SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We experienced 2 females with systemic lupus erythematosus (SLE) who developed serous retinal detachment in the posterior pole of both eyes in its active phase. Fluorescein angiography showed multifocal pigment epithelial damages with fluorescein leakage into the subretinal space. However, retinal hemorrhages or cotton-wool spots typical of SLE were not observed in their courses.
A 49-year old female in the course of chemotherapy for adult T-cell leukemia (ATL) noticed blurred vision and visual field defect in her right eye on February 26, 1991. Ophthalmoscopic findings showed exudative necrotizing retinitis with white exudative patches and scattered retinal hemorrhages in both eyes. CMV was isolated from the urine by the shell vial cell culture assay. Anti-viral therapy was commenced using ganciclovir and gamma-globulin, which are rich in anti-CMV antibodies. The exudative lesions were absorbed gradually. The ocular signs and symptoms agreed with the patient's systemic immunosuppressed T cell function state. CMV retinitis should be considered in the differential diagnosis of retinitis in immunocompromised patients. CMV retinitis will certainly be found more frequently in accordance with the increasing number of immunocompromised hosts who have received immunosuppressive therapy or transplantation.
PURPOSE: Oxidative damage to cellular membranes plays an important role in the pathobiology of tissue injury. Free radical-induced peroxidation of membrane lipid and protein is associated with alterations in cellular, morphological, biochemical, and physical dynamics, which are related to the mobility of lipid molecules. Retinal photoreceptors and platelets have been shown to be an easy target of oxidants because of their high proportion of polyunsaturated fatty acids. This study was undertaken, for the first time, to investigate membrane fluidity in the platelets of patients with Eales' disease. METHODS: Assays of malonaldialdehyde levels and the enzymes superoxide dismutase and catalase and fluorescence polarization, for estimating membrane fluidity, were carried out on platelets from 20 patients with Eales' disease (stage 1 characterized by periphlebitis of small (1a) and large (1b) caliber vessels with superficial retinal hemorrhages) and 15 healthy controls. RESULTS: A significant increase was observed in the malonaldialdehyde levels. A significant decrease in the activity of superoxide dismutase and catalase was also observed. Platelet fluorescence polarization was significantly higher in the patients, indicating decreased membrane fluidity compared to controls (p<0.01). CONCLUSION: A decrease in platelet membrane fluidity occurs as a result of oxidative stress in retinal periphlebitis in Eales' disease. The decreased membrane fluidity suggests alterations in the physiological events, which may result in alterations in the functioning of retinal photoreceptors.
In order to evaluate the treatments of subdural hematoma in neonates and to observe their prognosis, we carried out clinical analyses on 48 survived cases in the past three years from Jan. 1979 to Dec. 1981. Based on CT observations, hematomas were grouped into four types according to their locations as follows: Type I, localized around the posterior interhemispheric fissure in 25 cases (52%); Type II, extending from the posterior interhemispheric fissure to the hemispheric convexity in five cases (10%); type III, extending from incisura to the posterior fossa in 15 cases (31%); and type IV, having subdural hematoma accompanied by intracerebral hemorrhage in three cases (7%). Intracranial pressure was measured via the anterior fontanelle in 13 cases. Ten patients who had extensive hemorrhage were found to exceed above 200 mmH2O in the pressure. Ages of the patients studied were 0 to 7 days old. There were 36 mature infants (75%) and 12 cases immature (25%). The maternal history of delivery was primiparous in 27 cases (56%). The fetal presentations were 38 cephalic (79%) and 10 suction deliveries (21%). The fundus oculi was examined on 32 patients. Retinal hemorrhage was noted in 12 cases. Operations were performed on 13 patients in total; one case in type I, four cases in type II, five cases in type III and three cases in type IV. Functional prognoses were found to be as follows; Type I; normal, 15 cases, abnormal, four and undetermined, six: type II; normal, four and abnormal, one: type III; normal, 13, abnormal, one, and undetermined, one: and type IV; normal, two and abnormal, one case.
