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Retinopathy (Diabetic)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Three major types of diabetic retinopathy (DR): Nonproliferative diabetic retinopathy (NPDR) occurs when retinal microaneurysms form due to a lack of perfusion. In this early stage of diabetic retinopathy, the walls of the blood vessels in the retina weaken. Tiny bulges, or microaneurysms, protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina.Proliferative diabetic retinopathy (PDR) occurs when abnormal new blood vessels grow on the surface of the retina due to ischemia from capillary closure. In PDR, new fragile blood vessels which are easily damaged can hemorrhage into the retinal area of the eye. Diabetic vitreous hemorrhage secondary to PDR is a cause of severe vision loss in many diabetic patients.3 Patients with severe vision loss (e.g., of 5/200 or less) due to diabetic vitreous hemorrhage that does not clear spontaneously after one year typically require surgery.3Diabetic macular edema (DME). Diabetic retinopathy usually affects both eyes and is the leading cause of blindness in developed countries.
Tumors of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Visual loss: Because of enlargement of retinal hemangioblastoma.Exudative retinopathy/macular edema.Retinal detachment.Vitreous hemorrhage.Retinal lesions are often in the periphery of the retina, but large draining veins may be seen at the disc.
Endocyclophotocoagulation
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Uram8 noted a mean decrease of 65% in IOP in eyes with intractable neovascular glaucoma following a single session of microendoscopic laser ablation of the ciliary processes combined with pars plana vitrectomy and lensectomy (if phakic). Hypotony developed in two eyes with chronic retinal detachment. In the series by Uram9 of eyes with intraocular lenses, the mean IOP decrease was 57%; visual acuity improved in all patients postoperatively and there were no significant complications. The IOP decreased from a mean of 31.4 mmHg to 13.5 mmHg. Good IOP control without any topical medication was achieved in half of the patients. Visual acuity improved. Only one eye developed a transient vitreous hemorrhage postoperatively.
The genetic spectrum and clinical features of X-linked juvenile retinoschisis in Central China
Published in Ophthalmic Genetics, 2023
Zhenhui Liu, Ju Guo, Meng Pan, Kunpeng Xie, Liping Du, Xuemin Jin, Bo Lei
X-linked juvenile retinoschisis (XLRS) is the most common congenital retinoschisis in rare vitreoretinopathy with a prevalence of approximately 1 in 5000–25000 men and causes visual disturbances (1,2). The predominant clinical features are decreased visual acuity in childhood and a typical “stellate spoke-wheel pattern” in the macula on fundus examination, while some patients may be accompanied by peripheral retinoschisis. A few patients suffered severe visual impairment due to complications such as vitreous hemorrhage and total retinal detachment. Typical electroretinograms (ERGs) of XLRS-affected individuals reveal reduced b-wave amplitude with relative preservation of the a-wave amplitude (3). As a rule, it is very infrequent in females because of X-linked recessive inheritance, female carriers of XLRS rarely exhibit clinically apparent fundus abnormalities. However, careful clinical examination may reveal mild retinal abnormalities such as the presence of a functional abnormality on multifocal ERG (mfERG) testing (4). A recent study shows that the outer plexiform layer and photoreceptor microstructure defects are common in XLRS patients. Cone cell outer segment tip line defects and shortened photoreceptor outer segment (PROS) lengths as well as other photoreceptor microstructure defects may be closely related to poor vision in XLRS (5).
A review of techniques and challenges in performing sutureless intrascleral fixation of intraocular lens
Published in Expert Review of Ophthalmology, 2021
Neslihan Sevimli, Remzi Karadag, Özgür Çakıcı
Kim et al [37]. examined the short-term results of simultaneous three-piece dislocated IOL recovery and sutureless intrascleral fixation in 16 eyes of 16 patients. The authors created sclerotomy with scleral flaps and 22-gauge needles and performed 23-gauge pars plana vitrectomy. The haptics were grabbed with 23-gauge forceps and removed from sclerotomy. The haptic was then placed in the scleral tunnel created with a 26-gauge needle. Fibrin glue was used to close to flaps. Vitreous hemorrhage was observed in one patient and iris capture was observed in one eye[24]. Postoperative hypotonia may be the result of techniques using fibrin glue in closing scleral flaps and conjunctiva. Additionally, infectious agents are likely to be transmitted by certain forms of fibrin glue[38].
Aqueous Inflammation and Ischemia-Related Biomarkers in Neovascular Glaucoma with Stable Iris Neovascularization
Published in Current Eye Research, 2020
Chuan Sun, Hongsong Zhang, Yan Tang, You Chen, Yuxin Li, Chuang Nie, Jianwen Gu, Ling Luo, Zhijun Wang
Patients’ characteristics were collected on first visit, including date of birth, sex, past ocular history, past medical history, previous ocular surgeries and etiology of NVG. The examination date, best corrected visual acuity and IOP were recorded at each follow up. Visual acuity was measured with International Standard Visual Acuity Chart, and IOP was measured with a Goldmann applanation tonometer. A careful slit lamp examination and gonioscopy were carried out. Fundus photography and fluorescein angiography were also performed if possible. Iris fluorescein angiography was performed to confirm diagnosis in cases of whom the NVI was difficult to detect and to determine the maturity of NVI during follow up. B-scan ultra-sonography was performed in eyes with vitreous hemorrhage. The follow-up schedule for NVG patients was 1 month, 3 months, 6 months and then every 6 months after the last treatment.