Irreversible visual loss after an attack of central serous retinopathy

WOS: 000172980000010Central serous retinopathy is traditionally thought to he a self-limited disease entity that tends to spontaneously heal, with minimal residual visual complications. An episode of central serous retinopathy in a 30-year-old man that had been observed resulted in permanent visual loss! despite eventual, laser treatment in the affected eye

Laser photocoagulation of macular drusen: A preliminary report

WOS: 000167879600007We evaluated 36 consecutive patients observed to have macular drusen and subsequently treated I eye in each patient with the argon laser. These patients were followed up 6 to 24 months (average, IB months). Preliminary data showed loss of vision in only 3 treated eyes and no other complications. Surprisingly vision improved in 17 eyes. The remaining 16 eyes showed no visual change during this period

Choroidovitreal neovascularization following laser-induced chorioretinal venous anastomosis

WOS: 000088656400025There has been a great deal of interest in the use of the argon laser to produce chorioretinal venous anastomoses in the treatment of vision-threatening macular edema following central retinal vein occlusion. Complications associated with this procedure include: choroidal neovascularization, vitreous hemorrhage, preretinal fibrosis and fraction retinal detachment and choroidovitreal neovascularization. We report a case of choroidovitreal neovascularization following laser-induced chorioretinal venous anastomosis formation in a patient with central retinal vein occlusion

Automated computer system grading of diabetic retinopathy from fundus photographs

Purpose: To evaluate the efficacy of computer algorithms in the detection and grading of retinopathy derived from screening of diabetic photographs. Methods: Screening fundus photographs (5 per eye) taken with a mydriatic camera in a general ophthalmology clinic for 52 sequential diabetic patients were graded by a general ophthalmologist and a retina specialist and compared with computer grading of digitized images acquired from color slides. Results: Among the 104 eyes, 64 (61.5%) had no retinopathy lesions (Grade 10), 6 (5.8%) eyes had only 1 or 2 microaneurysms, 21 (20.2%) eyes had more than 2 microaneurysms but no other lesions (grade 21), and 18 (17.3%) had additional lesions (grade 21+). Among the ophthalmologists, there was exact agreement in the grading of 76 eyes; in 21 eyes grading by each was within 1 grade level, and in 7 the grades differed by 2 grade levels. Computer algorithm grading agreed with the ophthalmologists' grade in 51 (50%) eyes; in 24 (23%) eyes the computer under-graded by one grade level, and by 2 grades in 2 eyes. In 22 (21%) eyes, computer grading was greater by one grade level than the ophthalmologists' grading and in 5 (5%) eyes the algorithms overgraded by 2 grades. Conclusions: Computer algorithms were able to detect and grade retinopathy from fundus photographs taken of a set of sequentially screened diabetics with consistency similar to the agreement in grading between a general ophthalmologist and a retina specialist

Results of treatment of familial exudative vitreoretinopathy

WOS: 000089793700013This article presents a study of 30 eyes in 15 patients with familial exudative vitreoretinopathy, All the patients were followed for I to 4 years, and 18 eyes received some form of treatment during this period of time, including retinal detachment surgery with pars plana vitrectomy, cryoretinopexy, and laser therapy This study shows that the prognosis for survival of these eyes, despite careful observation and treatment remains guarded

Interactive, computer-based, self-reported, visual function questionnaire: the PalmPilot-VFQ

