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1

[Tortuous retinal vessels  

UK PubMed Central (United Kingdom)

The authors observed an occurrence of tortuosity of retinal vessels from the group of 5,000 investigations of an ocular fundus. Elimination of all local reasons or symptoms of general diseases, even in spite of the great possibility of modification of this feature, three characteristic types were found. In two of them the familiar and hereditary occurrence was proved.

Streicher T; Spirková J

1993-08-01

2

Tortuosidad retiniana vascular en neurofibromatosis tipo 1 Tortuous retinal vessels in neurofibromatosis type 1  

Directory of Open Access Journals (Sweden)

Full Text Available Caso clínico: Se describe un paciente de 4 años con neurofibromatosis tipo 1 (NF-1) y vasos retinianos tortuosos de primer, segundo y tercer orden que terminaban en forma de sacacorcho. Discusión: Los pacientes con NF-1 pueden tener anomalías retinianas vasculares.Case report: We report a 4-year-old patient with neurofibromatosis type 1 (NF-1) who had tortuous retinal vessels of first, second and third order which ended in a corkscrew appearance. Discussion: Vascular retinal abnormalities can be present in patients with NF-1.

VM Asensio-Sánchez; B Torreblanca-Agüera; MA Miñambres-Villar

2005-01-01

3

[A case of medulla oblongata compression by tortuous vertebral arteries presenting with spastic quadriplegia].  

UK PubMed Central (United Kingdom)

We report a 58-year-old man showing spastic paraparesis due to medulla oblongata compression by tortuous vertebral arteries. He noticed weakness of both legs and gait disturbance at the age of 58 years and his symptoms progressively worsened during the following several months. General physical findings were normal. Blood pressure was normal and there were no signs of arteriosclerosis. Neurological examination on admission revealed lower-limb-dominant spasticity in all four extremities, lower-limb weakness, hyperreflexia in all extremities with positive Wartenberg's, Babinski's and Chaddock's signs, mild hypesthesia and hypopallesthesia in both lower limbs, and spastic gait. Cranial nerves were all normal. Serum was negative for antibodies against human T-cell lymphotropic virus-1 antibody. Nerve conduction and needle electromyographic studies of all four limbs revealed normal findings. Cervical, thoracic and lumbo-sacral magnetic resonance imaging (MRI) findings were all normal. Brain MRI and magnetic resonance angiography demonstrated bilateral tortuous vertebral arteries compressing the medulla oblongata. Neurovascular decompression of the right vertebral artery was performed because compression of the right side was more severe than that of the left side. Post-operative MRI revealed outward translocation of the right vertebral artery and relieved compression of the medulla oblongata on the right side. The patient's symptoms and neurological findings improved gradually after the operation. Bilateral pyramidal tract signs without cranial nerve dysfunction due to compression of the medulla oblongata by tortuous vertebral arteries are extremely rare and clinically indistinguishable from hereditary spastic paraplegia (HSP). Although we did not perform a genetic test for HSP, we consider that the spastic paraparesis and mild lower-limb hypesthesia were caused by compression of the medulla oblongata by bilateral tortuous vertebral arteries based on the post-operative improvement in symptoms. Given the favorable effects of surgery, tortuous vertebral arteries should be considered in the differential diagnosis of patients presenting with progressive spastic paraparesis.

Kamada T; Tateishi T; Yamashita T; Nagata S; Ohyagi Y; Kira J

2013-01-01

4

A case with successful retrograde stent delivery via AC branch for tortuous right coronary artery.  

UK PubMed Central (United Kingdom)

The retrograde approach is a novel technique of percutaneous coronary intervention for chronic total occlusion. This technique has improved the success rate of guidewire passage through the occlusion. In the retrograde approach, a microcatheter and balloon are delivered through a retrograde channel. However, it is difficult for a stent to pass through collateral arteries. We report a case of coronary artery stenosis in a markedly tortuous right coronary artery for which a drug-eluting stent was delivered retrogradely via the atrial circumflex branch.

Uehara Y; Shimizu M; Yoshimura M

2013-02-01

5

Combined central retinal artery-central vein obstruction.  

UK PubMed Central (United Kingdom)

The cases of 23 patients with unilateral combined central retinal artery-central retinal vein obstruction are described. Criteria for the abnormality included: a history of relatively sudden visual loss; superficial retinal whitening in the posterior pole in combination with a cherry spot; and intraretinal blood, generally associated with dilated and/or tortuous retinal veins. In five instances (22%) the obstructions developed after retrobulbar injection. Among the 21 patients with followup for at least 6 months, or until the onset of neovascularization of the iris, 17 (81%) developed rubeosis iridis. Late histopathology was obtained in two eyes. Hemorrhagic necrosis of the retina was observed in some areas of the posterior pole and attenuation of the inner retinal layers, similar to that seen with late central retinal artery obstruction, was noted elsewhere. Periphlebitis of the central retinal vein within the optic nerve was found in each case.

Brown GC; Duker JS; Lehman R; Eagle RC Jr

1993-02-01

6

Iliac artery occlusion with "oxbow lake" formation following stent deployment in a tortuous external iliac artery during EVAR: a case report.  

UK PubMed Central (United Kingdom)

In this case report, we describe a complication that we term the "oxbow lake" deformity. This phenomenon occurs when a tortuous elongated external iliac artery segment is artificially straightened by an iliac stent resulting in kinking and compression of a redundant loop with lumen compromise. We describe the anatomy, corrective treatment, and outcome. This occurrence is potentially foreseeable with tortuous vascular anatomy and recognition can allow appropriate management planning avoiding complications for the patient.

Culverwell AD; Kent P; Puppala S

2011-10-01

7

Iliac artery occlusion with "oxbow lake" formation following stent deployment in a tortuous external iliac artery during EVAR: a case report.  

Science.gov (United States)

In this case report, we describe a complication that we term the "oxbow lake" deformity. This phenomenon occurs when a tortuous elongated external iliac artery segment is artificially straightened by an iliac stent resulting in kinking and compression of a redundant loop with lumen compromise. We describe the anatomy, corrective treatment, and outcome. This occurrence is potentially foreseeable with tortuous vascular anatomy and recognition can allow appropriate management planning avoiding complications for the patient. PMID:21788283

Culverwell, Adam D; Kent, Patrick; Puppala, Sapna

2011-07-25

8

Retinal arterial macroaneurysms.  

UK PubMed Central (United Kingdom)

Retinal arterial macroaneurysms are acquired saccular or fusiform dilatations of the large arterioles of the retina, usually within the first three orders of bifurcation. They are associated with systemic vascular conditions such as hypertension and arteriosclerotic disease occurring most commonly in elderly women. The primary reported symptom is a sudden loss of vision due to haemorrhage or oedema affecting the macula. Most of macroaneurysms regress without treatment and without causing decreased visual acuity. Poor visual outcome may occur secondary to foveal exudates and subfoveal haemorrhage.

Pitkänen L; Tommila P; Kaarniranta K; Jääskeläinen JE; Kinnunen K

2013-06-01

9

[Retinal artery occlusion during disseminated lupus erythematosus  

UK PubMed Central (United Kingdom)

Retinal vascular disease in lupus is the most common ophthalmic manifestation, but retinal neovascularization is rare. We report a patient with sytemic lupus erythematosus and retinal neovascularization caused by branch retinal artery occlusion.

Cheour M; Kamoun H; Hamidi K; Rokbani L; Kraiem A

1999-02-01

10

Idiopathic pediatric retinal artery occlusion  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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....

Manayath George; Shah Parag; Narendran V; Morris Rodney

11

[Bilateral retinal vasculitis with arterial aneurysms  

UK PubMed Central (United Kingdom)

The authors reported unusual and rare condition of bilateral retinal vasculitis primarily affecting the central retinal artery at the nerve head and its 4 main branches. The most striking feature was the presence of the diffuse vitreous cells, occlusion of branch retinal artery, segmental periarterial infiltration, arterial sheating, retinal arterial aneurysms, disc swelling, peripheral retinal non perfusion and their complications. During 13 year's observation and treatment one eye went blind 3 years after initial examination. Second eye started the same clinical course two years after beginning of the disease. To avoid similar devastating course of the disease we started systemic steroids and immunosuppressive therapy, followed by photocoagulation of nonperfused peripheral retina and vitreoretinal surgery. We achieved stabilization of the disease with decreased visual functions. Comprehensive systemic work-up was unrevealing, no clear etiology was identified and diagnosis of idiopathic retinal vasculitis was made.

Streicher T; Spirková J; Gürtler L

2006-04-01

12

Idiopathic pediatric retinal artery occlusion  

Directory of Open Access Journals (Sweden)

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.

Manayath George; Shah Parag; Narendran V; Morris Rodney

2010-01-01

13

Central retinal artery occlusion in Crohn disease.  

UK PubMed Central (United Kingdom)

Crohn disease is an inflammatory bowel disease frequently associated with extraintestinal manifestations. Ocular manifestations are uncommon but may cause significant morbidity, including blindness. We report the first case of a 9-year-old boy with biopsy-proven Crohn disease who developed a cilioretinal artery-sparing central retinal artery occlusion. After 2 months of follow-up, the patient developed optic atrophy with no change in visual acuity.

Falavarjani KG; Parvaresh MM; Shahraki K; Nekoozadeh S; Amirfarhangi A

2012-08-01

14

Transfemoral Edwards-Novaflex valve implantation in a patient with aorto-iliac endoprosthesis and severely tortuous bilateral external iliac arteries-"Railing track".  

Science.gov (United States)

Transcatheter aortic valve implantation (TAVI) has nowadays been introduced as an alternative for surgical aortic valve replacement as a treatment for high risk aortic stenosis patients. This procedure is not free of complications: the SOURCE registry, indeed, showed that vascular complications are more frequent with the transfemoral approach. We present the case of an 82-year-old man with known history of severe aortic stenosis at high-risk for surgery. Pre-TAVI screening shows bilateral severely tortuous iliac arteries and aorto-bi-iliac endoprosthesis. Transapical TAVI as a first choice was rejected due to severe lung disease. The patient was then treated by Transfemoral TAVI using a dedicated interventional technique that is described in this case-report. PMID:22521079

Dandale, Rajesh M; Pesarini, Gabriele; Santini, Francesco; Molinari, Gionata; Rossi, Andrea; Milano, Aldo; Faggian, Giuseppe; Vassanelli, Corrado; Ribichini, Flavio

2012-04-18

15

Transfemoral Edwards-Novaflex valve implantation in a patient with aorto-iliac endoprosthesis and severely tortuous bilateral external iliac arteries-"Railing track".  

