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Sample records for tortuous retinal arteries

  1. Straight versus tortuous retinal arteries in relation to blood pressure and genetics

    Taarnhøj, N C B B; Munch, I C; Sander, B;

    2008-01-01

    dizygotic same-sex healthy twin pairs, aged 20 to 46 years, who were characterised by determination of retinal vessel diameters, arterial blood pressure, blood glucose, body mass index, smoking habits and retinal arterial tortuosity, using a three-level grading scale (straight, wavy, tortuous). Heritability...... factors accounting for the remaining 18% (CI(95 )8, 36%). Increasing values of mean arterial blood pressure and body mass index were both associated with decreasing levels of retinal arterial tortuosity. CONCLUSION: There was a large variation in tortuosity of retinal arteries in these healthy subjects...

  2. Elk3 deficiency causes transient impairment in post-natal retinal vascular development and formation of tortuous arteries in adult murine retinae.

    Weinl, Christine; Wasylyk, Christine; Garcia Garrido, Marina; Sothilingam, Vithiyanjali; Beck, Susanne C; Riehle, Heidemarie; Stritt, Christine; Roux, Michel J; Seeliger, Mathias W; Wasylyk, Bohdan; Nordheim, Alfred

    2014-01-01

    Serum Response Factor (SRF) fulfills essential roles in post-natal retinal angiogenesis and adult neovascularization. These functions have been attributed to the recruitment by SRF of the cofactors Myocardin-Related Transcription Factors MRTF-A and -B, but not the Ternary Complex Factors (TCFs) Elk1 and Elk4. The role of the third TCF, Elk3, remained unknown. We generated a new Elk3 knockout mouse line and showed that Elk3 had specific, non-redundant functions in the retinal vasculature. In Elk3(-/-) mice, post-natal retinal angiogenesis was transiently delayed until P8, after which it proceeded normally. Interestingly, tortuous arteries developed in Elk3(-/-) mice from the age of four weeks, and persisted into late adulthood. Tortuous vessels have been observed in human pathologies, e.g. in ROP and FEVR. These human disorders were linked to altered activities of vascular endothelial growth factor (VEGF) in the affected eyes. However, in Elk3(-/-) mice, we did not observe any changes in VEGF or several other potential confounding factors, including mural cell coverage and blood pressure. Instead, concurrent with the post-natal transient delay of radial outgrowth and the formation of adult tortuous arteries, Elk3-dependent effects on the expression of Angiopoietin/Tie-signalling components were observed. Moreover, in vitro microvessel sprouting and microtube formation from P10 and adult aortic ring explants were reduced. Collectively, these results indicate that Elk3 has distinct roles in maintaining retinal artery integrity. The Elk3 knockout mouse is presented as a new animal model to study retinal artery tortuousity in mice and human patients. PMID:25203538

  3. Elk3 deficiency causes transient impairment in post-natal retinal vascular development and formation of tortuous arteries in adult murine retinae.

    Christine Weinl

    Full Text Available Serum Response Factor (SRF fulfills essential roles in post-natal retinal angiogenesis and adult neovascularization. These functions have been attributed to the recruitment by SRF of the cofactors Myocardin-Related Transcription Factors MRTF-A and -B, but not the Ternary Complex Factors (TCFs Elk1 and Elk4. The role of the third TCF, Elk3, remained unknown. We generated a new Elk3 knockout mouse line and showed that Elk3 had specific, non-redundant functions in the retinal vasculature. In Elk3(-/- mice, post-natal retinal angiogenesis was transiently delayed until P8, after which it proceeded normally. Interestingly, tortuous arteries developed in Elk3(-/- mice from the age of four weeks, and persisted into late adulthood. Tortuous vessels have been observed in human pathologies, e.g. in ROP and FEVR. These human disorders were linked to altered activities of vascular endothelial growth factor (VEGF in the affected eyes. However, in Elk3(-/- mice, we did not observe any changes in VEGF or several other potential confounding factors, including mural cell coverage and blood pressure. Instead, concurrent with the post-natal transient delay of radial outgrowth and the formation of adult tortuous arteries, Elk3-dependent effects on the expression of Angiopoietin/Tie-signalling components were observed. Moreover, in vitro microvessel sprouting and microtube formation from P10 and adult aortic ring explants were reduced. Collectively, these results indicate that Elk3 has distinct roles in maintaining retinal artery integrity. The Elk3 knockout mouse is presented as a new animal model to study retinal artery tortuousity in mice and human patients.

  4. Elk3 Deficiency Causes Transient Impairment in Post-Natal Retinal Vascular Development and Formation of Tortuous Arteries in Adult Murine Retinae

    Christine Weinl; Christine Wasylyk; Marina Garcia Garrido; Vithiyanjali Sothilingam; Beck, Susanne C.; Heidemarie Riehle; Christine Stritt; Michel J Roux; Seeliger, Mathias W.; Bohdan Wasylyk; Alfred Nordheim

    2014-01-01

    Serum Response Factor (SRF) fulfills essential roles in post-natal retinal angiogenesis and adult neovascularization. These functions have been attributed to the recruitment by SRF of the cofactors Myocardin-Related Transcription Factors MRTF-A and -B, but not the Ternary Complex Factors (TCFs) Elk1 and Elk4. The role of the third TCF, Elk3, remained unknown. We generated a new Elk3 knockout mouse line and showed that Elk3 had specific, non-redundant functions in the retinal vasculature. In E...

  5. Looped and Tortuous Ulnar Artery – An Erratic Unilateral Vascular Presentation in the Proximal Forearm

    Rodrigues, Vincent; Rao, Mohandas KG; Nayak, Shivananda

    2016-01-01

    Precise and detailed knowledge of possible anatomical variations of the arterial pattern in the upper extremity is vital during reparative surgery in this region. Scientific literatures witnessed several reports on variant origin and branching pattern of ulnar artery. But report on looped and tortuous ulnar artery is lacking in the literature. We report here a unique case of ulnar artery having double loop at its commencement giving it an appearance of sigmoid shape and its undue tortuous course in the forearm. Such an unusual and unpredictable variation of ulnar artery is vulnerable for life threatening hemorrhage during clinical approaches. It could also lead to misinterpretation of CT scans as presence of tumours. Awareness on such exceptional anatomical discrepancy of ulnar artery is important to clinicians, neuroradiologists and radiologists in general. PMID:27504273

  6. Retinal artery occlusion

    ... artery occlusion; Branch retinal artery occlusion; CRAO; BRAO Images Retina References Sanborn GE, Magargal LE. Arterial obstructive disease ... A.M. Editorial team. Related MedlinePlus Health Topics ... audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among ...

  7. Sequential bilateral retinal artery occlusion

    Padrón-Pérez N

    2014-04-01

    Full Text Available Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic embolic event. Initially, she presented a superior branch retinal artery occlusion in her right eye followed by a central retinal artery occlusion with cilioretinal artery sparing in her left eye. Some conservative maneuvers performed did not improve visual acuity in the left eye. Supra-aortic Doppler ultrasonography revealed mild right internal carotid artery stenosis and moderate left internal carotid artery stenosis with a small, smooth, and homogeneous plaque. The transthoracic echocardiography showed a severe calcification of the mitral valve with a mild-moderate rim of stenosis. Central retinal artery occlusion and branch retinal artery occlusion are characterized by painless monocular loss of vision. Clinical approach and management attempt to treat the acute event, find the source of the vascular occlusion, and prevent further vascular events from occurring. Giant cell arteritis is a potentially treatable cause of central retinal artery occlusion and should be excluded in every single patient over 50 years old.Keywords: loss of vision, branch retinal artery occlusion, central retinal artery occlusion, Hollenhorst plaque

  8. Pulsatile Tinnitus due to a Tortuous Siphon-Like Internal Carotid Artery Successfully Treated by Arterial Remodeling

    Dirk De Ridder

    2013-01-01

    Full Text Available A patient is described with a right-sided tortuous siphon-like extracranial internal carotid artery leading to highly distressing ipsilateral heart beat synchronous pulsatile tinnitus, scoring 9/10 measuring loudness. Dilating the balloon during the occlusion test in or distal to the siphon-like anomaly reduces the arterial pulsations. Subsequently, surgery is performed using Teflon as an external construct to straighten the siphon-like anomaly. Postoperatively, the pulsations improve to 5/10 in a standing position and disappear during a reclined position. By adding a hearing aid, the pulsations are almost completely gone during a standing position (1/10 and remain absent in a reclined position.

  9. Retinal Artery Occlusion Treatment with Hyperbaric Oxygen

    Harun Cakmak

    2016-01-01

    Full Text Available Retinal artery occlusion is one of the vision-threating emergency situations in ophthalmology. In this paper, a case of retinal artery occlusion is presented. Fifty seven year- old female patient presented with a sudden onset visual loss in her left eye. Best corrected visual acuity (BCVA levels were 1.0 and 0.7 in the right and left eye, respectiveley. Dilated fundus examination revealed no pathological finding in the right eye. Whereas calcified plaque was seen in upper arquat artery bifurcation in the left eye. Pallorness with retinal edema was seen in this arterial trace. Retinal artery occlusion was diagnosed and patient was referred for hyperbaric oxygen therapy. After a total of 20 sessions of hyperbaric oxygen therapy, the calcified plaques disappeared and her BCVA increased to 20/20. Hyperbaric oxygen treatment is vision-saving method which should be considered in retinal artery occlusion.

  10. Idiopathic pediatric retinal artery occlusion

    Manayath George

    2010-01-01

    Full Text Available We report a case of branch retinal artery occlusion (BRAO in a healthy young girl. An eight-year-old girl presented with sudden loss of vision in her left eye. She had a pale retina with macular edema consistent with extensive BRAO. A thorough workup was performed to determine any etiologic factor. All test results were within normal limits. Her visual acuity improved from finger counting to 20/40 over two weeks, on immediate treatment with intravenous steroids (methyl prednisolone. This case suggests that BRAO can occur in healthy children without any detectable systemic or ocular disorders and a dramatic improvement may be achieved with prompt treatment with intravenous steroids.

  11. Branch retinal artery occlusion in Susac's syndrome

    Ricardo Evangelista Marrocos de Aragão

    2015-02-01

    Full Text Available Susac's syndrome is a rare disease attribuited to a microangiopathy involving the arterioles of the cochlea, retina and brain. Encefalopathy, hearing loss, and visual deficits are the hallmarks of the disease. Visual loss is due to multiple, recurrent branch arterial retinal occlusions. We report a case of a 20-year-old women with Susac syndrome presented with peripheral vestibular syndrome, hearing loss, ataxia, vertigo, and vision loss due occlusion of the retinal branch artery.

  12. Retinal vein and artery occlusions

    Christiansen, Christine Benn; Lip, Gregory Y. H.; Lamberts, Morten;

    2013-01-01

    Retinal vascular occlusions may constitute an independent risk factor for stroke in patients with atrial fibrillation.......Retinal vascular occlusions may constitute an independent risk factor for stroke in patients with atrial fibrillation....

  13. Guyon's canal syndrome due to tortuous ulnar artery with DeQuervain stenosing tenosynovitis, ligamentous injuries and dorsal intercalated segmental instability syndrome, a rare presentation: a case report

    Zeeshan, Muhammad; Ahmed, Farhan; Kanwal, Darakhshan; Khalid, Qazi Saad Bin; Ahmed, Muhammad Nadeem

    2009-01-01

    The Guyon's canal syndrome is a well known clinical entity and may have significant impact on patient's quality of life. We report a case of 43-year-old male who presented with complaints of pain and numbness in right hand and difficulty in writing for past one month. On imaging diagnosis of Guyon's canal syndrome because of tortuous ulnar artery was made with additional findings of DeQuervain's stenosing tenosynovitis and dorsal intercalated segmental instability syndrome with ligamentous in...

  14. Metabolic syndrome and central retinal artery occlusion

    Kosanović-Jaković Natalija; Petrović Lidija; Risimić Dijana; Milenković Svetislav; Matić Danica

    2005-01-01

    Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. ...

  15. Intravitreal ranibizumab therapy for retinal arterial macroaneurysm

    Erol, Muhammet Kazim; Dogan, Berna; Coban, Deniz Turgut; Toslak, Devrim; Cengiz, Ayse; Ozel, Deniz

    2015-01-01

    Aim: To evaluate the anatomic and functional results of intravitreal ranibizumab injection for treatment of symptomatic retinal arterial macroaneurysm (RAM). Materials and Methods: A series of seven patients (seven eyes) who had been diagnosed with symptomatic RAM were assessed by comprehensive ophthalmologic examination, fluorescein angiography (FA), optical coherence tomography (OCT), and indocyanine green angiography (ICGA). All patients were treated by intravitreal ranibizumab injection w...

  16. PHACE association with intracranial, oropharyngeal hemangiomas, and an atypical patent ductus arteriosus arising from the tortuous left subclavian artery in a premature infant

    Do-Hyun Kim

    2012-01-01

    Full Text Available PHACE association is a rare neurocutaneous condition in which facial hemangiomas associate with a spectrum of posterior fossa malformations, arterial cerebrovascular anomalies, cardiovascular anomalies, and eye anomalies. We reported a case of PHACE association in a premature infant showing facial, intracranial, and oropharyngeal hemangiomas with evidence of the Dandy-Walker variant and complicated cardiovascular anomalies, including a right-sided aortic arch and an atypical patent ductus arteriosus arising from a tortuous left subclavian artery. To our knowledge, intracranial hemangiomas are rare in PHACE association, and a concomitant oropharyngeal hemangioma has not been previously reported in the PHACE association literature. In infants presenting with large, plaque-like facial hemangiomas, it is important to conduct active cardiovascular and neurological evaluations. Special attention should be given to the laryngoscopic examination to search for additional hemangiomas in the airway.

  17. Metabolic syndrome and central retinal artery occlusion

    Kosanović-Jaković Natalija

    2005-01-01

    Full Text Available Background. The accumulation of risk factors for central retinal artery occlusion can be seen in a single person and might be explained by the metabolic syndrome. Case report. We presented the case of a 52-year-old man with no light perception in his right eye. The visual loss was monocular and painless, fundoscopy showed central retinal artery occlusion and the laboratory investigation showed the raised erythrocyte sedimentation rate of 105 mm/h and the raised C-reactive protein of 22 mg/l. Specific laboratory investigations and fluorescein angiography excluded the presence of vasculitis, collagen vascular diseases, hypercoagulable state and antiphospholipid syndrome. Conclusion. The patient met all the five of the National Cholesterol Education Program (NCEP criteria for the metabolic syndrome: hypertension, abnormal lipid profile, abnormal glucose metabolism, obesity and hyperuricemia. Measurement of C-reactive protein is useful for the assessment of therapeutic systemic effect on any abnormality in the metabolic syndrome. Individual therapy for all risk factors in the metabolic syndrome is necessary to prevent complications such as cardiovascular, retinal vascular diseases and stroke.

  18. Concurrent central retinal artery occlusion and branch retinal vein occlusion in giant cell arteritis

    Chu, Edward

    2010-01-01

    Edward R Chu, Celia S ChenDepartment of Ophthalmology, Flinders Medical Centre and Flinders University, Bedford Park, SA, AustraliaAbstract: Ophthalmic involvement in giant cell arteritis can manifest in a number of ways. Central retinal artery occlusion is one of the common causes of visual loss in giant cell arteritis. On the contrary, branch retinal vein occlusion is rarely associated with the latter. We report an 89-year-old lady with acute left central retinal artery occlusion on a backg...

  19. Sequential occlusion of the branch retinal artery and branch retinal vein in a patient with hypertension: an interventional case report

    Okamoto, Norio; Matsumoto, Chota; Shimomura, Yoshikazu

    2014-01-01

    Background There are some cases that reported central retinal vein occlusion accompanied by ciliary artery occlusion, however, combined branch retinal artery and vein occlusion is a rare condition that has been infrequently reported. We describe in this report one case of retinal vein occlusion and branch retinal artery occlusion occurring simultaneously. Case presentation A 50 year-old woman presented with acute visual loss in her right eye. Fundus photography showed retinal ischemia and tor...

  20. Thrombophilic screening in retinal artery occlusion patients

    Valeria Nagy

    2008-10-01

    Full Text Available Valeria Nagy1, Lili Takacs1, Zita Steiber1, György Pfliegler2, Andras Berta11Department of Ophthalmology, 2Division of Rare Diseases, University of Debrecen Medical and Health Science Center, Debrecen, HungaryBackground: Retinal artery occlusion (RAO is an ischemic vascular damage of the retina, which frequently leads to sudden, mostly irreversible loss of vision. In this study, blood thrombophilic factors as well as cardiovascular risk factors were investigated for their relevance to this pathology. Thrombophilic risk factors so far not evaluated were included in the study.Patients and methods: 28 RAO patients and 81 matched control subjects were examined. From blood samples, protein C, protein S, antithrombinopathy, and factor V (Leiden mutation (FV, factor II gene polymorphism, factor VIII C level, plasminogen activity, lipoprotein(a and fibrinogen levels, hyperhomocysteinemia and presence of anticardiolipin – antiphospholipid antibodies were investigated. Possibly relevant pathologies such as diabetes mellitus, hypertension, and ischemic heart disease were also registered. Statistical analysis by logistic regression was performed with 95% confidence intervals.Results: In the group of patients with RAO only the incidence of hypertension (OR: 3.33, 95% CI: 1.30–9.70, p = 0.014 as an average risk factor showed significant difference, but thrombophilic factors such as hyperfibrinogenemia (OR: 2.9, 95% CI: 1.29–6.57, p = 0.010 and the presence of FV (Leiden mutation (OR: 3.9, 95% CI: 1.43–10.96, p = 0.008 increased the chances of developing this disease.Conclusions: Our results support the assumption that thrombophilia may contribute to the development of RAO besides vascular damage due to the presence of cardiovascular risk factors. Further studies are needed, however, to justify the possible use of secondary prophylaxis in form of anticoagulant/antiplatelet therapy.Keywords: retinal arterial occlusion, risk factors, thrombophilia

  1. Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing

    Arai H

    2014-04-01

    Full Text Available Haruka Arai,1 Tsutomu Sakai,1 Kiichiro Okano,1 Ranko Aoyagi,1 Ayano Imai,2 Hiroshi Takase,2 Manabu Mochizuki,2 Hiroshi Tsuneoka11Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan; 2Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, JapanAbstract: Central retinal artery occlusion (CRAO and multifocal retinitis with perivascular sheathing are rare in ocular toxoplasmosis. We report a case of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. A healthy 83-year-old male developed left panuveitis. Funduscopic examination of the left eye showed a swollen optic disc and sheathing of the retinal artery with a dense vitreous haze and a white retinal lesion. Serum anti-toxoplasma antibodies were positive in a latex agglutination assay. Vitrectomy was performed to improve visualization of the retinal lesions and for examination of causative microorganisms. A postoperative fundus examination revealed CRAO with optic disc involvement and multifocal retinitis with perivascular sheathing. Qualitative multiplex polymerase chain reaction detected the Toxoplasma gondii B1 gene in ocular fluid from both the aqueous and vitreous humor. The presumed diagnosis of ocular toxoplasmosis was made and treatment was started with prednisone and acetylspiramycin with subsequent improvement. Two months later, the patient developed active retinochoroiditis in the left eye. After 6 weeks of anti-toxoplasma therapy, the disease involuted. Retinal vascular occlusions and multifocal retinitis with perivascular sheathing are rare in toxoplasmosis. This is the first case report of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. The diagnosis of ocular toxoplasmosis should be considered in patients with retinal artery occlusions and multifocal retinitis with perivascular sheathing associated with inflammation.Keywords: ocular toxoplasmosis, toxoplasma retinochoroiditis

  2. A case of cilioretinal artery occlusion resembling hemicentral retinal artery occlusion

    Sato Y; Ohkawara Y; Makino S

    2012-01-01

    Shinji Makino, Yuriko Ohkawara, Yukihiro SatoDepartment of Ophthalmology, Jichi Medical University, Shimotsuke, Tochigi, JapanAbstract: A 77-year-old man presented with an inferior hemivisual field defect in the left eye. Funduscopy revealed well demarcated retinal edema of the superior quadrant resembling hemicentral retinal artery occlusion. Further, the upper and inferior retinal arteries emerged separately from the optic disc. Fluorescein angiography demonstrated a marked filling delay of...

  3. Combined branch retinal vein and artery occlusion in toxoplasmosis.

    Aggio, Fabio Bom; Novelli, Fernando José de; Rosa, Evandro Luis; Nobrega, Mário Junqueira

    2016-01-01

    A 22-year-old man complained of low visual acuity and pain in his left eye for five days. His ophthalmological examination revealed 2+ anterior chamber reaction and a white, poorly defined retinal lesion at the proximal portion of the inferotemporal vascular arcade. There were retinal hemorrhages in the inferotemporal region extending to the retinal periphery. In addition, venous dilation, increased tortuosity, and ischemic retinal whitening along the inferotemporal vascular arcade were also observed. A proper systemic work-up was performed, and the patient was diagnosed with ocular toxoplasmosis. He was treated with an anti-toxoplasma medication, and his condition slowly improved. Inferior macular inner and middle retinal atrophy could be observed on optical coherence tomography as a sequela of ischemic injury. To our knowledge, this is the first report of combined retinal branch vein and artery occlusion in toxoplasmosis resulting in a striking and unusual macular appearance. PMID:27463632

  4. Superselective transcatheter thrombolysis for treatment of central retinal artery occlusion

    Objective: Intra-arterial administration of urokinase to the territory of the ophthalmic artery was performed in 12 patients with occlusion of the central retinal artery. Methods: The thrombolysis was carried out with a microcatheter placed in the proximal part of the ophthalmic artery, for thrombolysis of the central ophthalmice arterial thrombosis covering impediment of visibility. Results: All patients achieved improvement of visual acuity, continually with one month follow up. Conclusions: Early diagnosis and early superselective trans-microcatheter thrombolytic infusion would be more effective than traditional treatment. (author)

  5. Association between retinal artery lesions and nonalcoholic fatty liver disease

    Yang, Wen; Xu, Hongtao; Yu, Xiaohong; Wang, Yuzhu

    2015-01-01

    Objective Retinal artery lesions have been reported to be a risk marker of morbidity and mortality for cardiovascular and cerebrovascular diseases in various study populations. Nonalcoholic fatty liver disease (NAFLD) is also a risk factor for cardiovascular disease. However, the relationship between retinal artery lesions and NAFLD is less certain. Methods Data were obtained from 2,454 patients who attended their annual health examination (2,143 males and 311 females, aged 62.34 ± 10.03 year...

  6. Central retinal artery occlusion: an unusual complication of snakebite

    A. Bhalla

    2004-01-01

    Full Text Available Snakebites are endemic in some parts of India, being associated with a number of complications. Ocular disturbances are rare, except for injury to the cornea or conjunctiva when the eye is directly exposed to the venom. In this work, we present a case of central retinal artery occlusion caused by snakebite.

  7. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Mason lll JO

    2015-06-01

    Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

  8. Automatic classification of retinal vessels into arteries and veins

    Niemeijer, Meindert; van Ginneken, Bram; Abràmoff, Michael D.

    2009-02-01

    Separating the retinal vascular tree into arteries and veins is important for quantifying vessel changes that preferentially affect either the veins or the arteries. For example the ratio of arterial to venous diameter, the retinal a/v ratio, is well established to be predictive of stroke and other cardiovascular events in adults, as well as the staging of retinopathy of prematurity in premature infants. This work presents a supervised, automatic method that can determine whether a vessel is an artery or a vein based on intensity and derivative information. After thinning of the vessel segmentation, vessel crossing and bifurcation points are removed leaving a set of vessel segments containing centerline pixels. A set of features is extracted from each centerline pixel and using these each is assigned a soft label indicating the likelihood that it is part of a vein. As all centerline pixels in a connected segment should be the same type we average the soft labels and assign this average label to each centerline pixel in the segment. We train and test the algorithm using the data (40 color fundus photographs) from the DRIVE database1 with an enhanced reference standard. In the enhanced reference standard a fellowship trained retinal specialist (MDA) labeled all vessels for which it was possible to visually determine whether it was a vein or an artery. After applying the proposed method to the 20 images of the DRIVE test set we obtained an area under the receiver operator characteristic (ROC) curve of 0.88 for correctly assigning centerline pixels to either the vein or artery classes.

  9. A Case of Incomplete Central Retinal Artery Occlusion Associated with Short Posterior Ciliary Artery Occlusion

    Shinji Makino

    2013-01-01

    Full Text Available To our knowledge, incomplete central retinal artery occlusion associated with short posterior ciliary artery occlusion is extremely rare. Herein, we describe a case of a 62-year-old man who was referred to our hospital with of transient blindness in his right eye. At initial examination, the patient’s best-corrected visual acuity was 18/20 in the right eye. Fundus examination showed multiple soft exudates around the optic disc and mild macular retinal edema in his right eye; however, a cherry red spot on the macula was not detected. Fluorescein angiography revealed delayed dye inflow into the nasal choroidal hemisphere that is supplied by the short posterior ciliary artery. The following day, the patient’s visual acuity improved to 20/20. Soft exudates around the optic disc increased during observation and gradually disappeared. His hemodynamic parameters revealed subclavian steal syndrome as examined by cervical ultrasonography and digital subtraction angiography. We speculate that his transient blindness was due to ophthalmic artery spasms. In this particular case, spasms of the ophthalmic artery and occlusion of the short posterior ciliary artery occurred simultaneously. As the short posterior ciliary artery branches from the ophthalmic artery, the anatomical location of the lesion might be near the branching of both arteries.

  10. Superselective ophthalmic intraarterial thrombolysis for central retinal artery thrombosis

    Objective: To investigate the effect of superselective ophthalmic artery thrombolysis for treatment of central retinal artery (CRAT). Methods: 250000-500000 u urokinase was directly perfused via ophthalmic artery (OA) through the retained superselective catheter after angiography into 8 eyes of 8 patients with CRAT. Results: The visual acuity (VA) was significantly improved in 4 eyes. the VA of 3 eyes reached 0.1-0.3 after 6 months follow-up. the other 3 eyes achieved no significant improvement of VA. The VA of 1 eye decreased from finger count (FC) to light perception (LP). Conclusions: Early diagnosis and early superselective trans-micro catheter thrombolysis would be more effective than traditional treatment. (authors)

  11. Central retinal artery occlusion resembling Purtscher-like retinopathy

    Etomi T

    2011-08-01

    Full Text Available Takuji Kurimoto1, Norio Okamoto2, Hidehiro Oku1, Yuko Kanbara1, Tomohiko Etomi1, Masahiro Tonari1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan; 2Okamoto Eye Clinic, Suita, Osaka, JapanAbstract: This paper reports three cases of central retinal artery occlusion (CRAO with Purtscher-like retinopathy and good recovery of visual function. The three cases of CRAO had similar fundus changes, ie, cotton wool patches surrounding the optic disc and whitening of the retina surrounding the fovea with a cherry red spot. Fluorescein angiography showed a delay of arm-to-retina circulation time and a partial defect of choroid circulation. Although the three cases were treated by different regimens of steroid pulse therapy and antiplatelet therapy, visual function recovered well and all disturbances of the retinal and choroid circulations resolved. Although eyes with a CRAO normally have a poor visual prognosis, our three cases responded well to the treatments and recovered good visual function. Thus, cases showing fundus changes similar to our three cases may have a pathogenesis different from that of a complete CRAO.Keywords: central retinal artery occlusion, cotton wool patches, Purtscher retinopathy, steroid therapy

  12. Sequential occlusion of the branch retinal artery and branch retinal vein in a patient with hypertension: an interventional case report

    Okamoto, Norio

    2014-01-01

    Norio Okamoto, Chota Matsumoto, Yoshikazu Shimomura Department of Ophthalmology, Kinki University Faculty of Medicine, Osakasayama City, Osaka, Japan Background: There are some cases that reported central retinal vein occlusion accompanied by ciliary artery occlusion, however, combined branch retinal artery and vein occlusion is a rare condition that has been infrequently reported. We describe in this report one case of retinal vein occlusion and branch retinal artery occlusion occurring simu...