WOS: 000268005800013PubMed: 19478821Purpose To evaluate the testing performance, reliability, and validity of a self-administered visual function questionnaire designed for a Palm Pilot in comparison with the interviewer-administered-National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) (interviewer-NEI-VFQ-25) and self-administered-NEI-VFQ-25 (self-NEI-VFQ-25). Method The interviewer-NEI-VFQ-25 was administered to 135 sequential patients who visited a retina clinic, followed on separate days by the Palm Pilot-Visual Function Questionnaire (PalmPilot-VFQ) and self-NEI-VFQ-25. Rasch analysis of ordinal difficulty ratings for the PalmPilot-VFQ was used to estimate interval measures of perceived visual ability. Reliability was determined by calculating Cronbach's alpha and test-retest intraclass correlation coefficients (ICCs). Concurrent validity was determined by calculating correlations of the PalmPilot-VFQ score with that of a general vision question. For evaluating convergent validity, the PalmPilot-VFQ was compared with the interviewer-NEI-VFQ-25, habitual-correction visual acuity (HCVA), and with two visual analogue scale (VAS) questions. Performance time and testability were compared among the three questionnaires. Results Rasch analysis eliminated two items in the PalmPilot-VFQ due to poor-fit statistics. The final items showed internal consistency (Cronbach's alpha=0.89) and test-retest reliability (ICC=0.79), as well as an excellent separation index (3.23 and 4.01) for item parameters with significant concurrent correlation (P20/200 in the better-seeing eye) could perform the PalmPilot-VFQ with their habitual correction or high-plus spectacles, but in significantly less time than either interviewer-NEI-VFQ-25 or self-NEI-VFQ-25 (P<0.0001). Conclusion The PalmPilot-VFQ seems to be a reliable, valid, interactive, computer-based, self-administered questionnaire that can be used routinely by physicians to evaluate functional vision disability in populations with a high prevalence of macular disease. Eye (2009) 23, 1572-1581; doi:10.1038/eye.2009.101; published online 29 May 2009TUBITAKTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK)This article was supported by TUBITAK, and was accepted by the ASRS committee in 2008 as a poster presentatio

Entoptic Phenomenon Following Pars Plana Vitrectomy Caused by Retained Preretinal Gel

WOS: 000264170000017PubMed: 19320311A patient who underwent pars plana vitrectomy for vitreous floaters is described. At the time of surgery, the posterior hyalold was avulsed and stripped from the posterior retinal surface. Postoperatively, the patient described filamentous and "sea-fan" entoptic phenomena scattered throughout the periaxial vision that were in focus, attached, and "waving" with movement that was counter to the direction of gaze pursuit and demonstrated after movement. The authors believe these structures represent vitreous gel retained at the retinal surface, even though the structures could not be demonstrated by optical coherence tomography or indocyanine green staining at later vitrectomy surgery. This case should raise caution when considering vitrectomy surgery that requires posterior hyalold stripping in patients with good vision. [Ophthalmic Surg Lasers Imaging 2009;40:188-191.]Vimetrics, Inc., Media, PennsylvaniaDr. Sinclair has proprietary and financial interest in Vimetrics, Inc., Media, Pennsylvania. The other authors have no financial or proprietary interest in the materials presented herein

Proliferatif diyabetik retinopatili hastalarda konvansiyonel vitrektomi sonrasi rehemoraji oluşumuna kan basincinin etkisi

Purpose: The aim of the present study was to investigate the impact of blood pressure on re-hemorrhage after conventional vitrectomy in patients with diabetic retinopathy who had vitreous hemorrhage due to proliferative diabetic retinopathy (PDR). Materials and Methods: A total of 40 eyes of 40 patients who had undergone pars plana vitrectomy (PPV) for PDR and vitreous hemorrhage were included in the study. All patients were monitored and blood pressure was measured during the operation. Silicone oil tamponade was not applied to any case after PPV. Results: A total 40 patients with a mean age of 58±6 years [16 female (40%), 24 male (60%)] were included in the study. Re-hemorrhage was found in 8 of 40 patients during postoperative follow-up. All of these eight patients had intraoperative or early postoperative high systemic blood pressure. Intraoperative or early postoperative high blood pressure was found only in 5 of 32 patients who did not encounter re-hemorrhage. The risk of re-hemorrhage was 61.5% in patients who had intraoperative or postoperative blood pressure of ?150 mmHg. No re-hemorrhage was detected in cases with intraoperative or postoperative blood pressure of <150. The difference was statistically significant (p<0.001). Conclusion: High systemic blood pressure increases the risk of re-hemorrhage in patients who underwent pars plana vitrectomy for PDR

Prognostic factors in eyes with severe proliferative diabetic retinopathy managed with pars plana vitrectomy