UK PubMed Central (United Kingdom)

Transcatheter aortic valve implantation (TAVI) has nowadays been introduced as an alternative for surgical aortic valve replacement as a treatment for high risk aortic stenosis patients. This procedure is not free of complications: the SOURCE registry, indeed, showed that vascular complications are more frequent with the transfemoral approach. We present the case of an 82-year-old man with known history of severe aortic stenosis at high-risk for surgery. Pre-TAVI screening shows bilateral severely tortuous iliac arteries and aorto-bi-iliac endoprosthesis. Transapical TAVI as a first choice was rejected due to severe lung disease. The patient was then treated by Transfemoral TAVI using a dedicated interventional technique that is described in this case-report.

Dandale RM; Pesarini G; Santini F; Molinari G; Rossi A; Milano A; Faggian G; Vassanelli C; Ribichini F

2012-05-01

16

Impending central retinal vein occlusion associated with cilioretinal artery obstruction  

Directory of Open Access Journals (Sweden)

Full Text Available Juliana Mantovani Bottós, Fabio Bom Aggio, Eduardo Dib, Michel Eid FarahVision Institute, Department of Ophthalmology, Federal University of São Paulo, BrazilAbstract: We report a case of a patient with an impending central retinal vein occlusion (CRVO) with cilioretinal artery obstruction, which may help to understand the nature of the retinal hemodynamic changes associated with CRVO which shows direct evidence of arterial vasospasm, suggesting an increased contractility of retinal arteries. The clinical course, with initial retinal whitening along a cilioretinal artery followed by signs of venous stasis, seems to confirm the pathogenesis hypothesis concerning a primary arterial affection due to arterial vasospasm.Keywords: retinal vein occlusion, cilioretinal artery obstruction, arterial spasm, fluorescein angiography

Juliana Mantovani Bottós; Fabio Bom Aggio; Eduardo Dib; Michel Eid Farah

2008-01-01

17

Hemi-central retinal artery occlusion in young adults  

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Full Text Available Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger?s syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

Rishi Pukhraj; Rishi Ekta; Sharma Tarun; Mahajan Sheshadri

2010-01-01

18

Metabolic syndrome and central retinal artery occlusion  

Directory of Open Access Journals (Sweden)

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.

Kosanovi?-Jakovi? Natalija; Petrovi? Lidija; Risimi? Dijana; Milenkovi? Svetislav; Mati? Danica

2005-01-01

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Central Retinal Artery Occlusion in a Patient with Pseudoxanthoma Elasticum  

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We examined a patient with central retinal artery occlusion (CRAO) who was diagnosed as having pseudoxanthoma elasticum and exhibited angioid streaks. Echocardiography revealed stenosis and plaques of the right carotid artery. Magnetic resonance imaging (MRI) showed multiple cerebral infarctions, wh...

Takeshita, Tetsuji; Ozaki, Mineo

20

Hemi-central retinal artery occlusion in young adults  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO) is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificia...

Rishi Pukhraj; Rishi Ekta; Sharma Tarun; Mahajan Sheshadri

 
 
 
 
21

Visual recovery in combined central retinal artery and central retinal vein occlusion.  

UK PubMed Central (United Kingdom)

We observed two patients who had combined central retinal artery occlusion and central retinal vein occlusion with severely reduced visual acuity and characteristic retinal changes. Over the course of several months, visual acuity and ophthalmoscopic appearance returned to normal. Both patients had a transient visual loss before their occlusive events and a mild nonconcurrent central retinal vein occlusion in their fellow eye. There was no evidence of inflammatory, vascular, or myeloproliferative disease.

Jorizzo PA; Klein ML; Shults WT; Linn ML

1987-10-01

22

[The change of retinal arteriolar circulation in a case of branch retinal artery occlusion].  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the retinal arteriolar circulation, morphology and sensitivity of an area in branch retinal artery occlusion (BRAO) using sequential investigation with laser Doppler velocimetry (LDV), optical coherence tomography (OCT) and microperimetry (MP-1). CASE REPORT: A 45-year-old woman was referred for decreased vision in the right eye with a visual acuity (VA) of 0.1. At the initial examination, retinal whitening and thickening were noted in the affected area. Fluorescein angiography revealed slightly delayed retinal filling time but no obstruction of arteries. Ophthalmoscopic and fluorescein angiographic examinations revealed incomplete branch retinal artery occlusion. OCT showed retinal thickening superior to the macula. MP-1 perimetry showed scotoma in the upper macula. LDV revealed a lower absolute value of retinal arterial blood flow (RBF) (7.5 microl/min) in the right eye. Laboratory test results showed iron deficiency anemia which probably induced the BRAO. The patient was treated with ocular massage and intravenous mannitol. The next day, VA improved to 1.2 and RBF normalized to 13.9 microl/min. On follow-up 2 months after the initial visit, OCT revealed retinal thinning and inner retinal atrophy; MP-1 showed improvement in retinal sensitivity overlaying the area of branch retinal artery occlusion following resolution of retinal edema. The RBV decreased to 6.0 microl/min, showing a marked decrease due to narrowing of the artery. CONCLUSION: In this case of acute transient BRAO, sequential LDV was performed and the quantitative retinal circulation was useful in evaluating the treatment and helped the prognosis of visual function in BRAO.

Omae T; Takahashi A; Nagaoka T; Ishiko S; Sato E; Yoshida A

2009-08-01

23

Retinal Arterial Macroaneurysm. A Case Report Macroaneurisma arterial retinal. Presentación de un caso.  

Directory of Open Access Journals (Sweden)

Full Text Available Retinal macroaneurysms are saccular dilatations of the retinal arteries. They commonly appear in temporary arches, which are found in elderly patients with hypertension and / or generalized vascular disease. They are slightly more frequent in women. In this article we present a case with a macroaneurysm rupture that was treated with laser photocoagulation and evolved favorably.Los macroaneurismas retinianos son dilataciones saculares de las arterias retinianas, con mayor frecuencia en arcadas temporales, que se detectan en pacientes de edad avanzada con hipertensión arterial y/o enfermedad vascular generalizada; son ligeramente más frecuentes en mujeres. Se presenta un caso clínico con ruptura de un macroaneurisma, que fue tratado con fotocoagulación con láser y evolucionó favorablemente.

Aimé Broche Hernández; Zailyt Morell Ochoa; Ilusimí Guillén Brizuela

2011-01-01

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Central retinal artery occlusion associated with head or neck pain revealing spontaneous internal carotid artery dissection.  

UK PubMed Central (United Kingdom)

PURPOSE: To report two cases of head or neck pain and central retinal artery occlusion associated with spontaneous dissection of the ipsilateral internal carotid artery. METHODS: Case reports. RESULTS: We describe two cases of sudden visual loss caused by central retinal artery occlusion. Both cases were preceded by ipsilateral headaches or neck pain and tinnitus. The patient had no other neurological signs or history of trauma. In both cases, cerebral angiography revealed ipsilateral internal carotid artery dissection. CONCLUSION: Ipsilateral headache or neck pain with tinnitus preceding central retinal artery occlusion is highly suggestive of internal carotid artery dissection. Early diagnosis and treatment may reduce the risk of hemispheric stroke.

Mokhtari F; Massin P; Paques M; Biousse V; Houdart E; Blain P; Gaudric A

2000-01-01

25

Unilateral branch retinal arterial occlusion following administration of bevacizumab for branch retinal vein occlusion.  

UK PubMed Central (United Kingdom)

Intravitreal bevacizumab has been adopted as a well-established treatment modality for the treatment of macular edema associated with branch retinal vein occlusion. It is considered a safe and efficacious option for improving visual acuity. We present an interesting case of unilateral superotemporal branch retinal vein occlusion in a 55-year-old man who received two doses of intravitreal bevacizumab one month apart. Laboratory tests including complete hypercoagulability and thrombotic work-up were completed but the patient successively developed branch retinal artery occlusion. We reviewed cases in literature and combined possible etiologies. We report a previously unpublished case of retinal artery occlusion following the use of intravitreal bevacizumab. Several studies have shown evidence of systemic thromboembolic events after the use of intravenous and systemic bevacizumab; however, to the best of our knowledge, no case has been reported of retinal artery occlusion immediately after administration of intravitreal bevacizumab.

Kaur S; Sachdev N

2013-10-01

26

A ruptured retinal arterial macroaneurysm presenting as subhyaloid haemorrhage  

Directory of Open Access Journals (Sweden)

Full Text Available We report a case of ruptured retinal arterial macroaneurysm with overlying subhyaloid haemorrhage. Both subhyaloid haemorrhage and subsequently the macroaneurysm was treated with argon laser photocoagulation

Vaidya Ashish; Shah Nikunj

2002-01-01

27

Neovascular Glaucoma Due to Branch Retinal Vein Occlusion Combined with Branch Retinal Artery Occlusion  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO) rarely cause neovascular glaucoma (NVG). A 58-year-old woman with hypertension and type 2 diabetic mellitus complained of progressive visual loss in her right eye for the previous 3 months. At initial examination, visual...

An, Tae-Su; Kwon, Soon-Il

28

Gaze-induced amaurosis from central retinal artery compression.  

UK PubMed Central (United Kingdom)

Color Doppler imaging was used to evaluate a patient with gaze-induced amaurosis caused by an intraconal orbital mass. The time-velocity waveform demonstrated abnormally high vascular resistance in the central retinal artery of the affected eye in the primary position. Abduction of the affected eye resulted in transient visual loss with an unreactive pupil. This same maneuver during color Doppler imaging resulted in a dramatic reduction of blood flow in the central retinal artery. Two months after surgical excision of the mass, the gaze-evoked amaurosis was no longer present, and color Doppler imaging demonstrated normal blood flow in the central retinal artery. This suggests that impaired retinal and optic nerve blood flow are responsible for gaze-induced amaurosis from compressive orbital lesions.

Knapp ME; Flaharty PM; Sergott RC; Savino PJ; Mazzoli RA; Flanagan JC

1992-02-01

29

Orbital cellulitis complicated by central retinal artery occlusion.  

UK PubMed Central (United Kingdom)

The authors present a case of a 16-year-old boy who sought treatment in Storm Eye Institute for orbital cellulitis complicated by central retinal artery occlusion. He was examined for severe signs of orbital cellulitis, including decreased vision and an afferent pupillary defect. Intravenous antibiotics failed to provide timely improvement, and the patient was surgically managed with endoscopic orbital decompression. An ocular examination under anesthesia revealed retinal ischemia in the affected eye, and fluorescein angiography confirmed the diagnosis of central retinal artery occlusion. The patient's vision improved slightly following resolution of the infection. Central retinal artery occlusion is a rare complication of orbital cellulitis in adults and has yet to be reported in the pediatric population.