PURPOSE: To evaluate the efficacy and safety of a silicone oil-RMN3 mixture ("heavy silicone oil") as heavier as water internal retinal tamponade after vitrectomy for complicated retinal detachment. The relative density of the heavier-than-water silicone oil was 1.03 g/cm3, and the viscosity was 3,800 cSt. Heavy silicone oil is designed to tamponade the inferior retina in complicated retinal detachment. METHODS: Patients with a complicated retinal detachment involving the inferior part of the retina requiring internal tamponade with silicone oil were recruited for this prospective study. Inclusion criteria were retinal detachment secondary to proliferative vitreoretinopathy (stage > or = C2), inferior or posterior tears, or penetrating trauma. The heavy silicone oil was injected at the end of surgery after peeling of retinal membranes or retinotomy. Follow-up examinations were scheduled at 1, 3, 6 months, and 1 year after the initial surgery. RESULTS: A total of 33 eyes of 33 patients aged from 20 to 84 years (mean, 56 +/- 18 years) were treated with heavy silicone oil. Follow-up ranged from 12 to 16 months. Rhegmatogenous retinal detachment with significant proliferative vitreoretinopathy accounted for 17 cases, inferior holes for three, and trauma with retinal detachment for three. Initial visual acuity ranged from 20/50 to hand motions. Initial retinal reattachment was achieved in all cases. Complications included increased intraocular pressure in six eyes (18%), intraocular inflammation and synechia formation in one eye (3%), a central retinal artery occlusion after heavy oil removal in one eye, and scattered retinal hemorrhages during follow-up in two eyes (6%). Significant emulsification was not observed during intraocular tamponade with heavy silicone oil. At the last follow-up, all eyes had macular attachment, and 24 eyes had a visual acuity better than or equal to 20/400. CONCLUSIONS: The results of this prospective study show the good intraocular tolerance of heavy silicone oil as tamponade in complicated retinal detachment. Its specific gravity allows for sufficient tamponade of inferior retinal tears for at least 3 months without significant side effects.
We present one case of acquired Toxoplasma gondii retinochoroiditis after livrer transplantation. Three weeks after receiving liver transplant from a seropositive donor for Toxoplasma gondii, the fundus examination showed a vitreal haze and an edematous retinal lesion with retinal hemorrhages. Routine screening tests for uveitis were performed. The serum toxoplasmosis titers revealed a seroconversion for toxoplasmosis (pre-transplantation tests were negative). The PCR assay on aqueous humor resulted in an amplified product identical to toxoplasmosis. This immunocompromised patient likely received an infected hepatic transplant. The patient's ocular inflammation cleared on 1-month pyrimethamine-sulfadiazine medication. Four months later, the patient developed a retinal detachment with massive proliferative vitreoretinopathy.
In Terson's syndrome a sudden increase in intracranial pressure due to spontaneous subarachnoid hemorrhage or head trauma may result in intraocular hemorrhage. A patient with bilateral vitreous hemorrhages underwent vitrectomy in both eyes with excellent result. In the right eye a glistening membrane was found with blood underneath, covering the macula. This was probably the internal limiting membrane (ILM). At the vitreous base and in the equatorial zone, attachment plaques are present between the ILM and the Müller cells. Because attachment plaques are missing in the posterior zone, where the ILM is much thicker, a retinal hemorrhage is capable of detaching the ILM from the retina in that area. The presence of attachment plaques is considered in relation to centripetal vitreous traction, which is absent in the area of the posterior precortical vitreous pocket (PPVP). The posterior wall of the PPVP coincides therefore probably exactly with the thick part of the ILM in the posterior zone.
A 24-year-old woman with systemic lupus erythematosus had decreased visual acuity, retinal cotton-wool spots, venous dilations, and multiple arteriolar occlusions around the optic disc in her left eye. The right eye showed good visual acuity and a few small retinal hemorrhages. Although abnormal serologic findings and systemic manifestations quieted with corticosteroid therapy, the retinopathy in the left eye progressed. After treatment with focal argon laser photocoagulation, progression of the retinopathy stopped.
Explore the source record for details and available documents.
PURPOSE: To report a case of stage IV macular hole associated with ruptured retinal arterial macroaneurysm. DESIGN: Observational case report. METHOD: The patient's clinical, angiographic, and ophthalmic coherent tomography data were reviewed. RESULTS: A stage IV macular hole was observed in association with a ruptured retinal arterial macroaneurysm in a 79-year-old patient. After vitrectomy surgery, the macular hole closed and vision improved from counting fingers to 20/100. CONCLUSIONS: Macular hole associated with ruptured retinal macroaneurysm can be closed successfully to result in improved vision.
Explore the source record for details and available documents.
Ocular manifestation in two observations on patients with anti-HIV positive antibodies are presented. The primer was done on a 47-year-old patient who presented retinal micro-vasculopathy with vetous exudates, retinal and pre-retinal hemorrhages and arterial obstructions at the right eye. The right eye vision was 2/50. The latter observation was done on a two-year and eight month old child with positive HIV who presented palpebral staphylococci and marginal keratitis at the left eye. These cases shows that AIDS, as an affection implying a small group of people, because of its epidemiological particularities and therapeutical difficulties must be known by ophthalmologists, being revealed by retinal primary vasculopathies and also by the presence of some ocular infections, as it has been in the latter observation.
An experimental dog model was used to reproduce the clinical picture of bilateral arteriole and choriocapillaris occlusion from a unilateral intracarotid injection of long-acting corticosteroids combined with other drugs including lidocaine, epinephrine, and penicillin. All five known long-acting corticosteroids, when combined with 1:1000,000 epinephrine, elicited vasoconstriction followed by dilatation of the retinal vessels with particulate material occlusion of the retinal vessels and choriocapillaris associated with small retinal hemorrhages. The fluorescein picture is described. The particles were identified by polarization as the long-acting corticosteroid.
