Photothermal Lasers
Anita Prasad in Laser Techniques in Ophthalmology, 2022
The OCT scan has become central to decision-making in treatment of maculopathy. It documents and quantifies the maculopathy (measures central retinal thickness). Central retinal thickness (CRT) is a better indicator of disease severity and outcome than vision alone.Helps select appropriate treatment, based on OCT parameters of maculopathy.Compares ‘before and after’ images to judge the effectiveness of treatment.Identifies other macular or retinal changes, which may affect prognosis.OCT documentation allows monitoring of disease trend to help decide if a switch in treatment is necessary.
Ophthalmology
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan in Essential Notes for Medical and Surgical Finals, 2021
Occurs in virtually all type I diabetics after 15–20 years and 80% of type II diabetics (» 10% at diagnosis and 50% at 10 years). Commonest cause of blindness in developed world in 30–60 year olds. Normally classified as: Background: microaneurysms; dot, blot and flame haemorrhages; hard exudates.Pre-proliferative: as for background + cotton wool spots; dilation and beading of veins; and intraretinal microvascular abnormalities (IRMAs).Proliferative: neovascularisation, vitreous haemorrhage, retinal detachment, glaucoma (rubeosis iridis). Maculopathy = retinopathy involving the macula, therefore likely to cause visual loss even with less severe disease: typically causes poor central vision with relatively intact peripheral vision.
Answers
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Diabetic eye disease is most commonly manifested as diabetic retinopathy. There are characteristic changes associated with this. It travels through the stages of background retinopathy denoted as presence of microaneurysms. Preproliferative retinopathy is denoted by cotton wool spots and flame-shaped haemorrhages, which mark the presence of ischaemia at the retina. Finally, proliferative retinopathy is denoted by the presence of new vessels at or around the optic disc. Maculopathy can also be present. Treatment for diabetic retinopathy is by panretinal photocoagulation with the aim of causing a regression in the new blood vessels. Diabetics are at high risk of many other eye conditions, and good glycaemic control is the aim for prevention of these occurring.
‘Poppers Maculopathy’ and the adverse ophthalmic outcomes from the recreational use of alkyl nitrate inhalants: a systematic review
Published in Seminars in Ophthalmology, 2023
Caleb Bartolo, Konstandina Koklanis, Meri Vukicevic
Consistent with the literature, this research found that a diagnosis of poppers maculopathy encompasses a decline in VA or visual disturbances secondary to foveal damage seen on SD-OCT and fundoscopy in association with a focused patient drug history. Anatomical changes are more readily identified on fundoscopy, with a bilateral yellow foveal spot commonly observed as a supporting feature of the maculopathy. SD-OCT also appears to be a useful imaging modality for diagnosing poppers maculopathy with the most common anatomical feature presenting as a disturbance in the sub-foveal ellipsoid layer. A previous case series by Van Bol et al.50 reported observations of three distinct phenotypes of maculopathy in 39 patients. The phenotypes included a sub-foveal disturbance of the ellipsoid layer, vitelliform-like lesion and micro-hole, which may aid clinicians in easier diagnosis. The use of FF-ERG, MF-ERG, FAF, FFA and VF appears to be less useful diagnostic tools.
Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) – Report 6: Dengue Uveitis at a Tertiary Eye Institution in Singapore
Published in Ocular Immunology and Inflammation, 2023
Aaron Wei Wen Ng, Helen Fang Mi, Su Ling Ho, Stephen Charn Beng Teoh, Rupesh Agrawal
A range of interventions have been described in the literature. Ocular manifestations of dengue fever are thought to be predominantly self-limiting and spontaneous recovery has been observed. Thus, close observation may be considered in selected patients, especially with mild disease. A report of patients hospitalized with dengue fever and ocular complications in an Indian epidemic described 50 patients to have spontaneous resolution of ocular complications without any form of treatment.24 Two cases of maculopathy were described by Kamath et al., and both patients had spontaneous improvement to 6/6 vision within 21 days.25 Despite good resolution of visual acuity, persistent scotoma may still be reported in some patients.26 Multifocal electroretinography has shown reduced N1 and P1 responses up to 1 year after the onset of disease suggesting persistent photoreceptor or bipolar cell damage.27 OCT-A has also demonstrated persistent changes in the superficial and deep retinal plexuses causing a flow deficit in the foveal region.28 It has been postulated that an underlying immune mechanism such as immune complex deposition is responsible for the ischemic changes causing persistent scotoma in these patients.29
Inter-Eye Comparison in Highly Myopic Patients with Unilateral Myopic Traction Maculopathy
Published in Current Eye Research, 2022
Jiaxin Tian, Yue Qi, Yinghan Zhang, Caixia Lin, Ningli Wang
Currently, many studies have analyzed the risk factors and pathogenesis of MTM by comparing highly myopic eyes with and without the tractional component.6,11 Pathological myopia might be manifested in different types of maculopathy, like some eyes presenting serious myopic atrophy maculopathy (MAM) and some eyes presenting serious MTM. A general comparison might confound the various factors in different types of maculopathy. Besides, the molecular and systemic diversity is difficult to be observed or adjusted. An inter-eye comparison for asymmetric ocular features in both eyes could directly reflect the major morphological factors associated with MTM and, to some extent, exclude the effect of molecular and systemic diversity. Therefore, we performed the study in patients with unilateral MTM to explicitly explore the mechanism and relevant risk factors.
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- Choroidal Neovascularization
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- Retina
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- Retinitis Pigmentosa
- Macula
- Hypotony Maculopathy
- Ocular Hypotony