  13. Sequential occlusion of the branch retinal artery and branch retinal vein in a patient with hypertension: an interventional case report

    Okamoto N; Matsumoto C; Shimomura Y

    2014-01-01

    Norio Okamoto, Chota Matsumoto, Yoshikazu Shimomura Department of Ophthalmology, Kinki University Faculty of Medicine, Osakasayama City, Osaka, Japan Background: There are some cases that reported central retinal vein occlusion accompanied by ciliary artery occlusion, however, combined branch retinal artery and vein occlusion is a rare condition that has been infrequently reported. We describe in this report one case of retinal vein occlusion and branch retinal artery occlusion occurring simu...

  14. Imaging of Dual Ophthalmic Arteries: Identification of the Central Retinal Artery

    Louise Louw

    2014-01-01

    Full Text Available Identification of the origin of the central retinal artery (CRA is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs, characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA and internal carotid artery (ICA origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA anomaly via the ECA, marked by a middle meningeal artery (MMA (origin: Maxillary artery; course: Through foramen spinosum with normal branches (i.e. anterior and posterior branches, and an OA variant (course: Through superior orbital fissure with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen with a distinct ocular branching pattern presented with the central retinal artery (CRA. The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.

  15. Automated construction of arterial and venous trees in retinal images.

    Hu, Qiao; Abràmoff, Michael D; Garvin, Mona K

    2015-10-01

    While many approaches exist to segment retinal vessels in fundus photographs, only a limited number focus on the construction and disambiguation of arterial and venous trees. Previous approaches are local and/or greedy in nature, making them susceptible to errors or limiting their applicability to large vessels. We propose a more global framework to generate arteriovenous trees in retinal images, given a vessel segmentation. In particular, our approach consists of three stages. The first stage is to generate an overconnected vessel network, named the vessel potential connectivity map (VPCM), consisting of vessel segments and the potential connectivity between them. The second stage is to disambiguate the VPCM into multiple anatomical trees, using a graph-based metaheuristic algorithm. The third stage is to classify these trees into arterial or venous (A/V) trees. We evaluated our approach with a ground truth built based on a public database, showing a pixel-wise classification accuracy of 88.15% using a manual vessel segmentation as input, and 86.11% using an automatic vessel segmentation as input. PMID:26636114

  16. A Rare Cause of Retinal Artery Occlusion in Severe Hypernatremic Dehydration in Newborns.

    Ozer, Pinar Altiaylik; Kabatas, Emrah Utku; Kurtul, Bengi Ece; Dilli, Dilek; Zenciroglu, Aysegul; Okumus, Nurullah

    2016-05-01

    Neonatal hypernatremia is an important electrolyte disorder that may have serious complications. It may be a rare and underdiagnosed cause of venous and arterial thrombosis, leading to severe brain damage by cerebral edema and intracranial hemorrhage. Here, the authors present a case of bilateral central retinal artery occlusion in a newborn with severe hypernatremic dehydration who is found to be normal in terms of other causes of retinal arterial thromboembolization. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:482-485.]. PMID:27183555

  17. Carotid arteries in central retinal vessel occlusion as assessed by Doppler ultrasound.

    Peternel, P; Keber, D; Videcnik, V

    1989-01-01

    Doppler ultrasound was used to detect possible flow changes in the carotid arteries of patients with central retinal artery and vein occlusion. Twenty-three patients with central retinal artery occlusion (mean age 56, SD 11, years) were examined 4 to 48 months after the development of the occlusion and compared with age and sex matched control subjects with no history of any disease known to be associated with pathological changes in carotid vessels. Significant stenosis or occlusion of one o...

  18. The Feasibility of Central Retinal Artery Doppler Ultrasonography in Patients with Sudden Visual Disturbance that's Caused by Retinal Vascular Occlusion

    We evaluated the usefulness of central retinal artery Doppler ultrasonography for assessing the patients with sudden visual disturbance that's caused by retinal vascular occlusion. The blood flow velocity and the resistive and pulsatile indexes were measured at the central retinal arteries of 65 patients with sudden visual disturbance. For all the subjects, the patient's affected eye was compared with the non-affected eye. We investigated the efficacy of the Doppler ultrasonography parameters to predict a significant visual loss on the Snellen test (<20/400). A significantly lower central retinal arterial flow velocity was measured in the affected eye as compared with the unaffected normal eye for all the subjects (p < 0.05). The ROC curves showed that the mean velocity was the best parameter to predict significant visual loss (p < 0.05). If a mean velocity of 4.3 cm/sec was chosen as the cutoff value to predict significant visual loss, then the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 89%, 95%, 95%, 88% and 92%, respectively (estimated area = 0.958, p-value <0.01). Central retinal artery Doppler ultrasonography was helpful for predicting significant visual loss in patients who complain of sudden visual disturbance. In addition to the other ophthalmologic diagnostic modalities, Doppler ultrasonography may be a feasible modality to depict impending further visual loss of an ischemic origin

  19. Preservation of retinal structure and function after cilioretinal artery occlusion: a case report

    Brown CJ

    2016-02-01

    Full Text Available Craig J Brown The Eye Center, Fayetteville, AR, USA Abstract: Cilioretinal artery occlusion is a cause of sudden, often catastrophic loss of central vision. There are no established effective treatments. Recently, a patient presented 24 hours after a cilioretinal artery occlusion, following a cardiac catheterization prior to which her blood thinners had been discontinued. Lacking an effective way to address the severe retinal ischemic oxidative stress, she was offered, under compassionate use, a multivitamin complex designed to address retinal ischemia and oxidative stress. Significant components of this product are l-methylfolate and n-acetyl cysteine. The patient experienced a rapid unexpected improvement in vision and preservation of retinal structure, suggesting that marked improvement in retinal artery occlusions outcomes may be possible as late as 24 hours postocclusion. This is the third reported case of cilioretinal artery occlusion associated with cardiac catheterization. Keywords: retinopathy, MTHFR, homocysteine, l-methylfolate, stroke, NAC

  20. The central retinal artery occlusion in the right eye followed by a branch retinal artery occlusion in the left eye four days later

    Cagatay Caglar

    2013-01-01

    Full Text Available A 65-year-old woman was admitted to our clinic with complaints of sudden, painless, decrease in vision, and sectoral visual field defect in the left eye and later presented to our clinic again with a history of sudden loss of vision in her right eye. In this case study we reported that the patient had branch retinal artery occlusion (BRAO in the left eye and at the same time progressing central retinal artery occlusion (CRAO in the right eye.

  1. Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction

    Ahmed M Emarah

    2010-09-01

    Full Text Available Ahmed M Emarah1, Shawky M El-Haggar2, Ihab A Osman2, Abdel Wahab S Khafagy21Departments of Ophthalmology, 2Andrology and Sexology, Cairo University Hospital, EgyptObjectives: Arteriogenic erectile dysfunction (ED is a target organ disease of atherosclerosis, and therefore might be a predictor of systemic atherosclerosis. Being systemic, it might be possible to evaluate the extent of atherosclerosis from retinal vascular findings. We investigated the possible correlation between penile cavernosal artery blood flow and retinal vascular findings in patients with arteriogenic ED.Patients and methods: Sixty patients with ED were divided according to the peak systolic velocity (PSV in their penile cavernosal arteries into two groups; Group A included 30 patients with PSV less than 25 cm/sec, and Group B included 30 patients with PSV more than 35 cm/sec. Blood flow in the penile cavernosal artery was measured with color Doppler ultrasonography. All patients were assessed by ocular fundus examination under amydriatic conditions to evaluate retinal vascular atherosclerotic changes using Hyman’s classification.Results: Evidence of retinal vascular atherosclerotic changes was found in 19 patients (63.3% in Group A and in 10 patients (33.3% in Group B.Conclusions: Our study confirms the possibility of predicting penile arterial vascular status in patients with ED from their retinal vascular findings by using amydriatic simple, practical funduscopy.Keywords: erectile dysfunction, atherosclerosis, retinal vascular atherosclerosis

  2. Idiopathic Macular Telangiectasia Type 1 with Ruptured Retinal Arterial Macroaneurysm Post Intravitreal Bevacizumab

    Chinmay P Nakhwa; Manavi D Sindal

    2015-01-01

    A 50-year-old Indian male presented with defective vision in the right eye for 6 months. He was diagnosed to have idiopathic macular telangiectasia (IMT) type 1 associated with diffuse macular edema and multiple retinal arterial macroaneurysms (RAM). Intravitreal bevacizumab was administered for the treatment of macular edema, following which there was a rupture of a preexisting RAM with multilevel retinal hemorrhages. The hemorrhage gradually resolved over time with foveal thinning noted at ...

  3. Protein kinase C in porcine retinal arteries and neuroretina following retinal ischemia-reperfusion

    Gesslein, Bodil; Gustafsson, Lotta; Wackenfors, Angelica;

    2009-01-01

    Identification of the intracellular signal-transduction pathways activated in retinal ischemia may be important in revealing novel pharmacological targets. To date, most studies have focused on identifying neuroprotective agents. The retinal blood vessels are key organs in circulatory failure, an...

  4. Central retinal artery occlusion in a patient with tetralogy of Fallot.

    Tsai, Frank F; Spindle, Jordan D; Lazzaro, E C; Olumba, Kenneth C

    2013-12-01

    A 17-year-old Caribbean male presented with painless acute vision loss in the left eye. The patient was found to have a central retinal artery occlusion and an underlying uncorrected tetralogy of Fallot. To our knowledge, this is the first such reported case. One week after presentation visual acuity in the left eye spontaneously improved to 20/200. PMID:24200806

  5. Bilateral internal carotid artery and vertebral artery dissections with retinal artery occlusion after a roller coaster ride - case report and a review.

    Ozkan Arat, Yonca; Volpi, John; Arat, Anıl; Klucznik, Richard; Diaz, Orlando

    2011-01-01

    We present the first case of a woman with no significant medical history who developed dissections of bilateral carotid and bilateral vertebral arteries, as well as a retinal artery occlusion, after a roller coaster ride. A 35-year-old woman developed right-sided neck pain followed by a frontal headache immediately after a roller coaster ride. Five days after the incident, she developed complete loss of vision in her right eye for two hours. Subsequently, the vision improved but remained significantly decreased. On presentation, her visual acuity was 20/200 in the right and 20/20 in the left eye. Her fundus exam revealed retinal edema in the superotemporal retinal artery distribution without any visible emboli. Her neurological exam was otherwise normal. The cerebral angiogram showed bilateral internal carotid and vertebral artery dissections. The patient remained stable with conservative therapy without further worsening of vision or any new neurological deficits. Outcomes for cervicocephalic arterial dissection are usually favorable, but early diagnosis is critical for initiation of appropriate treatment of possible complications. Physicians must have a high index of suspicion for arterial dissection when patients note any headache, neck pain or vertigo triggered by violent motion after leisure activities such as roller coaster rides. PMID:21341139

  6. Retinal arterial occlusions in the young: Systemic associations in Indian population

    Dhanashree Ratra

    2012-01-01

    Full Text Available Purpose: To determine the systemic associations in retinal arterial occlusions (RAO in young Indian individuals less than 40 years of age. Materials and Methods: Case records of 32 patients (35 eyes of less than 40 years, with non-traumatic RAO were analysed. All patients underwent detailed ophthalmic and systemic evaluation including hemogram, lipid profile, coagulation profile, vasculitis screening, carotid Doppler, echocardiogram. Results: In the study 21 were males and 11 were females. The age ranged from 11-39 years (Mean 27.6 ± 8.43. Nine (28% patients were below 20 years of age. Among 35 eyes, 28 (80% had central retinal artery occlusion (CRAO, three (8.6% had branch retinal artery occlusion (BRAO, two (5.7% each had cilio-retinal (CLAO and hemi-retinal artery occlusion (HRAO. Vision ranged from no perception of light to 20/20. On systemic evaluation, in 21 (65.6% patients a hypercoagulable state was responsible for the RAO. Conditions leading to a hypercoagulable state included hyperhomocysteinemia (21.9%, hyperlipidemia (15.6%, anticardiolipin antibody (6.2%, antiphospholipid antibody (6.2%, polycythemia, thrombocytosis, protein S deficiency, use of oral contraceptives and renal disorder (3.1% each. Six (18.7% patients had cardiac valvular defects. Vasculitis screening was positive in three (9.4% patients. Two (6.2% had isolated systemic hypertension. In two (6.2% patients no abnormality could be detected. Conclusion: The systemic associations of RAOs in the Indian population were distinctly different from those reported in the Western population. Hyperhomocysteinemia was the commonest association found. Whereas associations reported in the Western population such as cardiac abnormalities, coagulation disorders, hemoglobinopathies and oral contraceptive use were uncommon.

  7. Serial bevacizumab injections and laser photocoagulation for macular edema associated with a retinal artery macroaneurysm

    Leung EH; Reddy AK; Vedula AS; Flynn Jr HW

    2015-01-01

    Ella H Leung,1 Ashvini K Reddy,2 Anil S Vedula,1 Harry W Flynn Jr1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, 2Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA Abstract: An 84-year-old female with a history of hypertension and dyslipidemia was referred for a retinal artery macroaneurysm with exudation that had extended into the macula. She underwent a total of six injections of bevacizumab, with some improvement in...

  8. Clinicopathological correlation of parapapillary atrophy in monkeys with experimental glaucoma and temporary central retinal artery occlusion

    Jost B Jonas

    2014-01-01

    Full Text Available Objective: To investigate the clinicopathological correlation of parapapillary atrophy. Materials and Methods: The study included 16 eyes of rhesus monkeys (Macaca mulatta - 4 eyes with experimental glaucoma, 11 eyes after experimental temporary occlusion of the central retinal artery, and 1 normal eye. On histological sections, we measured zones with different histological characteristics.On fundus photographs, alpha zone and beta zone of parapapillary atrophy were measured and correlated with the histological data. Results: The size of the clinical alpha zone of parapapillary atrophy was significantly correlated with the size of the histological region with irregularities of the retinal pigment epithelium (P = 0.05; correlation coefficient r = 0.49 and with the size of the histological region with a decreased density of retinal photoreceptors (P = 0.01; r = 0.60. The size of clinical beta zone of parapapillary atrophy significantly correlated with the size of the histological region with complete loss of the retinal pigment epithelium (P <0.001; r = 0.91, with the size of the histological zone with a complete loss of photoreceptors (P <0.001; r = 0.81, and with the size of the histological zone with a closed choriocapillaris (P <0.001; r = 0.89. Conclusions: The clinically seen alpha zone of parapapillary atrophy correlates with histological parapapillary irregularities of the retinal pigment epithelium and decreased density of retinal photoreceptors. The clinically seen beta zone of parapapillary atrophy correlates with histological complete loss of the retinal pigment epithelium and of the photoreceptors, and a closure of the choriocapillaris.

  9. Bilateral Central Retinal Vein Occlusions Combined with Artery Occlusions in A Patient with Acquired Immune Deficiency Syndrome

    Feng Wen; Xuemei Chen; Haitai Li; Ruiduan Liao; Dezheng Wu

    2002-01-01

    Purpose: This is the first report of a bilateral nonischemic central retinal vein occlusionscombined with artery occlusions in a patient with acquired immune deficiency syndrome(AIDS). Methods: Case report. Results: A 22-year-old Chinese(male) with a positive human immunodeficiency virus(HIV) infection developed bilateral nonischemic central retinal vein occlusions combinedwith artery occlusions and severe vision loss. The manifestations of the fundus andfluorescein angiography were similar in both eyes.Conclusion: This case report provides the evidences that central retinal vein and arteryocclusions are probably part of the spectrum of AIDS vascular diseases.

  10. Automatic determination of the artery vein ratio in retinal images

    Niemeijer, Meindert; van Ginneken, Bram; Abràmoff, Michael D.

    2010-03-01

    A lower ratio between the width of the arteries and veins (Arteriolar-to-Venular diameter Ratio, AVR) on the retina, is well established to be predictive of stroke and other cardiovascular events in adults, as well as an increased risk of retinopathy of prematurity in premature infants. This work presents an automatic method that detects the location of the optic disc, determines the appropriate region of interest (ROI), classifies the vessels in the ROI into arteries and veins, measures their widths and calculates the AVR. After vessel segmentation and vessel width determination the optic disc is located and the system eliminates all vessels outside the AVR measurement ROI. The remaining vessels are thinned, vessel crossing and bifurcation points are removed leaving a set of vessel segments containing centerline pixels. Features are extracted from each centerline pixel that are used to assign them a soft label indicating the likelihood the pixel is part of a vein. As all centerline pixels in a connected segment should be the same type, the median soft label is assigned to each centerline pixel in the segment. Next artery vein pairs are matched using an iterative algorithm and the widths of the vessels is used to calculate the AVR. We train and test the algorithm using a set of 25 high resolution digital color fundus photographs a reference standard that indicates for the major vessels in the images whether they are an artery or a vein. We compared the AVR values produced by our system with those determined using a computer assisted method in 15 high resolution digital color fundus photographs and obtained a correlation coefficient of 0.881.

  11. Cerebro-retinal ischemia after bilateral occlusion of internal carotid artery

    Six patients with occlusion of internal carotid arteries (ICAs) were prospectively followed during a mean period of 14 months. Prior to demonstration of occlusions, four patients suffered a mild stroke, and three isolated transient ischemic attacks (TIAs) or amaurosis fugax. All patients remained alive and with an unchanged functional ability. During follow-up, one patient suffered amaurosis fugax and TIAs followed by a mild stroke, three suffered isolated TIAs or amaurosis fugax, two suffered reversible cerebro-retinal ischemia of more than 24 hours, and one remained symptomfree. In three cases, delayed cerebro-retinal ischemia distal to one of the occluded ICAs was systematically triggered by orthostatic, cardiogenic or iatrogenic hypotension, and resolved after adequate medical treatment or restoration of a functional collateral circulation by endarterectomy of a tightly stenosed ipsilateral external carotid artery (ECA), suggesting hemodynamic phenomena. In three cases, micro-emboli originating from a stump or an ulcerated ipsilateral common carotid artery and migrating through well-developed ECA collateral channels explained delayed episodes of ipsilateral TIAs or amaurosis fugax, which disappeared in two cases after adequate anticoagulant therepy was introduced. Bilateral occlusion of ICA may be a relatively benign condition, if the patients are carefully controlled and treated. (orig.)

  12. Central retinal artery occlusion in the 9 years old girl (Clinical case report

    E. Yu. Markova

    2014-07-01

    Full Text Available 9 years old girl was admitted to the Ophthalmological Department of Morozov Pediatric City Clinical Hospital with sudden persistent painless loss of vision of the left eye. Other organs and systems were without any changes. After ophthalmological examination (OS — white edema of central and peripapillar retina, a cherry red spot at the fovea the diagnosis of central retinal artery occlusion OS was formed, and treatment was started immediately. CRAO practically does not occur in pediatric ophthalmological practice. Therefore this clinical case can be of interest to clinicians and pediatric ophthalmologists.

  13. Unilateral central retinal artery occlusion as the sole presenting sign of Susac syndrome in a young man: case report

    Samira Luiza dos Apóstolos-Pereira

    2013-06-01

    Full Text Available We report the case of a 24-year-old man presenting with sudden visual loss in the left eye from a central retinal artery occlusion. An extensive clinical investigation revealed no etiology. Three weeks later, however, the patient developed hearing loss followed by encephalopathy and multiple branch retinal artery occlusions in the right eye. Fluorescein angiography confirmed retinal vascular occlusions with no sign of vasculitis. The neurological examination revealed a diffuse encephalopathy while the MRI scan disclosed several small areas of infarcts in the brain. Bilateral sensorineural hearing loss was confirmed on audiometry. The patient was diagnosed with Susac syndrome and treated with methylprednisolone and cyclophosphamide, resulting in slight improvement and stabilization. This case shows that Susac syndrome may be diagnosed late due to the absence at onset of one or more of the symptoms of the classic triad (encephalopathy, multiple branch retinal artery occlusions and hearing loss. This case also serves to emphasize that Susac syndrome should be considered in the differential diagnosis of central retinal artery occlusion, even in apparently healthy young men.

  14. Central retinal artery occlusion in a patient with ANCA-negative Churg-Strauss syndrome

    Miyazaki M

    2012-07-01

    Full Text Available Yuji Kumano,1 Noriko Yoshida,2 Satoru Fukuyama,3 Masanori Miyazaki,2 Hiroshi Enaida,2 Takaaki Matsui11Ohshima Hospital of Ophthalmology, Fukuoka, 2Department of Ophthalmology, 3Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanAbstract: Ocular involvement in Churg-Strauss syndrome is infrequent. We describe the case of a 54-year-old woman with eosinophilia and involvement of the respiratory tract, skin, and peripheral nervous system, fulfilling the American College of Rheumatology criteria for Churg-Strauss syndrome. The patient presented with acute, painless vision loss in her right eye. Central retinal artery occlusion (CRAO without accompanying retinal vasculitis was diagnosed by angiographic findings and funduscopic findings of retinal whitening with a cherry-red spot. Although her antineutrophil cytoplasmic antibody (ANCA status was negative, CRAO was thought to be an ocular manifestation of Churg-Strauss syndrome, and appropriate treatment was planned. She was treated with high-dose corticosteroids and anticoagulant therapy. Her macular edema improved, but visual recovery was poor. Specific therapy to alter inflammation, blood coagulation, and rheology reportedly plays an important role in ANCA-positive patients with Churg-Strauss syndrome who develop CRAO. Regardless of ANCA status, high-dose corticosteroids should be considered for CRAO in patients with Churg-Strauss syndrome, as discussed in this case.Keywords: CRAO, ANCA, Churg-Strauss syndrome

  15. Cerebral White Matter and Retinal Arterial Health in Hypertension and Type 2 Diabetes Mellitus

    P. L. Yau

    2013-01-01

    Full Text Available We examined 33 hypertensive (22 with comorbid type 2 diabetes mellitus (T2DM and 29 normotensive (8 with T2DM middle-aged and elderly adults, comparable in age and education. Relative to normotensive participants, those with hypertension, in addition to a higher prevalence of periventricular white matter (WM lesions, had significantly lower WM microstructural integrity of major fiber tracts as seen with MRI-based diffusion tensor imaging. Among participants with hypertension, those with co-morbid T2DM (n=22 had more widespread WM pathology than those without T2DM (n=11. Furthermore and consistent with previous research, both hypertension and T2DM were related to decreased retinal arterial diameter. Further exploratory analysis demonstrated that the observed retinal arteriolar narrowing among individual with hypertension was associated with widespread subclinical losses in WM microstructural integrity and these associations were present predominantly in the frontal lobe. We found that T2DM adds to the damaging effects of hypertension on cerebral WM, and notably these effects were independent of age and body mass index. Given that the decrease in retinal arteriolar diameter may be a biomarker for parallel pathology in cerebral arterioles, our data suggest that the frontal lobe may be particularly vulnerable to microvascular damage in the presence of hypertension and T2DM.

  16. Branch Retinal Artery Occlusion in a Patient with Patent Foramen Ovale

    Nasser Shoeibi

    2013-01-01

    Full Text Available Purpose: To report branch retinal artery occlusion (BRAO in a patient with patent foramen ovale (PFO. Case Report: A 29-year-old female patient was referred for sudden onset superior visual field defect in her left eye. Ocular examination revealed visual acuity of 20/32 in the affected eye along with a positive relative afferent pupillary defect. A calcified white embolus was noted at the first bifurcation of the inferior temporal artery in her left eye together with mild retinal edema. With a diagnosis of BRAO, the patient received oral acetazolamide, topical timolol, ocular massage and anterior chamber paracentesis. The visual field defect partially recovered and the embolus moved to the third bifurcation level as revealed by fundus examination. An extensive workup, including neurology, rheumatology, cardiology and hematology consultation, carotid ultrasonography, transthoracic/transesophageal echocardiography and laboratory testing was performed. All results were within normal limits except for a small-sized PFO detected by transesophageal echocardiography. Low-dose aspirin therapy was initiated and over the subsequent two years, no other embolic event occurred. Conclusion: The association between PFO and BRAO has not yet been reported. Intracardiac right-to-left shunting through a PFO, accentuated by Valsalva maneuver, may predispose to embolic events while the source of initial thrombosis remains unknown.

  17. Duplex Color Doppler Evaluation of Retinal Arterial Blood Flow in Type 2 Diabetic Subjects without Retinopathy

    Mashah Binte Amin

    2014-09-01

    Full Text Available Background: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathy is diagnosed early and treated promptly. In ophthalmology, color Doppler imaging is a new method that enables us to assess the orbital vasculature. It allows for simultaneous two dimensional anatomical and Doppler evaluations of hemodynamic characteristics of retinal artery. Objective: To observe the difference between Doppler flow velocity indices (peak systolic velocity, end diastolic velocity and resistive index of retinal artery in type 2 diabetic subjects without retinopathy and those of normal controls. Materials and Methods: This case-control study was carried out in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM in collaboration with Ophthalmology Outpatient Department, BIRDEM, Dhaka from July 2011 to June 2013. Eighty diabetic patients without retinopathy aged 27–68 years were enrolled as cases and age and sex matched 80 healthy subjects were selected as controls. Type 1 diabetic patients, type 2 diabetics with retinopathy, hypertensive and dyslipidemic subjects were excluded from the study. All the selected subjects underwent duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHZ linear phase transducer. Duplex color Doppler findings including spectral analysis (PSV, EDV and RI were recorded. Unpaired t test was done to compare blood flow velocity indices of retinal artery in type 2 diabetic patients without retinopathy and that of healthy control subjects. p value <0.05 was considered as significant. Results: Majority (42.5% and 47.5% of subjects were in 4th decade of life in both groups with predominance of males. The mean duration of diabetes was 4.56 ± 2.1 years. Mean peak systolic

  18. A REPORT OF CENTRAL RETINAL ARTERY OCCLUSION (CRAO , IN YOUNG MALES IN ITS INITIAL MANIFESTATION, AS PRIMAR Y ANTIPHOSPHOLIPID SYNDROME

    Rani

    2013-05-01

    Full Text Available ABSTRACT: AIM: To report a case of Central Retinal Artery Occlusi on (CRAO in young males in its initial manifestation as Primary Antiphospholipid Syndrome. METHODS: 32 year healthy male, with abrupt sudden painless loss of vision in r ight eye since 48 hours, with Grade 2 Relative afferent pupillary defect, visual acuity of hand movements in OD and 6/18 in OS. Fundoscopy disclosed signs compatible of central reti nal artery occlusion confirmed with FFA. Carotid Doppler imaging and echocardiography was done to determine the source. RESULTS: Antiphospholipid antibody cofactor, beta2-glycoprotein 1 antibodies, IgM, was positive with titre of more than 94 un its/ml on two occasions, 1 2 weeks apart, with normal range being less than 20 units/ml for each isotope (IgG, IgM, or IgA .According to the 2006 revised Sapporo criteria Antiphospholipid syndrome was diagnosed. Thor ough examination excluded other system involvement. Immunological studies excluded other systemic disorders. CONCLUSIONS: In literature, prevalence of CRAO is 0.85% for every 100000 and prevalence of Antiphospholipid Syndrome in patients showing a major retinal vascula r obstruction is 5% - 33%. Antiphospholipid syndrome should be ruled out in every young patient who presents with Central retinal artery occlusion. Association must be considered, as Central retinal artery occlusion could be the initial manifestation of ant iphospholipid syndrome with high risk of recurrence.

  19. Retinal vein occlusion

    Central retinal vein occlusion; Branch retinal vein occlusion; CRVO; BRVO ... Retinal vein occlusion is most often caused by hardening of the arteries ( atherosclerosis ) and the formation of a blood clot. Blockage ...

  20. Mitogen-activated protein kinases in the porcine retinal arteries and neuroretina following retinal ischemia-reperfusion

    Gesslein, Bodil; Håkansson, Gisela; Carpio, Ronald;

    2010-01-01

    The aim of the present study was to examine changes in the expression of intracellular signal-transduction pathways, specifically mitogen-activated protein kinases, following retinal ischemia-reperfusion.......The aim of the present study was to examine changes in the expression of intracellular signal-transduction pathways, specifically mitogen-activated protein kinases, following retinal ischemia-reperfusion....