PURPOSE: To photographically document venous collateral development, remodeling, and regression in a patient with traumatic glaucoma. METHODS: Consecutive fundus photographs were evaluated, labeled, and correlated with the clinical history of a patient with unilateral posttraumatic glaucoma. RESULTS: This report photographically documents the appearance, remodeling, and subsequent disappearance of collateral vessels from venous occlusion on the surface of the optic disk in an eye with increased intraocular pressure and progressive glaucomatous cupping. CONCLUSIONS: Asymptomatic chronic obstruction of a branch retinal vein on the optic disk may cause venous collaterals to develop in the absence of retinal hemorrhages or other signs of venous occlusive disease. Increased intraocular pressure, arteriolarsclerosis, and glaucomatous cupping are risk factors for these occlusions.
Injuries due to child abuse have continued to attract the attention of investigators. There was new evidence to show that cardiopulmonary resuscitation is a rare cause of rib fracture and that posterior rib fractures without a history of significant trauma are highly suggestive of abuse. An autopsy study examined ocular nerve sheath hemorrhage in deaths caused by abuse. The incidence and characteristics of abuse and neglect were studied for drowning victims. Female circumcision was well described, and physicians need to familiarize themselves with this cultural practice. The American Academy of Pediatrics published policy statements on sudden infant death and shaken baby syndrome. They stressed the need for protocols to deal with unexpected childhood deaths and to obtain autopsies in such cases. Reviews of fractures of abuse and retinal hemorrhages were enlightening. Reporting abuse and coping with violence remained topics of interest.
PURPOSE: To report a first case of Terson-like syndrome associated with asphyxiophilic practices in an adolescent. METHODS: A 12-year-old boy was referred for decreased visual acuity in his right eye. His father had been diagnosed 3 weeks before with subarachnoidal hemorrhage. Fundus examination showed a dense preretinal hemorrhage in the right eye suggestive of Terson syndrome. RESULTS: Angio-magnetic resonance imaging eliminated aneurysm and arteriovenous malformation from the diagnosis. After questioning the boy further, he reported that he had participated in the "scarf game", a very popular (but lethal) asphyxiophilic practice in middle school, some hours before he noticed a sharp drop in the visual acuity of his right eye. After 2 months of follow-up, he recovered 20/20 vision in his right eye. CONCLUSION: Retinal hemorrhages are quite rare in children. When the cause is not clear (subarachnoidal hemorrhage, arteriovenous malformation, shaken baby syndrome), it must be determined whether the patient has participated in the asphyxiophilic "scarf game" in order to prevent its lethal consequences.
PURPOSE: To evaluate the technique of silicone oil removal through a posterior capsulorhexis combined with phacoemulsification and intraocular lens (IOL) implantation. SETTING: Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India. METHODS: Fifteen eyes of 15 patients had phacoemulsification with removal of silicone oil, which had been used for intraocular tamponade after a previous pars plana vitrectomy. Eyes with a stable retina were included in the series. In all eyes, the silicone oil was removed through a planned posterior capsulorhexis after phacoemulsification. The parameters evaluated were the primary diagnosis, duration between silicone oil instillation and phacoemulsification, type of cataract, preoperative and postoperative best corrected visual acuities (BCVAs), and complications such as frequency of retinal redetachment and secondary cataract. RESULTS: Vitreoretinal surgery with silicone oil instillation was performed for rhegmatogenous-tractional detachment resulting from Eales' disease in 6 eyes and from proliferative diabetic retinopathy in 2 eyes, for primary rhegmatogenous retinal detachment in 6 eyes, and for traumatic rhegmatogenous detachment in 1 eye. The mean duration between the silicone oil instillation and phacoemulsification was 7.5 months +/- 3.8 (SD). Fourteen eyes had posterior subcapsular cataract, and 10 had nuclear sclerosis. Preoperative BCVA was worse than 6/60 in all eyes. The BCVA was 6/60 or better in 9 eyes after a minimum follow-up of 6 months. Two eyes had choroidal detachment in the early postoperative period. No eye had vitreous hemorrhage, retinal redetachment, secondary cataract, clinically significant endothelial decompensation or macular edema, or a dislocated IOL. CONCLUSION: The results indicate that silicone oil removal through a posterior capsulorhexis during phacoemulsification is a viable option and can be performed in selected cases of cataract with previous silicone oil instillation and a stable retina.
Patients with long bone fractures are at risk for the fat embolism syndrome (FES). Although an estimated 50% of patients with overt FES have retinal abnormalities, the overall incidence of fundus lesions in patients with long bone fractures has not been studied. We examined 100 consecutive patients who had suffered long bone or pelvic fractures in the absence of head, abdominal, or thoracic injury, and who had no other diseases associated with retinopathy. Only one patient had visual symptoms. Cotton-wool spots and retinal hemorrhages were observed in four patients, none of whom were suspected of FES prior to our examination. Subclinical FES may be found by ophthalmoscopy in patients with long bone fractures.