Proctor CM; Magrath GN; de Castro LE; Johnson JH; Teed RG

2013-03-01

30

Retinal arterial occlusion in Takayasu?s arteritis  

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Full Text Available Takayasu?s arteritis is an auto-immune disorder of the large and medium-sized arteries, commonly involving the heart and its main vessels. It is now recognised that the inflammatory process of the large arteries affects regions of the walls supplied by the vasa vasorum, suggesting that primary small vessel involvement may contribute to the development of the clinico-pathological features of Takayasu aorto-arteritis. Classical ophthalmic features of the disease result from reduced ocular perfusion, which manifests as hypoxic retinal changes such as microaneurysms, arterio-venous anastomosis and non-perfused areas. Branch retinal artery occlusion has not been previously described in this condition. This case illustrates retinal arterial occlusion as the presenting feature of Takayasu?s arteritis.

Kaushik Sushmita; Gupta Amod; Gupta Vishali; Jain Sanjay; Lal Vivek

2005-01-01

31

Retinal artery embolization during carotid angioplasty and carotid artery stenting: case report.  

Science.gov (United States)

A 69-year-old man presented with a rare case of retinal artery embolization, which occurred as a complication of carotid angioplasty and carotid artery stenting performed for recurrent cerebral infarction. Magnetic resonance imaging and angiography showed right internal carotid artery stenosis with ulceration. Carotid angioplasty and carotid artery stenting were performed using the distal protection system with the PercuSurge GuardWire. However, just after dilation, the patient complained of ocular pain and blurred vision on the right, which was subsequently diagnosed as retinal artery embolization. Heparin was given for 15 hours after stenting, and aspirin and ticlopidine medication were continued. The patient received hyperbaric oxygen therapy for 1 week. The patient's blurred vision gradually improved, but visual field defect remained. Debris was probably flushed into the external carotid artery, and passed through an anastomosis into the ophthalmic artery, resulting in retinal artery embolization. PMID:19465793

Yamasaki, Hiroyuki; Matsubara, Shunji; Sasaki, Isao; Nagahiro, Shinji

2009-05-01

32

Retinal artery embolization during carotid angioplasty and carotid artery stenting: case report.  

UK PubMed Central (United Kingdom)

A 69-year-old man presented with a rare case of retinal artery embolization, which occurred as a complication of carotid angioplasty and carotid artery stenting performed for recurrent cerebral infarction. Magnetic resonance imaging and angiography showed right internal carotid artery stenosis with ulceration. Carotid angioplasty and carotid artery stenting were performed using the distal protection system with the PercuSurge GuardWire. However, just after dilation, the patient complained of ocular pain and blurred vision on the right, which was subsequently diagnosed as retinal artery embolization. Heparin was given for 15 hours after stenting, and aspirin and ticlopidine medication were continued. The patient received hyperbaric oxygen therapy for 1 week. The patient's blurred vision gradually improved, but visual field defect remained. Debris was probably flushed into the external carotid artery, and passed through an anastomosis into the ophthalmic artery, resulting in retinal artery embolization.

Yamasaki H; Matsubara S; Sasaki I; Nagahiro S

2009-05-01

33

A Case of Branch Retinal Artery Occlusion following Uneventful Phacoemulsification.  

UK PubMed Central (United Kingdom)

We would like to present a case of branch retinal artery occlusion following uneventful phacoemulsification, possibly caused by sub-Tenon's anaesthesia. There were no predisposing general health problems. There are two possible mechanisms: (1) mechanical effect of the bolus anaesthetic; (2) pharmacologically mediated changes in the vascular calibre. The latter mechanism is much more probable, because of the vasoconstrictive properties of both medications used. This is the first reported case of branch retinal artery occlusion after sub-Tenon's anaesthesia with preservative-free medications.

Dragnev D; Barr D; Kulshrestha M; Shanmugalingam S

2013-01-01

34

Unilateral central retinal artery occlusion following intravenous streptokinase.  

Directory of Open Access Journals (Sweden)

Full Text Available A 38-year-old male with acute myocardial infraction who had received streptokinase presented with acute painless diminution of vision in the left eye. Examination revealed features of central retinal artery occlusion on the left side with vision of perception of light. Treatment in the form of systemic and local intraocular pressure lowering agents, retrobulbar xanthinol nicotinate and systemic injection of B-complex resulted in improvement of vision to counting fingers up to one meter. In this case thrombolytic therapy itself led to embolism into the left central retinal artery resulting in its occlusion and eventually optic atrophy and blindness.

Potdar N; Shinde C; Murthy G; Ingole A

2001-01-01

35

[A case of central retinal vein occlusion followed by branch retinal artery occlusion].  

UK PubMed Central (United Kingdom)

BACKGROUND: The influence of retinal artery circulation on central retinal vein occlusion (CRVO) is not well known. CASE: A 73-year-old man with hypertension complained of transient visual loss in his left eye. At initial examination, ophthalmoscopy of his left eye showed mild dilatation and tortuosity of the retinal vein and a few dot hemorrhages. Fluorescein angiography disclosed normal arm-to-retina circulation time and no leakage of dye, but delayed retinal circulation time. These findings indicated venous stasis retinopathy of CRVO. In spite of intravenous infusion of prostaglandin E1 and vasodilative treatment, four days after initial examination, the patient's left eyeground showed complication of branch retinal artery occlusion (BRAO). A fibrinolytic agent was given intravenously, but four weeks later, his left eyeground developed typical hemorrhagic retinopathy. The hemodynamics of retrobulbar arterial circulation were investigated by color Doppler imaging. CONCLUSION: We report a case of venous stasis retinopathy of CRVO associated with BRAO, that developed hemorrhagic retinopathy despite treatment with prostaglandin E1 and other vasodilative agents. We think that arterial insufficiency might be responsible for the conversion from venous stasis retinopathy to hemorrhagic retinopathy of CRVO.

Yoshimoto M; Sumi I; Matsumoto S

2001-01-01

36

Retinal branch artery occlusion following injection of hyaluronic acid (Restylane).  

UK PubMed Central (United Kingdom)

The authors report a retinal branch artery occlusion occurring after facial injection of a dermal filler. The superior temporal artery showed occlusion due to a clearly visible long and fragmented embolus suggestive of gel and clearly distinguishable from calcific or cholesterol emboli. The authors suppose that hyaluronic acid gel was embolized in the patient. The embolized material is supposed to enter the ocular circulation through retrograde arteriolar flow after intra-arterial injection into one of the peripheral branches of the ophthalmic artery. If there is any evidence of a visual problem after facial injection of a dermal filler, prompt consultation of an ophthalmologist is recommended.

Peter S; Mennel S

2006-05-01

37

[Isolated and combined occlusion of the cilioretinal artery and the central retinal vein  

UK PubMed Central (United Kingdom)

Cilioretinal artery occlusion is rare pathological condition because of infrequent occurrence of the cilioretinal artery in the human retina. It presents as an isolated entity, or as a combined cilioretinal artery--central retinal vascular, mostly venous occlusion. Authors present the course, angiographic features, prognosis, risk factors and final outcome of the isolated cilioretinal artery occlusion and combined cilioretinal artery--central retinal vein occlusion. Occlusion of the cilioretinal artery is believed to result from obstruction of the central retinal vein, as a primary process, in the case of combined cilioretinal artery--central retinal vein occlusion.

Streicher T; Spirková J

2001-01-01

38

Central retinal artery occlusion: an unusual complication of snakebite  

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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.

A. Bhalla; A. P. Jain; S. Banait; U. N. Jajoo; S.P. Kalantri

2004-01-01

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Central retinal artery occlusion: an unusual complication of snakebite  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english 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.

Bhalla, A.; Jain, A. P.; Banait, S.; Jajoo, U. N.; Kalantri, S.P.

2004-01-01

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Makino, Shinji; Takezawa, Mikiko; Sato, Yukihiro

 
 
 
 
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Unilateral electronegative ERG in a presumed central retinal artery occlusion  

Science.gov (United States)

A unilateral electronegative electroretinogram (ERG) was seen in a 94-year-old man with presumed central retinal artery occlusion. Goldmann perimetry revealed central scotoma in the right eye and no abnormalities in the left eye. Full-field ERG in the right eye described a reduction of the b-wave with a relative preservation of the a-wave which is characteristic of electronegative ERG. Hence, our case illustrates that ERG testing is essential for the work-up of individuals with suspected retinal vascular disorders.

Lima, Luiz H; Cella, Wener; Brue, Claudia; Tsang, Stephen H

2010-01-01

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Change in retinal blood flow and retinal arterial diameter after intraocular pressure reduction in glaucomatous eyes.  

UK PubMed Central (United Kingdom)

PURPOSE: To study retinal blood flow and vessel diameter after intra-ocular pressure (IOP) reduction in high- and low-pressure glaucomas, that is, exfoliation glaucoma (ExG) and normal-tension glaucoma (NTG). METHODS: The study included 17 eyes with ExG and 20 with NTG. A minimum of 25% IOP reduction was achieved by deep sclerectomy. Blood flow in the temporal peripapillary retina was measured with scanning laser Doppler flowmetry (Heidelberg Retina Flowmeter, HRF), and retinal vessel diameters were evaluated with the retinal vessel analyser (RVA). Examinations were carried out before and 3 months after the operation. RESULTS: Pre-operative IOP was significantly higher in ExG than in NTG (median 26 mmHg, range 20-33 mmHg versus 15 mmHg, 12-20; p < 0.001). Surgery reduced IOP significantly both in ExG eyes (postoperative IOP 13 mmHg, 5-17; p < 0.001) and NTG eyes (9 mmHg, 3-13; p < 0.001). After the operation, systolic retinal flow was significantly reduced in ExG eyes, whereas in NTG, HRF parameters remained unchanged. Pre-operatively, the central retinal artery equivalent (CRAE) and arteriovenous ratio (AVR) were higher in ExG than in NTG eyes. After IOP reduction, both CRAE and AVR were reduced in ExG eyes, but remained unchanged in NTG. CONCLUSION: The study showed that before IOP reduction, arterial diameter was larger in ExG eyes than in NTG eyes. IOP reduction resulted in vasoconstriction and reduction of flow in ExG, whereas in NTG, both vessel diameter and retinal flow remained unchanged.

Kurvinen L; Kytö JP; Summanen P; Vesti E; Harju M

2013-09-01

43

Postpartum central retinal artery occlusion simulating Purtscher's retinopathy.  

UK PubMed Central (United Kingdom)

A 30-year-old woman noticed sudden visual loss in her right eye 3 days after a normal childbirth and without eclampsia during pregnancy. An ophthalmic examination revealed that she had impending central retinal artery occlusion and her right visual acuity was 20/2000, which recovered to 20/30. A systemic examination showed hypercoagulability and hyperlipidemia but no abnormal findings on brain CT scan and echocardiography. Clinical features of this case were very similar to Purtscher's retinopathy.