  1. Retinal artery and vein thrombotic occlusion during pregnancy: markers for familial thrombophilia and adverse pregnancy outcomes

    Kurtz WS

    2016-05-01

    Full Text Available Will S Kurtz,1 Charles J Glueck,1 Robert K Hutchins,2,3 Robert A Sisk,2,3 Ping Wang1 1Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, 2Cincinnati Eye Institute, 3Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA Background: Ocular vascular occlusion (OVO, first diagnosed during or immediately after giving birth, often reflects superposition of the physiologic thrombophilia of pregnancy on previously undiagnosed underlying familial or acquired thrombophilia associated with spontaneous abortion, eclampsia, or maternal thrombosis. Specific aim: We describe OVO, first diagnosed during pregnancy or immediately postpartum, in three young females (ages 32, 35, 40 associated with previously undiagnosed familial thrombophilia. Results: Branch retinal artery occlusion (BRAO occurred at 9 and 13 weeks gestation in two females, aged 32 and 35. Central retinal vein occlusion occurred immediately postpartum in a 40-year-old. One of the two females with BRAO subsequently developed eclampsia, and one had a history of unexplained first trimester spontaneous abortion. All three females were found to have previously unexplained familial thrombophilia. The two females with BRAO had low first trimester free protein S 42 (41%, lower normal limit (50%, and one of these two had high factor VIII (165%, upper normal limit 150%. The woman with central retinal vein occlusion had high factor XI (169%, upper normal limit 150%. Enoxaparin (40–60 mg/day was started and continued throughout pregnancy in both females with BRAO to prevent maternal–placental thrombosis, and of these two females, one had an uncomplicated pregnancy course and term delivery, and the second was at gestational week 22 without complications at the time of this manuscript. There were no further OVO events in the two females treated with enoxaparin or in the untreated patient with postpartum eclampsia. Conclusion: OVO during

  2. Central Retinal Artery Occlusion- A rare complication of oral contraceptive pills

    Nidhi Pancholi

    2013-07-01

    Full Text Available Aim: To propose a hypothesis of causal association between central retinal artery occlusion (CRAO and oral contraceptive pills (OCPCase Summary:A case report-A 22 yr old, female presented with sudden painless loss of vision in OS [Right Eye] for 1 day. VA [Visual Activity] in OS was PL PR [Perception of Light and Projection of Rays] Faulty with RAPD [Relative Afferent Papillary Defect] with normal for fifteen minutes, given five hundred mg of acetazolamide orally stat, 0.4 ml of anterior chamber paracentesis done, 5400 IU LMW [Low Molecular Weight] heparin given SC[Subcutaneous] with carbogen inhalation. Retrospectively she was on oral contraceptives(Mala D for 1 month. She was not hypertensive or diabetic with normal blood, coagulation profile & carotid Doppler. She was evaluated by an intern to find the cause of coagulation disorder and was found to be normal. On first day FFA [Fundus Florescien Angiography] showed no blockage with normal cilioretinal artery perfusion established. Visual fields after one week showed central tubular vision and OCT [Ocular Coherent Tomography] showed normal fovea. After 2 weeks vision was 20/80 with persistent RAPD papilla macular bundle being perfused.

  3. Automated detection and classification of major retinal vessels for determination of diameter ratio of arteries and veins

    Muramatsu, Chisako; Hatanaka, Yuji; Iwase, Tatsuhiko; Hara, Takeshi; Fujita, Hiroshi

    2010-03-01

    Abnormalities of retinal vasculatures can indicate health conditions in the body, such as the high blood pressure and diabetes. Providing automatically determined width ratio of arteries and veins (A/V ratio) on retinal fundus images may help physicians in the diagnosis of hypertensive retinopathy, which may cause blindness. The purpose of this study was to detect major retinal vessels and classify them into arteries and veins for the determination of A/V ratio. Images used in this study were obtained from DRIVE database, which consists of 20 cases each for training and testing vessel detection algorithms. Starting with the reference standard of vasculature segmentation provided in the database, major arteries and veins each in the upper and lower temporal regions were manually selected for establishing the gold standard. We applied the black top-hat transformation and double-ring filter to detect retinal blood vessels. From the extracted vessels, large vessels extending from the optic disc to temporal regions were selected as target vessels for calculation of A/V ratio. Image features were extracted from the vessel segments from quarter-disc to one disc diameter from the edge of optic discs. The target segments in the training cases were classified into arteries and veins by using the linear discriminant analysis, and the selected parameters were applied to those in the test cases. Out of 40 pairs, 30 pairs (75%) of arteries and veins in the 20 test cases were correctly classified. The result can be used for the automated calculation of A/V ratio.

  4. Patient-specific simulation of endovascular repair surgery with tortuous aneurysms requiring flexible stent-grafts.

    Perrin, David; Badel, Pierre; Orgeas, Laurent; Geindreau, Christian; du Roscoat, Sabine Rolland; Albertini, Jean-Noël; Avril, Stéphane

    2016-10-01

    The rate of post-operative complications is the main drawback of endovascular repair, a technique used to treat abdominal aortic aneurysms. Complex anatomies, featuring short aortic necks and high vessel tortuosity for instance, have been proved likely prone to these complications. In this context, practitioners could benefit, at the preoperative planning stage, from a tool able to predict the post-operative position of the stent-graft, to validate their stent-graft sizing and anticipate potential complications. In consequence, the aim of this work is to prove the ability of a numerical simulation methodology to reproduce accurately the shapes of stent-grafts, with a challenging design, deployed inside tortuous aortic aneurysms. Stent-graft module samples were scanned by X-ray microtomography and subjected to mechanical tests to generate finite-element models. Two EVAR clinical cases were numerically reproduced by simulating stent-graft models deployment inside the tortuous arterial model generated from patient pre-operative scan. In the same manner, an in vitro stent-graft deployment in a rigid polymer phantom, generated by extracting the arterial geometry from the preoperative scan of a patient, was simulated to assess the influence of biomechanical environment unknowns in the in vivo case. Results were validated by comparing stent positions on simulations and post-operative scans. In all cases, simulation predicted stents deployed locations and shapes with an accuracy of a few millimetres. The good results obtained in the in vitro case validated the ability of the methodology to simulate stent-graft deployment in very tortuous arteries and led to think proper modelling of biomechanical environment could reduce the few local discrepancies found in the in vivo case. In conclusion, this study proved that our methodology can achieve accurate simulation of stent-graft deployed shape even in tortuous patient specific aortic aneurysms and may be potentially helpful to

  5. Acute Central Retinal Artery Occlusion Associated with Intraocular Silicone Oil Tamponade

    Mehmet Yasin Teke

    2012-05-01

    Full Text Available Many systemic and ocular factors may cause acute central retinal artery occlusion (CRAO. Herein, we aimed to describe a case of CRAO due to intraocular silicone oil (SO tamponade. To the best of our knowledge, a case like our has not been reported previously. A 58-yearold male patient had undergone combined pars plana vitrectomy-lensectomy and intraocular SO for lens luxation and vitreus hemorrhage associated with a blunt ocular trauma in his right eye. Two weeks after the surgery, he presented with acute vision loss in the same eye. He was diagnosed with acute CRAO and it should be related with mechanical press or raised intraocular pressure (IOP associated with SO. He was treated by partial removal of SO immediately. In spite of the regression of retina edema, his visual acuity did not improve due to optic atrophy. SO may cause CRAO due to raised IOP and/or its mechanical pressure and this complication must be kept in mind. (Turk J Oph thal mol 2012; 42: 238-40

  6. Changes in central retinal artery blood flow after ocular warming and cooling in healthy subjects

    Shamshad M

    2010-01-01

    Full Text Available Context: Retinal perfusion variability impacts ocular disease and physiology. Aim: To evaluate the response of central retinal artery (CRA blood flow to temperature alterations in 20 healthy volunteers. Setting and Design: Non-interventional experimental human study. Materials and Methods: Baseline data recorded: Ocular surface temperature (OST in °C (thermo-anemometer, CRA peak systolic velocity (PSV and end diastolic velocity (EDV in cm/s using Color Doppler. Ocular laterality and temperature alteration (warming by electric lamp/cooling by ice-gel pack were randomly assigned. Primary outcomes recorded were: OST and intraocular pressure (IOP immediately after warming or cooling and ten minutes later; CRA-PSV and EDV at three, six and nine minutes warming or cooling. Statistical Analysis: Repeated measures ANOVA. Results: (n = 20; μ±SD: Pre-warming values were; OST: 34.5±1.02°C, CRA-PSV: 9.3±2.33cm/s, CRA-EDV: 4.6±1.27cm/s. OST significantly increased by 1.96°C (95% CI: 1.54 to 2.37 after warming, but returned to baseline ten minutes later. Only at three minutes, the PSV significantly rose by 1.21cm/s (95% CI: 0.51to1.91. Pre-cooling values were: OST: 34.5±0.96°C, CRA-PSV: 9.7±2.45 cm/s, CRA-EDV: 4.7±1.12cm/s. OST significantly decreased by 2.81°C (95% CI: -2.30 to -3.37 after cooling, and returned to baseline at ten minutes. There was a significant drop in CRA-PSV by 1.10cm/s (95% CI: -2.05 to -0.15 and CRA-EDV by 0.81 (95% CI: -1.47 to -0.14 at three minutes. At six minutes both PSV (95% CI: -1.38 to -0.03 and EDV (95% CI: -1.26 to -0.02 were significantly lower. All values at ten minutes were comparable to baseline. The IOP showed insignificant alteration on warming (95% CI of difference: -0.17 to 1.57mmHg, but was significantly lower after cooling (95% CI: -2.95 to -4.30mmHg. After ten minutes, IOP had returned to baseline. Conclusion : This study confirms that CRA flow significantly increases on warming and decreases on cooling

  7. Association of the Fractal Dimension of Retinal Arteries and Veins with Quantitative Brain MRI Measures in HIV-Infected and Uninfected Women

    Crystal, Howard A.; Holman, Susan; Lui, Yvonne W.; Baird, Alison E.; Yu, Hua; Klein, Ronald; Rojas-Soto, Diana Marcella; Gustafson, Deborah R.; Stebbins, Glenn T.

    2016-01-01

    Objective The fractal dimension of retinal arteries and veins is a measure of the complexity of the vascular tree. We hypothesized that retinal fractal dimension would be associated with brain volume and white matter integrity in HIV-infected women. Design Nested case-control within longitudinal cohort study. Methods Women were recruited from the Brooklyn site of the Women’s Interagency HIV study (WIHS); 34 HIV-infected and 21 HIV-uninfected women with analyzable MRIs and retinal photographs were included. Fractal dimension was determined using the SIVA software program on skeletonized retinal images. The relationship between predictors (retinal vascular measures) and outcomes (quantitative MRI measures) were analyzed with linear regression models. All models included age, intracranial volume, and both arterial and venous fractal dimension. Some models were adjusted for blood pressure, race/ethnicity, and HIV-infection. Results The women were 45.6 ± 7.3 years of age. Higher arterial dimension was associated with larger cortical volumes, but higher venous dimension was associated with smaller cortical volumes. In fully adjusted models, venous dimension was significantly associated with fractional anisotropy (standardized β = -0.41, p = 0.009) and total gray matter volume (β = -0.24, p = 0.03), and arterial dimension with mean diffusivity (β = -0.33,.p = 0.04) and fractional anisotropy (β = 0.34, p = 0.03). HIV-infection was not associated with any retinal or MRI measure. Conclusions Higher venous fractal dimension was associated with smaller cortical volumes and lower fractional anisotropy, whereas higher arterial fractal dimension was associated with the opposite patterns. Longitudinal studies are needed to validate this finding. PMID:27158911

  8. Cerebral Angiographic Findings of Cosmetic Facial Filler-related Ophthalmic and Retinal Artery Occlusion

    2015-01-01

    Cosmetic facial filler-related ophthalmic artery occlusion is rare but is a devastating complication, while the exact pathophysiology is still elusive. Cerebral angiography provides more detailed information on blood flow of ophthalmic artery as well as surrounding orbital area which cannot be covered by fundus fluorescein angiography. This study aimed to evaluate cerebral angiographic features of cosmetic facial filler-related ophthalmic artery occlusion patients. We retrospectively reviewed cerebral angiography of 7 patients (4 hyaluronic acid [HA] and 3 autologous fat-injected cases) showing ophthalmic artery and its branches occlusion after cosmetic facial filler injections, and underwent intra-arterial thrombolysis. On selective ophthalmic artery angiograms, all fat-injected patients showed a large filling defect on the proximal ophthalmic artery, whereas the HA-injected patients showed occlusion of the distal branches of the ophthalmic artery. Three HA-injected patients revealed diminished distal runoff of the internal maxillary and facial arteries, which clinically corresponded with skin necrosis. However, all fat-injected patients and one HA-injected patient who were immediately treated with subcutaneous hyaluronidase injection showed preserved distal runoff of the internal maxillary and facial arteries and mild skin problems. The size difference between injected materials seems to be associated with different angiographic findings. Autologous fat is more prone to obstruct proximal part of ophthalmic artery, whereas HA obstructs distal branches. In addition, hydrophilic and volume-expansion property of HA might exacerbate blood flow on injected area, which is also related to skin necrosis. Intra-arterial thrombolysis has a limited role in reconstituting blood flow or regaining vision in cosmetic facial filler-associated ophthalmic artery occlusions. PMID:26713062

  9. Hyperbaric Oxygen Therapy in Branch Retinal Artery Occlusion in a 15-Year-Old Boy with Methylenetetrahydrofolate Reductase Mutation

    Ali Riza Cenk Celebi

    2015-01-01

    Full Text Available Purpose. To report the efficacy of hyperbaric oxygen (HBO therapy in a case of branch retinal artery occlusion (BRAO in a 15-year-old boy. Methods. We report a 15-year-old boy with sudden loss of vision due to BRAO. Examination included laboratory evaluation for systemic risk factors. Follow-up exams included visual acuity, fundus examination, fundus fluorescein angiography, and visual field testing. HBO therapy was employed for treatment. Results. Medical history was positive for isolated glucocorticoid deficiency. Laboratory evaluation disclosed hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR mutation. The visual acuity 0.05 at presentation improved to 0.8 after 20 days of HBO therapy. There was no change on visual fields. Conclusion. In this pediatric case, HBO therapy was useful in the treatment of BRAO.

  10. Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction

    Emarah, Ahmed

    2010-01-01

    Ahmed M Emarah1, Shawky M El-Haggar2, Ihab A Osman2, Abdel Wahab S Khafagy21Departments of Ophthalmology, 2Andrology and Sexology, Cairo University Hospital, EgyptObjectives: Arteriogenic erectile dysfunction (ED) is a target organ disease of atherosclerosis, and therefore might be a predictor of systemic atherosclerosis. Being systemic, it might be possible to evaluate the extent of atherosclerosis from retinal vascular findings. We investigated the possible correlation between penile cavern...

  11. Obstrução arterial retiniana periférica associada com hiper-homocisteinemia: relato de caso Peripheral retinal arterial obstruction associated with hyperhomocysteinemia: case report

    Alexandre Kazuo Misawa

    2008-10-01

    Full Text Available A hiperhomocisteinemia é fator de risco para fenômenos trombo-embólicos retinianos associados a quadro de oclusão vascular venosa e arterial. Descrevemos um paciente com obstrução arterial retiniana periférica, sem sinais de vasculite ativa, associada a proliferação de neovasos com tração vítreo-retiniana e hemorragia vítrea recidivante. O alto nível sérico de homocisteína decorrente de deficiência de vitamina B12 e ácido fólico, sem outras alterações na cascata da coagulação, inclusive com a pesquisa do fator V de Leiden, sugere que a hiper-homocisteinemia esteja diretamente ligada como fator causal deste quadro clínico. Embora apresentasse PPD elevado, o diagnóstico diferencial mais importante de doença de Eales foi menos considerado por ser diagnóstico de exclusão. O controle do quadro clínico foi feito com suplemento de vitaminas (B12 e ácido fólico e fotocoagulação retiniana periférica. A homocisteína plasmática total deve ser dosada em pacientes com obstrução vascular retiniana, já que a hiper-homocisteinemia é fator de risco modificável e de fácil tratamento por meio de dieta ou suplementação vitamínica.Hyperhomocysteinemia is a risk factor for thromboembolic events of the retina associated with vascular venous or arterial occlusion. We describe a patient with occlusion of the peripheral arteriolar network without active vasculitis, associated with neovascular proliferation, peripheral vitreous-retinal traction and relapsing vitreous hemorrhage. The high serum homocysteine level resulting from vitamin B12 and folic acid deficiency, without further changes in the coagulation cascade including the test for Leiden's Factor V, indicates hyperhomocysteinemia as a direct causal factor in this clinical condition. Despite a high PPD, Eales Disease, a major differential diagnosis, was not fully considered, since it is established by exclusion. The patient was treated with photocoagulation and vitamin

  12. Multifocal central serous chorioretinopathy with photoreceptor-retinal pigment epithelium diastasis in heritable pulmonary arterial hypertension

    Li, Xiao Qiang; Pryds, Anders; Carlsen, Jørn;

    2015-01-01

    PURPOSE: To report atypical central serous chorioretinopathy and choroidal thickening in a patient with heritable pulmonary arterial hypertension. METHODS: A 40-year-old man with heritable pulmonary arterial hypertension presented with blurred vision in his left eye and was followed up for 1 year...... chorioretinopathy and choroidal thickening that responded to treatment of pulmonary arterial hypertension suggest a pathophysiological link between pulmonary arterial hypertension and central serous chorioretinopathy, perhaps mediated by choroidal venous stasis....... choroidal vessels were seen in the patient's symptomatic left eye. After treatment for pulmonary hypertension, the serous detachments disappeared and choroidal thickness gradually decreased over a period of 4 weeks and remained unchanged at 13 months of follow-up. CONCLUSION: Central serous...

  13. Unusual retinal manifestations of PORN combined complications of central retinal artery and vein occlusions%并发视网膜中央动静脉阻塞的特殊PORN1例

    E-Shawn Goh; Stephen C.B.Teoh; Albert T.H.Lim

    2008-01-01

    ·AIM:To describe an unusual combination of retinal manifestations in an AIDS patient with progressive outer retinal necrosis (PORN),complicated by combined central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO).·METHODS:A case report.·RESULTS:The patient presented with PORN with primary optic nerve involvement complicated by combined central retinal artery occlusion(CRAO) and central retinal vein occlusion(CRVO) as a primary manifestation of Varicella Zoster Virus (VZV).Aggressive treatment with intravitreal and specific systemic anti-VZV therapy,in addition to systemic highly active antiretroviral therapy (HAART) achieved retinal quiescence with sparing of the fellow eye.Visual outcome of the affected eye was poor.·CONCLUSION:We present the first report of PORN associated with the unusual combined complications of CRAO and CRVO. Aggressive local treatment was combined with systemic therapy,which achieved local control and empirical prophylaxis for the fellow eye.%目的:报道1例艾滋病患者特殊的进行性外层视网膜坏死(PORN),同时合并视网膜中央动脉及静脉阻塞.方法:病例报告.结果:患者表现为进行性外层视网膜坏死,视神经亦受累,合并视网膜中央动静脉阻塞,与带状疱疹性视网膜病变的最初表现一样.积极的治疗包括玻璃体腔和特异性系统抗带状疱疹病毒治疗,以及强化的抗逆转录病毒治疗(HAART).视网膜坏死静止,对侧眼未受累,而患眼的视力极差.结论:首次报道了1例并发视网膜中央动静脉阻塞的特殊PORN,积极的局部联合系统治疗使得局部病情控制,并预防了对侧眼发病.

  14. A case report and brief review of the literature on bilateral retinal infarction following cardiopulmonary bypass for coronary artery bypass grafting

    Trethowan Brian A

    2011-11-01

    Full Text Available Abstract Postoperative visual loss is a devastating perioperative complication. The commonest aetiologies are anterior ischaemic optic neuropathy (AION, posterior ischaemic optic neuropathy (PION, and central retinal artery occlusion (CRAO. These appear to be related to certain types of operation, most commonly spinal and cardiac bypass procedures; with the rest divided between: major trauma causing excessive blood loss; head/neck and nasal or sinus surgery; major vascular procedures (aortic aneurysm repair, aorto-bifemoral bypass; general surgery; urology; gynaecology; liposuction; liver transplantation and duration of surgery. The non-surgical risk factors are multifactorial: advanced age, prolonged postoperative anaemia, positioning (supine v prone, alteration of venous drainage of the retina, hypertension, smoking, atherosclerosis, hyperlipidaemia, diabetes, hypercoagulability, hypotension, blood loss and large volume resuscitation. Other important cardiac causes are septic emboli from bacterial endocarditis and emboli caused by atrial myxomata. The majority of AION cases occur during CPB followed by head/neck surgery and prone spine surgery. CPB is used to allow coronary artery bypass grafting on a motionless heart. It has many side-effects and complications associated with its use and we report here a case of bilateral retinal infarction during routine coronary artery bypass grafting in a young male patient with multiple risk factors for developing this complication despite steps to minimise its occurrence.

  15. Bilateral congenital venous tortuosity and dilatation combined with cilioretinal artery: a photographic essay

    Xu N

    2016-04-01

    Full Text Available Nuo Xu,1 Yi Cui,2 Zhonghai Gao1 1Department of Ophthalmology, Fujian Provincial Hospital, 2Department of Ophthalmology, The Union Hospital of Fujian Medical University, Fuzhou City, Fujian Province, People's Republic of China Abstract: To report the case of bilateral congenital venous tortuosity and dilatation combined with cilioretinal artery. A 48-year-old woman complained of headache and underwent routine ophthalmic examination. The best-corrected visual acuity was 20/20 in both eyes. The examination of the fundus through a dilated pupil revealed that the retinal veins were strikingly tortuous and slightly dilated in the posterior pole and mid-peripheral retina of both eyes. However, the course and shape of the veins were normally straight in the peripheral retina. There was no change in the appearance and shape of the vein. The visual acuity remained unaffected during a 2-year follow-up. Keyword: retinal vascular anomalies, retinal disease, retinal vessels, cilioretinal artery, retina, congenital

  16. 前部缺血性视神经病变并发视网膜分支动脉阻塞1例%A case of branch retinal artery obstruction complicated after anterior ischemic optic neuropathy

    Ungsoo Samuel Kim; Hyoung-Seok Kim; Young Ju Lew

    2011-01-01

    AIM: To report a case of branch retinal artery obstruction (BRAO) complicated after anterior ischemic optic neuropathy (AION).METHODS: A 42-year-old woman who complained of visual disturbance was performed ophthalmological examinations such as fundus photography, fluorescent angiography (FAG) and visual field test. RESULTS: At first visit, disc swelling was noted and arterial circulation was intact, however, 1 week after onset, the inferior branch retinal artery began to shrink and the flame hemorrhage intensified. Sixteen months later, the optic disc evidenced an atrophic change; additionally, a ghost vessel in the inferior branch retinal artery was found.CONCLUSION: We report a case of complications of BRAO arising after AION which caused the mechanical compression on the arterial circulation.%目的:报告1例前部缺血性视神经病变(anterior ischemic optic neuropathy,AION)并发视网膜分支动脉阻塞(branch retinal artery obstruction,BRAO).方法:患者,女,42岁,因视力障碍进行如下眼科检查:眼底照相、荧光血管造影(fluorescent angiography,FAG)和视野测试.结果:第一次就诊时,患者视盘肿胀,动脉循环完整,发病1wk后,视网膜下支动脉开始萎缩并火焰状出血加剧.16mo后,视盘呈萎缩性改变,此外,发现视网膜下分支动脉血管影一条.结论:AION并发BRAO可造成动脉循环的机械性压迫.

  17. Retinal oximetry

    Sveinn Hákon Harðarson 1978

    2012-01-01

    Purpose Malfunction of retinal blood flow or oxygenation is believed to be involved in various diseases. Among them are retinal vessel occlusions, diabetic retinopathy and glaucoma. Reliable, non-invasive technology for retinal oxygen measurements has been scarce and most of the knowledge on retinal oxygenation comes from animal studies. This thesis describes human retinal oximetry, performed with novel retinal oximetry technology. The thesis describes studies on retinal vessel oxygen satu...

  18. An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

    Ming, Zhu; Qian, Wang [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

    2009-08-15

    An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

  19. An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

    An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

  20. Retinitis Pigmentosa

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... die. Forms of RP and related diseases include Usher syndrome, Leber’s congenital amaurosis, rod-cone disease, Bardet- ...

  1. Retinal Detachment

    ... are three different types of retinal detachment: Rhegmatogenous [reg-ma-TAH-jenous]—A tear or break in the retina allows fluid to get under the retina and separate it from the retinal pigment epithelium (RPE), the pigmented cell layer that nourishes the retina. These types of ...

  2. Isolated Upgaze Palsy in a Patient with Vertebrobasilar Artery Dolichoectasia; a Case Report

    Ortak, Huseyin; Tas, Ufuk; Aksoy, Durdane Bekar; Ayan, Erdoğan

    2014-01-01

    Purpose To report isolated upgaze palsy in a patient with a dolichoectatic vertebrobasilar artery. Case Report We report a 48-year-old man who showed upgaze palsy and convergence insufficiency. The left vertebral artery and basilar artery were shown to be greatly expanded, elongated and tortuous in cranial magnetic resonance imaging (MRI). The vertebrobasilar artery runs along the sulcus basilaris superior to the pontomesencephalic junction. Conclusion A dolichoectatic basilar artery may resu...

  3. Anatomical Variations in the Arteries and Nerves of the Right Carotid Triangle

    Quadros LS; Pandey AK; D'Souza AS

    2014-01-01

    Variations of the arteries and nerves are of clinical importance to the clinicians and surgeons in performing the surgeries. During the routine dissection for the undergraduates, variation in the branches of external carotid artery was noted in the right carotid triangle. The superior thyroid artery showed an upward loop from its origin and had a highly tortuous course, the lingual and facial arteries arouse from a common linguo-facial trunk and the ascending pharyngeal artery took origin fro...

  4. Sequential bilateral retinal artery occlusion

    Padrón-Pérez N; Aronés JR; Muñoz S; Arias-Barquet L; Arruga J

    2014-01-01

    Noel Padrón-Pérez,1 Janny Rosario Aronés,2 Silvia Muñoz,1 Luis Arias-Barquet,1 Jorge Arruga1,31Department of Ophthalmology, Hospital Universitari de Bellvitge, 2Hospital de l'Esperança – Parc de Salut Mar, 3Institut Català de Retina, Barcelona, SpainAbstract: An 86 year old woman experienced a sequential bilateral loss of vision over a period of less than 24 hours. Clinical findings and complementary studies suggested a bilateral atherogenic...

  5. The relationship between association of microalbuminuria and retinal vessel diameter in population with essential hypertension

    黄秋霞

    2013-01-01

    Objective To investigate the association of urinary albumin-to-creatinine ratio(UACR) and the diameter of retinal vessel in population with essential hypertension inFujian coastal area.Methods Central retinal artery and

  6. Other Retinal Diseases

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... affected by retinitis pigmentosa, age-related macular degeneration, Usher syndrome and the entire spectrum of retinal diseases. ...

  7. Retinal vascular calibres are significantly associated with cardiovascular risk factors

    von Hanno, T.; Bertelsen, G.; Sjølie, Anne K.;

    2014-01-01

    . Association between retinal vessel calibre and the cardiovascular risk factors was assessed by multivariable linear and logistic regression analyses. Results: Retinal arteriolar calibre was independently associated with age, blood pressure, HbA1c and smoking in women and men, and with HDL cholesterol in men......Purpose: To describe the association between retinal vascular calibres and cardiovascular risk factors. Methods: Population-based cross-sectional study including 6353 participants of the TromsO Eye Study in Norway aged 38-87years. Retinal arteriolar calibre (central retinal artery equivalent) and...... retinal venular calibre (central retinal vein equivalent) were measured computer-assisted on retinal photographs. Data on blood pressure, body mass index (BMI), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, glycosylated haemoglobin (HbA1c) and smoking were collected...

