Changes in the retina accompanying the Osler syndrome (author's transl)].
A histological examination was carried out on the eye of an eleven-year-old patient who, like his brother, was suffering from the lung variety of the Osler syndrome. The examination showed rubeosis of the iris accompanied by secondary glaucoma. One striking feature was extensive proliferous retinopathy presumably caused by chronic lack of oxygen in the arterial blood.
Blindness↗
Hereditary central retinal angiopathy.
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Adult↗
Serum alpha-1 acid glycoprotein levels in patients with idiopathic peripheral retinal vasculitis (Eales' disease).
Serum alpha-1 acid glycoprotein levels were measured in 27 patients with idiopathic peripheral retinal vasculitis (Eales' disease) and 31 healthy subjects by single radial immunodiffusion technique. The levels were found to be significantly increased in both moderate and severe types of the disease. The serum levels of this protein paralleled the severity of the disease. The increased alpha-1 acid glycoprotein in serum showed a significant fall to near normal levels during the quiescent stage. Our observations support the hypothesis that idiopathic peripheral retinal vasculitis is an immune mediated disease. It is proposed that serum alpha-1 acid glycoprotein may be considered as a reliable parameter of the activity and the degree of severity of the disease, as well as an useful tool for monitoring the efficacy of treatment.
Adolescent↗
Resolution of macular scotoma after radial optic neurotomy in central retinal vein occlusion.
Radial optic neurotomy was performed on a hypertensive 65-year-old man with decreased vision in the right eye secondary to ischemic central retinal vein occlusion. Three months later, his visual acuity improved to 20/50. There was improvement in disc and macular edema, and reduction in retinal hemorrhages clinically and angiographically. Liquid crystal display microperimetry revealed improvement in fixation stability and macular sensitivity. Radial optic neurotomy appears to be an effective treatment alternative for selected patients with ischemic central retinal vein occlusion, and results in rapid improvement in visual acuity, central fixation, and macular scotoma as measured by a liquid crystal display microperimeter. Liquid crystal display microperimetry is a good and reliable alternative to the scanning laser ophthalmoscope for macular perimetry.
Aged↗