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Examinations of the fundus oculi in red-free polarized light, carried out in 19 patients (12 with albinism and 7 with the albinotic type of the fundus oculi) have revealed for the first time a peculiar ring-like figure. Since there is no evidence that this figure is formed by retinal folds, the authors suppose that it may result from light wave interference. Light waves on the fundus oculi of albinos may be reflected not only by the internal border membrane, but by Bruch's membrane or sclera as well. These waves, overlapping each other, form a figure identical to Newton's interference rings. The presence of a ring-like figure in the centre of the fundus oculi may be regarded as an additional clinical sign of albinism of the fundus oculi. Together with other signs, this phenomenon may be used as a marker of albinism gene carriership.
INTRODUCTION AND OBJECTIVE: The fundus oculi is useful for observation of the interior of the eye and the retina. This study establishes a relationship between patients with established cerebral infarcts and the results observed in their fundi. PATIENTS AND METHODS: A retrospective study of the clinical histories of 177 patients seen in the rehabilitation department over a period of one year. RESULTS: The patients were aged between 29 and 85 years. The majority were men; 101 patients (57.06%) had systolic-diastolic arterial hypertension. On study of the fundus oculi there was a predominance of alterations of the blood vessels of the retina due to vascular sclerosis (93.1%) but only 24.4% had frank alterations caused by arterial hypertension. CONCLUSIONS: We found a slight relation between arterial hypertension and the alterations observed in the fundus oculi of these patients.
Histological, histochemical, and electron microscopic studies of tissues of the fundus oculi in 111 eyes with senile maculopathy revealed amyloid in the nodules. Bruch's membrane, and between the basal membrane of retinal pigmented epithelium and the internal collagen layer of Bruch's membrane in the center of the fundus oculi. The detected amyloid incorporations are referred to senile amyloidosis and reliably differ from amyloid in generalized amyloidosis. Comparative analysis of morphologic changes in tissues of the macular and paramacular areas of the fundus oculi and of the incidence of amyloid incorporations in them permit us to propose that accumulation of local senile amyloid is conductive to development and aggravation of senile maculopathy. A relationship between the degree of pigmented epithelium degeneration and accumulation of amyloid in the fundus oculi was revealed. The authors put forward a hypothesis of the pathogenesis of some stages of senile maculopathy, in which the principal role in the formation and deposition of abnormal protein, amyloid, is played by degenerative cells of pigmented epithelium. It is followed by amyloid destruction of Bruch's membrane and accumulation of amyloid under it and the basal membrane of pigmented epithelium. this in its turn, promoting neovascularization and formation of fibrovascular membrane.
Hemodynamics of the fundus oculi was studied in 41 patients with arteriovenous aneurysms and arteriosinus anastomoses by fluorescent angiography. Fifty-eight fluorescent angiographic examinations of the fundus oculi were performed. The findings were compared with the clinical course of the disease and the degree of the development of the arteriovenous shunt. Analysis of the fluorescent angiograms in patients with a normal fundus oculi showed that the disorders of its hemodynamics reflect the degree of changes in the cerebral circulation in the brain vascular disease that is studied. Prolongation of the venous phase of the retinal hemodynamics is the first sign and prolongation of the arterial phase too, a later sign of changes in cerebral circulation.
The prevalence of fundus oculi changes among elderly persons living in a rural community was investigated and the relationship of those changes to the development of cerebrovascular diseases (C.V.D.), total mortality, declines in mental and physical functions was examined. The subjects consisted of 241 residents aged 70 to 75 years as of 1986, in a rural area of Yamagata prefecture, Japan. The baseline survey was carried out in 1986, and the follow-up survey was done in 1991. The results obtained were as follows: 1) The fundus oculi examination revealed that among changes observed, there were high prevalences of senile tigroid fundus, drusen, broadened light reflex, and crossing phenomenon. 2) Multivariate analysis by Hayashi's Quantification III showed that the findings of broadened light reflex, crossing phenomenon, blood pressure, and ECG were discriminated from those of senile tigroid fundus, drusen, mental function as measured by the Benton Visual Retention Test, and physical functions. It was suggested that the former fundus oculi changes were related to circulatory disease, while the latter were related to aging. 3) A severe broadened reflex predicted a high occurrence of C.V.D., and total mortality. In women, drusen had a significant direct relationship to a decline in score of the Benton Visual Retention Test. Retinal haemorrhage was related to higher total death rate in men, and women with crossing phenomenon tended to have strokes.