  8. Isolated Upgaze Palsy in a Patient with Vertebrobasilar Artery Dolichoectasia; a Case Report

    Huseyin Ortak; Ufuk Tas; Durdane Bekar Aksoy; Erdogan Ayan

    2014-01-01

    Purpose: To report isolated upgaze palsy in a patient with a dolichoectatic vertebrobasilar artery. Case Report: We report a 48-year-old man who showed upgaze palsy and convergence insufficiency. The left vertebral artery and basilar artery were shown to be greatly expanded, elongated and tortuous in cranial magnetic resonance imaging (MRI). The vertebrobasilar artery runs along the sulcus basilaris superior to the pontomesencephalic junction. Conclusion: A dolichoectatic basilar arte...

  9. RX-08-HD, a low-viscosity, injection-moldable explosive for filling tortuous paths

    Hoffman, D.M.; Jessop, E.S.; Swansiger, R.W.

    1997-10-01

    Cast cure, extrusion cast, and paste extrudable explosives have not been designed for transferring through long tortuous paths or into fine three dimensional shapes. To allow the crystalline explosive to flow a lubricating fluid is required. The energetic liquid ethane trinitrate (TMETN) was used as the lubricant to maximize the explosive energy. TMETN is a liquid nitrate ester which requires stabilization with conventional free radical stabilizers such as 2- nitrodiphenylamine, methyl-nitroanaline, or ethyl centrylite. Since these injection moldable explosives are expected to cure in place, a polyesterurethane binder based on polymeric isocyanate of hexamethylene diisocyanate and polycaprolactone polyols is dissolved in TMETN. The solubility of the polymer precursors in TMETN also reduces the energetic liquids sensitivity. The latent cure catalyst Dabco T-131 was used to minimize shrinkage associated with thermal expansion, reduce cost associated with oven cures, to give 4-6 hour potlife and overnight cure to handling strength. The product RX-08-HD is a new, low-viscosity, injection moldable explosive that can be extruded into complex, void-free shapes. Combined with appropriate design and other aspects of weaponization, RX-08-HD has produced outstanding results.

  10. Water vapour permeability of poly(lactic acid): Crystallinity and the tortuous path model

    Duan, Z.; Thomas, N. L.

    2014-02-01

    The water vapour transmission rates (WVTR) through samples of polylactic acid of different crystallinities have been measured. Three different grades of commercial poly(lactic acid) (PLA) were used with different ratios of L-lactide and D-lactide to give a range of crystallinities from 0% to 50%. Sheets of PLA were prepared by melt compounding followed by compression moulding and annealing at different temperatures and for different times to give the range of crystallinities required. Crystallinity was measured by differential scanning calorimetry and the morphology of the samples was observed under crossed polars in a transmitted light microscope. Water vapour transmission rates through the films were measured at 38 °C and at a relative humidity of 90%. It was found that the measured values of WVTR decreased linearly with increasing crystallinity of the PLA from 0% to 50%. The results are discussed in terms of the effect of crystallinity on solubility and shown to fit the "Tortuous Path Model." The model was also successfully used to explain published data on water permeability of polyethylene terephthalate.

  11. Hypoxia-ischemia and retinal ganglion cell damage

    Charanjit Kaur; Foulds, Wallace S.; Eng-Ang Ling

    2008-01-01

    Charanjit Kaur1, Wallace S Foulds2, Eng-Ang Ling11Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore Eye Research Institute, SingaporeAbstract: Retinal hypoxia is the potentially blinding mechanism underlying a number of sight-threatening disorders including central retinal artery occlusion, ischemic central retinal vein thrombosis, complications of diabetic eye disease and some types of glaucoma. Hypoxia is implicated in loss of re...

  12. Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia

    Congenital absence of the unilateral internal carotid artery (ICA) was found in a patient during MR imaging examination for right trigeminal neuralgia. Magnetic resonance angiography showed complete absence of the right ICA and a large tortuous basilar artery (BA). The source images revealed a deformed right trigeminal nerve resulting from compression by the BA. Computed tomography of the skull base showed absence of the right carotid canal, suggesting agenesis of the right ICA. Longstanding hemodynamic stress may have caused the BA to become extremely tortuous, resulting in the trigeminal neuralgia. (orig.)

  13. Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia

    Uchino, A.; Sawada, A.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga (Japan); Hirakawa, N.; Totoki, T. [Department of Anesthesiology, Saga Medical School, 5-1-1, Nabeshima, Saga (Japan)

    2002-09-01

    Congenital absence of the unilateral internal carotid artery (ICA) was found in a patient during MR imaging examination for right trigeminal neuralgia. Magnetic resonance angiography showed complete absence of the right ICA and a large tortuous basilar artery (BA). The source images revealed a deformed right trigeminal nerve resulting from compression by the BA. Computed tomography of the skull base showed absence of the right carotid canal, suggesting agenesis of the right ICA. Longstanding hemodynamic stress may have caused the BA to become extremely tortuous, resulting in the trigeminal neuralgia. (orig.)

  14. Retinitis pigmentosa

    Hamel Christian

    2006-10-01

    Full Text Available Abstract Retinitis pigmentosa (RP is an inherited retinal dystrophy caused by the loss of photoreceptors and characterized by retinal pigment deposits visible on fundus examination. Prevalence of non syndromic RP is approximately 1/4,000. The most common form of RP is a rod-cone dystrophy, in which the first symptom is night blindness, followed by the progressive loss in the peripheral visual field in daylight, and eventually leading to blindness after several decades. Some extreme cases may have a rapid evolution over two decades or a slow progression that never leads to blindness. In some cases, the clinical presentation is a cone-rod dystrophy, in which the decrease in visual acuity predominates over the visual field loss. RP is usually non syndromic but there are also many syndromic forms, the most frequent being Usher syndrome. To date, 45 causative genes/loci have been identified in non syndromic RP (for the autosomal dominant, autosomal recessive, X-linked, and digenic forms. Clinical diagnosis is based on the presence of night blindness and peripheral visual field defects, lesions in the fundus, hypovolted electroretinogram traces, and progressive worsening of these signs. Molecular diagnosis can be made for some genes, but is not usually performed due to the tremendous genetic heterogeneity of the disease. Genetic counseling is always advised. Currently, there is no therapy that stops the evolution of the disease or restores the vision, so the visual prognosis is poor. The therapeutic approach is restricted to slowing down the degenerative process by sunlight protection and vitaminotherapy, treating the complications (cataract and macular edema, and helping patients to cope with the social and psychological impact of blindness. However, new therapeutic strategies are emerging from intensive research (gene therapy, neuroprotection, retinal prosthesis.

  15. Bietti crystalline retinal dystrophy with subfoveal neurosensory detachment and congenital tortuosity of retinal vessels: case report.

    Padhi, Tapas Ranjan; Kesarwani, Siddharth; Jalali, Subhadra

    2011-06-01

    A 34-year-old man presented with reduction and distortion of vision in both the eyes. The best-corrected vision was 20/20 parts, N6 in either eye. The external and slit lamp examination of both the eyes was unremarkable. The fundus examination showed multiple intraretinal crystalline deposits at the posterior pole, extending up to midperiphery, tortuous retinal blood vessels with S-shaped deflections, and absent foveal reflex in both the eyes. There were no corneal crystals, and the color vision was defective in both the eyes. Fundus autofluorescence and fundus fluorescein angiogram (FFA) were suggestive of geographic areas of retinal pigment epithelium (RPE) and choriocapillary (CC) loss. OCT revealed subfoveal neurosensory detachment. Flash ERG and EOG were normal except for a slight decrease in amplitude and delay in latency of pattern ERG waveforms. The Humphrey's visual field showed paracentral scotoma with reduction in the amplitude of waveforms from the corresponding area in the multifocal ERG in both the eyes. Systemic evaluation for crystalline retinopathy was unremarkable. He was diagnosed to be a case of Bietti crystalline retinopathy (local/regional variant). The subfoveal neurosensory detachment could represent early RPE dysfunction caused by these crystals and could account for the mild visual disturbance in both the eyes. Retinal vascular tortuosity and neurosensory detachment seen in this case is the first time to be reported in literature. PMID:21611771

  16. EFFECT OF SYSTEMIC ADMINISTRATION OF HMG Co A REDUCTASE INHIBITOR ATORVASTATIN ON CENTRAL RETINAL ARTERY FLOW DYNAMICS, INTRA OCULAR PRESSURE AND VISUAL FIELD CHANGES IN PRIMARY OPEN ANGLE GLAUCOMA AND NORMAL TENSION GLAUCOMA PATIENTS

    Deepak Kumar

    2015-12-01

    Full Text Available PURPOSE To study the effect of systemic administration of HMG CoA reductase inhibitor Atorvastatin on Central Retinal Artery (CRA flow dynamics, Intraocular Pressure (IOP and Visual Field (VF changes in Primary Open Angle Glaucoma (POAG and Normal Tension Glaucoma (NTG patients. MATERIALS AND METHODS Prospective randomized placebo controlled double blind parallel group study consisting of 80 eyes of 40 patients suffering from POAG and NTG was conducted. After baseline clinical evaluation and Color Doppler Imaging (CDI of CRA subjects were randomized to receive 40mg/day of Atorvastatin (Tonact or matching Placebo for 3 months and followed at two weeks, one month and three months. Main outcome measures were Peak Systolic Velocity (PSV, End Diastolic Velocity (EDV, Resistive Index (RI, IOP and Mean Deviation (MD in VF. RESULTS Atorvastatin group showed decrease in IOP (P=0.0009 in right eye and P=0.0049 in left eye and in RI (P=0.0005 in right eye and P=0.0008 in left eye, while there was increase in RI in the placebo group (P=0.0006 in right eye and P=0.0007 in left eye after 3 months. No significant change in MD of VF was noticed in both groups. CONCLUSION Atorvastatin has favorable effect in POAG and NTG patients causing decrease in IOP and resistance of CRA with increase in CRA flow dynamics.

  17. Treatment of splenic artery aneurysm with double overlapping bare stents: case report

    Kwak, Hyo Sung; Han, Young Min; Jin, Gong Yong [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2004-09-01

    The traditional treatment of splenic artery aneurysm (SAA) is generally surgery and/or transcatheter arterial embolization, but recently, the treatment of SAA using a stent graft has been reported. However, the acute angle of the celiac axis, as well as the tortuous path of the splenic artery makes the use of stent graft difficult for treatment of aneurysma. We report here a case of SAA treated with the technique of double overlapping metallic stents.

  18. Anatomical Variations in the Arteries and Nerves of the Right Carotid Triangle

    Quadros LS

    2014-08-01

    Full Text Available Variations of the arteries and nerves are of clinical importance to the clinicians and surgeons in performing the surgeries. During the routine dissection for the undergraduates, variation in the branches of external carotid artery was noted in the right carotid triangle. The superior thyroid artery showed an upward loop from its origin and had a highly tortuous course, the lingual and facial arteries arouse from a common linguo-facial trunk and the ascending pharyngeal artery took origin from the Internal carotid artery. The ansa cervicalis showed absence of inferior root. The second and third cervical spinal nerves joined the superior root separately.

  19. Heritability of retinal vessel diameters and blood pressure

    Taarnhøj, Nina C B B; Larsen, Michael; Sander, Birgit;

    2006-01-01

    , aged 20 to 46 years, interpolated diameter estimates for the central retinal artery (CRAE), the central retinal vein (CRVE), and the artery-to-vein diameter ratio (AVR) were assessed by analysis of digital gray-scale fundus photographs of right eyes. RESULTS: The heritability was 70% (95% CI: 54...... for CRVE, and 0.67 +/- 0.05 microm for AVR. No significant influence on artery or vein diameters was found for gender, smoking, body mass index (BMI), total cholesterol, fasting blood glucose, or 2-hour oral glucose tolerance test values. CONCLUSIONS: In healthy young adults with normal blood pressure...... and blood glucose, variations in retinal blood vessel diameters and blood pressure were predominantly attributable to genetic effects. A genetic influence may have a role in individual susceptibility to hypertension and other vascular diseases. The results suggest that retinal vessel diameters and the...

  20. Spectrophotometric retinal oximetry in pigs

    Traustason, Sindri; Kiilgaard, Jens Folke; Karlsson, Robert;

    2013-01-01

    PURPOSE: To assess the validity of spectrophotometric retinal oximetry, by comparison to blood gas analysis and intra-vitreal measurements of partial pressure of oxygen (pO2). METHODS: Female domestic pigs were used for all experiments (n=8). Oxygen fraction in inspired air was changed using a......, Reykjavik, Iceland). The device simultaneously acquires images at two wavelengths (570 nm and 600 nm) and specialized software automatically detects retinal blood vessels. In three pigs, invasive pO2-measurements were performed after the initial non-invasive measurements. RESULTS: Comparison of femoral......-measurements in three pigs. This relationship was approximately linear (R(2) = 0.45, p = 0.04). CONCLUSIONS: Non-invasive spectrophotometric oximetry is sensitive to changes in oxygen saturation in pigs and correlated with intravitreal pO2-measurements and with femoral artery pO2. Pigs present a higher intra...

  1. 微创玻璃体视网膜手术治疗视网膜大动脉瘤性玻璃体积血%Micro-invasive vitrectomy for vitreous hemorrhage secondary to retinal arterial macroaneurysm

    孙敏; 陈春丽; 宋宗明; 杨嘉嵩; 毕秀增

    2012-01-01

    Objective To evaluate the safety and efficacy of micro-invasive vitrectomy combined with endophotocoagulation in cases with dense vitreous hemorrhage secondary to retinal arterial macroaneurysm. Methods Retrospective,consecutive,interventional cases series of 10 eyes of 10 patients with retinal arterial macroaneurysm who underwent 3-port pars plana vitrectomy and endophotocoagulation using 23-guage instrumentation combined with 25-gauge infusion.Follow-up ranged from 3 to 32 months (mean,18.6±10.03 months).Main outcome measures included pre and post operation best-corrected visual acuity (BCVA),intraocular pressure,and complications. Results The postoperative visual acuities improved in all eyes.The mean BCVA improved from 0.03±0.02 (ranged from hand motions to 0.06) preoperatively to 0.24±0.14 (ranged from 0.05 to 0.4) at the one week after surgery and there was a significant statistical difference between them (t =-4.72,P <0.01).At the final follow-up,the BCVA was 0.36±0.21 (ranged from 0.1 to 0.6),and vision was better than 0.3 in seven eyes.There was a significant statistical difference between pre-operation and the final follow-up (t =-4.94,P <0.01).The intraocular pressure of one day before operation,one day after operation,three day after operation and the final follow-up were (9.87±3.23),(11.91±4.66),(10.47±2.83),(ll.94±2.89)mmHg respectively,no statistically significant difference was found among them (F=0.895,P>0.05).No serious complications and recurrenee occurred. Conclusions Micro-invasive vitrectomy combined with endophotocoagulation is a feasible treatment for cases with dense vitreous hemorrhage secondary to retinal arterial macroaneurysm.%目的 观察微创玻璃体视网膜手术联合眼内激光光凝治疗视网膜大动脉瘤致玻璃体积血的临床疗效及安全性.方法 回顾性分析2008年3月至2010年8月因不明原因大量玻璃体积血病人,经术中眼底检查及术后

  2. An anatomical study of double brachial arteries – a case report

    Krstonosic B

    2010-02-01

    Full Text Available Superficial brachial artery is one of the major variations of the arterial pattern in the upper limb. During routine anatomical dissection in our department, we observed a case of unilateral double brachial artery in a formalin-fixed female cadaver.Left axillary artery entered into the anterior region of the arm, where it branched into two brachial arteries – the superficial brachial artery (SBA, which was longer, tortuous and with a smaller caliber, and the brachial artery (BA, which was placed deep and medially. In the cubital fossa, covered with an aponeurosis of the biceps brachii muscle, both brachial arteries were connected with an anastomotic vessel. Under this anastomotic branch, in the forearm, SBA continued as the radial artery, whereas BA continued as the ulnar artery.Variations of the arterial pattern in the upper limb are undoubtedly of interest to the anatomists as well as to the clinicians.

  3. Isolated Upgaze Palsy in a Patient with Vertebrobasilar Artery Dolichoectasia; a Case Report

    Huseyin Ortak

    2014-01-01

    Full Text Available Purpose: To report isolated upgaze palsy in a patient with a dolichoectatic vertebrobasilar artery. Case Report: We report a 48-year-old man who showed upgaze palsy and convergence insufficiency. The left vertebral artery and basilar artery were shown to be greatly expanded, elongated and tortuous in cranial magnetic resonance imaging (MRI. The vertebrobasilar artery runs along the sulcus basilaris superior to the pontomesencephalic junction. Conclusion: A dolichoectatic basilar artery may result in compression of midbrain structures related to vertical gaze.

  4. Interventional therapy of complications after liver transplantation: hepatic artery stricture

    Hepatic artery stricture (HAS) after liver transplantation can lead directly to transplanted liver function exhaustion and complications of biliary system. The early diagnosis and treatment are crucial for better prognosis. Doppler ultrasound is the first method of choice, and angiography can give further clear dignosis. The balloon dilatation is still effective for hepatic arterial stenosis. With the more adaptable usage of oronary stent, if possible, would reveal more promising result especially for tortuous stenotic hepatic artery. The vascular reconstruction or repeated liver transplantation is still the effective therapeutic methods. (authors)

  5. Recanalization of Splenic Artery Aneurysm After Transcatheter Arterial Embolization Using N-Butyl Cyanoacrylate

    A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using an n-butyl cyanoacrylate (NBCA)-lipiodol mixture was successfully performed. Fifty days later, the patient developed sudden abdominal pain again. Repeated angiography demonstrated recanalization of the splenic artery and splenic artery aneurysm. This time, the recanalized aneurysm was embolized using metallic coils with the isolation method. Physicians should keep in mind that recanalization can occur after transcatheter arterial embolization using N-butyl cyanoacrylate, which has been used as a permanent embolic agent.

  6. Variação do fluxo sanguíneo da artéria central da retina durante as diferentes fases do ciclo menstrual ovulatório Central retinal artery blood flow variation during menstrual cycle

    Luiz Carlos Viana

    2007-03-01

    Full Text Available OBJETIVO: avaliar a resistência vascular da artéria central da retina, por meio do fluxo Doppler, nas diferentes fases do ciclo menstrual ovulatório. MÉTODOS: estudo observacional, longitudinal e prospectivo com avaliação de 34 mulheres saudáveis, submetidas a estudo dopplerfluxométrico do fundo do olho para avaliação da resistência vascular da artéria central da retina nas posições sentada e deitada, durante quatro fases do ciclo menstrual: fase folicular inicial, fase folicular média, fase periovulatória e fase lútea média. A confirmação da ovulação no ciclo de estudo foi feita pela dosagem de progesterona sérica na fase lútea média. Foram avaliados os índices de pulsatilidade (IP e de resistência, e as velocidades máxima, mínima e média. RESULTADOS: a idade média foi de 29,7 anos. Não foram observadas diferenças entre os índices obtidos para ambos os olhos; assim, utilizamos as médias dos índices para realizar o cálculo estatístico. Quando comparadas às posições de realização do exame, detectou-se um IP maior na posição sentada; assim, as análises foram avaliadas em separado, respeitando-se a posição da paciente. O IP da artéria central da retina, avaliado com a paciente deitada, variou durante o ciclo menstrual, apresentando-se significativamente mais baixo nas fases folicular média (1,5±0,3 e periovulatória (1,5±0,3 quando comparadas às fases folicular precoce (1,7±0,4 e lútea média (1,7±0,4. Quando a avaliação foi feita com a paciente sentada não foram observadas diferenças para as diferentes fases do ciclo. CONCLUSÕES: num ciclo menstrual ovulatório ocorre diminuição da resistência vascular na artéria central da retina e posterior reversão do efeito, como demonstrado pelas variações do IP.PURPOSE: to evaluate the vascular blood flow of the central retinal arteries using dopplervelocimetry in the different phases of the ovulatory menstrual cycle. METHODS: we performed

  7. Retinal blood flow velocity in patients with active uveitis using the retinal function imager

    FENG Xing; Kedhar Sanjay; Bhoomibunchoo Chavakij

    2013-01-01

    Background Previous studies suggest a link between macular edema and retinal blood flow velocity (RBFV).The effects of inflammation in the retinal blood vessels are not clearly understood.We want to evaluate the differences in retinal blood flow velocities of patients with active uveitis and healthy controls using the retinal function imager (RFI)and determine the correlation between retinal blood flow veiocity and central macular thickness in uveitis patients.Methods Twenty-eight eyes of 24 patients with active anterior uveitis and 51 eyes of 51 normal control subjects were enrolled.Retinal blood flow velocities evaluated by RFI and central macular thickness evaluated by optical coherence tomography (SLO-OCT) were obtained.Differences among the groups were assessed using Stata statistical software.Results Ten eyes had uveitic cystoid macular edema (CME).Median (first quartile,third quartile) venous velocity for uveitic eyes with CME,uveitic eyes without CME,and controls were 2.09 (1.92,2.44),2.64 (2.32,2.86),and 2.82 (2.39,3.53) mm/s respectively.Median (first and quartile) arterial velocity for uveitic eyes with CME,uveitic eyes without CME,and controls were 3.79 (3.61,4.09),3.46 (2.86,4.12),and 3.93 (3.35,4.65) mm/s.Uveitic eyes with CME had significantly lower venous velocity than controls (P=0.044).There was a strong linear relationship between venous velocity and central retinal thickness (P=-0.007).Conclusions Retinal venous velocities were significantly decreased in eyes with uveitic CME relative to controls.Decreased venous velocity was correlated with increased central retinal thickness in uveitic eyes.

  8. Branch Retinal Vein Occlusion and Its Management

    Desmond; Archer

    1992-01-01

    The natural course of Branch Retinal Vein Occlusion is determined by the site and completeness of the occlusion, the integrity of arterial perfusion to the affected sector and the efficiency of the developing collateral circulation. Most patients with tributary vein occlusion have some capillary fall out and microvascular incompetence in the distribution of the affected retina and vision is significantly compromised in over 50% of patients who have either chronic macular oedema or ischemia involving the...

  9. Retinal vessel diameters in relation to hematocrit variation during acclimatization of highlanders to sea level altitude

    Kofoed, Peter Kristian; Sander, Birgit; Zubieta-Calleja, Gustavo;

    2009-01-01

    traveled by airplane to Copenhagen, Denmark, near sea level. RESULTS: In the study subjects, hematocrit decreased from 49.6% (day 2) to 45.9% (P = 0.0066, day 23) and 41.7% (P <0.0001, day 72); from days 2 to 23, retinal vein diameter increased by 2.68% (P = 0.0079); whereas retinal artery and vein...

  10. [Retinal venous obliteration and general pathology].

    Aconiu, M; Mihălaş, G; Nemoianu, C

    1992-01-01

    The study of 148 retinal venous obliterations have shown 81 occlusions of central vein and 67 of I and II venous branch. A number of 90 was for the feminine gender (sex) and 59 for the masculine sex. The average age for the appearance of the venous occlusions was 62 years old, having extreme limits between 36-84 years old. Bilaterality has been for 3 cases. Concerning the associated medical affections, hypertension was for 67 patients, myocardiosclerosis have been mentioned for 67 patients, atherosclerosis for 21 patients, pulmonary scleroemphisis for 12 patients. Arterial hypertension with its aspersion that is arteriosclerosis are the main factors that have generated retinal circulation modifyings and have led to a degree of arterial insufficiency. Comparing the ophthalmological aspect to the pressure in the ophthalmic artery, most of the patients had a concordance of TACR and the retinal and choroidal angiosclerosis. The oscillometric examination to the inferior members has been effectuated for 21 patients and it has shown diminished values only for 3 cases. The forecast of the disease is still reserved. Following a group of 40 patients having OVR between 5 and 15 years old it has been established an average survival of 6.2 years. It is mentioned that 26% between these have dyed during the first six years. PMID:1520668

  11. From basilar artery dolichoectasia to basilar artery aneurysm: natural history in images.

    Zis, Panagiotis; Fragkis, Stylianos; Lykouri, Maria; Bageris, Ioannis; Kolovos, Georgios; Angelidakis, Panagiotis; Tavernarakis, Antonios

    2015-05-01

    Dolichoectasia is a medical term used to describe elongated and dilated vessels that follow a tortuous and windy course with frequent loops and curves. We are presenting the natural history in images of a normal basilar artery becoming dolichoectatic, followed by the formation of an aneurysm, over a period of many years, in 60-year-old Caucasian man with a long history of secondary progressive multiple sclerosis and uncontrolled arterial hypertension, who was diagnosed with dolichoectasia of basilar artery in 2008. Although relatively stable at this point, eventually his mobility deteriorated and signs from the cranial nerves, such as trigeminal neuralgia and bilateral palsy of the VI and the VII nerves were added in the clinical picture. In 2014, both computed tomography and magnetic resonance imaging of the brain revealed the formation of an unruptured aneurysm of the basilar artery. PMID:25765208

  12. A rare and unusual retinal arterioarterial communication in a prepapillary vascular loop

    Makino, Shinji

    2014-01-01

    Fundus examination of a 40-year-old man presenting with blurred vision in his right eye revealed mild vitreous hemorrhage, a prepapillary vascular loop, and a peripapillary epiretinal membrane. Additionally, a superotemporal branch retinal artery communicated directly with an inferotemporal branch retinal artery in the temporal fovea at 2 locations. Fluorescein angiography confirmed an extremely rare arterioarterial communication. Two weeks later the vitreous hemorrhage and small intraretinal...

  13. The comparison of retinal blood flow after scleral buckling surgery with or without encircling procedure

    Alireza Dehghani; Hassan Razmjoo; Farhad Fazel; Mehdi Karami; Akbar Etesampour; Heshmatolah Ghanbari; Farzan Kianersi; Mohammadreza Akhlaghi; Hamid Fesharaki

    2013-01-01

    Aim: We aimed to compare peak systolic velocity of central retinal artery (PSV.CRA) and peak systolic velocity of ophthalmic artery (PSV.OA) between patients with retinal detachment who were treated with segmental scleral bucking and scleral buckling with encircling procedure. Materials and Methods: This study was a descriptive-analytic cross sectional study that was performed in Isfahan university referral centers since April 2010 to April 2011. Of the patients who have undergone scleral buc...

  14. Changes in retinal vessels related to varicocele: a pilot investigation.

    Coşkun, M; Ilhan, N; Elbeyli, A; Rifaioğlu, M M; Inci, M; Davran, R; Tuzcu, E A; Yarbağ, A; Davarci, M; Gökçe, A

    2016-06-01

    The aim of this study was to investigate whether retinal vasculature changes had occurred (retinal artery diameter, retinal vein diameter and artery/vein ratio) in patients with varicocele. This pilot study included 50 healthy subjects with any eye disease apart from slight refractive errors and 55 patients with varicocele. Retinal arteriolar and venular diameters were measured and summarised as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE). Retinal microvascular diameters and the arteriolar-to-venular ratio (AVR) were assessed with a digital retinal camera. All measurements and calculations were performed using a computer-based program. The mean CRAE value was 151.8 ± 3.6 μm in the study group and 150.4 ± 4.5 μm in the control group. Mean CRVE value was 209.4 ± 5.9 μm in the study group and 200.1 ± 8.7 μm in the control group. AVR was found 0.72 ± 0.02 in the study group and 0.75 ± 0.03 in the control group. There were significant differences between groups in terms of CRVE and AVR. There were no significant differences between groups in terms of CRAE. The results of this study showed that the patients with varicocele showed significant changes on retinal vascular diameter. PMID:26314401

  15. Modern retinal laser therapy

    Kozak, Igor; Luttrull, Jeffrey K.

    2014-01-01

    Medicinal lasers are a standard source of light to produce retinal tissue photocoagulation to treat retinovascular disease. The Diabetic Retinopathy Study and the Early Treatment Diabetic Retinopathy Study were large randomized clinical trials that have shown beneficial effect of retinal laser photocoagulation in diabetic retinopathy and have dictated the standard of care for decades. However, current treatment protocols undergo modifications. Types of lasers used in treatment of retinal dise...

