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Pars plana vitrectomy for diabetic macular edema associated with posterior hyaloidal traction
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Sophie J Bakri, Peter K Kaiser, Hilel Lewis
Fluorescein angiography is a useful adjuvant to the clinical examination. This usually demonstrates a characteristic pattern of deep, diffuse, late retinal leakage in the central macula. This is in contrast to the traditional, multifocal vascular leakage seen in diabetic patients.8 It is postulated that the tangential traction of the taut posterior cortical vitreous is more likely to produce diffuse leakage rather than the traditional discrete areas of leakage seen in diabetic macular edema. In some cases, late leakage in a petalloid pattern consistent with cystoid macular edema is also seen. Good capillary perfusion, especially of the fovea, is another important variable to consider on fluorescein angiography, because patients with significant macular ischemia will likely not benefit from surgery.
The HbS Containing Cell
Published in Ronald L. Nagel, Genetically Abnormal Red Cells, 2019
Ronald L. Nagel, Mary E. Fabry
Peripheral retinopathy, in the form of retinitis proliferans, is the consequence of the presence of arterio-venous anastomosis. A number of events can be associated with the presence of the anastomosis. First, they can autoinfarct, suppressing the circulation of the region and resulting in a white fibrotic scar. These events can be regarded as self-limiting. Other complications are vitreous hemorrhage and retinal detachment which have the potential of seriously impairing vision. A staging classification of this retinopathy has been proposed by Goldberg273 and modified by Condon and Serjeant.274 Diagnostic procedures involve slit-lamp examination, but more importantly, fluorescein angiography that is able to detect the arterio-venous shunts by their increased permeability to the dye (Figure 21 and Plates 3 and 4).* Initial enthusiasm for laser coagulation of anastomosis has given way to a more conservative approach after the realization that progression does not always take place275 and that the procedure is not without complications.
Emerging Biomedical Imaging Optical Coherence Tomography
Published in Lawrence S. Chan, William C. Tang, Engineering-Medicine, 2019
Diabetic retinopathy is a common complication of a very common disease diabetes mellitus and is a major cause of blindness. In one European study, it is ranked as the most common cause of blindness (Bourne et al. 2014). One of the excellent and cost-effective ways of prevent blindness from diabetic retinopathy is to assess early disease and control the progression of retinal neovascularization (Romero-Aroca et al. 2016). Fluorescein angiography has been the “gold standard” for such assessment but without the ability to examine vessels of different layers. Here, OCT angiography (OCTA) can help provide that 2- and 3-dimensional visualization of the retinal and choroidal vascular network, including micro-aneurysm, non-perfusion region, intraretinal vascular abnormality, neovascularization, vascular density quantification, and foveal avascular zone, without the need for intravenous dye administration (Coscas et al. 2018, Liu et al. 2018, Spaide et al. 2018). Moreover, OCTA could be useful for assessment of other retinal and choroidal vascular diseases such as age-related macular degeneration, central serous chorioretinopathy, uveitis, and inherited retinal disorders (Borrelli et al. 2018, Lauermann et al. 2018, Tan et al. 2018). OCTA photos taken from normal and diabetic retinas are shown in Figs. 3, 4 and Fig. 5, respectively.
A Case Report of Sweet’s Syndrome with Panuveitis and Rhegmatogenous Retinal Detachment
Published in Ocular Immunology and Inflammation, 2021
Wenjuan Wang, Xin Wang, Hongran Zhao, Yan Cui
The vitreous opacity diffused throughout the vitreous cavity, but not limited to the basal vitreous or inferior part of vitreous cavity, so we diagnosed the patient with panuveitis. The fluorescein angiography may be a manifestation of diabetic retinopathy. However, compared with the fundus photography, there is no obvious characteristic of diabetic retinopathy, and this fluorescence characteristic could not rule out that inflammation aggravated the expression of diabetic retinopathy. Unfortunately, since the patient has not received fluorescein angiography before, we cannot determine the retinal and choroidal involvement caused by SS. For our patient, we think that vitreous opacity caused by uveitis resulted in PVD and the following rhegmatogenous retinal detachment. The vitreous opacity and some retina fold demonstrated proliferative vitreoretinopathy (PVR) Grade C3. It has been reported that the incidence of rhegmatogenous retinal detachment for uveitis patients is 3.1%,5 while it was only 0.01% for healthy people. The incidence of proliferative vitreoretinopathy (PVR) is higher in patients with uveitis than in healthy subjects. Inflammation weakens the adhesion between the retinal neuroepithelial layer and the retinal pigment epithelium, and vitreous proliferation, where shrinkage leads to retinal breaks.
OCT-Angiography Comparison between Obstructive Sleep Apnea Children and Normal Subjects in China
Published in Current Eye Research, 2021
Haiyun Ye, Chenjin Jin, Xiaoyan Li, Limin Zhao, Yuan Li, Tong Qiao
The gold standard of retinal imaging technique is fluorescein angiography currently. However, this method may not reflect capillary plexus situation.22 OCT-A can make up for this deficiency with better resolution and better time efficiency. Shahlaee et al. demonstrated that OCT-A is reliable for the quantification of the FAZ at the SCP.23 The FAZ value of the OSA group in our study was obviously lower than that of the control group in the SCP/DCP. This should be relevant with the lower level of oxygen supplements and the corresponding retinal blood distribution. Additionally, the mean FAZ area in healthy children was 0.30 ± 0.11 mm2 in SCP and 0.63 ± 0.20 mm2 in DCP, respectively, which were similar to those reported by Iafe.24
HLA-DRB1*04:05 and HLA-DQB1*04:01: Alleles Potentially Associated with Vogt-Koyanagi-Harada in Northern Thai Patients
Published in Ocular Immunology and Inflammation, 2021
Nampeung Anukul, Kessara Pathanapitoon, Nipapan Leetrakool, Tiphakorn Guntiya, Ratsameetip Wita, Poonsub Palacajornsuk, Phennapha Klangsinsirikul
To recruit the VKH and non-VKH uveitis patients, medical history, and eye examination data were extracted from medical files by physicians. Each patient underwent a full ophthalmic examination, including slit-lamp biomicroscopy, tonometry, and indirect ophthalmoscopy. Additional examinations as fluorescein angiography and optical coherence tomography were performed when required. Patients were thoroughly screened (including serology tests for HIV and syphilis, chest x-ray, and a tuberculin test) and those with infectious uveitis were excluded. All uveitis patients (VKH and non-VKH) were classified according to the Standardization of Uveitis Nomenclature Working Group criteria. VKH patients were also classified according to the revised criteria for VKH in 2001 consisted of five sections as follows: (1) no history of ocular trauma; (2) no evidence suggestive of other ocular diseases; (3) bilateral ocular involvement in early manifestation of disease included diffuse choroiditis focal area of subretinal fluid or bullous serous retinal detachment and late stage of disease included ocular depigmentation and nummular chorioretinal depigmentation, RPE clumping; (4) neurological/auditory findings; (5) integumentary findings. There were three distinct categories of the disease and classified as complete requires criteria 1–5, incomplete requires criteria 1–3 and either 4 or 5, and probable VKH requires criteria 1–3 only.16