Twenty-two diabetics with concomitant diabetic encephalopathy are examined. Control group consisted of 22 diabetics without encephalopathy. In the main group the fundus oculi was normal in 4 (18.2%) patients, common diabetic retinopathy with vascular changes was found in 3 (13.6%), common diabetic retinopathy with exudative and hemorrhagic changes in 7 (31.8%), and descending optic nerve atrophy in 8 (36.4%); two of these latter patients developed diabetic retinopathy, although little expressed. The fundus oculi was abnormal in all controls. Common diabetic retinopathy with hemorrhagic and exudative changes was observed in 12 (54.5%) and proliferative diabetic retinopathy in 10 (45.5%) patients. Diabetic encephalopathy concomitant with diabetes mellitus prevents or delays the development of diabetic retinopathy. The mechanism of this phenomenon is discussed. The "parquet" pattern of the fundus oculi can be an important differential diagnostic sign of diabetic and dyscirculatory encephalopathy.
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Examinations of 407 patients with angiological disorders of the fundus oculi (diabetic retinopathy, retinal vein thrombosis, central chorioretinal dystrophy, retinal angiitis) revealed relapsing hemorrhagic syndrome in 40% (170) patients. No thrombocytopenia was revealed in any of the patients, which suggests qualitative impairment of platelets in such patients. Evaluation of the platelet aggregation coefficient (PAC) using thrombin aggregation inducers and adenosine diphosphate disodium revealed a statistically significant decrease of PAC for one or both aggregants in all 170 patients with the hemorrhagic syndrome, which indicated platelet dysfunction. A course of intramuscular injections of 1% adenosine triphosphate sodium normalized platelet function and stimulated resorption of hemorrhages.
Signs in the fundus oculi, long regarded as prognostic in hypertensive disease, have been shown to be subject to gross observer error and bias when assessed in conventional ways. The authors describe unconventional ways of assessing diminution of vascularity in a population sample of men aged 50 and also in a group of hospital patients.They show that a method simple enough to be learnt by a schoolboy in 20 minutes gives information that is more precise and less biased than data obtained by more conventional means. Standards can be prepared and the information is quantitative.The unconventional data are closely related to the level of hypertension. Some anomalies in the data, possible ways of improving them and ways of testing their relation to prognosis are discussed.
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Prolonged (3 to 9 years) follow-up of 219 patients with high rapidly progressing myopia, treated with scleroplasty, has demonstrated an inhibiting effect of this surgery on the development and progress of peripheral vitreochorioretinal dystrophies: a negative time course on the fundus oculi periphery of the operated on eye was observed in 21.5 percent of patients and that of the intact eye in 35.1 percent of patients. Scleroplasty, carried out at the age of 9-11 and 15-17, was found the most effective from the viewpoint of preventing the peripheral vitreochorioretinal dystrophies. Reduced incidence of such dystrophies on the operated on eyes may be explained by the favorable effect of surgery, i.e. scleral distension arrest or delay, improved hemodynamics and trophics of ocular tissues. The results helped define the indications to scleroplasty with due regard for the patient's age and fundus oculi status.
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Explore the source record for details and available documents.
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Vascular and retinal changes seen with the ophthalmoscope in hypertension and arteriosclerosis are described, their pathogenesis is discussed, and the whole is integrated by means of a rational hypothesis.The morphological changes in the arterioles, in the venules, and at the arteriolarvenous crossings are considered, and a classification is suggested for ease of reference.Retinal changes (retinopathy) in these diseases and their pathogenesis are outlined, showing how their appearance may be used to assess the function of the peripheral vascular system and how they may reflect the general status.Because of the great variety of changes found in the fundus oculi, any adequate classification of the total fundus picture is not proposed. It is best to describe the findings objectively, and only then to speculate as to their significance.