  16. The retinal ciliopathies.

    Adams, N A; Awadein, Ahmed; Toma, Hassanain S

    2007-09-01

    While the functions of many of the proteins located in or associated with the photoreceptor cilia are poorly understood, disruption of the function of these proteins may result in a wide variety of phenotypes ranging from isolated retinal degeneration to more pleiotropic phenotypes. Systemic findings include neurosensory hearing loss, developmental delay, situs-inversus, infertility, disorders of limb and digit development, obesity, kidney disease, liver disease, and respiratory disease. The concept of "retinal ciliopathies" brings to attention the importance of further molecular analysis of this organelle as well as provides a potential common target for therapies for these disorders. The retinal ciliopathies include retinitis pigmentosa, macular degeneration, cone-dystrophy, cone-rod dystrophy, Leber congenital amaurosis, as well as retinal degenerations associated with Usher syndrome, primary ciliary dyskinesia, Senior-Loken syndrome, Joubert syndrome, Bardet-Biedl syndrome, Laurence-Moon syndrome, McKusick-Kaufman syndrome, and Biemond syndrome. Mutations for these disorders have been found in retinitis pigmentosa-1 (RP1), retinitis pigmentosa GTPase regulator (RPGR), retinitis pigmentosa GTPase regulator interacting protein (RPGR-IP), as well as the Usher, Bardet-Biedl, and nephronophthisis genes. Other systemic disorders associated with retinal degenerations that may also involve ciliary abnormalities include: Alstrom, Edwards-Sethi, Ellis-van Creveld, Jeune, Meckel-Gruber, Orofaciodigital Type 9, and Gurrieri syndromes. Understanding these conditions as ciliopathies may help the ophthalmologist to recognize associations between seemingly unrelated diseases and have a high degree of suspicion that a systemic finding may be present. PMID:17896309

  17. Flow patterns on spectral-domain optical coherence tomography reveal flow directions at retinal vessel bifurcations

    Willerslev, Anne; Li, Xiao Q; Munch, Inger C;

    2014-01-01

    from the population-based, observational Copenhagen Child Cohort 2000 study. RESULTS: The blood stream in retinal arteries maintains a figure-of-8 SD-OCT profile consistent with a laminar flow in concentric sheets and a parabolic velocity distribution up to the point of divergence at arterial...... bifurcations. In contrast, the blood stream at the site of confluence of two retinal veins remains divided into two parallel sets of sheets with separate velocity distribution for a downstream distance of at least four trunk vessel diameters. Consequently, retinal trunk vessels near bifurcations...

  18. The blood pressure-induced diameter response of retinal arterioles decreases with increasing diabetic maculopathy

    Frederiksen, Christian Alcaraz; Jeppesen, Peter; Knudsen, Søren Tang;

    2006-01-01

    were measured using the Retinal Vessel Analyzer (RVA, Imedos, Germany) before, during, and after an increase in the blood pressure induced by isometric exercise. Additionally, the retinal thickness was measured using optical coherence tomography scanning. RESULTS: The arterioles contracted during......BACKGROUND: The aim of the study was to compare the diameter response of retinal arterioles and retinal thickness in patients with different stages of diabetic maculopathy during an increase in the arterial blood pressure. METHODS: Four groups each consisting of 19 individuals were studied. Group A...

  19. Relationship between retinal vascular occlusions and incident cerebrovascular diseases: A systematic review and meta-analysis.

    Zhou, Yue; Zhu, Wengen; Wang, Changyun

    2016-06-01

    Several studies investigating the role of retinal vascular occlusions, on cerebrovascular diseases (CVD) have been reported, but the results are still inconsistent. We therefore sought to evaluate the relationship between retinal vascular occlusions and CVD.We systematically searched the Cochrane Library, PubMed, and ScienceDirect databases through January 31, 2016 for studies evaluating the effect of retinal vascular occlusions on the risk of CVD. Data were abstracted using predefined criteria, and then pooled by RevMan 5.3 software.A total of 9 retrospective studies were included in this meta-analysis. When compared with individuals without retinal vascular occlusions, both individuals with retinal artery occlusion (RAO) (odds ratio [OR] = 2.01, 95% confidence interval [CI]: 1.21-3.34; P = 0.005) and individuals with retinal vein occlusion (RVO) (OR = 1.37, 95% CI: 1.24-1.50; P < 0.00001) had higher risks of developing CVD. Additionally, both individuals with central retinal artery occlusion (CRAO) (OR = 2.00, 95% CI: 1.12-3.56; P = 0.02) and branch retinal artery occlusion (BRAO) (OR = 1.60, 95% CI: 1.03-1.48; P = 0.04) were significantly associated with increased risk of CVD.Published literatures support both RVO and RAO are associated with increased risks of CVD. Further prospective studies are needed to confirm these findings. PMID:27368050

  20. Dorzolamide increases retinal oxygen tension after branch retinal vein occlusion

    Noergaard, Michael Hove; Bach-Holm, Daniella; Scherfig, Erik;

    2008-01-01

    To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs.......To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs....

  1. Comorbidity in patients with branch retinal vein occlusion

    Bertelsen, Mette; Linneberg, Allan René; Rosenberg, Niels Thomas; Christoffersen, Nynne; Vorum, Henrik; Gade, Else; Larsen, Michael

    2012-01-01

    To evaluate comorbidity before and after the diagnosis of branch retinal vein occlusion to determine whether it is a consequence of arterial thickening and therefore could serve as a diagnostic marker for other comorbidities and to evaluate the risk factors for the development of such occlusion....

  2. Ectopic Origin of Coronary Arteries Diagnozed by Coronary Angiography

    Krasniqi, Xhevdet; Gorani, Daut; Sejdiu, Basri; Citaku, Hajdin

    2016-01-01

    Introduction: Anomalous origin of coronary arteries from opposite sinus of Valsalva is rare finding. The incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. The ectopic origin of left coronary artery or right coronary artery from opposite sinus depending on pathways and considering atherosclerotic changes are manifested with different clinical significance. Case report: We report two cases, the first case the coronary angiography showed the left coronary artery arising from the right coronary sinus, presenting with proximally and distally stenosed left anterior descending artery (LAD), associated with medial and distal stenosed right coronary artery (RCA). The second case the coronary angiography revealed the right coronary artery arising from the left coronary sinus, associated with tortuous medial and distal segments of left anterior descending artery (LAD), without atherosclerotic changes. The first case successfully underwent treatment procedures based on guidelines for revascularization. Conclusion: The coronary angiography of patients with coronary ischemia determines atherosclerotic disease with possibility of the presence of coronary artery anomalies that in cases with ectopic origin from opposite sinus continues to exist as a challenge during treatment in interventional cardiology. PMID:27482140

  3. Differential Diagnosis of Retinal Vasculitis

    Abu El-Asrar, Ahmed M.; Herbort, Carl P.; Tabbara, Khalid F.

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings. PMID:20404987

  4. Differential Diagnosis of Retinal Vasculitis

    Abu El-Asrar Ahmed; Herbort Carl; Tabbara Khalid

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein a...

  5. Differential diagnosis of retinal vasculitis

    Abu El-Asrar Ahmed

    2009-01-01

    Full Text Available Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  6. Normative Values of Retinal Oxygen Saturation in Rhesus Monkeys: The Beijing Intracranial and Intraocular Pressure (iCOP) Study

    Jing LI; Yang, Yiquan; Yang, Diya; Liu, Xiangxiang; Sun, Yunxiao; Wei, Shifei; Wang, Ningli

    2016-01-01

    Objective To study the normal values of the retinal oxygen saturation in Rhesus monkeys and to evaluated repeatability and reproducibility of retinal oxygen saturation measurements. Methods Eighteen adult Rhesus macaque monkeys were included in this experimental study. An Oxymap T1 retinal oximeter (Oxymap, Reykjavik, Iceland) was used to perform oximetry on all subjects. Global arterial (SaO2) and venous oxygen saturation (SvO2), arteriovenous difference in SO2 were measured. In the first ex...

  7. Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis

    Yin, Suo; Zhang, Hong T.; Zhang, Dao P.; Zhang, Shu L.

    2015-01-01

    In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings. PMID:25935186

  8. Persistent primitive trigeminal artery associated with monocular blindness and external carotid-vertebral artery anastomosis.

    Yin, Suo; Zhang, Hong T; Zhang, Dao P; Zhang, Shu L

    2015-05-01

    In this paper, we present 2 rare cases of persistent embryonic anastomoses. In one case, the patient presented with persistent trigeminal artery along with multiple foci of cerebral infarction as well as central retinal artery thrombosis. In the other case, the patient had direct anastomosis of the vertebral artery with ipsilateral external carotid artery as well as pontine infarction, aneurysm, and unilateral hypoplasia of the vertebral artery. The findings in these cases may shed light on the clinical presentation of such persistent anastomoses and aid their detection in clinical settings. PMID:25935186

  9. Retropharyngeal internal carotid artery: case report

    Figueiredo, Ricardo Rodrigues

    2009-03-01

    Full Text Available Introduction: Variations to the course of carotid arteries may lead to abnormal pharyngeal protrusions, to which the otorhinolaryngologist should always attentive. Objective: To report a case of abnormal pharyngeal protrusion due to vascular anomaly in the course of the internal carotid artery, with literature review. Case Report: A 73- year-old woman complained of globus pharyngeus and intermittent dysphonia. A pulsating convexity was observed at the right part of the oropharynx, associated to laryngoscopic signals of pharyngo-laryngeal reflux. The pharyngeal computed tomography scan showed an abnormal tortuous internal carotid in the retropharyngeal space. The patient was sent to the vascular surgeon, who, after a normal blood flow finding at the Doppler, opted for an expectation conduct. The pharyngeal symptoms improved with the antireflux treatment. Final Comments: Internal carotid vascular anomalies must always be recalled in the pharyngeal wall convexity differential diagnosis.

  10. Arterial Catheterization

    ... version AMERICAN THORACIC SOCIETY Patient Information Series Arterial Catheterization An arterial catheter is a thin, hollow tube ... PHYSICIANS: AND COPY Why Do I Need Arterial Catheterization? Common reasons an arterial catheterization is done include: ■ ...

  11. [Acute retinal necrosis].

    Lucke, K; Reinking, U; el-Hifnawi, E; Dennin, R H; Laqua, H

    1988-12-01

    The authors report on three patients with acute retinal necrosis who were treated with the virostatic agent Acyclovir and who underwent vitreoretinal surgery with silicone oil filling for total retinal detachment. In two eyes the retina was reattached, but useful vision was only preserved in one patient. Titers from blood and the vitreous, as well as microscopic findings in retinal biopsies, support the view that the necrosis is caused by a herpes simplex virus infection. After therapy with Acyclovir was instituted no further progression on the necrosis was observed. However, the development of retinal detachment could not be prevented. Early diagnosis and antiviral therapy are essential to improve the otherwise poor prognosis in this rare syndrome. PMID:3221657

  12. Retinal laser optical aids

    Das Traprasad

    1991-01-01

    Full Text Available Knowledge of optics, comparative magnification and working field of view is essential for rational use of ophthalmoscopic contact lenses for retinal photocoagulation. The three commonly used contact lenses are described and compared.

  13. Retinal Tears and Detachments

    ... does not cause retinal damage. However, inflammation or myopia (nearsightedness) may cause the vitreous to pull away ... repaired? If your retina is only torn, prompt treatment may prevent detachment. Your eye surgeon will discuss ...

  14. Intraocular retinal prosthesis.

    Humayun, M. S.

    2001-01-01

    PURPOSE: An electronic implant that can bypass the damaged photoreceptors and electrically stimulate the remaining retinal neurons to restore useful vision has been proposed. A number of key questions remain to make this approach feasible. The goal of this thesis is to address the following 2 specific null hypotheses: (1) Stimulus parameters make no difference in the electrically elicited retinal responses. (2) Just as we have millions of photoreceptors, so it will take a device that can gene...

  15. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-01-01

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. PMID:27511757

  16. Hypoxia-ischemia and retinal ganglion cell damage

    Charanjit Kaur

    2008-08-01

    Full Text Available Charanjit Kaur1, Wallace S Foulds2, Eng-Ang Ling11Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 2Singapore Eye Research Institute, SingaporeAbstract: Retinal hypoxia is the potentially blinding mechanism underlying a number of sight-threatening disorders including central retinal artery occlusion, ischemic central retinal vein thrombosis, complications of diabetic eye disease and some types of glaucoma. Hypoxia is implicated in loss of retinal ganglion cells (RGCs occurring in such conditions. RGC death occurs by apoptosis or necrosis. Hypoxia-ischemia induces the expression of hypoxia inducible factor-1α and its target genes such as vascular endothelial growth factor (VEGF and nitric oxide synthase (NOS. Increased production of VEGF results in disruption of the blood retinal barrier leading to retinal edema. Enhanced expression of NOS results in increased production of nitric oxide which may be toxic to the cells resulting in their death. Excess glutamate release in hypoxic-ischemic conditions causes excitotoxic damage to the RGCs through activation of ionotropic and metabotropic glutamate receptors. Activation of glutamate receptors is thought to initiate damage in the retina by a cascade of biochemical effects such as neuronal NOS activation and increase in intracellular Ca2+ which has been described as a major contributing factor to RGC loss. Excess production of proinflammatory cytokines also mediates cell damage. Besides the above, free-radicals generated in hypoxic-ischemic conditions result in RGC loss because of an imbalance between antioxidant- and oxidant-generating systems. Although many advances have been made in understanding the mediators and mechanisms of injury, strategies to improve the damage are lacking. Measures to prevent neuronal injury have to be developed.Keywords: retinal hypoxia, retinal ganglion cells, glutamate receptors, neuronal injury, retina

  17. Retinal vessel diameter changes induced by transient high perfusion pressure

    Yin-Ying; Zhao; Ping-Jun; Chang; Fang; Yu; Yun-E; Zhao

    2014-01-01

    ·AIM: To investigate the effects of transient high perfusion pressure on the retinal vessel diameter and retinal ganglion cells.·METHODS: The animals were divided into four groups according to different infusion pressure and infusion time(60 mm Hg-3min, 60 mm Hg-5min, 100 mm Hg-3min, 100 mm Hg-5min). Each group consisted of six rabbits. The left eye was used as the experimental eye and the right as a control. Retinal vascular diameters were evaluated before, during infusion, immediately after infusion, 5min, 10 min and 30 min after infusion based on the fundus photographs. Blood pressure was monitored during infusion. The eyes were removed after 24 h.Damage to retinal ganglion cell(RGC) was analyzed by histology.·RESULTS: Retina became whiten and papilla optic was pale during perfusion. Measurements showed significant decrease in retinal artery and vein diameter during perfusion in all of the four groups at the proximal of the edge of the optic disc. The changes were significant in the 100 mm Hg-3min group and 100 mm Hg-5min group compared with 60 mm Hg-3min group(P 1=0.025, P 2=0.000).The diameters in all the groups recovered completely after 30 min of reperfusion. The number of RGC)showed no significant changes at the IOP in 100 mm Hg with5 min compared with contralateral untreated eye(P >0.05).·CONCLUSION: Transient fluctuations during infusion lead to temporal changes of retinal vessels, which could affect the retinal blood circulation. The RGCs were not affected by this transient fluctuation. Further studies are necessary to evaluate the effect of pressure during realtime phacoemusification on retinal blood circulation.

  18. Retinal oxygen extraction in humans

    René M. Werkmeister; Doreen Schmidl; Gerold Aschinger; Veronika Doblhoff-Dier; Stefan Palkovits; Magdalena Wirth; Gerhard Garhöfer; Linsenmeier, Robert A.; Rainer A. Leitgeb; Leopold Schmetterer

    2015-01-01

    Adequate function of the retina is dependent on proper oxygen supply. In humans, the inner retina is oxygenated via the retinal circulation. We present a method to calculate total retinal oxygen extraction based on measurement of total retinal blood flow using dual-beam bidirectional Doppler optical coherence tomography and measurement of oxygen saturation by spectrophotometry. These measurements were done on 8 healthy subjects while breathing ambient room air and 100% oxygen. Total retinal b...

  19. Arteriovenous fistulas of the anterior spinal artery mimicking other types of vascular malformations of the spinal cord

    Extramedullary direct arteriovenous (AV) fistulas of the anterior spinal artery are a rare type of vascular malformation of the spinal cord. This paper compares the angiographic appearance and flow dynamics of four atypical direct AV fistulas with the findings in 21 with a more classic appearance (I-III). Three of the direct AV fistulas had an angiographic appearance mimicking an intramedullary AV malformation, and one mimicked a dural AV fistula with medullar venous drainage. These four cases demonstrated direct AV fistulas of the anterior spinal artery whose tortuous arterial or venous collaterals observed the true nature of the single fistular type of lesion

  20. Probabilistic retinal vessel segmentation

    Wu, Chang-Hua; Agam, Gady

    2007-03-01

    Optic fundus assessment is widely used for diagnosing vascular and non-vascular pathology. Inspection of the retinal vasculature may reveal hypertension, diabetes, arteriosclerosis, cardiovascular disease and stroke. Due to various imaging conditions retinal images may be degraded. Consequently, the enhancement of such images and vessels in them is an important task with direct clinical applications. We propose a novel technique for vessel enhancement in retinal images that is capable of enhancing vessel junctions in addition to linear vessel segments. This is an extension of vessel filters we have previously developed for vessel enhancement in thoracic CT scans. The proposed approach is based on probabilistic models which can discern vessels and junctions. Evaluation shows the proposed filter is better than several known techniques and is comparable to the state of the art when evaluated on a standard dataset. A ridge-based vessel tracking process is applied on the enhanced image to demonstrate the effectiveness of the enhancement filter.

  1. Increased ER stress as a mechanism of retinal neurovasculopathy in mice with severe hyperhomocysteinemia

    Tawfik, Amany; Smith, Sylvia B.

    2014-01-01

    Hyperhomocysteinemia is implicated in retinal neurovascular diseases including arterial occlusive disease, venous occlusive disease and pseudoexfoliation glaucoma. The mechanism for these diseases is not known. Here we used hyperhomocysteinemic mice lacking the gene encoding cystathionine-beta-synthase (cbs −/−) to examine whether ER stress could be a mechanism for the retinal neurovasculopathy reported in these mice. Retinas of cbs+/+ and cbs −/− mice (age: 3–5 wks) were used to invest...

  2. Retinal vascular calibre and response to light exposure and serial imaging

    von Hanno, T.; Sjølie, Anne K.; Mathiesen, E. B.

    2014-01-01

    Purpose: To investigate whether retinal vessel calibre measurements on optical retinal photography are affected by light and dark exposure prior to photography and whether the vessel calibre changes during an imaging sequence of several images. Methods: Digital optical retinal photographs were...... obtained from 32 healthy adults in two separate image sequences of six images during 1 min; one sequence with 10 min of dark exposure and one with 10 min of light exposure prior to imaging. Retinal arteriolar and venular calibres were measured computer-assisted and summarized as central retinal artery and...... vein equivalents (CRAE and CRVE). Outcome measures were difference in calibres after prior light versus prior dark exposure and difference in calibre during each of the two imaging sequences. Results: CRVE was wider with prior light exposure (2.7%, p = 0.0001), comparing the first image in each image...

  3. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience.

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-10-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt-Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment. PMID:26629289

  4. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-01-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant renal anatomy presents a unique challenge to an interventional radiologist. In this study, we present three cases from our practice highlighting the use of a balloon-expandable Multi-Link RX Ultra coronary stent system (Abbott Laboratories, Abbott Park, Illinois, USA) for treating high grade focal stenosis along very tortuous renal arterial segments. Cobalt–Chromium alloy stent scaffold provides excellent radial force, whereas the flexible stent design conforms to the vessel course allowing for optimal stent alignment. PMID:26629289

  5. Improvement in retinal venous oxygen saturation after panretinal photocoagulation is predictive of progression of proliferative diabetic retinopathy

    Torp, Thomas Lee; Kawasaki, Ryo; Wong, Tien Yin;

    blood pressure was 152/84mmHg. Retinal arterial and venous saturation was 96.7% and 67.4%, respectively. Patients in Group 1 and 2 did not differ in baseline retinal arterial and venous oxygen saturation, number of laser spots delivered, total laser energy delivered, or change in retinal arterial oxygen...... PRP was independently associated with PDR-activity. This might reflect absence in reduction in vascular endothelial growth factor (VEGF) and could be a potential non-invasive marker of disease activity.......®; OD-OS GmbH, Berlin, Germany). At follow-up, WFA was used to evaluate PDR activity and patients were categorized into two groups: progression (Group 1, n=10) or stability/regression of PDR (Group 2, n=29). Retinal oximetry measurements were performed on optic disc centered images using the in...

  6. Automated measurement of retinal blood vessel tortuosity

    Joshi, Vinayak; Reinhardt, Joseph M.; Abramoff, Michael D.

    2010-03-01

    Abnormalities in the vascular pattern of the retina are associated with retinal diseases and are also risk factors for systemic diseases, especially cardiovascular diseases. The three-dimensional retinal vascular pattern is mostly formed congenitally, but is then modified over life, in response to aging, vessel wall dystrophies and long term changes in blood flow and pressure. A characteristic of the vascular pattern that is appreciated by clinicians is vascular tortuosity, i.e. how curved or kinked a blood vessel, either vein or artery, appears along its course. We developed a new quantitative metric for vascular tortuosity, based on the vessel's angle of curvature, length of the curved vessel over its chord length (arc to chord ratio), number of curvature sign changes, and combined these into a unidimensional metric, Tortuosity Index (TI). In comparison to other published methods this method can estimate appropriate TI for vessels with constant curvature sign and vessels with equal arc to chord ratios, as well. We applied this method to a dataset of 15 digital fundus images of 8 patients with Facioscapulohumeral muscular dystrophy (FSHD), and to the other publically available dataset of 60 fundus images of normal cases and patients with hypertensive retinopathy, of which the arterial and venous tortuosities have also been graded by masked experts (ophthalmologists). The method produced exactly the same rank-ordered list of vessel tortuosity (TI) values as obtained by averaging the tortuosity grading given by 3 ophthalmologists for FSHD dataset and a list of TI values with high ranking correlation with the ophthalmologist's grading for the other dataset. Our results show that TI has potential to detect and evaluate abnormal retinal vascular structure in early diagnosis and prognosis of retinopathies.

  7. Arterial stick

    ... the main arteries in the forearm (radial and ulnar arteries). The procedure is done as follows: The ... Arteries also have thicker walls and have more nerves. When the needle is inserted, there may be ...

  8. Risk factor profile in retinal detachment

    Azad Raj; Nayak B; Sharma Y; Tiwari Hem; Khosla P

    1988-01-01

    150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain gu...

  9. Blood pressure modifies retinal susceptibility to intraocular pressure elevation.

    Zheng He

    Full Text Available Primary open angle glaucoma affects more than 67 million people. Elevated intraocular pressure (IOP is a risk factor for glaucoma and may reduce nutrient availability by decreasing ocular perfusion pressure (OPP. An interaction between arterial blood pressure and IOP determines OPP; but the exact contribution that these factors have for retinal function is not fully understood. Here we sought to determine how acute modifications of arterial pressure will affect the susceptibility of neuronal function and blood flow to IOP challenge. Anaesthetized (ketamine:xylazine Long-Evan rats with low (∼60 mmHg, sodium nitroprusside infusion, moderate (∼100 mmHg, saline, or high levels (∼160 mmHg, angiotensin II of mean arterial pressure (MAP, n = 5-10 per group were subjected to IOP challenge (10-120 mmHg, 5 mmHg steps every 3 minutes. Electroretinograms were measured at each IOP step to assess bipolar cell (b-wave and inner retinal function (scotopic threshold response or STR. Ocular blood flow was measured using laser-Doppler flowmetry in groups with similar MAP level and the same IOP challenge protocol. Both b-wave and STR amplitudes decreased with IOP elevation. Retinal function was less susceptible to IOP challenge when MAP was high, whereas the converse was true for low MAP. Consistent with the effects on retinal function, higher IOP was needed to attenuated ocular blood flow in animals with higher MAP. The susceptibility of retinal function to IOP challenge can be ameliorated by acute high BP, and exacerbated by low BP. This is partially mediated by modifications in ocular blood flow.

  10. A semi-automated computer tool for the analysis of retinal vessel diameter dynamics.

    Euvrard, Guillaume; Genevois, Olivier; Rivals, Isabelle; Massin, Pascale; Collet, Amélie; Sahel, José-Alain; Paques, Michel

    2013-06-01

    Retinal vessels are directly accessible to clinical observation. This has numerous potential interests for medical investigations. Using the Retinal Vessel Analyzer, a dedicated eye fundus camera enabling dynamic, video-rate recording of micrometric changes of the diameter of retinal vessels, we developed a semi-automated computer tool that extracts the heart beat rate and pulse amplitude values from the records. The extracted data enabled us to show that there is a decreasing relationship between heart beat rate and pulse amplitude of arteries and veins. Such an approach will facilitate the modeling of hemodynamic interactions in small vessels. PMID:23566397

  11. Clinical and immunological features of retinal vasculitis in systemic diseases

    Paović Jelena

    2009-01-01

    Full Text Available Background/Aim. Vasculitis is a clinical, pathologic process characterized by inflammation and necrosis of blood vessel occurring anywhere in the body. The aim of the study was to present some clinical and immunologic features of retinal vasculitis in systemic diseases: systemic lupus erythematosus, multiple sclerosis, sarcoidosis, Behcet's diseases, and others. Methods. A total of 1 254 patients with uveitis were included in the study. The immunochemical diagnostic methods were used to determine the pathogenesis of ocular manifestations. Ocular manifestations were examined using biomicroscope, direct or indirect ophtalmoscopy. Results. Primary retinal vasculitis was diagnosed in 85/1254 (6.8% of total uveitis. In more than half of the cases of vasculitis (58.8%, both arteries and veins were involved in inflammatory process. Periphlebitis was diagnosed far more commonly (36.5% than periarteritis (4.7%. Retinal vasculitis associated with systemic lupus erythematosus was characterized by microinfarctions and the consequent foci of inflammatory cells or diseases of large arteries manifesting in vasospasm and occlusions. Cotton wool spots occurred in 38.3% and retinal hemorrhages in 34% of the cases. In this study periphlebitis of the retina was one of the less frequent ocular manifestations of multiple sclerosis. Comparing with the other changes of the retinal blood vessels, venous sheating occurred in 25.1% and occlusion and vein trombosis in 43.75% of the cases. Retinal vasculitis associated with chronic sarcoidosis occured in 37.5% of patients with sarcoidosis. The most frequent manifestation of ocular sarcoidosis was intermediary uveitis (43.75%. Anterior granulomatous uveitis occured in 37.5% of patients with sarcoidoses. Immune complexes occurred in 13/20 (65% of the patients. Antiretinal anti-S antibody in the serum occurred in 73% of the patients with retinal detachment as a complication of primary disease and in 25% those with vasculitis

  12. Summarising the retinal vascular calibres in healthy, diabetic and diabetic retinopathy eyes.

    Leontidis, Georgios; Al-Diri, Bashir; Hunter, Andrew

    2016-05-01

    Retinal vessel calibre has been found to be an important biomarker of several retinal diseases, including diabetic retinopathy (DR). Quantifying the retinal vessel calibres is an important step for estimating the central retinal artery and vein equivalents. In this study, an alternative method to the already established branching coefficient (BC) is proposed for summarising the vessel calibres in retinal junctions. This new method combines the mean diameter ratio with an alternative to Murray׳s cube law exponent, derived by the fractal dimension,experimentally, and the branch exponent of cerebral vessels, as has been suggested in previous studies with blood flow modelling. For the above calculations, retinal images from healthy, diabetic and DR subjects were used. In addition, the above method was compared with the BC and was also applied to the evaluation of arteriovenous ratio as a biomarker of progression from diabetes to DR in four consecutive years, i.e. three/two/one years before the onset of DR and the first year of DR. Moreover, the retinal arteries and veins around the optic nerve head were also evaluated. The new approach quantifies the vessels more accurately. The decrease in terms of the mean absolute percentage error was between 0.24% and 0.49%, extending at the same time the quantification beyond healthy subjects. PMID:27017067

  13. Successful technical and clinical outcome using a second generation balloon expandable coronary stent for transplant renal artery stenosis: Our experience

    Salsamendi, Jason; Pereira, Keith; Baker, Reginald; Bhatia, Shivank S; Narayanan, Govindarajan

    2015-01-01

    Transplant renal artery stenosis (TRAS) is a vascular complication frequently seen because of increase in the number of renal transplantations. Early diagnosis and management is essential to optimize a proper graft function. Currently, the endovascular treatment of TRAS using angioplasty and/or stenting is considered the treatment of choice with the advantage that it does not preclude subsequent surgical correction. Treatment of TRAS with the use of stents, particularly in tortuous transplant...