Ayaki M; Yokoyama N; Furukawa Y

1995-01-01

44

[Tibolone's effect on retinal and ophthalmic arteries flowmetry].  

UK PubMed Central (United Kingdom)

PURPOSE: to evaluate the effect of tibolone use on doppler-velocimetric parameters of ophthalmic and retinal arteries. METHODS: clinical, prospective, longitudinal, randomized, placebo-controlled, triple-blind study, in which among 100 menopausal women, 50 have used 2.5 mg of the active principle tibolone (Tib Group) and 50, placebo as a means to form the control-group (Plac Group). In the Tib Group, 44 of the 50 women returned after 84 days to finish the exams, and in the Plac Group, 47. The ophthalmic and retinal arteries were studied to determine the resistance index (RI), the pulsatility index (PI) and the systole/diastole ratio (S/D). Assessments have been done before and 84 days after medication. The t-Student test has been used for the comparison of means between the groups in independent samples, as well as for within-group comparisons in dependent samples. RESULTS: in both groups, the women's characteristics were similar in age, menopause duration, body mass index, arterial blood pressure, deliveries and cardiac rate. The Tib Group presented the following values in the ophthalmic artery: RI(pre)=0.71+/-0.05, RI(post)0.72+/-0.08 (p=0.43); PI(pre)=1.29+/-0.22, PI(post)=1.30+/-0.25 (p=0.4) and S/D(pre)=3.49+/-0.77, SD(post)=3.65+/-0.94 (p=0.32). In the retinal artery, the following values have been found: RI(pre)=0.67+/-0.09, RI(post)=0.69+/-0.10 (p=0.7); PI(pre)=1.20+/-0.29, PI(post)=1.22+/-0.3 (p=0.2) and SD(pre)=3.29+/-0.95, SD(post)=3.30+/-1.07 (p=0.3). Also, the tibolone and control groups did not show any significant difference in regard to the above indexes in the end of the study. CONCLUSIONS: the 2.5 mg dose of tibolone had no effect on the Doppler velocimetry indexes of the ophthalmic and retinal arteries.

Souza MA; Geber S

2008-11-01

45

Central retinal artery occlusion resembling Purtscher-like retinopathy  

Directory of Open Access Journals (Sweden)

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

Kurimoto T; Okamoto N; Oku H; Kanbara Y; Etomi T; Tonari M; Ikeda T

2011-01-01

46

Unilateral electronegative ERG in a presumed central retinal artery occlusion  

Directory of Open Access Journals (Sweden)

Full Text Available Luiz H Lima1, Wener Cella2,4, Claudia Brue5, Stephen H Tsang2.31Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil; 2Department of Ophthalmology, 3Bernard and Shirlee Brown Glaucoma Laboratory, Edward S Harkness Eye Institute and Departments of Opthamology, Pathology and Cell Biology, Columbia University, New York, NY, USA; 4Department of Ophthalmology, University of Brasilia, Brasilia, Brazil; 5Department of Opthamology, University Politecnica delle Marche, Ancona, ItalyAbstract: A unilateral electronegative electroretinogram (ERG) was seen in a 94-year-old man with presumed central retinal artery occlusion. Goldmann perimetry revealed central scotoma in the right eye and no abnormalities in the left eye. Full-field ERG in the right eye described a reduction of the b-wave with a relative preservation of the a-wave which is characteristic of electronegative ERG. Hence, our case illustrates that ERG testing is essential for the work-up of individuals with suspected retinal vascular disorders.Keywords: central retinal artery occlusion, electronegative ERG, inner retina, spectral domain optical coherence tomography

Luiz H Lima; Wener Cella; Claudia Brue; et al

2010-01-01

47

The tortuous behavior of lightning  

CERN Multimedia

The complex branched structure of lightning induce scientists to think that dielectric breakdown is a very complicated phenomena, we will show that this is not true and that simulating the structure of lightning is an easy task, but depends strongly on boundary conditions. In this work we will introduce a new way of understanding the origin of this tortuous path that relies on minimizing the total energy stored in the system.

Vera, F

2002-01-01

48

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

International Nuclear Information System (INIS)

[en] 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 (

2009-01-01

49

Treatment of Branch Retinal Artery Occlusion With Transluminal Nd:YAG Laser Embolysis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The purpose of this paper was to report a successful treatment of transluminal Nd:YAG laser embolysis (NYE) for branch retinal artery occlusion (BRAO) with visible emboli. Two patients with acute, severe vision loss secondary to a branch retinal artery occlusion with visible emboli in one eye underw...

Lim, Jong Yoon; Lee, Joo Yong; Chung, Hye Won; Yoon, Young Hee; Kim, June-Gone

50

Central retinal artery occlusion secondary to orbital cellulitis and abscess following dacryocystitis.  

UK PubMed Central (United Kingdom)

PURPOSE: To report a case of dacryocystitis that progressed to orbital abscess resulting in the rare complication of central retinal artery occlusion. METHODS: A patient without any other known health problems presented with dacryocystitis complicated by orbital cellulitis, orbital abscess, and finally central retinal artery occlusion despite medical treatment. RESULTS: After 48 hours of medical treatment, there was no recovery, and there was loss of light perception; because of this, surgery indication was determined. Fundus fluorescein angiogram demonstrated findings of central retinal artery occlusion. There was no recovery of light perception after surgical intervention. CONCLUSIONS: We report a case of orbital abscess following dacryocystitis in a healthy middle-aged woman resulting in the rare complication of central retinal artery occlusion. To our knowledge, this is the first report of central retinal artery occlusion secondary to orbital abscess following dacryocystitis.

Co?kun M; Ilhan Ö; Keskin U; Ayintap E; Tuzcu E; Semiz H; Öksüz H

2011-09-01

51

Recurrent transient monocular blindness from stenotic central retinal artery.  

UK PubMed Central (United Kingdom)

Transient monocular blindness (TMB) is caused by a temporary reduction of blood flow to the retina or optic nerve. Even though embolism from the ipsilateral carotid artery has been considered the main mechanism of TMB, the vascular pathology remains unknown in many patients. A 42-year-old man presented with recurrent transient visual loss in the left eye for 2months. The attacks tended to develop more frequently when his head was bent down. Fluorescence angiography during an attack revealed hypoperfusion of the left central retinal artery (CRA) and cerebral angiography documented a focal isolated stenosis of the CRA at the origin. Aspirin and nimodipine reduced the attacks markedly. Stenosis of the CRA may be a cause of TMB. Intermittent vasospasm in addition to static hypoperfusion may have caused TMB in our patient with isolated CRA stenosis.

Choi SY; Moon HJ; Huh YE; Yang HK; Woo SJ; Jung C; Kwon OK; Kim JS

2013-07-01

52

Branch retinal artery occlusion secondary to dengue fever  

Directory of Open Access Journals (Sweden)

Full Text Available Dengue is known to affect the posterior segment of the eye, with a range of hemorrhagic and inflammatory sequelae. A 28-year-old lady convalescing from dengue fever complained of unilateral blurring of inferior visual field. She was evaluated clinically and with fluorescein angiography. Her best-corrected visual acuity was 20/20 bilaterally. Fundus examination revealed a branch retinal artery occlusion in the right eye. Fluorescein angiogram confirmed the clinical diagnosis; and also revealed a late staining and leakage from the affected arterial segment. The patient maintained status quo over a follow-up of six months. We report a major vascular occlusion complicating classic dengue fever even in the absence of severe systemic manifestations.

Kanungo Sanghamitra; Shukla Dhananjay; Kim Ramasamy

2008-01-01

53

Innervation pattern of the preocular human central retinal artery.  

UK PubMed Central (United Kingdom)

The central retinal artery (CRA) is the main vessel for inner retinal oxygen and nutrition supply. While the intraocular branches lack autonomic innervation, the innervation pattern of the extra-ocular part of this vessel along its course within the optic nerve is poorly investigated. This part however is essential for maintenance of retinal blood supply, in physiological and pathological conditions. Therefore, the aim of this study was the characterization of the autonomic innervation of the preocular CRA in humans with morphological methods. Meeting the Declaration of Helsinki, eyes of body or cornea donors were processed for single or double immunohistochemistry against tyrosine hydroxilase (TH), dopamine-?-hydroxylase (DBH), choline acetyl-transferase (ChAT), vesicular acetylcholine transporter (VAChT), neuronal nitric oxide synthase (nNOS), calcitonin gene-related peptide (CGRP), substance P (SP), vasoactive intestinal polypeptide (VIP), and cytochemistry for NADPH-diaphorase (NADPH-d). For documentation, light-, fluorescence-, and confocal laser-scanning microscopy were used. TH and DBH immunoreactive nerve fibres were detected in the CRA vessel wall, although a distinct perivascular plexus was missing. Further, nerve fibres immunoreactive for ChAT and VAChT were found, while CGRP, SP, and VIP were not detected. NADPH-d staining revealed scattered nerve fibres in the adventitia of the CRA and in close vicinity; however, nNOS-immunostaining could not confirm this finding. The CRA receives adrenergic and cholinergic innervations, indicating sympathetic and parasympathetic components, respectively. Remarkably, a peptidergic primary afferent innervation was missing. Since clinical results suggest an autoregulation of intraretinal vessels, further studies are needed to clarify the impact of CRA innervation for retinal perfusion.

Bergua A; Kapsreiter M; Neuhuber WL; Reitsamer HA; Schrödl F

2013-05-01

54

Innervation pattern of the preocular human central retinal artery.  

Science.gov (United States)

The central retinal artery (CRA) is the main vessel for inner retinal oxygen and nutrition supply. While the intraocular branches lack autonomic innervation, the innervation pattern of the extra-ocular part of this vessel along its course within the optic nerve is poorly investigated. This part however is essential for maintenance of retinal blood supply, in physiological and pathological conditions. Therefore, the aim of this study was the characterization of the autonomic innervation of the preocular CRA in humans with morphological methods. Meeting the Declaration of Helsinki, eyes of body or cornea donors were processed for single or double immunohistochemistry against tyrosine hydroxilase (TH), dopamine-?-hydroxylase (DBH), choline acetyl-transferase (ChAT), vesicular acetylcholine transporter (VAChT), neuronal nitric oxide synthase (nNOS), calcitonin gene-related peptide (CGRP), substance P (SP), vasoactive intestinal polypeptide (VIP), and cytochemistry for NADPH-diaphorase (NADPH-d). For documentation, light-, fluorescence-, and confocal laser-scanning microscopy were used. TH and DBH immunoreactive nerve fibres were detected in the CRA vessel wall, although a distinct perivascular plexus was missing. Further, nerve fibres immunoreactive for ChAT and VAChT were found, while CGRP, SP, and VIP were not detected. NADPH-d staining revealed scattered nerve fibres in the adventitia of the CRA and in close vicinity; however, nNOS-immunostaining could not confirm this finding. The CRA receives adrenergic and cholinergic innervations, indicating sympathetic and parasympathetic components, respectively. Remarkably, a peptidergic primary afferent innervation was missing. Since clinical results suggest an autoregulation of intraretinal vessels, further studies are needed to clarify the impact of CRA innervation for retinal perfusion. PMID:23220730

Bergua, Antonio; Kapsreiter, Markus; Neuhuber, Winfried L; Reitsamer, Herbert A; Schrödl, Falk

2012-12-06

55

Acute Central Retinal Artery Occlusion Associated with Livedoid Vasculopathy: A Variant of Sneddon's Syndrome.  