Purpose: To determine the prognostic factors of functional outcomes in eyes with severe proliferative diabetic retinopathy (PDR) managed with pars plana vitrectomy (PPV). Materials and Methods: A series of 136 consecutive eyes with severe PDR and non-clearing vitreous hemorrhage (VH) or retinal detachment (RD) that underwent PPV were retrospectively reviewed for prognostic risk factors of surgical outcomes and post-operative vision. Chi-square and logistic regression analysis were used for statistical analysis. Results: Average follow-up was 35 months (range 6-56). A functional outcome (VA>5/200) was achieved in 109 eyes (80.1%) and in 51 of 66 eyes (77.3%) with traction retinal detachment. The VA was improved two lines or more in 79 eyes (58.1%), unchanged in 37 (27.2%), and was worse by 2 lines or more in 20 eyes (14.7%). Complete retinal attachment was observed at the final visit in 122 eyes (89.7%). Predictors of a poor visual outcome were found to be preoperative neovascularization severity (p=0.02), presence of iris neovascularization (RI) (p=0.04), absence of prior pan-retinal photocoagulation (p=0.03), intraoperative fluid/gas exchange (p=0.003), iatrogenic retinotomy (p=0.04), postoperative RI (p=0.0001), recurrent VH (p=0.003), RD requiring PPV and/or buckle surgery (p=0.0001). Logistic regression analysis demonsrated that the significant factors responsible for poor functional outcome to be post-operative RI and RD. Conclusion: Vitreoretinal surgery has been demonstrated to preserve and improve vision in eyes with severe proliferative diabetic retinopathy. Counselling of patients who are to undergo surgery can be performed with a better understanding of the risks of major complications and the likely outcomes

Impact of blood pressure on re-hemorrhage after conventional vitrectomy in patients with proliferative diabetic retinopathy

Amaç: Bu çalışmada amacımız proliferatif diyabetik retinopati (PDR) nedeniyle vitreus hemorajisi geçiren hastalarda konvansiyonel vitrektomi sonrası rehemoraji oluşumuna kan basıncının etkisini araştırmaktır. Gereç ve Yöntem: Çalışmamızda PDR ve vitreus hemorajisi nedeniyle pars plana vitrektomi (PPV) uygulanan 40 hastanın 40 gözü çalışma kapsamına alındı. Tüm olgular ameliyat esnasında monitörize edilerek sistemik kan basıncı takibi yapıldı. PPV sonrası hiçbir olguya silikon yağı uygulanmadı. Bulgular: Yaşları ortalaması 586 yıl olan 16 kadın (%40) ve 24 erkek (%60) toplam 40 hasta çalışmaya alındı. Sekiz hastada postoperatif takipte rehemoraji saptandı. Bu sekiz olgunun tümünde intraoperatif veya erken postoperatif yüksek sistemik kan basıncı mevcuttu. Rehemoraji gelişmeyen 32 hastanın 5inde intraoperatif veya erken postoperatif yüksek kan basıncı mevcuttu. İntraoperatif ve erken postoperatif kan basıncı 150 mmHg olan olgularda rehemoraji riski %61.5 tespit edildi. İntraoperatif ve erken postoperatif kan basıncı 150 mmHg olan olgularda ise rehemorajiye rastlanmadı. Bu fark istatistiksel olarak anlamlı idi (p0.001). Sonuç: PDR nedeniyle PPV uygulanan olgularda yüksek sistemik kan basıncı postoperatif rehemoraji riskini önemli ölçüde artırmaktadır.Purpose: The aim of the present study was to investigate the impact of blood pressure on re-hemorrhage after conventional vitrectomy in patients with diabetic retinopathy who had vitreous hemorrhage due to proliferative diabetic retinopathy (PDR). Materials and Methods: A total of 40 eyes of 40 patients who had undergone pars plana vitrectomy (PPV) for PDR and vitreous hemorrhage were included in the study. All patients were monitored and blood pressure was measured during the operation. Silicone oil tamponade was not applied to any case after PPV. Results: A total 40 patients with a mean age of 58±6 years [16 female (40%), 24 male (60%)] were included in the study. Re-hemorrhage was found in 8 of 40 patients during postoperative follow-up. All of these eight patients had intraoperative or early postoperative high systemic blood pressure. Intraoperative or early postoperative high blood pressure was found only in 5 of 32 patients who did not encounter re-hemorrhage. The risk of re hemorrhage was 61.5% in patients who had intraoperative or postoperative blood pressure of &#8805;150 mmHg. No re-hemorrhage was detected in cases with intraoperative or postoperative blood pressure of <150. The difference was statistically significant (p<0.001). Conclusion: High systemic blood pressure increases the risk of re-hemorrhage in patients who underwent pars plana vit- rectomy for PDR