  14. Retinal tolerance to dyes

    Lüke, C; Lüke, M; Dietlein, T S; Hueber, A; Jordan, J; Sickel, W.; Kirchhof, B

    2005-01-01

    Background: Dye solutions for intraoperative staining of epiretinal membranes and the internal limiting membrane improve the visualisation of these thin structures and facilitate their removal. In the present study the authors investigated the effects of indocyanine green 0.05%, trypan blue 0.15%, and patent blue 0.48% on bovine retinal function.

  15. Lycium barbarum polysaccharides reduce neuronal damage, blood-retinal barrier disruption and oxidative stress in retinal ischemia/reperfusion injury.

    Suk-Yee Li

    Full Text Available Neuronal cell death, glial cell activation, retinal swelling and oxidative injury are complications in retinal ischemia/reperfusion (I/R injuries. Lycium barbarum polysaccharides (LBP, extracts from the wolfberries, are good for "eye health" according to Chinese medicine. The aim of our present study is to explore the use of LBP in retinal I/R injury. Retinal I/R injury was induced by surgical occlusion of the internal carotid artery. Prior to induction of ischemia, mice were treated orally with either vehicle (PBS or LBP (1 mg/kg once a day for 1 week. Paraffin-embedded retinal sections were prepared. Viable cells were counted; apoptosis was assessed using TUNEL assay. Expression levels of glial fibrillary acidic protein (GFAP, aquaporin-4 (AQP4, poly(ADP-ribose (PAR and nitrotyrosine (NT were investigated by immunohistochemistry. The integrity of blood-retinal barrier (BRB was examined by IgG extravasations. Apoptosis and decreased viable cell count were found in the ganglion cell layer (GCL and the inner nuclear layer (INL of the vehicle-treated I/R retina. Additionally, increased retinal thickness, GFAP activation, AQP4 up-regulation, IgG extravasations and PAR expression levels were observed in the vehicle-treated I/R retina. Many of these changes were diminished or abolished in the LBP-treated I/R retina. Pre-treatment with LBP for 1 week effectively protected the retina from neuronal death, apoptosis, glial cell activation, aquaporin water channel up-regulation, disruption of BRB and oxidative stress. The present study suggests that LBP may have a neuroprotective role to play in ocular diseases for which I/R is a feature.

  16. Influence of cataract surgery and blood pressure changes caused by sodium restriction on retinal vascular diameter

    Takatoshi Tano

    2010-11-01

    Full Text Available Takatoshi Tano1, Yoshimune Hiratsuka2, Koichi Ono1, Akira Murakami11Department of Ophthalmology, Juntendo University School of Medicine, Tokyo; 2National Institute of Public Health, Tokyo, JapanPurpose: To investigate the impact of cataract surgery and blood pressure changes induced by one week of sodium restriction on retinal vascular diameter.Methods: Fundus photographs of 200 patients were obtained before and one week after cataract surgery. For one week after admission, 100 patients received sodium restriction and 100 patients (ie, the control group did not receive sodium restriction. The diameter of the retinal vessels and blood pressure were compared between the sodium restriction group and the control group. The vascular diameter was measured using an objective computer-based method.Results: Neither group had a significant change in the diameter of the retinal vessels after cataract surgery. Although there was no significant change in retinal arterial and venular diameter in the sodium restriction group, one-week sodium restriction significantly reduced mean blood pressure. However, multiple linear regression analyses indicated that an increase in retinal arteriolar diameter was significantly associated with diabetes, hyperlipidemia, and alcohol intake.Conclusion: Cataract surgery and blood pressure reduction induced by one week of sodium restriction resulted in no significant change in retinal arteriolar diameter.Keywords: cataract surgery, hypertension, retinal blood vessel diameter, retinal fundus camera, sodium restriction.

  17. Visible-light OCT to quantify retinal oxygen metabolism (Conference Presentation)

    Zhang, Hao F.; Yi, Ji; Chen, Siyu; Liu, Wenzhong; Soetikno, Brian T.

    2016-03-01

    We explored, both numerically and experimentally, whether OCT can be a good candidate to accurately measure retinal oxygen metabolism. We first used statistical methods to numerically simulate photon transport in the retina to mimic OCT working under different spectral ranges. Then we analyze accuracy of OCT oximetry subject to parameter variations such as vessel size, pigmentation, and oxygenation. We further developed an experimental OCT system based on the spectral range identified by our simulation work. We applied the newly developed OCT to measure both retinal hemoglobin oxygen saturation (sO2) and retinal retinal flow. After obtaining the retinal sO2 and blood velocity, we further measured retinal vessel diameter and calculated the retinal oxygen metabolism rate (MRO2). To test the capability of our OCT, we imaged wild-type Long-Evans rats ventilated with both normal air and air mixtures with various oxygen concentrations. Our simulation suggested that OCT working within visible spectral range is able to provide accurate measurement of retinal MRO2 using inverse Fourier transform spectral reconstruction. We called this newly developed technology vis-OCT, and showed that vis-OCT was able to measure the sO2 value in every single major retinal vessel around the optical disk as well as in micro retinal vessels. When breathing normal air, the averaged sO2 in arterial and venous blood in Long-Evans rats was measured to be 95% and 72%, respectively. When we challenge the rats using air mixtures with different oxygen concentrations, vis-OCT measurement followed analytical models of retinal oxygen diffusion and pulse oximeter well.

  18. Small Animal Retinal Imaging

    Choi, WooJhon; Drexler, Wolfgang; Fujimoto, James G.

    Developing and validating new techniques and methods for small animal imaging is an important research area because there are many small animal models of retinal diseases such as diabetic retinopathy, age-related macular degeneration, and glaucoma [1-6]. Because the retina is a multilayered structure with distinct abnormalities occurring in different intraretinal layers at different stages of disease progression, there is a need for imaging techniques that enable visualization of these layers individually at different time points. Although postmortem histology and ultrastructural analysis can be performed for investigating microscopic changes in the retina in small animal models, this requires sacrificing animals, which makes repeated assessment of the same animal at different time points impossible and increases the number of animals required. Furthermore, some retinal processes such as neurovascular coupling cannot be fully characterized postmortem.

  19. Inherited Retinal Degenerative Disease Registry

    2016-03-21

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  20. Retinal flow cytometer

    Alt, C.; Veilleux, I.; Lee, H; Pitsillides, C. M.; D. Côté; Lin, C.P.

    2007-01-01

    The in vivo flow cytometer is an instrument capable of continuous, real-time monitoring of fluorescently labeled cells in the circulation without the need to draw blood samples. However, the original system probes a single vessel in the mouse ear; the small sample volume limits the sensitivity of the technique. We describe an in vivo retinal flow cytometer that simultaneously probes five artery–vein pairs in the mouse eye by circularly scanning a small laser spot rapidly around the optic nerv...

  1. Aphakic retinal detachment.

    Le Mesurier, R; Vickers, S; Booth-Mason, S; Chignell, A H

    1985-01-01

    A study of 132 cases of aphakic retinal detachment (ARD) following mainly intracapsular cataract surgery has been made. Forty-nine cases (37%) were found to have vitreous incarcerated into the cataract section out of a total of 54 (41%) cases who had suffered a vitreous complication during cataract surgery. A study of the characteristics of ARD reveals that those cases having had a vitreous complication in the management of their cataracts are more likely to develop detachment within three mo...

  2. Buckling Reduces eNOS Production and Stimulates Extracellular Matrix Remodeling in Arteries in Organ Culture.

    Xiao, Yangming; Liu, Qin; Han, Hai-Chao

    2016-09-01

    Artery buckling alters the fluid shear stress and wall stress in the artery but its temporal effect on vascular wall remodeling is poorly understood. The purpose of this study was to investigate the early effect of artery buckling on endothelial nitric oxide synthase (eNOS) expression and extracellular matrix remodeling. Bilateral porcine carotid arteries were maintained in an ex vivo organ culture system with and without buckling while under the same physiological pressure and flow rate for 3-7 days. Matrix metalloproteinase-2 (MMP-2), MMP-9, fibronectin, elastin, collagen I, III and IV, tissue inhibitor of metalloproteinase-2 (TIMP-2), and eNOS were determined using Western blotting and immunohistochemistry. Our results showed that MMP-2 expression level was significantly higher in buckled arteries than in the controls and higher at the inner curve than at the outer curve of buckled arteries, while collagen IV content showed an opposite trend, suggesting that artery buckling increased MMP-2 expression and collagen IV degradation in a site-specific fashion. However, no differences for MMP-9, fibronectin, elastin, collagen I, III, and TIMP-2 were observed among the outer and inner curve sides of buckled arteries and straight controls. Additionally, eNOS expression was significantly decreased in buckled arteries. These results suggest that artery buckling triggers uneven wall remodeling that could lead to development of tortuous arteries. PMID:26913855

  3. Retinal Thickening and Photoreceptor Loss in HIV Eyes without Retinitis.

    Cheryl A Arcinue

    Full Text Available To determine the presence of structural changes in HIV retinae (i.e., photoreceptor density and retinal thickness in the macula compared with age-matched HIV-negative controls.Cohort of patients with known HIV under CART (combination Antiretroviral Therapy treatment were examined with a flood-illuminated retinal AO camera to assess the cone photoreceptor mosaic and spectral-domain optical coherence tomography (SD-OCT to assess retinal layers and retinal thickness.Twenty-four eyes of 12 patients (n = 6 HIV-positive and 6 HIV-negative were imaged with the adaptive optics camera. In each of the regions of interest studied (nasal, temporal, superior, inferior, the HIV group had significantly less mean cone photoreceptor density compared with age-matched controls (difference range, 4,308-6,872 cones/mm2. A different subset of forty eyes of 20 patients (n = 10 HIV-positive and 10 HIV-negative was included in the retinal thickness measurements and retinal layer segmentation with the SD-OCT. We observed significant thickening in HIV positive eyes in the total retinal thickness at the foveal center, and in each of the three horizontal B-scans (through the macular center, superior, and inferior to the fovea. We also noted that the inner retina (combined thickness from ILM through RNFL to GCL layer was also significantly thickened in all the different locations scanned compared with HIV-negative controls.Our present study shows that the cone photoreceptor density is significantly reduced in HIV retinae compared with age-matched controls. HIV retinae also have increased macular retinal thickness that may be caused by inner retinal edema secondary to retinovascular disease in HIV. The interaction of photoreceptors with the aging RPE, as well as possible low-grade ocular inflammation causing diffuse inner retinal edema, may be the key to the progressive vision changes in HIV-positive patients without overt retinitis.

  4. Retinal circulation and its role in macular disorders in patients without systemic disease

    Priyangshu; Chandra; Aditya; Sudhalkar; Souvik; Mandal; Jay; Chhablani

    2015-01-01

    AIM: To determine whether retinal circulatory changes play a role in the pathogenesis of macular disorders in patients who are otherwise healthy. METHODS: Patients with macular disorders that required angiographic imaging were included in this prospective case series. After a complete ocular exam,fluorescein angiography was performed using a standardized technique on the HRA-II(Heidelberg Engineering, Heidelberg, Germany) with special focus on the posterior pole. Only patients with good quality images were included in the analysis. Circulatory parameters recorded included the arm-choroid time,choroid-retinal artery, and finally the retinal artery-vein time. Zonal asymmetry(between the upper and lower zones divided by a line passing through the centre of the fovea) in transit times, if any was also noted. Appropriate statistical analysis was done. Circulation times were compared with age matched historical controls. Changes in retinal dye transit times relative to historical age matched controls, if any, were noted and compared between various disorders.RESULTS: A total of 156 eyes of 156 patients(120 males)were included in the study. Mean age: 49.14 ±14.93 y.Macular disorders studied were age related degeneration,polypoidal vasculopathy, central serous chorioretinopathy(CSCR) and parafoveal telangiectasia. Delayed circulation time was noted in CSCR patients only.CONCLUSION: CSCR patients appear to have delayed arterial filling, retinal circulatory disturbances do not seem to contribute to the pathogenesis of other macular disorders.

  5. Left common carotid artery arising from brachiocephalic trunk and their aberrant course displacing trachea

    Pratiksha Yadav

    2016-09-01

    Full Text Available Bovine arch commonly refer a group of congenital variations in the branches of arch of aorta, in which there is aberrant origin of left common carotid artery. These are usually detected incidentally, however rarely they can cause dysphagia lusoria. We report a case of bovine arch and aberrant left common carotid artery in a 62 years old female who had come with complaint of mild dyspnea. On radiograph there was superior mediastinal widening and shift of trachea to right side. CT scan was advised for further evaluation. On CECT there was only two main branches arised from arch of aorta, brachiocephalic trunk and right subclavian artery. There was aberrant origin of left common carotid artery seen from brachiocephalic trunk. The brachiocephalic trunk was very tortuous and displacing trachea to right side. [Int J Res Med Sci 2016; 4(9.000: 4220-4222

  6. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    Lee, Seung Young; Cha, Sang Hoon [Chungbuk National University College of Medicine, Iksan (Korea, Republic of)

    2011-11-15

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  7. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  8. Genetics Home Reference: retinitis pigmentosa

    ... by the combination of vision loss and hearing loss beginning early in life. Retinitis pigmentosa is also a feature of several other genetic syndromes, including Bardet-Biedl syndrome ; Refsum disease ; and neuropathy, ... for retinitis pigmentosa lead to a gradual loss of rods and cones in the retina. The ...

  9. Retinal detachment surgery without cryotherapy.

    Chignell, A H; Markham, R H

    1981-01-01

    A series of cases of retinal detachment treated without the application of cryotherapy at the time of surgery has been studied. The omission of cryotherapy while not interfering with retinal reattachment, carries the risk of redetachment at a later date. Macular pucker may still occur in spite of the absence of cryotherapy.

  10. New Wrinkles in Retinal Densitometry

    Masella, Benjamin D.; Hunter, Jennifer J.; Williams, David R.

    2014-01-01

    Retinal densitometry has the potential to provide objective information about the function of the retina. However, a number of factors complicate the interpretation of retinal reflectance. We have discovered additional sources of reflectance change and have defined a method to minimize their impact.

  11. Oxygen saturation imaging of human retinal vessels and measurement in eye disease patient for clinical application

    Nakamura, D.; Matsuoka, N.; Tatsuguchi, K.; Ogata, M.; Yoshinaga, Y.; Enaida, H.; Okada, T.; Ishibashi, T.

    2010-02-01

    We have proposed a new automatic visualization procedure based the ratio of optical densities (ODs) obtained at two different wavelength for the oxygen saturation imaging in human retinal vessels. This method utilized the morphological processing and the line convergence index filter to estimate the reflection image of outside vessels and extract the vessel structure from retinal image, respectively. In the experimental measurement, clear difference between retinal arteries and veins has been observed. In this study, the data processing technique of the line convergence index filter was applied to a color fundus image to investigate the ability of vessel extraction. In addition, four-wavelength imaging was proposed to evaluate oxygen saturation of the retinal capillary vessels and to decrease the influence of the melanin pigmentation.

  12. Kyrieleis plaques associated with Herpes Simplex Virus type 1 acute retinal necrosis

    Neha Goel

    2016-04-01

    Full Text Available We report the case of a 55-year-old immunocompetent male who presented with features typical of acute retinal necrosis (ARN. Polymerase chain reaction of the aqueous tap was positive for Herpes Simplex Virus (HSV – 1. Following therapy with intravenous Acyclovir, followed by oral Acyclovir and steroids, there was marked improvement in the visual acuity and clinical picture. At one week after initiation of treatment, Kyrieleis plaques were observed in the retinal arteries. They became more prominent despite resolution of the vitritis, retinal necrosis and vasculitis and persisted till six weeks of follow-up, when fluorescein angiography was performed. The appearance of this segmental retinal periarteritis also known as Kyrieleis plaques has not been described in ARN due to HSV-1 earlier.

  13. Arterial Ageing

    Lee, Seung-Jun; Park, Sung-Ha

    2013-01-01

    Arterial ageing is characterized by age associated degeneration and sclerosis of the media layer of the large arteries. However, besides ageing, clinical conditions, which enhance oxidative stress and inflammation act to accelerate the degree of arterial ageing. In this review, we summarized the pathophysiology and contributing factors that accelerate arterial ageing. Among them, we focused on hypertension, the renin-angiotensin-aldosterone system and vascular inflammation which are modifiabl...

  14. Persistent trigeminal artery variants detected by MR angiography

    Uchino, A.; Kato, A.; Takase, Y.; Kudo, S. [Dept. of Radiology, Saga Medical School (Japan)

    2000-11-01

    Persistent trigeminal artery (PTA) variants are cerebellar arteries that originate directly from the precavernous portion of the internal carotid artery (ICA). The goal of our study was to determine the incidence and MR angiographic features of PTA variants. Between April 1996 and September 1999, 523 cranial MR angiographies were performed at our institution. Most of the patients examined had or were suspected of having cerebrovascular disease. We retrospectively reviewed these 523 MR angiograms. A 1.5-T scanner was used in all studies, and maximum intensity projection (MIP) images obtained using the three-dimensional time-of-flight (3D TOF) technique were displayed stereoscopically. Four PTA variants were detected on MR angiograms, at a rate of 0.76 %. At least three of the four PTA variants were anterior inferior cerebellar arteries (AICAs), small tortuous arteries arising from the precavernous portions of the ICAs and taking a posterior course. Although the clinical significance is not great, we found a relatively high incidence of PTA variants on MR angiograms. We stress that knowledge and recognition of these anomalous cerebellar arteries are useful and important in the interpretation of cranial MR angiograms. (orig.)

  15. Assessing the Causality between Blood Pressure and Retinal Vascular Caliber through Mendelian Randomisation

    Li, Ling-Jun; Liao, Jiemin; Cheung, Carol Yim-Lui; Ikram, M. Kamran; Shyong, Tai E.; Wong, Tien-Yin; Cheng, Ching-Yu

    2016-02-01

    We aimed to determine the association between blood pressure (BP) and retinal vascular caliber changes that were free from confounders and reverse causation by using Mendelian randomisation. A total of 6528 participants from a multi-ethnic cohort (Chinese, Malays, and Indians) in Singapore were included in this study. Retinal arteriolar and venular caliber was measured by a semi-automated computer program. Genotyping was done using Illumina 610-quad chips. Meta-analysis of association between BP, and retinal arteriolar and venular caliber across three ethnic groups was performed both in conventional linear regression and Mendelian randomisation framework with a genetic risk score of BP as an instrumental variable. In multiple linear regression models, each 10 mm Hg increase in systolic BP, diastolic BP, and mean arterial BP (MAP) was associated with significant decreases in retinal arteriolar caliber of a 1.4, 3.0, and 2.6 μm, and significant decreases in retinal venular caliber of a 0.6, 0.7, and 0.9 μm, respectively. In a Mendelian randomisation model, only associations between DBP and MAP and retinal arteriolar narrowing remained yet its significance was greatly reduced. Our data showed weak evidence of a causal relationship between elevated BP and retinal arteriolar narrowing.

  16. Clinical features and etiology of retinal vasculitis in Northern Thailand

    Supanut Apinyawasisuk

    2013-01-01

    Full Text Available Purpose: To report on the clinical features and etiology of patients with retinal vasculitis (RV. Materials and Methods: We reviewed medical records of 47 patients (75 affected eyes diagnosed with RV. Clinical presentations, ocular complications, associated systemic diseases, and treatment regimens were registered. Results: Etiology of RV included infectious causes in 10/47, (21% while an association with systemic and/or ocular non-infectious disorders was noted in 22/47 (47%. Eales′ disease and Behcet′s disease represented the most common clinical entities in non-infectious group while tuberculosis-associated RV was diagnosed in 6/10 (60% among those with infectious disorders. RV was bilateral in 28/47 (60% patients. Retinal veins were most commonly affected (72%, 34/47. Involvement of arteries was present in 12/47 (25% and was associated with viral infections and Behcet′s disease. Ocular complications developed in 60/75 (80% eyes. The most common complications were elevated intraocular pressure and/or glaucoma (33/75, 44%. Retinal detachment, vitreous hemorrhage, and cystoid macular edema developed in similar percentages (15%. Conclusions: RV in Thailand manifested mostly in male patients, was typically bilateral and involved mostly veins. Involvement of arteries was observed in patients with viral infections and Behcet′s disease. Tuberculosis was the most common infectious cause.

  17. Acute retinal ischemia caused by controlled low ocular perfusion pressure in a porcine model. Electrophysiological and histological characterisation

    Kyhn, Maria Voss; Warfvinge, Karin; Scherfig, Erik;

    2009-01-01

    The purpose of this study was to establish, and characterize a porcine model of acute, controlled retinal ischemia. The controlled retinal ischemia was produced by clamping the ocular perfusion pressure (OPP) in the left eye to 5 mm Hg for 2 h. The OPP was defined as mean arterial blood pressure...... (MAP) minus the intraocular pressure (IOP). It was clamped to 0-30 mm Hg by continuous monitoring of MAP and adjustment of the IOP, which was controlled by cannulation of the anterior chamber. Inner retinal function was assessed by induced multifocal electroretinography (mfERG) with comparisons of the...

  18. Acute arterial occlusion - kidney

    ... arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury ...

  19. Retinal synaptic regeneration via microfluidic guiding channels

    Ping-Jung Su; Zongbin Liu; Kai Zhang; Xin Han; Yuki Saito; Xiaojun Xia; Kenji Yokoi; Haifa Shen; Lidong Qin

    2015-01-01

    In vitro culture of dissociated retinal neurons is an important model for investigating retinal synaptic regeneration (RSR) and exploring potentials in artificial retina. Here, retinal precursor cells were cultured in a microfluidic chip with multiple arrays of microchannels in order to reconstruct the retinal neuronal synapse. The cultured retinal cells were physically connected through microchannels. Activation of electric signal transduction by the cells through the microchannels was demon...

  20. Retinal Image Preprocessing: Background and Noise Segmentation

    Usman Akram

    2012-01-01

    Retinal images are used for the automated screening and diagnosis of diabetic retinopathy. The retinal image quality must be improved for the detection of features and abnormalities and for this purpose preprocessing of retinal images is vital. In this paper, we present a novel automated approach for preprocessing of colored retinal images. The proposed technique improves the quality of input retinal image by separating the background and noisy area from the overall image. It contains coarse ...

  1. CRB1 mutations in inherited retinal dystrophies.

    Bujakowska, Kinga; Audo, Isabelle; Mohand-Saïd, Saddek; Lancelot, Marie-Elise; Antonio, Aline; Germain, Aurore; Léveillard, Thierry; Letexier, Mélanie; Saraiva, Jean-Paul; Lonjou, Christine; Carpentier, Wassila; Sahel, José-Alain; Bhattacharya, Shomi; Zeitz, Christina

    2012-01-01

    Mutations in the CRB1 gene are associated with variable phenotypes of severe retinal dystrophies, ranging from leber congenital amaurosis (LCA) to rod-cone dystrophy, also called retinitis pigmentosa (RP). Moreover, retinal dystrophies resulting from CRB1 mutations may be accompanied by specific fundus features: preservation of the para-arteriolar retinal pigment epithelium (PPRPE) and retinal telangiectasia with exudation (also referred to as Coats-like vasculopathy). In this publication, we...

  2. Fifty-eight cases of ocular ischemic diseases caused by carotid artery stenosis

    LUO Rong-jiang; LIU Shao-rui; LI Xiao-min; ZHUO Ye-hong; TIAN Zhen

    2010-01-01

    Background The blood supply to the eye comes from the retinal central vascular system of the ophthalmic artery and the ciliary vascular system. The ophthalmic artery stems from the ipsilateral internal carotid artery. If occlusion or stenosis occurs in the carotid artery, the blood perfusion to the ophthalmic artery becomes insufficient, leading to signs and symptoms of anterior and posterior ocular ischemia. The objective of this study was to evaluate the clinical characteristics and risk factors of ocular ischemic diseases caused by carotid artery stenosis.Methods This study was a retrospective review of 145 patients with carotid artery stenosis. Fifty-eight patients who had symptoms of ocular ischemic disease caused by carotid artery stenosis formed group A and the other 87 patients who only had carotid artery stenosis formed group B. We analyzed the causes and course of disease, and relative risk factors,by comparing the two groups.Results The degree of carotid artery stenosis in group A was higher than that in group B. And group A had a greater decrease of ophthalmic artery flow. Male, hypertension, hyperlipidemia, and smoking were significantly related to carotid artery stenosis. Amaurosis fugax was the most common ocular symptom in group A. The ocular ischemic diseases mainly included ischemic optic neuropathy, central/branch retinal artery occlusion, ophthalmoplegia externa, and ocular ischemic syndrome.Conclusions Carotid artery stenosis correlates with ocular ischemic diseases. Ophthalmologists must observe for ocular symptoms, which were the onset symptoms in some patients.

  3. Retinal detachment following excimer laser

    Charteris, D; Cooling, R; Lavin, M; McLeod, D

    1997-01-01

    AIMS—To report the clinical presentation, surgical management, and outcome of retinal detachment following excimer laser.
METHODS—Retrospective analysis of retinal detachments observed in 11 eyes of 10 myopic patients who had previously undergone photorefractive keratectomy (PRK) or phototherapeutic keratectomy (PTK) by excimer laser.
RESULTS—Symptoms of visual loss in two eyes were initially attributed to corneal haze. In 10 of 11 eyes visualisation of the retinal detachment and causative br...

  4. Flexible retinal electrode array

    Okandan, Murat (Albuquerque, NM); Wessendorf, Kurt O. (Albuquerque, NM); Christenson, Todd R. (Albuquerque, NM)

    2006-10-24

    An electrode array which has applications for neural stimulation and sensing. The electrode array can include a large number of electrodes each of which is flexibly attached to a common substrate using a plurality of springs to allow the electrodes to move independently. The electrode array can be formed from a combination of bulk and surface micromachining, with electrode tips that can include an electroplated metal (e.g. platinum, iridium, gold or titanium) or a metal oxide (e.g. iridium oxide) for biocompatibility. The electrode array can be used to form a part of a neural prosthesis, and is particularly well adapted for use in an implantable retinal prosthesis where the electrodes can be tailored to provide a uniform gentle contact pressure with optional sensing of this contact pressure at one or more of the electrodes.

  5. Internal Carotid Artery Ectasia: The Value of Imaging Studies Prior to Biopsy of a Retropharyngeal Mass

    Kenneth Chan

    2010-11-01

    Full Text Available The presence of retropharyngeal tissue mass often raises the suspicion of malignancy, especially in elderly patients. This prompts urgent biopsy to investigate tissue histology. We discuss a case where this is contraindicated as the retropharyngeal mass was illustrated by CT scanning and confirmed with MRI to be a tortuous coursing internal carotid artery. An awareness of this unusual anatomical variation and a careful interpretation of imaging studies both at the stage of differential diagnosis and pre-operative screening are essential to avoid damage to important structures, causing unnecessary complications.