UK PubMed Central (United Kingdom)

Livedoid vasculopathy (LV) is characterized by a long history of ulceration of the feet and legs and histopathology indicating a thrombotic process. We report a case of acute central retinal artery occlusion in a 32-year-old woman who had LV. She showed no discernible laboratory abnormalities such as antiphospholipid antibodies and no history of cerebrovascular accidents. Attempted intra-arterial thrombolysis showed no effect in restoring retinal arterial perfusion or vision. The central retinal artery occlusion accompanied by LV in this case could be regarded as a variant form of Sneddon's syndrome, which is characterized by livedo reticularis and cerebrovascular accidents.

Song HB; Woo SJ; Jung CK; Lee YJ; Ahn J; Park KH; Kwon OK

2013-10-01

56

Retinal arterial occlusive disease in a young patient with cat scratch disease.  

UK PubMed Central (United Kingdom)

PURPOSE: To report an unusual case of a branch retinal arterial occlusion and bilateral multifocal retinitis in a young woman with cat scratch disease. METHODS: A 23-year-old woman was referred to our clinic complaining of a sudden scotoma in the upper part of the visual field of her left eye. Fundoscopy revealed occlusion of an inferior temporal branch of the retinal artery in the left eye and bilateral multifocal retinitis, which was confirmed by fluorescein angiography. Subsequent indocyanine angiography did not reveal choroidal involvement. Laboratory analysis showed rising IgG titers for Bartonella henselae. RESULTS: Cat scratch disease was diagnosed, and a 4-week course of doxycycline was initiated. The patient responded well to the antibiotics. Both retinitis and arterial occlusion were resolved, the visual field was regained and the patient reported elimination of her symptoms. CONCLUSIONS: Cat scratch disease should be considered in the differential diagnosis in young patients with retinal occlusive disease.

Batsos G; Kabanarou SA; Fotiou P; Rouvas A; Xirou T

2013-01-01

57

Retinal vein and artery occlusions: a risk factor for stroke in atrial fibrillation.  

UK PubMed Central (United Kingdom)

BACKGROUND: Retinal vascular occlusions may constitute an independent risk factor for stroke in patients with atrial fibrillation. METHODS: We performed a retrospective study on a nationwide cohort with atrial fibrillation from 1997 to 2008. The rate of stroke/systemic thromboembolism (TE)/transitory ischemic attack (TIA) was determined for atrial fibrillation patients with and without a history of retinal vascular occlusion. A Cox regression analysis, adjusted for risk factors and medications, was performed to determine the independent predictive value of retinal arterial or venous occlusion for the risk of ischemic stroke, TE or TIA in atrial fibrillation patients. RESULTS: We included 87 202 patients with non-valvular atrial fibrillation. At baseline, a history of retinal arterial occlusion was diagnosed in 224 patients (0.26%) and a history of retinal venous occlusion in 361 (0.41%). Patients without retinal occlusion had a rate of stroke/TE/TIA of 4.52 (95% confidence interval [CI] 4.44-4.60). For patients with retinal arterial occlusion, the rate of stroke/TE/TIA was 8.16 (95% CI 6.35-10.49) per 100 person-years, and for patients with retinal venous occlusion it was 7.28 (95% CI 5.93-8.94) per 100 person-years. In multivariate analysis, both retinal arterial occlusions (hazard ratio [HR] 1.39, 95% CI 1.08-1.79) and retinal venous occlusions (HR 1.26, 95% CI 1.02-1.54) were associated with an increased risk of future stroke/TE/TIA. CONCLUSIONS: A history of retinal arterial or retinal venous occlusion is associated with an increased risk of stroke/TE/TIA in patients with atrial fibrillation. Thus, prior retinal vascular occlusion may be considered as a previous thromboembolic event when evaluating stroke risk in patients with atrial fibrillation.

Christiansen CB; Lip GY; Lamberts M; Gislason G; Torp-Pedersen C; Olesen JB

2013-08-01

58

Selective thrombolysis performed through meningo-ophthalmic artery in central retinal artery occlusion.  

UK PubMed Central (United Kingdom)

The poor natural history of central retinal artery occlusion (CRAO) is usually not modified with conventional, conservative management techniques. Guidelines for selective intraarterial ophthalmic thrombolysis are still lacking. While many centers continue to perform this procedure with promising results, others are reluctant due to conflicting findings in recent studies. We present our experience in a 36-year-old male with CRAO. Based on the patient's clinical presentation, we planned to perform selective intraarterial ophthalmic thrombolysis via the ophthalmic artery. When angiography demonstrated that the retina was not supplied by the ophthalmic artery, but by a meningo-ophthalmic artery branching from the internal maxillary artery, we instead administered thrombolytic agents via the meningo-ophthalmic artery. The patient's vision recovered completely, with visual acuity and visual field examination at 30 day follow up comparable to his pre-treatment status. This case emphasizes the need for external carotid artery examination in cases of nonvisualization of the ophthalmic artery. In addition, it illustrates the successful use of the meningo-ophthalmic artery to perform selective intraarterial thrombolysis for CRAO.

Cohen JE; Moscovici S; Halpert M; Itshayek E

2012-03-01

59

Treatment of branch retinal arterial occlusion with sodium ozagrel, a thromboxane A2 synthetase inhibitor.  

UK PubMed Central (United Kingdom)

A 47-year-old woman with branch retinal arterial occlusion treated with sodium ozagrel is described. The patient presented with acute visual field loss in her right eye. Blood tests demonstrated the elevation of beta-thromboglobulin and platelet factor 4. Sodium ozagrel, a thromboxane A2 synthetase inhibitor, 160 mg daily was administered for 14 days. This treatment prevented exacerbation of retinal arterial thrombosis and produced a marked improvement in the visual field loss. Sodium ozagrel may be a useful drug in the treatment of acute retinal arterial occlusion thought to be caused by thrombosis.

Kato H; Emura S; Takeuchi N; Enoki M; Oogushi K; Takashima T; Ohmori K; Saito I

1997-03-01

60

[Antiphospholipid syndrome and bilateral retinal artery and vein occlusion: case report].  

UK PubMed Central (United Kingdom)

The antiphospholipid syndrome (APS) has been related to venous and arterial thrombosis of large and small vessels. Ocular vessels can also be involved causing transient visual loss, diplopia, ischemic optic neuropathy and central artery and venous occlusion. We describe here a case of antiphospholipid syndrome with occlusion of central retinal artery and vein to call the attention to this diagnosis.

Beckhauser AP; Arana LA; Skare TL

2008-03-01

 
 
 
 
61

[Bilateral simultaneous central retinal artery occlusion revealing giant cell arteritis].  

UK PubMed Central (United Kingdom)

AIM: To point out the importance of the early diagnosis of giant cell arteritis (GCA) (Horton's disease). MATERIALS AND METHODS: a case report of a sudden bilateral blindness that had revealed GCA. CASE REPORT: A 68-year old female patient with a history of elevated blood pressure and diabetes mellitus type 2, was examined in emergency for a right painful headache developed one week previously. In ophthalmological examination, her BCVA was 0.9 and P2 in both eyes. Diagnosis of Horton's disease was not initially done in spite of elevated erythrocytes sedimentation rate (ESR) at 30 mm, protein C reactive (CRP) at 19 mg/l. The patient consulted seven weeks later in emergency for a sudden bilateral blindness associated with severe headache, recent asthenia, and limping of the lower jaw. At that time, visual acuity was reduced to light perception in both eyes whereas ophthalmoscopy revealed a bilateral central retinal artery occlusion (CRAO). ESR was 74 mm and CRP 233 mg/I. Temporal artery biopsy confirmed the diagnosis of GCA. The patient was treated with systemic steroids without visual recovery. CONCLUSION: This case outlines the importance of the early diagnosis of GCA in order to make possible to start treatment before the occurrence of irreversible complications.

Ayena KD; Lawson SL; Koffi A; Amegbor K; Pio M; Machihude MI; Tchabia Nabroulaba K; Gaoussou T; Feys J; Feys PH; Forestier F; Balo KP

2011-01-01

62

Interventions for acute non-arteritic central retinal artery occlusion.  

UK PubMed Central (United Kingdom)

BACKGROUND: Acute central retinal artery occlusion (CRAO) occurs as a sudden interruption of the blood supply to the retina and results in an almost complete loss of vision in the affected eye. There is no generally agreed treatment regimen although a number of therapeutic interventions have been proposed. OBJECTIVES: The objective of this review was to examine the effects of treatments used for acute non-arteritic CRAO. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library, Issue 3, 2008), MEDLINE (January 1966 to September 2008), EMBASE (January 1980 to September 2008) and the reference lists of relevant papers. SELECTION CRITERIA: We included randomised controlled trials (RCTs) only in which one treatment aimed to re-establish blood supply to the retina in people with acute CRAO was compared to another treatment. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the search results for relevant trials. Discrepancies were resolved by discussion. MAIN RESULTS: We found two RCTs that met our inclusion criteria. AUTHORS' CONCLUSIONS: The included studies in this review were small and from single centres. Neither study was completely clear about it's method of treatment allocation. One study described the use of pentoxifylline tablets (three 600 mg tablets daily) and the other the use of enhanced external counterpulsation (EECP) combined with haemodilution. Both studies indicated improved retinal perfusion in the non-control group but neither showed an improvement in vision. Large, well-designed RCTs are still required to establish the most effective treatment for acute CRAO. These studies should be looking at factors important to the patient i.e. improved vision with acceptable risk/side-effects.

Fraser SG; Adams W

2009-01-01

63

Ocular vascular thrombotic events: central retinal vein and central retinal artery occlusions.  

