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Wavy Lines, Distorted Vision and Blur
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Diagnosis can be made clinically based on examination findings with OCT to help confirm the diagnosis. The most common conditions that cause distortion include choroidal neovascular membrane (CNV), epiretinal membrane and macular hole. There are various causes of CNV (see Table 13.1), and the patient's age and demographics can give you some clues.
Vitreoretinal surgery for idiopathic epiretinal membranes
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
H Richard McDonald, Robert N Johnson, Robert N Johnson, Everett Ai, J Michael Jumper, Arthur D Fu
Attention is then directed toward the membrane. If the membrane is thick and fibrotic, it may be possible to grasp the membrane directly with an intraocular foreign body forceps and lift it from the macular surface. A variety of instruments have been developed to aid in the initiation and completion of epiretinal membrane removal.55–;59 In
Chronic Hyperglycemia Impairs Vision, Hearing, and Sensory Function
Published in Robert Fried, Richard M. Carlton, Type 2 Diabetes, 2018
Robert Fried, Richard M. Carlton
The cause of epiretinal membrane (ERM) is a defect in the surface layer of the retina where glial cells can migrate and grow into a membranous sheet on the retinal surface. This membrane can appear like cellophane and over time may contract and cause traction (or pulling) and puckering of the retina, leading to decreased vision and visual distortion.
Intravitreal Ranibizumab and Dexamethasone Implant Injections as Primary Treatment of Diabetic Macular Edema: The Month 24 Results from Simultaneously Double Protocol
Published in Current Eye Research, 2023
Mahmut Kaya, Ferdane Atas, Nilufer Kocak, Taylan Ozturk, Ziya Ayhan, Suleyman Kaynak
Studies have established correlations between visual acuity and foveal morphological changes, such as the intactness of the ELM and EZ.14 In our study, it was shown that the ELM and EZ integrity were better in the double protocol group compared to the ranibizumab monotherapy group at month 24. There was a decrease in macular lipid exudate in both groups, but it was not statistically significant. In addition, there was no statistically significant increase in the percentage of patients with ERM in double protocol group at month 24, however, in ranibizumab monotherapy group, this was statistically significant. Various studies have shown that the epiretinal membrane develops as a result of persistent inflammation.15–17 Moreover, the morphological changes are usually associated with active inflammation such as, subfoveal neuroretinal detachment, intraretinal hyperreflective foci, foveal hard exudates, or large foveal cystoid spaces. At month 24 compared to month 12, we found that although OCT findings of both groups showed significant improvements, whereas the BCVA did not improve significantly in both the double protocol group and the ranibizumab monotherapy group. Moreover, we observed that the ranibizumab monotherapy group was found to have more ERM on SD-OCT than those in the double protocol group and increased over 24 months.
Clinical Features of Endogenous Endophthalmitis Secondary to Minimally Invasive Upper Urinary Tract Calculus Removal
Published in Ocular Immunology and Inflammation, 2022
Bingsheng Lou, Yi Sun, Jialiu Lin, Zhaohui Yuan, Liwen He, Chongde Long, Xiaofeng Lin
All patients received oral voriconazole 6–8 weeks. As shown in Table 2, pars plana vitrectomy (PPV) alone or in combination with other procedures was performed in 11 patients 15 eyes), and 1 patient (2 eyes) was given only repeated intravitreal fluconazole because of lung infection and spinal canal abscess. All 15 eyes underwent complete vitrectomy. During surgery, induced posterior vitreous detachment (PVD) was performed in 6 eyes without natural PVD developed, and no complications of retinal break or retinal detachment ocurred. Epiretinal membrane (ERM) around the retinal exudates existed in 5 eyes. Retinal tears occurred in 2 eyes due to the peeling of ERM (Case 2, Case 6 OS). ERM could not be completely removed and retinal reattachment failed because of the severe and extensive adhesion between the membrane and the detached retina in Case 10. Endophthalmitis reoccurred at 2 weeks postoperatively in one eye (Case 12), another vitrectomy combined with lensectomy and silicon oil replacement was conducted. Macular epiretinal membrane developed at 4 months postoperatively in one eye (Case 1, OS), and ERM removal was performed. Silicon oil was removed 3 to 9 months (mean, 6 ± 2.3 months) after silicon oil tamponade. Significant cataract developed in case 3 and case 4 (OD), and phacoemulsification was conducted with silicon oil removal. No complications such as retinal detachment occurred after silicon oil removal.
Posterior Subhyaloid Precipitates: ‘KPs’ of the Posterior Segment
Published in Seminars in Ophthalmology, 2021
Ashish Khalsa, Anup Kelgaonkar, Srikanta Kumar Padhy, Tushar Agarwal, Anamika Patel, Umesh Chandra Behera, Soumyava Basu
A 28-year-old male presented with an active Toxoplasma retinochoroiditis lesion at macula with overlying vitritis in his right eye along with old healed pigmented Toxoplasma retinochoroiditis scar along the inferotemporal arcade. The left eye had the presence of healed Toxoplasma retinochoroiditis scar as well. IgG for Toxoplasma (ELISA) was positive with negative IgM. A similar treatment regimen as in the first case consisting of oral antibiotics, steroids and baseline intravitreal clindamycin was used. At 1-week follow-up, partial PVD with inferior curvilinear pattern deposition of multiple, spherical, yellowish-white PSPs was noted (Figure 3). We tested him for TPHA, VDRL and HIV to rule out the alternative diagnosis. All three tests were non-reactive. These PSPs resolved completely over the next 1 month. Retinochoroiditis lesion healed with a pigmented scar at two months follow up. Epiretinal membrane developed over the lesion causing surface contraction. Intravitreal clindamycin injection was injected weekly for 4 weeks, oral steroids were given in tapering doses for 1 month while oral antimicrobials were given for 6 weeks. During the last follow up at 16 months the scar was stable with no recurrences of either retinochoroiditis or PSPs.