  6. Adult retinal stem cells revisited.

    Bhatia, B; Singhal, S; Jayaram, H.; Khaw, P T; Limb, G A

    2010-01-01

    Recent advances in retinal stem cell research have raised the possibility that these cells have the potential to be used to repair or regenerate diseased retina. Various cell sources for replacement of retinal neurons have been identified, including embryonic stem cells, the adult ciliary epithelium, adult Müller stem cells and induced pluripotent stem cells (iPS). However, the true stem cell nature of the ciliary epithelium and its possible application in cell therapies has now been question...

  7. Light and inherited retinal degeneration

    Paskowitz, D M; LaVail, M.M.; Duncan, J. L.

    2006-01-01

    Light deprivation has long been considered a potential treatment for patients with inherited retinal degenerative diseases, but no therapeutic benefit has been demonstrated to date. In the few clinical studies that have addressed this issue, the underlying mutations were unknown. Our rapidly expanding knowledge of the genes and mechanisms involved in retinal degeneration have made it possible to reconsider the potential value of light restriction in specific genetic contexts. This review summ...

  8. Cytomegalovirus retinitis mimicking intraocular lymphoma

    Patrick Gooi

    2008-12-01

    Full Text Available Patrick Gooi1, James Farmer2, Bernard Hurley3, Elliott Brodbaker41Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada; 2Department of Pathology and Lab Medicine University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; 3Department of Ophthalmology, University of Ottawa Eye Institute and The Ottawa Hospital, Ottawa, Ontario, Canada; 4Faculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaAbstract: We present a case of an unusual retinal infiltrate requiring retinal biopsy for definitive diagnosis. A 62-year-old man with treated lymphoma presented with decreased vision in the right eye associated with a white retinal lesion, which extended inferonasally from an edematous disc. Intraocular lymphoma was considered as a diagnosis; thus, the patient was managed with vitrectomy and retinal biopsy. Cytological analysis of the vitreous aspirate could not rule out a lymphoproliferative disorder. The microbial analysis was negative. Histology of the lesion showed extensive necrosis and large cells with prominent nucleoli. To rule out lymphoma, a battery of immunostains was performed and all were negative. However the limited amount of tissue was exhausted in the process. Subsequently, a hematoxylin and eosin (H/E slide was destained, on which a CMV immunostain was performed. This revealed positivity in the nuclei and intranuclear inclusions within the large atypical cells. A diagnosis of CMV retinitis was made. Retinal biopsy may provide a definitive diagnosis and direct patient care toward intravenous gancyclovir in the case of CMV or toward radiation and chemotherapy for intraocular lymphoma. When faced with a limited amount of tissue, destaining regular H/E slides is a possible avenue to performing additional immunohistochemical studies.Keywords: CMV retinitis, retinal biopsy, immunohistochemistry, destaining

  9. Retinal oxygen extraction in humans

    Werkmeister, René M.; Schmidl, Doreen; Aschinger, Gerold; Doblhoff-Dier, Veronika; Palkovits, Stefan; Wirth, Magdalena; Garhöfer, Gerhard; Linsenmeier, Robert A.; Leitgeb, Rainer A.; Schmetterer, Leopold

    2015-01-01

    Adequate function of the retina is dependent on proper oxygen supply. In humans, the inner retina is oxygenated via the retinal circulation. We present a method to calculate total retinal oxygen extraction based on measurement of total retinal blood flow using dual-beam bidirectional Doppler optical coherence tomography and measurement of oxygen saturation by spectrophotometry. These measurements were done on 8 healthy subjects while breathing ambient room air and 100% oxygen. Total retinal blood flow was 44.3 ± 9.0 μl/min during baseline and decreased to 18.7 ± 4.2 μl/min during 100% oxygen breathing (P < 0.001) resulting in a pronounced decrease in retinal oxygen extraction from 2.33 ± 0.51 μl(O2)/min to 0.88 ± 0.14 μl(O2)/min during breathing of 100% oxygen. The method presented in this paper may have significant potential to study oxygen metabolism in hypoxic retinal diseases such as diabetic retinopathy. PMID:26503332

  10. Retinal vascular caliber is associated with cardiovascular biomarkers of oxidative stress and inflammation: the POLA study.

    Vincent Daien

    Full Text Available PURPOSE: Retinal vascular caliber has been linked with increased cardiovascular risk and is predictive of cardiovascular pathology, including stroke and coronary heart disease. Oxidative stress, as well as inflammatory mechanisms, plays a major role in the pathogenesis and progression of atherosclerosis, plaque rupture and vascular thrombotic propensity. The purpose of this study is to explore the relationship between retinal vascular calibers and biomarkers of oxidative stress and inflammation, in subjects free of cardiovascular pathology. PATIENTS AND METHODS: Cross-sectional analysis from a community-dwelling cohort comprising 1224 individuals aged 60 years and over, without a history of coronary or peripheral artery disease or stroke. Retinal vascular caliber was measured from fundus photographs using semi-automated standardized imaging software. Oxidative stress was evaluated using plasma superoxide dismutase 2 and glutathione peroxidase (GPx-3 activities, and inflammatory state was assessed using plasma high sensitivity C-reactive protein (hsCRP and orosomucoid. RESULTS: In a multivariate model controlling for cardiovascular risk factors, larger retinal arteriolar caliber was independently related to higher level of GPx-3 activity (p = 0.003 whereas larger venular caliber was associated with higher levels of hsCRP (p = 0.0001 and orosomucoid (p = 0.01. CONCLUSION: In the present study, biomarkers of oxidative stress regulation and inflammation were independently associated with retinal vascular calibers. This suggests that an assessment of retinal vessels may offer early and non-invasive detection of subclinical vascular pathology.

  11. Retinal Oximetry with 510-600 nm Light Based on Partial Least-Squares Regression Technique

    Arimoto, Hidenobu; Furukawa, Hiromitsu

    2010-11-01

    The oxygen saturation distribution in the retinal blood stream is estimated by measuring spectral images and adopting the partial-least squares regression. The wavelengths range used for the calculation is from 510 to 600 nm. The regression model for estimating the retinal oxygen saturation is built on the basis of the arterial and venous blood spectra. The experiment is performed using an originally designed spectral ophthalmoscope. The obtained two-dimensional (2D) oxygen saturation indicates the reasonable oxygen level across the retina. The measurement quality is compared with those obtained using other wavelengths sets and data processing methods.

  12. Changes in cardiopulmonary values after heartworm removal from pulmonary artery using flexible alligator forceps

    Radiograph, arteriograph, echocardiogram, electrocardiogram and cardiopulmonary values were obtained in dogs with dirofilariasis before and after heartworm removal with a flexible alligator forceps. After heartworm removal, the following results were obtained: 1) Dilations of the pulmonary artery, the right ventricle and the right atrium reduced on radiograph and ultrasonic echocardiogram; 2) tortuousness of the pulmonary artery was reduced, and pruning of the peripheral arteries improved on arteriogram: 3) electrocardiographic findings indicated the correction of right axis deviation in mean electric axis in frontal plane and decreases of voltages; 4) pulmonary arterial and right ventricular pressures fell (improvement of pulmonary hypertension); 5) right cardiac output decreased; 6) heart rate tended to decrease; and 7) total pulmonary arterial resistance decreased. These results indicated that pulmonary arterial resistance and blood flow volume might be reduced, thus decreasing the burden on the heart. It was considered that not only lesions of the pulmonary arteries but also heartworms themselves in the pulmonary artery play an important role in affecting right heart hemodynamics

  13. Retinal detachment in paediatric patients

    Objective: To assess the causes of retinal detachment in children and the various operative procedures requiring vitreoretinal surgical intervention for the same. Study Design: Case series. Place and Duration of Study: Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2006 to May 2009. Methodology: A total of 281 eyes of 258 patients, (aged 0 - 18 years) who underwent vitreo-retinal surgical intervention for retinal detachment were included. Surgical log was searched for the type of retinal detachment and its causes. Frequencies of various interventions done in these patients viz. vitrectomy, scleral buckle, use of tamponading agents, laser photocoagulation and cryotherapy were noted. Results were described as descriptive statistics. Results: Myopia was the cause in 62 (22.1%) and trauma in 51 (18.1%) of the eyes. Total retinal detachment (RD) was treated in 94 (33.5%) eyes, sub total RD in 36 (12.8%), recurrent RD in 32 (11.4%), giant retinal tear in 28 (10%), tractional RD in 15 (5.3%) and exudative RD in 2 (0.7%). Prophylactic laser or cryotherapy was applied in 74 (26.3%) of the eyes. Pars plana vitrectomy (PPV) was carried out in 159 (56.6%) eyes while scleral buckle procedure was done in 129 (45.9%) eyes. Silicon oil was used in 149 (53%), perfluorocarbon liquid in 32 (11.4%) and gas tamponade in 20 (7.1%) eyes. Conclusion: The most common cause of retinal detachment in paediatric patients was myopia, followed by trauma. Total RD was more common as compared to the other types. The most common procedure adopted was pars plana vitrectomy followed by scleral buckle procedure. (author)

  14. Retinal vascular oximetry during ranibizumab treatment of central retinal vein occlusion

    Traustason, Sindri; la Cour, Morten; Larsen, Michael

    2014-01-01

    PURPOSE: To investigate the effect of intravitreal injections of the vascular endothelial growth factor inhibitor ranibizumab on retinal oxygenation in patients with central retinal vein occlusion (CRVO). METHODS: Retinal oxygen saturation in patients with CRVO was analysed using the Oxymap Retin...

  15. Temperature controlled retinal photocoagulation

    Schlott, Kerstin; Koinzer, Stefan; Baade, Alexander; Birngruber, Reginald; Roider, Johann; Brinkmann, Ralf

    2013-06-01

    Retinal photocoagulation lacks objective dosage in clinical use, thus the commonly applied lesions are too deep and strong, associated with pain reception and the risk of visual field defects and induction of choroidal neovascularisations. Optoacoustics allows real-time non-invasive temperature measurement in the fundus during photocoagulation by applying short probe laser pulses additionally to the treatment radiation, which excite the emission of ultrasonic waves. Due to the temperature dependence of the Grüneisen parameter, the amplitudes of the ultrasonic waves can be used to derive the temperature of the absorbing tissue. By measuring the temperatures in real-time and automatically controlling the irradiation by feedback to the treatment laser, the strength of the lesions can be defined. Different characteristic functions for the time and temperature dependent lesion sizes were used as rating curves for the treatment laser, stopping the irradiation automatically after a desired lesion size is achieved. The automatically produced lesion sizes are widely independent of the adjusted treatment laser power and individual absorption. This study was performed on anaesthetized rabbits and is a step towards a clinical trial with automatically controlled photocoagulation.

  16. Risk Factors for Giant Retinal Tears

    Morteza Mehdizadeh

    2010-01-01

    Full Text Available Purpose: To evaluate the risk factors associated with giant retinal tears. Methods: This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic, and high myopia were evaluated in association with giant retinal tears. Results: Of 150 patients with retinal detachments, 99 subjects (66% were older than 30 years while 51 (34% were 30 years of age or younger. Overall, 26 (17.3% patients had giant retinal tears. Controlling for all variables, only age had a significant correlation with giant retinal tears. Each year of advancing age was associated with a 6% decrease in the incidence of giant retinal tears. Conclusion: Young age is a significant risk factor for development of giant retinal tears.

  17. Identifying All True Vessels from Segmented Retinal Images

    G. Delucta Mary

    2014-02-01

    Full Text Available Measurements of retinal blood vessel morphology have been shown to be related to the risk of cardiovascular diseases. The wrong identification of vessels may result in a large variation of these measurements, leading to a wrong clinical diagnosis Both the arteries and veins of the retina are generally binary trees, whose properties can be considered either locally or globally. Measurable geometrical changes in diameter, branching angle, length, or tortuosity, as a result of disease, have been described in retinal blood vessels. The detection and measurement of retinal blood vessels can be used to quantify the severity of disease such as hypertension, stroke and arteriosclerosis, as part of the process of automated diagnosis of disease or in the assessment of the progression of therapy. Thus, a reliable method of vessel detection and quantification would be valuable. In this paper, we address the problem of identifying true vessels as a postprocessing step to vascular structure segmentation. We model the segmented vascular structure as a vessel segment graph and formulate the problem of identifying vessels as one of finding the optimal forest in the graph given a set of constraints.

  18. IDENTIFYING ALL TRUE VESSELS FROM SEGMENTED RETINAL IMAGES

    G. Delucta Mary

    2015-11-01

    Full Text Available Measurements of retinal blood vessel morphology have been shown to be related to the risk of cardiovascular diseases. The wrong identification of vessels may result in a large variation of these measurements, leading to a wrong clinical diagnosis Both the arteries and veins of the retina are generally binary trees, whose properties can be considered either locally or globally. Measurable geometrical changes in diameter, branching angle, length, or tortuosity, as a result of disease, have been described in retinal blood vessels. The detection and measurement of retinal blood vessels can be used to quantify the severity of disease such as hypertension, stroke and arteriosclerosis, as part of the process of automated diagnosis of disease or in the assessment of the progression of therapy. Thus, a reliable method of vessel detection and quantification would be valuable. In this paper, we address the problem of identifying true vessels as a postprocessing step to vascular structure segmentation. We model the segmented vascular structure as a vessel segment graph and formulate the problem of identifying vessels as one of finding the optimal forest in the graph given a set of constraints.

  19. Risk Factors for Giant Retinal Tears

    Morteza Mehdizadeh; Mehrdad Afarid; Mohammad Shabanpour Haqiqi

    2010-01-01

    Purpose: To evaluate the risk factors associated with giant retinal tears. Methods: This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic), and high myopia were evaluated in association with giant retinal tears. Results: Of 150 patients with retinal detachments, 99 subjects (66%) were older than 30 years while 51 (34%) were 30 years of age or you...

  20. Risk Factors for Giant Retinal Tears

    Mehdizadeh, Morteza; Afarid, Mehrdad; Haqiqi, Mohammad Shabanpour

    2010-01-01

    Purpose To evaluate the risk factors associated with giant retinal tears. Methods This retrospective study was performed on medical records of 150 patients who had undergone retinal detachment surgery. Age, sex, history of trauma, lens status (phakic, pseudophakic, or aphakic), and high myopia were evaluated in association with giant retinal tears. Results Of 150 patients with retinal detachments, 99 subjects (66%) were older than 30 years while 51 (34%) were 30 years of age or younger. Overa...

  1. Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage

    Hong, T.-M.; Tseng, H.-S. E-mail: hstseng@vghtpe.gov.tw; Lee, R.-C.; Wang, J.-H.; Chang, C.-Y

    2004-01-01

    AIM: To present the findings of uterine artery embolization (UAE) in the management of obstetric haemorrhage. MATERIALS AND METHODS: From October 1999 to February 2003, 10 women with postpartum haemorrhage (n=7) and post-abortion haemorrhage with placenta accreta (n=3), were referred to our department for pelvic angiography and possible arterial embolization. RESULTS: Angiography revealed engorged and tortuous uterine arteries in all patients; and contrast medium extravasation in three patients. Eight patients (three with and five without detectable active bleeding) then underwent bilateral UAE. Medium-sized (250-355 {mu}m) polyvinyl alcohol particles were injected via a coaxial catheter into the uterine arteries, followed by gelatin sponge pieces via a 4 F Cobra catheter. Microcoil devascularization was also performed in the two patients with visible, active bleeding. The vaginal bleeding resolved in all patients, without any ischaemic complications. At follow-up, all patients who underwent UAE had normal menstruation; three of them subsequently gave birth to full-term healthy babies. CONCLUSION: Selective UAE by the coaxial method is safe and effective to control obstetric haemorrhage, with the potential to preserve fertility.

  2. Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage

    AIM: To present the findings of uterine artery embolization (UAE) in the management of obstetric haemorrhage. MATERIALS AND METHODS: From October 1999 to February 2003, 10 women with postpartum haemorrhage (n=7) and post-abortion haemorrhage with placenta accreta (n=3), were referred to our department for pelvic angiography and possible arterial embolization. RESULTS: Angiography revealed engorged and tortuous uterine arteries in all patients; and contrast medium extravasation in three patients. Eight patients (three with and five without detectable active bleeding) then underwent bilateral UAE. Medium-sized (250-355 μm) polyvinyl alcohol particles were injected via a coaxial catheter into the uterine arteries, followed by gelatin sponge pieces via a 4 F Cobra catheter. Microcoil devascularization was also performed in the two patients with visible, active bleeding. The vaginal bleeding resolved in all patients, without any ischaemic complications. At follow-up, all patients who underwent UAE had normal menstruation; three of them subsequently gave birth to full-term healthy babies. CONCLUSION: Selective UAE by the coaxial method is safe and effective to control obstetric haemorrhage, with the potential to preserve fertility

  3. Ischemic Retinal Vasculitis and Its Management

    Lazha Talat

    2014-01-01

    Full Text Available Ischemic retinal vasculitis is an inflammation of retinal blood vessels associated with vascular occlusion and subsequent retinal hypoperfusion. It can cause visual loss secondary to macular ischemia, macular edema, and neovascularization leading to vitreous hemorrhage, fibrovascular proliferation, and tractional retinal detachment. Ischemic retinal vasculitis can be idiopathic or secondary to systemic disease such as in Behçet’s disease, sarcoidosis, tuberculosis, multiple sclerosis, and systemic lupus erythematosus. Corticosteroids with or without immunosuppressive medication are the mainstay treatment in retinal vasculitis together with laser photocoagulation of retinal ischemic areas. Intravitreal injections of bevacizumab are used to treat neovascularization secondary to systemic lupus erythematosus but should be timed with retinal laser photocoagulation to prevent further progression of retinal ischemia. Antitumor necrosis factor agents have shown promising results in controlling refractory retinal vasculitis excluding multiple sclerosis. Interferon has been useful to control inflammation and induce neovascular regression in retinal vasculitis secondary to Behçet’s disease and multiple sclerosis. The long term effect of these management strategies in preventing the progression of retinal ischemia and preserving vision is not well understood and needs to be further studied.

  4. Embolization of a Bleeding Maxillary Arteriovenous Malformation via the Superficial Temporal Artery after External Carotid Artery Ligation

    An arteriovenous malformation (AVM) of the jaw is an uncommon lesion found mainly in children. It can present with massive oral bleeding, resulting in death. The external carotid artery (ECA) is often the feeding artery and can be ligated to control the hemorrhage. As a result, transarterial embolization is difficult or even impossible to perform when re-bleeding occurs. We report a new approach of a successful embolization of a bleeding maxillary AVM via the superficial temporal artery (STA) after a previous ECA ligation. This technique has not yet been reported for endovascular management of a bleeding maxillary AVM. This approach of embolization of a maxillary AVM via the STA is minimally invasive, repeatable and has little effect on the physical appearance of the patient. It may be performed on patients with hyper vascular craniofacial lesions whose feeding arteries have been ligated or are too tortuous to navigate a catheter. It can also be performed urgently during active bleeding, pre-operatively and before trans-venous embolization

  5. Genetics Home Reference: retinal arterial macroaneurysm with supravalvular pulmonic stenosis

    ... vessel walls (macroaneurysms) occur. These macroaneurysms can tear (rupture), leading to bleeding that can spread into other ... the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition ...

  6. Retinal vessel diameters decrease with macular ganglion cell layer thickness in autosomal dominant optic atrophy and in healthy subjects

    Rönnbäck, Cecilia; Grønskov, Karen; Larsen, Michael

    2014-01-01

    diameters (central retinal artery equivalent, CRAE, and central retinal vein equivalent, CRVE). Statistical analysis was corrected for age, gender, spherical equivalent refraction, axial length and mean arterial blood pressure (MABP) in a mixed model analysis. RESULTS: Retinal arteries and veins were...... thinner in ADOA than in healthy controls (CRAE (mean ± 2 standard deviations (SD)) 153.9 ± 41.0 μm and CRVE 236.1 ± 42.0 μm in ADOA, CRAE 172.5 ± 25.0 μm (p = 0.0004) and CRVE 254.2 ± 37.6 μm (p = 0.0019) in healthy controls). MABP was comparable in the two groups (p = 0.18), and in both groups, CRAE...... ganglion cell-inner plexiform layer (GC-IPL) thickness (p = 0.0017 and p = 0.0057, respectively). CONCLUSION: Narrow retinal arteries and veins were associated not only with the severity of ADOA but with ganglion cell volume in patients with ADOA and in healthy subjects. This suggests that narrow vessels...

  7. Diabetes and Retinal Vascular Dysfunction

    Eui Seok Shin

    2014-01-01

    Full Text Available Diabetes predominantly affects the microvascular circulation of the retina resulting in a range of structural changes unique to this tissue. These changes ultimately lead to altered permeability, hyperproliferation of endothelial cells and edema, and abnormal vascularization of the retina with resulting loss of vision. Enhanced production of inflammatory mediators and oxidative stress are primary insults with significant contribution to the pathogenesis of diabetic retinopathy (DR. We have determined the identity of the retinal vascular cells affected by hyperglycemia, and have delineated the cell autonomous impact of high glucose on function of these cells. We discuss some of the high glucose specific changes in retinal vascular cells and their contribution to retinal vascular dysfunction. This knowledge provides novel insight into the molecular and cellular defects contributing to the development and progression of diabetic retinopathy, and will aid in the development of innovative, as well as target specific therapeutic approaches for prevention and treatment of DR.

  8. Measurement of the total retinal blood flow using dual beam Fourier-domain Doppler optical coherence tomography with orthogonal detection planes

    Doblhoff-Dier, Veronika; Schmetterer, Leopold; Vilser, Walthard; Garhöfer, Gerhard; Gröschl, Martin; Rainer A. Leitgeb; René M. Werkmeister

    2014-01-01

    We present a system capable of measuring the total retinal blood flow using a combination of dual beam Fourier-domain Doppler optical coherence tomography with orthogonal detection planes and a fundus camera-based retinal vessel analyzer. Our results show a high degree of conformity of venous and arterial flows, which corroborates the validity of the measurements. In accordance with Murray’s law, the log-log regression coefficient between vessel diameter and blood flow was found to be ~3. The...

  9. Retinal Optical Coherence Tomography Imaging

    Drexler, Wolfgang; Fujimoto, James G.

    The eye is essentially transparent, transmitting light with only minimal optical attenuation and scattering providing easy optical access to the anterior segment as well as the retina. For this reason, ophthalmic and especially retinal imaging has been not only the first but also most successful clinical application for optical coherence tomography (OCT). This chapter focuses on the development of OCT technology for retinal imaging. OCT has significantly improved the potential for early diagnosis, understanding of retinal disease pathogenesis, as well as monitoring disease progression and response to therapy. Development of ultrabroad bandwidth light sources and high-speed detection techniques has enabled significant improvements in ophthalmic OCT imaging performance, demonstrating the potential of three-dimensional, ultrahigh-resolution OCT (UHR OCT) to perform noninvasive optical biopsy of the living human retina, i.e., the in vivo visualization of microstructural, intraretinal morphology in situ approaching the resolution of conventional histopathology. Significant improvements in axial resolution and speed not only enable three-dimensional rendering of retinal volumes but also high-definition, two-dimensional tomograms, topographic thickness maps of all major intraretinal layers, as well as volumetric quantification of pathologic intraretinal changes. These advances in OCT technology have also been successfully applied in several animal models of retinal pathologies. The development of light sources emitting at alternative wavelengths, e.g., around #1,060 nm, not only enabled three-dimensional OCT imaging with enhanced choroidal visualization but also improved OCT performance in cataract patients due to reduced scattering losses in this wavelength region. Adaptive optics using deformable mirror technology, with unique high stroke to correct higher-order ocular aberrations, with specially designed optics to compensate chromatic aberration of the human eye, in

  10. Angiographic results of retinal-retinal anastomosis and retinal-choroidal anastomosis after treatments in eyes with retinal angiomatous proliferation

    Saito M

    2012-08-01

    Full Text Available Masaaki Saito,1 Tomohiro Iida,1,2 Mariko Kano,1 Kanako Itagaki11Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, 2Department of Ophthalmology, Tokyo Women's Medical University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to evaluate the angiographic results of retinal-retinal anastomosis (RRA and retinal-choroidal anastomosis (RCA for eyes with retinal angiomatous proliferation (RAP after treatment with intravitreal bevacizumab injections as monotherapy or intravitreal bevacizumab combined with photodynamic therapy.Methods: In this interventional, consecutive case series, we retrospectively reviewed five naïve eyes from four patients (mean age 80 years treated with three consecutive monthly intravitreal bevacizumab (1.25 mg/0.05 mL injections as initial treatment, and followed up for at least 3 months. In cases with over 3 months of follow-up and having recurrence of RAP or leakage by fluorescein angiography, retreatment was performed with a single intravitreal bevacizumab injection and photodynamic therapy.Results: Indocyanine green angiography showed RRA in three eyes with subretinal neovascularization and RCA in two eyes with choroidal neovascularization at baseline. At 3 months after baseline (month 3, neither the RRA nor RCA was occluded in any eye on indocyanine green angiography. Retreatment with intravitreal bevacizumab plus photodynamic therapy was performed in three eyes at months 3 (persistent leakage on fluorescein angiography, 6, and 7 (recurrence of RAP lesion, which achieved obvious occlusion of the RRA and RCA. Mean best-corrected visual acuity improved from 0.13 to 0.21 at month 3 (P = 0.066. No complications or systemic adverse events were noted.Conclusion: Although intravitreal bevacizumab for RAP was effective in improving visual acuity during short-term follow-up, intravitreal bevacizumab could not achieve complete occlusion of RRA and RCA, which could

  11. Tortuosity and calcification of the splenic artery. More than an additional finding

    Tortuosity of the splenic artery and calcification of the vessel wall are typical additional findings on plain abdominal x-ray. The combination of both anomalies is common in elderly persons presenting without symptoms of splenic ischemia. Its pathogenesis is thought to be multifactorial. In infancy and childhood, the splenic artery is stretched in its entire course. A growing difference between the length of the vessel and the distance between its origin and the splenic hilum gives rise to tortuosity. The artery's proximal segment is involved more frequently and more severely than the distal one. The tortuous route of the vessel is accentuated by the direction of its major branches, which is roughly perpendicular to the main trajectory. Neither tortuosity nor calcification should be taken to be risk factors for the comparatively common splenic artery aneurysm. Calcific deposits are not confined to the media but are also detected in the intima of the vascular wall. Critical narrowings of the lumen arising on the calcium deposits are not observed. Calcifying atherosclerosis of the splenic artery is comparable to medial sclerosis of the peripheral arteries frequently noticed in diabetics and dialysis patients. Only the less important calcification of the intima may be attributed to mechanisms of the hydrohemodynamic theory of atherosclerosis. The spleen's blood storage capacity may contribute to the characteristic age-dependent alterations of the shape and course of the splenic artery. (orig.)

  12. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Mason, John O.

    2015-01-01

    John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV) rate...

  13. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Mason lll JO; Patel SA; Feist RM; Albert Jr MA; Huisingh C; McGwin Jr G; Thomley ML

    2015-01-01

    John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV) rate...

  14. Risk factor profile in retinal detachment

    Azad Raj

    1988-01-01

    Full Text Available 150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain guidelines are offered which may be of value in decision making, in prophylactic detachment surgery. Tractional breaks in the superior temporal quadrant especially when symptomatic. mandate prophylactic treatment. Urgency is enhanced it′ the patient is aphakic. Associated myopia adds to the urgency. The higher incidence of initial right e′ e involvement in all groups suggests a vascular original possibly ischaemic.

  15. Retinitis Pigmentosa and Education Issues

    Brown, Thomas J.