Science.gov (United States)

We prospectively assessed associations of thrombophilia- hypofibrinolysis with central retinal vein occlusion (CRVO) (40 patients) and central retinal artery occlusion (CRAO) (9 patients). We used polymerase chain reaction measures for thrombophilia (factor V Leiden, prothrombin, C677T MTHFR, platelet glycoprotein PlA1/A2) and hypofibrinolysis (plasminogen activator inhibitor-1 4G4G). Serologic thrombophilia measures included protein C, protein S (total and free) and antithrombin III, homocysteine, lupus anticoagulant, anticardiolipin antibodies IgG-IgM, and factors VIII and XI. Serologic hypofibrinolysis measures included Lp(a) and plasminogen activator inhibitor activity. For comparison with 40 CRVO and 9 CRAO patients, 80 and 45 race-gender matched controls were studied. The factor V mutation was more common in CRVO (3/40, 8%) than controls (0/79, 0%), P = .036, as was high (>150%) factor VIII (12/40, 30%) versus (4/77, 5%), P = .0002. Low antithrombin III ( or =13.5 micromol/L) in 5/39 (13%) CRVO patients versus 2/78 controls (3%), P = .04. Three of 9 CRAO patients (33%) had low ( or =13.5 micromol/L) homocysteine versus 0/42 controls (0%), P =. 028. Four of 9 CRAO patients had the lupus anticoagulant (44%) versus 4/33 (12%) controls (P = .050). CRVO is associated with familial thrombophilia (factor V Leiden, factor VIII, low antithrombin III, homocysteinemia), and CRAO is associated with familial and acquired thrombophilia (low protein C, homocysteinemia, lupus anticoagulant), providing avenues for thromboprophylaxis, and triggering family screening. PMID:18160589

Glueck, Charles J; Ping Wang; Hutchins, Robert; Petersen, Michael R; Golnik, Karl

2007-12-26

64

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

DEFF Research Database (Denmark)

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, and this study was therefore designed to examine the retinal vasculature separately from the neuroretina.

Gesslein, Bodil; Gustafsson, Lotta

2009-01-01

65

No association of 9p21 with arterial elasticity and retinal microvascular findings.  

UK PubMed Central (United Kingdom)

OBJECTIVE: How 9p21 variation affects risk of cardiovascular disease is unclear, so we assessed whether 9p21 variants are associated with arterial elasticity or retinal microvascular findings. METHODS: In the prospective Multi-Ethnic Study of Atherosclerosis (MESA) we assessed 378 SNPs in the 9p21 locus. Within four ethnic groups, we used an additive genetic model to relate the 9p21 SNPs to five vascular phenotypes: small and large elasticity derived from radial diastolic pulse contour analysis; Young's elastic modulus from carotid artery ultrasound measurements; and the diameter of the central retinal arteries and veins. RESULTS: In neither ethnic-specific nor pooled data was there any statistically significant association between any of the 9p21 SNPs and any of the five vascular phenotypes. CONCLUSION: Our study does not support an association of 9p21 variation with arterial elasticity or retinal microvascular abnormalities.

Folsom AR; Pankow JS; Li X; Duprez DA; Jacobs DR Jr; Klein R; Klein B; Tang W; Wong TY; Cotch MF; Taylor KD; Rich SS; Hall JL; Post WS; Rotter JI

2013-10-01

66

Development of an automated system to classify retinal vessels into arteries and veins.  

Science.gov (United States)

There are some evidence of the association between the calibre of the retinal blood vessels and hypertension. Computer-assisted procedures have been proposed to measure the calibre of retinal blood vessels from high-resolution photopraphs. Most of them are in fact semi-automatic. Our objective in this paper is twofold, to develop a totally automated system to classify retinal vessels into arteries and veins and to compare the measurements of the arteriolar-to-venular diameter ratio (AVR) computed from the system with those computed from observers. Our classification method consists of four steps. First, we obtain the vascular tree structure using a segmentation algorithm. Then, we extract the profiles. After that, we select the best feature vectors to distinguish between veins and arteries. Finally, we use a clustering algorithm to classify each detected vessel as an artery or a vein. Our results show that compared with an observer-based method, our method achieves high sensitivity and specificity in the automated detection of retinal arteries and veins. In addition the system is robust enough independently of the radii finally chosen, which makes it more trustworthy in its clinical application. We conclude that the system represents an automatic method of detecting arteries and veins to measure the calibre of retinal microcirculation across digital pictures of the eye fundus. PMID:22424729

Saez, Marc; González-Vázquez, Sonia; González-Penedo, Manuel; Barceló, Maria Antònia; Pena-Seijo, Marta; Coll de Tuero, Gabriel; Pose-Reino, Antonio

2012-03-17

67

Bilateral central retinal artery occlusion and vein occlusion complicated by severe choroidopathy in systemic lupus erythematosus.  

UK PubMed Central (United Kingdom)

Severe retinal vascular occlusions resulting in blindness is a rare occurrence in patients with systemic lupus erythematosus (SLE). Herein, we report a case of a 33-year-old female who developed combined central retinal artery occlusion, retinal vein occlusion, and choroidopathy and rapidly became completely blind in both eyes within a week. The electroretinogram revealed a severely attenuated a-wave and b-wave, indicating a profound dysfunction of both choroidal and retinal circulation, respectively. The current case demonstrates objectively the functional impact of severe choroidopathy in SLE for the first time. Patients with unilateral blindness due to combined retinal/choroidal vascular obstructions should be monitored carefully to ensure adequate anticoagulant therapy in an attempt to guard the vision in the fellow eye.

Nishiguchi KM; Ito Y; Terasaki H

2013-06-01

68

[Branch retinal artery occlusion as the sole ocular manifestation of Takayasu arteritis].  

Science.gov (United States)

We report a case of branch retinal artery occlusion in a young woman suffering from established Takayasu arteritis. A 35-year-old woman with a previous history of Takayasu arteritis, diagnosed 5 years before, presented to the emergency department reporting sudden visual loss in her left eye and restriction of the visual field for the past hour. On ophthalmologic examination, occlusion of the superior temporal branch of the central retinal artery was revealed. However, no other classic signs of ocular ischemia associated with Takayasu arteritis were observed. Three out of the six criteria set out by the American College of Rheumatology for the diagnosis of Takayasu disease were met. Visual acuity recovered to 7/10(e), corrected, with the presence of a patent cilioretinal artery. The occurrence of retinal artery occlusion at such a young age is exceptional, justifying a thorough examination to reveal the underlying pathology. There is only one other report in the literature of a case of branch retinal artery occlusion as a manifestation of Takayasu arteritis. The case reported here is exceptional because of the absence of more typical signs of ocular ischemia and the moderate degree of involvement of the major cervical arteries. PMID:20031261

Balaskas, K; Potamitou, D; Spastri, A

2009-12-22

69

[Branch retinal artery occlusion as the sole ocular manifestation of Takayasu arteritis].  

UK PubMed Central (United Kingdom)

We report a case of branch retinal artery occlusion in a young woman suffering from established Takayasu arteritis. A 35-year-old woman with a previous history of Takayasu arteritis, diagnosed 5 years before, presented to the emergency department reporting sudden visual loss in her left eye and restriction of the visual field for the past hour. On ophthalmologic examination, occlusion of the superior temporal branch of the central retinal artery was revealed. However, no other classic signs of ocular ischemia associated with Takayasu arteritis were observed. Three out of the six criteria set out by the American College of Rheumatology for the diagnosis of Takayasu disease were met. Visual acuity recovered to 7/10(e), corrected, with the presence of a patent cilioretinal artery. The occurrence of retinal artery occlusion at such a young age is exceptional, justifying a thorough examination to reveal the underlying pathology. There is only one other report in the literature of a case of branch retinal artery occlusion as a manifestation of Takayasu arteritis. The case reported here is exceptional because of the absence of more typical signs of ocular ischemia and the moderate degree of involvement of the major cervical arteries.

Balaskas K; Potamitou D; Spastri A

2010-01-01

70

Acute retinal artery occlusion in systemic sclerosis: A rare manifestation of systemic sclerosis fibroproliferative vasculopathy.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To describe three patients with systemic sclerosis (SSc) who developed acute unilateral blindness in the absence of any common etiologic factor for blindness. In one patient, the affected eye required enucleation and was examined histopathologically. METHODS: Following identification of the first patient with retinal artery occlusion at the Scleroderma Center of Thomas Jefferson University, every patient evaluated at the Center from May 2001 to December 2010 was prospectively assessed for the development of acute unilateral blindness. Two additional cases were identified. Here, we describe the clinical features, laboratory and ancillary examinations of the three patients with SSc who developed acute unilateral blindness and present the histopathological examination of one eye enucleated from one of the patients. RESULTS: Clinical and angiographic studies were consistent with acute retinal artery occlusion. The histopathological studies showed severe retinal ischemic atrophy and concentric narrowing and fibrosis of small retinal vessels. CONCLUSIONS: These findings suggest that acute retinal artery occlusion in these patients is a manifestation of the fibroproliferative vasculopathy characteristic of SSc.

Busquets J; Lee Y; Santamarina L; Federman JL; Abel A; Del Galdo F; Eagle RC Jr; Jimenez SA

2013-02-01

71

A case of central retinal artery occlusion following embolization procedure for juvenile nasopharyngeal angiofibroma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 23-year-old male patient with right nasal Juvenile Nasopharyngeal Angiofibroma (JNA) developed Central Retinal Artery Occlusion (CRAO) during embolization of the tumor using polyvinyl alcohol particles before endoscopic excision. Classic CRAO management was initiated by an ophthalmologist after 12...

Ramezani, Alireza; Haghighatkhah, Hamidreza; Moghadasi, Habibollah; Taheri, Morteza S; Parsafar, Hiva

72

A case of Churg-Strauss syndrome complicated with bilateral central retinal artery occlusion  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 56-year-old Japanese woman treated for bronchial asthma came to our hospital because of sudden vision loss of the left eye and plantar numbness of the right foot. Central retinal artery occlusion (CRAO) was diagnosed. Vision loss of the right eye also appeared, and the numbness of the right foot w...

Ken Uchibori; Emi Shinohara; Haruhiko Furusawa; Shinichiro Tominaga; Ichiro Natsume; Minoru Ohkouchi

73

Central retinal artery occlusion caused by fat embolism following endoscopic sinus surgery.  

UK PubMed Central (United Kingdom)

Endoscopic sinus surgery (ESS) can lead to a variety of ophthalmic complications. Central retinal arterial occlusion (CRAO) is one such complication, usually due to orbital compartment syndrome. We report a case of CRAO following endoscopic sinus surgery as a result of fat embolism.

Kim KE; Ahn SJ; Woo SJ; Kim N; Hwang JM

2013-06-01

74

Undiagnosed Patent Foramen Ovale Presenting as Retinal Artery Occlusion—An Emerging Association  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Purpose. To report patent foramen ovale (PFO) as the cause of retinal artery occlusion in a young and previously fit male and discuss the appropriate medical and surgical management options. Methods. Interventional case report with serial fundus photographs of an 18-year-old male presenting to...

Sheth, Hiten G.; Laverde-Konig, Tania; Raina, Jyoti

75

Surgical removal of a branch retinal artery embolus: a case report.  

UK PubMed Central (United Kingdom)

A patient with embolic retinal artery occlusion of sixty-hour duration underwent a surgical procedure resulting in the removal of one embolus and the fragmentation with distal flow of a second. Visual acuity improved from counting fingers to 20/200 and was stable 3 months postoperatively.

Peyman GA; Gremillion CM Jr

1990-07-01

76

Surgical removal of a branch retinal artery embolus: a case report.  

Science.gov (United States)

A patient with embolic retinal artery occlusion of sixty-hour duration underwent a surgical procedure resulting in the removal of one embolus and the fragmentation with distal flow of a second. Visual acuity improved from counting fingers to 20/200 and was stable 3 months postoperatively. PMID:2370131

Peyman, G A; Gremillion, C M

1990-07-01

77

A Case of Central Retinal Artery Occlusion after Chiropractic Manipulation of the Neck  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Here we report a case of central retinal artery occlusion after chiropractic manipulation on the neck. A 49-year old man presented at the hospital because of sudden visual loss in his right eye after chiropractic neck manipulation. He had received chiropractic manipulation of the neck by a chiroprac...

Jang, Young-Jun; Chun, Jun-Woo; Lee, Seung-Woo; Kim, Ho-Chang

78

A case of Churg-Strauss syndrome and central retinal artery occlusion with good visual recovery.  

UK PubMed Central (United Kingdom)

Here we report a case of Churg-Strauss syndrome (CSS) and central retinal artery occlusion (CRAO), with good visual recovery. A 58-year-old Japanese man with CSS experienced acute painless loss of vision in his right eye. CRAO was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). Steroid pulse therapy (methylprednisolone at 1 g daily for 3 days) followed by combined treatment with prednisolone (30 mg/day) and cyclophosphamide (150 mg/day) was administered; his visual acuity recovered to 20/30 in 1 month, and no recurrence has occurred for 1 year. Steroid pulse therapy may be effective for CRAO in CSS patients.

Kamata Y; Hashizume K; Kaneko M; Kurosaka D

2013-04-01

79

Branch retinal artery occlusion and non-ischemic central retinal vein occlusion due to hyperhomocysteinemia in a 14-year-old child.  

UK PubMed Central (United Kingdom)

A 14-year-old girl presented with sudden, painless loss of vision in the left eye. Complete ophthalmologic examination including fluorescein angiography revealed an impending central vein occlusion and a branch retinal artery occlusion inferotemporally. One month later, there was a non-ischemic central retinal vein occlusion of the same eye. Systemic evaluation led to the diagnosis of hyperhomocysteinemia. This case report underscores the importance of excluding hyperhomocysteinemia in vascular occlusive disease.

Rosenbaum PS; Srinivasan S; Zelefsky JR; Mayers M; Moradi IE

2010-01-01

80

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

Energy Technology Data Exchange (ETDEWEB)

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.

Park, Ji Won; Lee, Hui Joong; Lee, Jong Min [Kyungpook National University Hospital, Daegu (Korea, Republic of)

2009-03-15

 
 
 
 
81

Spectral domain optical coherence tomography findings of acute branch retinal artery occlusion from calcific embolus  

Science.gov (United States)

An 82-year-old female presented with sudden painless decrease in vision in the right eye after awakening. She could see the “superior half” of her vision from the right eye only. On examination, best-corrected vision was 20/300 in the right eye and 20/30 in the left eye. The fundus in the right eye revealed recent superotemporal branch retinal artery occlusion (BRAO) with calcified plaque at the disc. Spectral domain optical coherence tomography (OCT) (OTI Ophthalmic Technologies, Inc.), revealed hyperreflectivity and increased thickness of the inner retinal layers of the superior compared to the inferior retina. Imaging at the optic disc revealed the blocked artery containing a highly reflective material. The high reflectivity of the material and underlying optical shadowing could be characterized as calcific emboli.

Shah, Vinay A; Wallace, Billi; Sabates, Nelson R

2010-01-01

82

Spectral domain optical coherence tomography findings of acute branch retinal artery occlusion from calcific embolus  

Directory of Open Access Journals (Sweden)

Full Text Available An 82-year-old female presented with sudden painless decrease in vision in the right eye after awakening. She could see the "superior half" of her vision from the right eye only. On examination, best-corrected vision was 20/300 in the right eye and 20/30 in the left eye. The fundus in the right eye revealed recent superotemporal branch retinal artery occlusion (BRAO) with calcified plaque at the disc. Spectral domain optical coherence tomography (OCT) (OTI Ophthalmic Technologies, Inc.), revealed hyperreflectivity and increased thickness of the inner retinal layers of the superior compared to the inferior retina. Imaging at the optic disc revealed the blocked artery containing a highly reflective material. The high reflectivity of the material and underlying optical shadowing could be characterized as calcific emboli.

Shah Vinay; Wallace Billi; Sabates Nelson

2010-01-01

83

Occlusion of the central retinal artery and ocular neovascularisation: an indirect association?  

UK PubMed Central (United Kingdom)

Ocular neovascularisation is recognised as an uncommon complication of central retinal artery occlusion (CRAO) but has been associated most frequently in those patients suffering from carotid artery occlusive disease. We report the finding of neovascularisation after CRAO in a group of 8 patients, who have presented over the previous 6 years. Four showed no evidence of atherosclerotic carotid disease and only 2 were diabetic. Although the group numbers are necessarily small, it is suggested that these cases support the assertion that ocular neovascularisation may occur following CRAO in the absence of any underlying and predisposing ischaemic or inflammatory condition.

Jacobs NA; Trew DR

1992-01-01

84

Effects of topical carteolol on retinal arterial blood flow in primary open-angle glaucoma patients.  

UK PubMed Central (United Kingdom)

PURPOSE: Our aim was to evaluate the effects of topical carteolol on retinal arterial blood flow (RBF) in patients with primary open-angle glaucoma. METHODS: Sixteen patients received carteolol topically for 90 days. Changes in RBF in the major retinal artery were evaluated using laser Doppler velocimetry at baseline and after 30, 60, and 90 days. Patients were divided into groups based on changes in RBF; retinal arterial blood column diameter, blood velocity, and ocular perfusion pressure (OPP) were compared. RESULTS: Overall, no significant changes in RBF were observed. Twelve patients had unchanged and four decreased RBF. In patients with unchanged RBF, no significant changes in diameter, velocity, and OPP were observed. In patients with decreased RBF, the diameter did not change significantly; velocity decreased from baseline on day 90 (p = 0.041); OPP did not change significantly, but the values on days 30, 60, and 90 were lower than in patients with unchanged RBF. CONCLUSIONS: Although carteolol preserved RBF, some patients had decreased RBF with low blood pressure, suggesting that carteolol decreases RBF in some patients with decreased ocular perfusion after the topical instillation of carteolol.

Kawai M; Nagaoka T; Takahashi A; Sato E; Yoshida A

2012-09-01

85

Cilioretinal artery occlusion combined with central retinal vein occlusion - a report of two cases and review of the literature.  

UK PubMed Central (United Kingdom)

BACKGROUND: We describe the clinical findings and course of cilioretinal artery occlusion (CAO) combined with central retinal vein occlusion (CRVO) in two patients and present a review of the relevant literature. HISTORY AND SIGNS: Case 1: An otherwise healthy 24-year-old woman presented to the emergency unit with a painless visual decrease in her right eye. Fundus examination revealed retinal edema due to CAO in association with signs of venous stasis. Fluorescein angiography (FA) showed a patent cilioretinal artery. Case 2: A heavy smoker, hypertensive, 59-year-old man was referred for sudden visual loss in his left eye. Fundus examination and FA revealed CAO and CRVO. THERAPY AND OUTCOME: No treatment was applied for the first patient. Two weeks after diagnosis, retinal edema had subsided and only the signs of venous stasis were evident. The central scotoma remained unchanged. In the second patient, within the next three months, the development of retinal ischemia led to retinal neovascularization. Panretinal photocoagulation was applied. Visual acuity remained very low (light perception). CONCLUSIONS: The combination of CAO and CRVO comprises a discrete clinical entity. In both our cases, FA did not show full obstruction of the cilioretinal artery. Even though many hypotheses have been postulated about this entity, it seems that it ensues from the increased intraluminal pressure in the retinal capillaries (due to the CRVO), which exceeds the pressure in the cilioretinal artery. Thus, it is probably a functional obstruction of the cilioretinal artery, although its pathogenesis remains controversial.

Theoulakis PE; Livieratou A; Petropoulos IK; Lepidas J; Brinkmann CK; Katsimpris JM

2010-04-01

86

Central Retinal and Posterior Ciliary Artery Occlusion After Intralesional Injection of Sclerosant to Glabellar Subcutaneous Hemangioma  

International Nuclear Information System (INIS)

The aim of this study is to describe vision loss caused by central retinal artery and posterior ciliary artery occlusion as a consequence of sclerotherapy with a polidocanol injection to a glabellar hemangioma. An 18-year-old man underwent direct injection with a 23-gauge needle of 1 mL of a polidocanol-carbon dioxide emulsion into the glabellar subcutaneous hemangioma under ultrasound visualization of the needle tip by radiologists. He developed lid swelling the next day, and 3 days later at referral, the visual acuity in the left eye was no light perception. Funduscopy revealed central retinal artery occlusion and fluorescein angiography disclosed no perfusion at all in the left fundus, indicating concurrent posterior ciliary artery occlusion. The patient also showed mydriasis, blepharoptosis, and total external ophthalmoplegia on the left side. Magnetic resonance imaging demonstrated the swollen medial rectus muscle. In a month, blepharoptosis and ophthalmoplegia resolved but the visual acuity remained no light perception. Sclerosing therapy for facial hemangioma may develop a severe complication such as permanent visual loss.

2009-01-01

87

Plasma homocysteine and retinal artery occlusive disease : a case-control study.  