    2005-01-01

    Retinitis Pigmentosa includes a number of inherited diseases which usually result in blindness. The disease is progressive in nature and begins with the deterioration of cells in the eye responsible for peripheral vision. As the condition worsens there is a gradual loss of peripheral vision and night blindness. Proper educational planning requires…

  16. Retinal imaging and image analysis

    Abramoff, M.D.; Garvin, Mona K.; Sonka, Milan

    2010-01-01

    Many important eye diseases as well as systemic diseases manifest themselves in the retina. While a number of other anatomical structures contribute to the process of vision, this review focuses on retinal imaging and image analysis. Following a brief overview of the most prevalent causes of blindne

  17. Clinical application of uterine arterial embolization for treatment of placenta praevia with hemorrhage in advanced stage of pregnancy

    Objective: To investigate the value of the uterine arterial embolization for the placenta praevia and hemorrhage in late stage of pregnancy. Methods: 16 patients of placenta praevia with hemorrhage in late stage of pregnancy were treated with uterine arterial embolization (UAE)and simultaneously with Lee Rivanol intra-amniotic membrane injection for artificial laboring. Results: During late stage of pregnancy, uterine arteries appeared to be elongated and enlarged with numerous dilated tortuous branches with positive proportion to gestalional age, and rich in blood supply of the placenta. 15 cases passed successfully through the induced abortion. The procedure completed with an average of 4.5 h afterwards, without postpartum hemorrhage. The other ease failed due to complicated reasons and cured by caesarean section. Conclusion: UAE is a safe and effective method for late stage placenta praevia with hemaorrhage and also provides the reservation of fertility and together with promotion of induced abortion. (authors)

  18. Bilateral retinal cyst accompanying with renal and thyroidal multiorgan cyst

    Amber Şenel; Rıfat Rasier; Alper Şengül; Erdal Yüzbaşıoğlu; Özgür Artunay; Halil Bahçecioğlu

    2011-01-01

    Although retinal cysts are commonly seen in von Hippel Lindau syndrome, bilateral retinal cysts can occasionally appear unrelated to this syndrome. Retinal cysts can be confused with retinal tumours and infectious diseases of retina. In this report we represent a patient demonstrating bilateral retinal cyst accompanying with renal and thyroidal multiorgan cysts without Von-Hippel Lindau syndrome.

  19. Prostatic Artery Embolization for Enlarged Prostates Due to Benign Prostatic Hyperplasia. How I Do It

    Carnevale, Francisco C., E-mail: fcarnevale@uol.com.br [University of Sao Paulo Medical School, Interventional Radiology Unit (Brazil); Antunes, Alberto A., E-mail: antunesuro@uol.com.br [University of Sao Paulo Medical School, Division of Urology (Brazil)

    2013-12-15

    Prostatic artery embolization (PAE) has emerged as an alternative to surgical treatments for benign prostatic hyperplasia (BPH). Patient selection and refined technique are essential for good results. Urodynamic evaluation and magnetic resonance imaging are very important and technical limitations are related to elderly patients with tortuous and atherosclerotic vessels, anatomical variations, difficulty visualizing and catheterizing small diameter arteries feeding the prostate, and the potential risk of bladder and rectum ischemia. The use of small-diameter hydrophilic microcatheters is mandatory. Patients can be treated safely by PAE with low rates of side effects, reducing prostate volume with clinical symptoms and quality of life improvement without urinary incontinence, ejaculatory disorders, or erectile dysfunction. A multidisciplinary approach with urologists and interventional radiologists is essential to achieve better results.

  20. Carotid Artery Screening

    ... Resources Professions Site Index A-Z Carotid Artery Screening What is carotid artery screening? Who should consider ... about carotid artery screening? What is carotid artery screening? Screening examinations are tests performed to find disease ...

  1. Retinal vascular changes in hypertensive patients in Ibadan, Sub-Saharan Africa

    Oluleye ST

    2016-08-01

    Full Text Available Sunday Tunji Oluleye,1 Bolutife Ayokunu Olusanya,1 Abiodun Moshood Adeoye2 1Department of Ophthalmology, 2Department of Medicine, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria Background: Earlier studies in Nigeria reported the rarity of retinal vascular changes in hypertensives. The aim of this study was to describe the various retinal vascular changes in the hypertensive patients of Nigeria.Patients and methods: Nine hundred and three hypertensive patients were studied. This study was approved by the ethical and research committee of the University of Ibadan and University College Hospital, Ibadan, Nigeria. Blood pressure and anthropometric measurements were measured. Cardiac echocardiography was performed on 156 patients. All patients had dilated fundoscopy and fundus photography using the Kowa portable fundus camera and an Apple iPhone with 20 D lens. Statistical analysis was done with Statistical Packages for the Social Sciences (Version 21.Results: The mean age of patients was 57 years with a male:female ratio of 1. No retinopathy was found in 556 (61.5% patients. In all, 175 (19.4% patients had features of hypertensive retinopathy. Retinal vascular occlusion was a significant finding in 121 patients (13.4%, of which branch retinal vein occlusion, 43 (4.7%, and central retinal vein occlusion, 30 (3.3%, were the most prominent ones in cases. Hemicentral retinal vein occlusion, 26 (2.9%, and central retinal artery occlusion, 17 (1.9%, were significant presentations. Other findings included nonarteritic anterior ischemic optic neuropathy in five (0.6% patients, hypertensive choroidopathy in seven (0.8% patients, and hemorrhagic choroidal detachment in five (0.6% patients. Left ventricular (LV geometry was abnormal in 85 (55.5% patients. Concentric remodeling, eccentric hypertrophy, and concentric hypertrophy were observed in 43 (27.6%, 26 (17.2%, and 15 (9.7% patients, respectively. LV

  2. Retinal vasculature classification using novel multifractal features

    Retinal blood vessels have been implicated in a large number of diseases including diabetic retinopathy and cardiovascular diseases, which cause damages to retinal blood vessels. The availability of retinal vessel imaging provides an excellent opportunity for monitoring and diagnosis of retinal diseases, and automatic analysis of retinal vessels will help with the processes. However, state of the art vascular analysis methods such as counting the number of branches or measuring the curvature and diameter of individual vessels are unsuitable for the microvasculature. There has been published research using fractal analysis to calculate fractal dimensions of retinal blood vessels, but so far there has been no systematic research extracting discriminant features from retinal vessels for classifications. This paper introduces new methods for feature extraction from multifractal spectra of retinal vessels for classification. Two publicly available retinal vascular image databases are used for the experiments, and the proposed methods have produced accuracies of 85.5% and 77% for classification of healthy and diabetic retinal vasculatures. Experiments show that classification with multiple fractal features produces better rates compared with methods using a single fractal dimension value. In addition to this, experiments also show that classification accuracy can be affected by the accuracy of vessel segmentation algorithms. (paper)

  3. Cytomegalovirus retinitis associated with acquired immunodeficiency syndrome

    GENG Shuang; YE Jun-jie; ZHAO Jia-liang; LI Tai-sheng; HAN Yang

    2011-01-01

    Background Cytomegalovirus (CMV) retinitis is the most severe intraocular complication that results in total retinal destruction and loss of visual acuity in patients with acquired immunodeficiency syndrome (AIDS). This study aimed to investigate the fundus characteristics, systemic manifestations and therapeutic outcomes of CMV retinitis associated with AIDS.Methods It was a retrospective case series. CMV retinitis was present in 39 eyes (25 patients). Best corrected visual acuities, anterior segment, fundus features, fundus fluorescence angiography (FFA) and CD4+ T-lymphocyte counts of the patients with CMV retinitis associated with AIDS were analyzed. Intravitreal injections of ganciclovir (400 μg) were performed in 4 eyes (2 patients).Results Retinal vasculitis, dense, full-thickness, yellow-white lesions along vascular distribution with irregular granules at the border, and hemorrhage on the retinal surface were present in 28 eyes. The vitreous was clear or mildly opaque.Late stage of the retinopathy was demonstrated in 8 eyes characterized as atrophic retina, sclerotic and attenuated vessels, retinal pigment epithelium (RPE) atrophy, and optic nerve atrophy. Retinal detachment was found in 3 eyes. The average CD4+ T-lymphocyte count in peripheral blood of the patients with CMV retinitis was (30.6±25.3) ×106/L (range,(0-85) × 106/L). After intravitreal injections of ganciclovir, visual acuity was improved and fundus lesions regressed.Conclusions CMV retinitis is the most severe and the most common intraocular complication in patients with AIDS. For the patients with yellow-white retinal lesions, hemorrhage and retinal vasculitis without clear cause, human immunodeficiency virus (HIV) serology should be performed. Routine eye examination is also indicated in HIV positive patients.

  4. The effect of intravitreal bevacizumab on ocular blood flow in diabetic retinopathy and branch retinal vein occlusion as measured by laser speckle flowgraphy

    Nitta F

    2014-06-01

    Full Text Available Fumihiko Nitta,1 Hiroshi Kunikata,1,2 Naoko Aizawa,1 Kazuko Omodaka,1 Yukihiro Shiga,1 Masayuki Yasuda,1 Toru Nakazawa1–31Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan; 2Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan; 3Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, JapanBackground: This study evaluated the effect of intravitreal injection of bevacizumab (IVB on macular edema associated with diabetic retinopathy (DME or branch retinal vein occlusion (BRVOME using laser speckle flowgraphy.Methods: A comparative interventional study of 25 eyes from 22 patients with macular edema (DME group: 12 eyes; BRVOME group: 13 eyes who underwent IVB. Mean blur rate (MBR was measured in the retinal artery, retinal vein, optic nerve head (ONH, and choroid before and after IVB. Results: In the BRVOME group, there was no significant change in MBR in the retinal artery, retinal vein or ONH, but choroidal MBR decreased significantly (P=0.04. In the DME group, the MBR in the retinal artery, retinal vein, ONH, and choroid decreased significantly (P=0.02, P=0.04, P<0.001, and P=0.04, respectively. In the DME group, pre-IVB MBR in the ONH was significantly correlated with post-IVB foveal thickness (R= -0.71, P=0.002. There was no such correlation in the BRVOME group in the ONH.Conclusion: IVB had a suppressive effect on circulation in eyes with DME but not in those with BRVOME. This suggests that this noninvasive and objective biomarker may be a useful part of pre-IVB evaluations and decision-making in DME.Keywords: macular edema, mean blur rate, optic nerve head, biomarker, ocular circulation

  5. Reliability of retinal vessel calibre measurements using a retinal oximeter

    Heitmar, Rebekka; Kalitzeos, Angelos A.

    2015-01-01

    Background Summarised retinal vessel diameters are linked to systemic vascular pathology. Monochromatic images provide best contrast to measure vessel calibres. However, when obtaining images with a dual wavelength oximeter the red-free image can be extracted as the green channel information only which in turn will reduce the number of photographs taken at a given time. This will reduce patient exposure to the camera flash and could provide sufficient quality images to reliably measure vessel...

  6. Automatic diagnosis of retinal diseases from color retinal images

    Jayanthi, D.; N. Devi; SwarnaParvathi, S.

    2010-01-01

    Teleophthalmology holds a great potential to improve the quality, access, and affordability in health care. For patients, it can reduce the need for travel and provide the access to a superspecialist. Ophthalmology lends itself easily to telemedicine as it is a largely image based diagnosis. The main goal of the proposed system is to diagnose the type of disease in the retina and to automatically detect and segment retinal diseases without human supervision or interaction. The proposed system...

  7. Retinal Image Preprocessing: Background and Noise Segmentation

    Usman Akram

    2012-07-01

    Full Text Available Retinal images are used for the automated screening and diagnosis of diabetic retinopathy. The retinal image quality must be improved for the detection of features and abnormalities and for this purpose preprocessing of retinal images is vital. In this paper, we present a novel automated approach for preprocessing of colored retinal images. The proposed technique improves the quality of input retinal image by separating the background and noisy area from the overall image. It contains coarse segmentation and fine segmentation. Standard retinal images databases Diaretdb0, Diaretdb1, DRIVE and STARE are used to test the validation of our preprocessing technique. The experimental results show the validity of proposed preprocessing technique.

  8. Current perspectives of herpesviral retinitis and choroiditis.

    Madhavan, H N; Priya, K; Biswas, J

    2004-10-01

    Vision-threatening viral retinitis are primarily caused by members of the herpesvirus family. The biology and molecular characterization of herpesviruses, clinical presentations of retinopathies, pathology and pathogenesis including the host responses, epidemiology and the laboratory methods of aetiological diagnosis of these diseases are described. Clinical syndromes are acute retinal necrosis (ARN), progressive outer retinal necrosis (PORN), cytomegalovirus (CMV) retinitis, multifocal choroiditis and serpiginous choroiditis besides other viral retinopathies. Herpes simplex virus (HSV) retinitis is more common in immunocompetent persons while varicella zoster virus (VZV) affects both immunocompetent and immunosuppressed patients equally. CMV retinitis is most common among patients with AIDS. The currently employed laboratory methods of antigen detection, virus isolation and antibody detection by enzyme linked immuno-sorbent assay (ELISA) have low sensitivity. Polymerase chain reaction (PCR) has increased the value of diagnosis due to its high clinical sensitivity and absolute specificity in detection of herpesviruses in intraocular specimens. PMID:16295367

  9. Advances in Retinal Stem Cell Biology

    Andrea S Viczian

    2013-01-01

    Full Text Available Tremendous progress has been made in recent years to generate retinal cells from pluripotent cell sources. These advances provide hope for those suffering from blindness due to lost retinal cells. Understanding the intrinsic genetic network in model organisms, like fly and frog, has led to a better understanding of the extrinsic signaling pathways necessary for retinal progenitor cell formation in mouse and human cell cultures. This review focuses on the culture methods used by different groups, which has culminated in the generation of laminated retinal tissue from both embryonic and induced pluripotent cells. The review also briefly describes advances made in transplantation studies using donor retinal progenitor and cultured retinal cells.

  10. Inner Retinal Oxygen Delivery and Metabolism in Streptozotocin Diabetic Rats

    Wanek, Justin; Teng, Pang-yu; Blair, Norman P.; Shahidi, Mahnaz

    2014-01-01

    Measurements of inner retinal oxygen delivery and oxygen metabolism in streptozotocin diabetic rats indicate that oxygen supplied by the retinal circulation and consumed by the inner retinal tissue were not altered within 6 weeks of diabetes.

  11. Retinal Doppler Ultrasound and Homocystein Levels in Children with Type I Diabetes Mellitus

    Tolga Altuğ Şen

    2008-06-01

    Full Text Available Aim: We aimed to measure plasma homocysteine levels and retinal arterial blood flow of type 1 diabetic children by Doppler ultrasound, which were known to be related with diabetic retinopathy and to compare them with healthy children. Materials and Methods: We selected 42 diabetic children (22 females, 20 males, between the ages of 8 to18 years (mean 13,2±4,3. Mean duration of type 1 diabetes was 5,02±2,99 years. For the control group, 30 children (15 females, 15 males between the ages of 9 to 18 years (mean 14,01±3,5 were selected. In central retinal arteries and ophthalmic arteries, peak systolic velocity, diastolic velocity, pulsatility and resistivity indexes were measured. Results: Except for the higher central retinal artery diastolic velocity in the control group, retinal blood flow velocities were similiar in diabetic children and the control group (p0,05. Mean ophthalmic artery peak systolic velocity (37,33±12,79 cm/sec for well controlled diabetic children was higher than the poorly controlled group (31,1±17,17 cm/sec; mean ophthalmic artery resistivity index (0,76±0,08 for well controlled group was lower than the mean resistivity index (0,82±0,04 of poorly controlled group. Plasma homocysteine levels were higher in diabetic children (10,3±2,18 mmol/L than the control group (9,12±1,9 mmol/L (p<0,05. Plasma homocysteine levels of the poorly controlled diabetics (9,42±2,12 mmol/L were higher than the well controlled diabetics (11,33±2,05 mmol/L.Conclusion: In the poorly controlled group total plasma homocysteine levels and ophthalmic artery resistivity indexes were increased compared to the well controlled diabetics and healthy children which might be risk factors for diabetic retinopathy. (Journal of Current Pediatrics 2008; 6: 19-25

  12. Retinal vein occlusion: current treatment.

    Lattanzio, Rosangela; Torres Gimeno, Ana; Battaglia Parodi, Maurizio; Bandello, Francesco

    2011-01-01

    Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management. PMID:20938213

  13. Chronic granulomatous disease presenting as retinal mass

    Ahmad M. Mansour; Al Dairy, Mays; Hamam, Rola; Hidayat, Ahmed A

    2008-01-01

    1-year-old girl was admitted for fever of unknown origin. Funduscopy revealed juxtapapillary retinal inflammatory mass in one eye with a differential diagnosis of sarcoidosis, tuberculosis, retinoblastoma or metastatic disease. Retinal biopsy showed necrotizing granulomatous retinitis. Extensive workup and therapeutic trials failed to confirm the diagnosis of tuberculosis or sarcoidosis. Her 7-month brother and 4-year-old male cousin presented with nystagmus, poor vision, paravascular pigment...

  14. Acquired retinal folds in the cat.

    MacMillan, A D

    1976-06-01

    Retinal folds were found in 5 cats. The apparent cause of the folding was varied: in 1 cat the folds appeared after a localized retinal detachment; in 2 cats the condition accompanied other intraocular abnormalities associated with feline infectious peritonitis; 1 cat had active keratitis, and the retinal changes were thought to have been injury related; and 1 cat, bilaterally affected, had chronic glomerulonephritis. PMID:945253

  15. Retinal detachment following cataract surgery with capsulorhexis.

    Kelley, J S; Doxanas, M T

    1995-01-01

    PURPOSE: To estimate the incidence of retinal detachment after cataract surgery with capsulorhexis. METHODS: A consecutive series of 2,150 cataract operations were followed for incidence of retinal detachment. A series of 1,000 patients from this group were analyzed for high risk factors: myopia, age, sex, operative complications and capsulotomy. RESULTS: With minimum one year follow up in 90% of patients the incidence of retinal detachment was 0.25% (5 cases). CONCLUSION: The true incidence ...

  16. Astigmatism following retinal detachment surgery.

    Goel, R.; Crewdson, J; Chignell, A H

    1983-01-01

    Eighty-three patients on whom successful retinal detachment had been performed were studied to note astigmatic changes following surgery. In the majority of cases the errors following such surgery are of no great clinical importance. However, in some situations a high degree of astigmatism may be produced. This study showed that these sequelae are particularly likely after radial buckling procedures, and surgeons favouring these techniques should be aware that astigmatic errors can be induced...

  17. Cytomegalovirus retinitis mimicking intraocular lymphoma

    Gooi, Patrick

    2008-01-01

    Patrick Gooi1, James Farmer2, Bernard Hurley3, Elliott Brodbaker41Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada; 2Department of Pathology and Lab Medicine University of Ottawa and The Ottawa Hospital, Ottawa, Ontario, Canada; 3Department of Ophthalmology, University of Ottawa Eye Institute and The Ottawa Hospital, Ottawa, Ontario, Canada; 4Faculty of Medicine, University of Ottawa, Ottawa, Ontario, CanadaAbstract: We present a case of an unusual retinal infiltra...

  18. Intrinsically photosensitive retinal ganglion cells

    Gary; E.PICKARD; Patricia; J.SOLLARS

    2010-01-01

    A new mammalian photoreceptor was recently discovered to reside in the ganglion cell layer of the inner retina.These intrinsically photosensitive retinal ganglion cells(ipRGCs) express a photopigment,melanopsin,that confers upon them the ability to respond to light in the absence of all rod and cone photoreceptor input.Although relatively few in number,ipRGCs extend their dendrites across large expanses of the retina making them ideally suited to function as irradiance detectors to assess changes in ambient light levels.Phototransduction in ipRGCs appears to be mediated by transient receptor potential channels more closely resembling the phototransduction cascade of invertebrate rather than vertebrate photoreceptors.ipRGCs convey irradiance information centrally via the optic nerve to influence several functions.ipRGCs are the primary retinal input to the hypothalamic suprachiasmatic nucleus(SCN),a circadian oscillator and biological clock,and this input entrains the SCN to the day/night cycle.ipRGCs contribute irradiance signals that regulate pupil size and they also provide signals that interface with the autonomic nervous system to regulate rhythmic gene activity in major organs of the body.ipRGCs also provide excitatory drive to dopaminergic amacrine cells in the retina,providing a novel basis for the restructuring of retinal circuits by light.Here we review the ground-breaking discoveries,current progress and directions for future investigation.

  19. Retinal Macroglial Responses in Health and Disease

    Rosa de Hoz

    2016-01-01

    Full Text Available Due to their permanent and close proximity to neurons, glial cells perform essential tasks for the normal physiology of the retina. Astrocytes and Müller cells (retinal macroglia provide physical support to neurons and supplement them with several metabolites and growth factors. Macroglia are involved in maintaining the homeostasis of extracellular ions and neurotransmitters, are essential for information processing in neural circuits, participate in retinal glucose metabolism and in removing metabolic waste products, regulate local blood flow, induce the blood-retinal barrier (BRB, play fundamental roles in local immune response, and protect neurons from oxidative damage. In response to polyetiological insults, glia cells react with a process called reactive gliosis, seeking to maintain retinal homeostasis. When malfunctioning, macroglial cells can become primary pathogenic elements. A reactive gliosis has been described in different retinal pathologies, including age-related macular degeneration (AMD, diabetes, glaucoma, retinal detachment, or retinitis pigmentosa. A better understanding of the dual, neuroprotective, or cytotoxic effect of macroglial involvement in retinal pathologies would help in treating the physiopathology of these diseases. The extensive participation of the macroglia in retinal diseases points to these cells as innovative targets for new drug therapies.

  20. Retinal Macroglial Responses in Health and Disease

    de Hoz, Rosa; Rojas, Blanca; Ramírez, Ana I.; Salazar, Juan J.; Gallego, Beatriz I.; Triviño, Alberto; Ramírez, José M.

    2016-01-01

    Due to their permanent and close proximity to neurons, glial cells perform essential tasks for the normal physiology of the retina. Astrocytes and Müller cells (retinal macroglia) provide physical support to neurons and supplement them with several metabolites and growth factors. Macroglia are involved in maintaining the homeostasis of extracellular ions and neurotransmitters, are essential for information processing in neural circuits, participate in retinal glucose metabolism and in removing metabolic waste products, regulate local blood flow, induce the blood-retinal barrier (BRB), play fundamental roles in local immune response, and protect neurons from oxidative damage. In response to polyetiological insults, glia cells react with a process called reactive gliosis, seeking to maintain retinal homeostasis. When malfunctioning, macroglial cells can become primary pathogenic elements. A reactive gliosis has been described in different retinal pathologies, including age-related macular degeneration (AMD), diabetes, glaucoma, retinal detachment, or retinitis pigmentosa. A better understanding of the dual, neuroprotective, or cytotoxic effect of macroglial involvement in retinal pathologies would help in treating the physiopathology of these diseases. The extensive participation of the macroglia in retinal diseases points to these cells as innovative targets for new drug therapies.

  1. Improved circulation in ocular ischemic syndrome after carotid artery stenting

    WANG Yan-ling; ZHAO Lu; LI Ming-ming

    2011-01-01

    Ocular ischemic syndrome is a chronic ischemic eye disease including a series of ischemic ocular and brain syndromes caused by carotid artery occlusion or stenosis.Because of the different degrees of ischemia,clinical manifestations of ocular ischemic syndrome are diverse,and it is difficult to diagnose in the initial stage.The main strategy to treat ocular ischemic syndrome is elimination of carotid stenosis.We presented a patient who recovered dramatically after carotid artery stenting.The pre-stenting arm-retinal circulation time of the patient's left eye was prolonged,and a large amount of microaneurysm appeared at the posterior polar and mid-peripheral aspects of the left retina.The post-stenting arm-retinal circulation time of the left eye decreased to 16.3 seconds,and the microaneurysm almost disappeared.

  2. Accordion effect during carotid artery stenting. Report of two cases and review of the literature

    Tsutsumi, Masanori; Kazekawa, Kiyoshi; Onizuka, Masanari; Aikawa, Hiroshi; Iko, Minoru; Kodama, Tomonobu; Nii, Kouhei; Matsubara, Shuko; Etou, Housei; Tanaka, Akira [Fukuoka University Chikushi Hospital, Department of Neurosurgery, Fukuoka (Japan)

    2007-07-15

    The term ''accordion effect'' is used to describe a mechanical distortion of tortuous arteries mimicking spasm or dissection. This phenomenon has been reported in patients undergoing percutaneous coronary intervention. To our knowledge, this is the first documentation of the accordion effect during carotid artery intervention. Two patients who developed the accordion effect during carotid artery stenting (CAS) are described. Angiograms obtained just after CAS showed a stenosing lesion with wall irregularity at the distal part of the stent. This lesion disappeared and tortuosity of the internal carotid artery developed after withdrawing the guidewire until its floppy segment rested equally on the lesion. In another patient, the lesion did not disappear completely until the guiding catheter had been withdrawn to the proximal portion of the common carotid artery. We conclude that these stenosing lesions reflected the accordion effect. It is essential to differentiate the accordion effect from dissection, spasm, and thrombosis because the management is importantly different. We report our findings and present a review of the literature. (orig.)

  3. Prevalence of generalized retinal dystrophy in Denmark

    Bertelsen, Mette; Jensen, Hanne; Bregnhøj, Jesper F;

    2014-01-01

    PURPOSE: Generalized retinal dystrophy is a frequent cause of visual impairment and blindness in younger individuals and a subject of new clinical intervention trials. Nonetheless, there are few nation-wide population-based epidemiological data of generalized retinal dystrophy. The purpose of thi...

  4. Fundus autofluorescence applications in retinal imaging

    Andrea Gabai; Daniele Veritti; Paolo Lanzetta

    2015-01-01

    Fundus autofluorescence (FAF) is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications.

  5. Fundus autofluorescence applications in retinal imaging

    Andrea Gabai

    2015-01-01

    Full Text Available Fundus autofluorescence (FAF is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications.

  6. Fundus autofluorescence applications in retinal imaging.

    Gabai, Andrea; Veritti, Daniele; Lanzetta, Paolo

    2015-05-01

    Fundus autofluorescence (FAF) is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications. PMID:26139802

  7. Argus II retinal prosthesis system: An update.

    Rachitskaya, Aleksandra V; Yuan, Alex

    2016-09-01

    This review focuses on a description of the Argus II retinal prosthesis system (Argus II; Second Sight Medical Products, Sylmar, CA) that was approved for humanitarian use by the FDA in 2013 in patients with retinitis pigmentosa with bare or no light perception vision. The article describes the components of Argus II, the studies on the implant, and future directions. PMID:26855177

  8. Retinal vein occlusion: pathophysiology and treatment options

    Karia, Niral

    2010-01-01

    Niral KariaDepartment of Ophthalmology, Southend Hospital, Prittlewell Chase, Westcliff on Sea, Essex, United KingdomAbstract: This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.Keywords: central, hemispheric, branch, retinal vein occlusion, visual loss

  9. Retinal vein occlusion: pathophysiology and treatment options

    Niral Karia

    2010-07-01

    Full Text Available Niral KariaDepartment of Ophthalmology, Southend Hospital, Prittlewell Chase, Westcliff on Sea, Essex, United KingdomAbstract: This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.Keywords: central, hemispheric, branch, retinal vein occlusion, visual loss

  10. Energetic and spatial constraints of arterial networks

    Sandro Rossitti

    1995-06-01

    Full Text Available The principle of minimum work (PMW is a parametric optimization model for the growth and adaptation of arterial trees. A balance between energy dissipation due to frictional resistance of laminar flow (shear stress and the minimum volume of the blood and vessel wall tissue is achieved when the vessel radii are adjusted to the cube root of the volumetric flow. The PMW is known to apply over several magnitudes of vessel calibers, and in many different organs, including the brain, in humans and in animals. Animal studies suggest that blood flow in arteries is approximately proportional to the cube of the vessel radius, and that arteries alter their caliber in response to sustained changes of blood flow according to PMW. Remodelling of the retinal arteriolar network to long-term changes in blood flow was observed in humans. Remodelling of whole arterial networks occurs in the form of increase or diminishing of vessel calibers. Shear stress induced endothelial mediation seems to be the regulating mechanism for the maintenance of this optimum blood flow/vessel diameter relation. Arterial trees are also expected to be nearly space filing. The vascular system is constructed in such a way that, while blood vessels occupy only a small percentage of the body volume leaving the bulk to tissue, they also crisscross organs so tightly that every point in the tissue lies on the boundary between an artery and a vein. This review describes how the energetic optimum principle for least energy cost for blood flow is also compatible with the spatial constraints of arterial networks according to concepts derived from fractal geometry.