Directory of Open Access Journals (Sweden)

Full Text Available BACKGROUND: Previous studies have documented that elevated plasma homocysteine is a risk factor for cardiovascular, cerebrovascular and peripheral vascular disease. In a case-control study, we sought to determine whether elevated homocysteine (HCY) is a risk factor for retinal artery occlusive disease PATIENTS AND METHODS. Study subjects consisted of 20 patients (12 male, 8 female) (mean age, 55.8; range 42-70 years) with clinical and objective evidence of retinal vascular occlusive disease and 20 age-matched control subjects (9 males, 11 females) (mean age, 55.3 years; range 50-68 years). Hyperhomocysteinemia was defined as a plasma HCY level >15 micromol/L by HPLC. We also measured concentrations of triglycerides, and total cholesterol, LDL cholesterol, and HDL cholesterol. RESULTS: The mean plasma HCY level in the patient group was 21.23+/-9.53 micromol/L (range, 8.00-43.99 micromol/L) compared with 12.59+/-4.97 micromol/L (range, 6.38 to 22.88 micromol/L) in the control group (P<0.008). There was no correlation between HCY and serum triglycerides or cholesterol levels within each group. We conclude that high plasma HCY level may be a risk factor for retinal artery occlusive disease.

Narin F; Narin N; Halici C; Oner Ayse; Dogan H; Karakukcu M

2004-01-01

88

A case of central retinal artery occlusion following embolization procedure for juvenile nasopharyngeal angiofibroma  

Science.gov (United States)

A 23-year-old male patient with right nasal Juvenile Nasopharyngeal Angiofibroma (JNA) developed Central Retinal Artery Occlusion (CRAO) during embolization of the tumor using polyvinyl alcohol particles before endoscopic excision. Classic CRAO management was initiated by an ophthalmologist after 12 h. Retrospective evaluation of the angiograms revealed a tiny communication between the external carotid and ophthalmic arteries which had not been noticed before embolization. During endoscopic excision, the tumor was found to originate extraordinarily from midline structures. It was concluded that CRAO might be a rare complication of JNA embolization. Careful preoperative angiographic evaluations to detect communicating arteries and immediate ophthalmologic consultation in case of developing visual symptoms during the procedure are necessary.

Ramezani, Alireza; Haghighatkhah, Hamidreza; Moghadasi, Habibollah; Taheri, Morteza S; Parsafar, Hiva

2010-01-01

89

A case of central retinal artery occlusion following embolization procedure for juvenile nasopharyngeal angiofibroma  

Directory of Open Access Journals (Sweden)

Full Text Available A 23-year-old male patient with right nasal Juvenile Nasopharyngeal Angiofibroma (JNA) developed Central Retinal Artery Occlusion (CRAO) during embolization of the tumor using polyvinyl alcohol particles before endoscopic excision. Classic CRAO management was initiated by an ophthalmologist after 12 h. Retrospective evaluation of the angiograms revealed a tiny communication between the external carotid and ophthalmic arteries which had not been noticed before embolization. During endoscopic excision, the tumor was found to originate extraordinarily from midline structures. It was concluded that CRAO might be a rare complication of JNA embolization. Careful preoperative angiographic evaluations to detect communicating arteries and immediate ophthalmologic consultation in case of developing visual symptoms during the procedure are necessary.

Ramezani Alireza; Haghighatkhah Hamidreza; Moghadasi Habibollah; Taheri Morteza; Parsafar Hiva

2010-01-01

90

A case of central retinal artery occlusion after chiropractic manipulation of the neck.  

UK PubMed Central (United Kingdom)

Here we report a case of central retinal artery occlusion after chiropractic manipulation on the neck. A 49-year old man presented at the hospital because of sudden visual loss in his right eye after chiropractic neck manipulation. He had received chiropractic manipulation of the neck by a chiropractor eight days prior. When he first visited us, his best corrected visual acuity in his right eye was hand motion. A full ophthalmic examination was performed. There was cherry-red spot in the macula in his right eye. We performed a fluorescein angiogram and cervical color Doppler. The arterio-venous transit time in the fluorescein angiogram was delayed, and we detected stenosis of the right internal carotid artery with diffuse atherosclerotic plaques in the right common carotid artery. We prescribed ginko biloba extract (Tanamin). Three years after his first visit, the best corrected visual acuity of his right eye was 20 / 200.

Jang YJ; Chun JW; Lee SW; Kim HC

2012-04-01

91

A case of central retinal artery occlusion after chiropractic manipulation of the neck.  

Science.gov (United States)

Here we report a case of central retinal artery occlusion after chiropractic manipulation on the neck. A 49-year old man presented at the hospital because of sudden visual loss in his right eye after chiropractic neck manipulation. He had received chiropractic manipulation of the neck by a chiropractor eight days prior. When he first visited us, his best corrected visual acuity in his right eye was hand motion. A full ophthalmic examination was performed. There was cherry-red spot in the macula in his right eye. We performed a fluorescein angiogram and cervical color Doppler. The arterio-venous transit time in the fluorescein angiogram was delayed, and we detected stenosis of the right internal carotid artery with diffuse atherosclerotic plaques in the right common carotid artery. We prescribed ginko biloba extract (Tanamin). Three years after his first visit, the best corrected visual acuity of his right eye was 20 / 200. PMID:22511840

Jang, Young-Jun; Chun, Jun-Woo; Lee, Seung-Woo; Kim, Ho-Chang

2012-03-22

92

Cilioretinal arteries in diabetic eyes are associated with increased retinal blood flow velocity and occurrence of diabetic macular edema.  

UK PubMed Central (United Kingdom)

PURPOSE: The main purpose was to investigate the relationship between occurrence of cilioretinal arteries and macular edema in diabetic eyes in terms of retinal blood flow characteristics revealed by the Retinal Function Imager (RFI). Other standard imaging techniques such as fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography/scanning laser ophthalmoscopy were also used along with the RFI. The additional purpose was to look for the evidence of cilioretinal-retinal collaterals using the RFI. METHODS: Patients with a diagnosis of diabetic retinopathy were included. All patients underwent fundus photography, fluorescein angiography, spectral-domain optical coherence tomography, and imaging using RFI. The presence of cilioretinal artery (CilRA) was recognized using color/red-free fundus photographs, fluorescein angiography, and RFI. There were two groups according to the presence (CilRA group) or absence (NoCilRA group) of cilioretinal artery or arteries in the study eye. RESULTS: Thirty-nine eyes with diabetic retinopathy were included. Cilioretinal artery was identified in 15 eyes (38%). In the CilRA group, spectral-domain optical coherence tomography evidence of macular edema was observed in 13 of 15 eyes (87%), whereas in the NoCilRA group, macular edema was observed on spectral-domain optical coherence tomography in 7 of 24 eyes (29%). Mean blood flow velocities in retinal arteries and veins were significantly higher in diabetic eyes with cilioretinal artery (P = 0.04 and P = 0.005, respectively). Mean blood velocity in cilioretinal arteries was significantly higher in comparison with the mean arterial blood velocity (P = 0.03). In the CilRA group, cilioretinal-retinal collaterals, assessed by RFI, were detected in 4 of 15 eyes (27%) with cilioretinal arteries. In the NoCilRA group, mean blood velocity in retinal veins was significantly higher in eyes with macular edema in comparison with those without macular edema (P = 0.03). CONCLUSION: Using the RFI in conjunction with standard fundus imaging techniques, the presence of cilioretinal artery in diabetic eyes was found to be associated with increased retinal blood flow velocity and increased occurrence of diabetic macular edema. The occurrence of cilioretinal-retinal collaterals was also noted; however, the pathophysiologic significance of this finding requires further investigation.

Landa G; Amde W; Haileselassie Y; Rosen RB

2011-02-01

93

A case of Churg-Strauss syndrome and central retinal artery occlusion with good visual recovery.  

Science.gov (United States)

Here we report a case of Churg-Strauss syndrome (CSS) and central retinal artery occlusion (CRAO), with good visual recovery. A 58-year-old Japanese man with CSS experienced acute painless loss of vision in his right eye. CRAO was diagnosed by fundoscopic findings (retinal whitening with a cherry-red spot). Steroid pulse therapy (methylprednisolone at 1 g daily for 3 days) followed by combined treatment with prednisolone (30 mg/day) and cyclophosphamide (150 mg/day) was administered; his visual acuity recovered to 20/30 in 1 month, and no recurrence has occurred for 1 year. Steroid pulse therapy may be effective for CRAO in CSS patients. PMID:23685491

Kamata, Yuki; Hashizume, Kouhei; Kaneko, Muneyoshi; Kurosaka, Daijiro

2013-04-01

94

Central retinal artery occlusion and recurrent papillitis in a patient with incomplete Behçet disease.  

Science.gov (United States)

A 40-year-old man presented with painless sudden visual loss due to a central retinal artery occlusion (CRAO) in his right eye. Three months later, he had painless acute visual loss in his left eye with visual acuity of 20/100 and a swollen optic disc. After oral prednisone treatment, the disc swelling resolved and acuity recovered to 20/20. Five months later, the patient experienced another episode of vision loss in the left eye associated with optic disc edema. With steroid therapy, he regained 20/20 acuity once again. With a history of recurrent oral ulcers, fluorescein angiography showing obliterative retinal vasculitis in the right eye, and steroid responsive optic neuropathy in the left eye, we made the diagnosis of incomplete Behçet disease. PMID:21857189

Tian, Guohong; Lu, Ning; Yan, Rong; Zhang, Xiaojun

2011-09-01

95

Central retinal artery occlusion and recurrent papillitis in a patient with incomplete Behcet disease.  

UK PubMed Central (United Kingdom)

A 40-year-old man presented with painless sudden visual loss due to a central retinal artery occlusion (CRAO) in his right eye. Three months later, he had painless acute visual loss in his left eye with visual acuity of 20/100 and a swollen optic disc. After oral prednisone treatment, the disc swelling resolved and acuity recovered to 20/20. Five months later, the patient experienced another episode of vision loss in the left eye associated with optic disc edema. With steroid therapy, he regained 20/20 acuity once again. With a history of recurrent oral ulcers, fluorescein angiography showing obliterative retinal vasculitis in the right eye, and steroid responsive optic neuropathy in the left eye, we made the diagnosis of incomplete Behçet disease.

Tian G; Lu N; Yan R; Zhang X

2011-09-01

96

Cerebro-retinal ischemia after bilateral occlusion of internal carotid artery  

International Nuclear Information System (INIS)

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.)

1985-01-01

97

Central retinal artery occlusion following severe blow-out fracture in young adult  

Directory of Open Access Journals (Sweden)

Full Text Available Noriko Himori, Hiroshi Kunikata, Takaaki Otomo, Nobuo Fuse, Kohji NishidaDepartment of Ophthalmology and Visual Science, Tohoku University Graduate School of Medicine, Sendai, JapanAbstract: A 20-year-old woman was involved in a traffic accident while riding a motorcycle. The vision in her right eye was severely reduced. At the first examination, the eyelids of her right eye were severely swollen, and the eye could barely be seen. The fundus was not visible. She had no light perception in her vision. Computed tomography revealed a severe blow-out fracture in her right eye. Surgery was immediately performed to correct the fracture and the eye globe was replaced in the orbit. On the fourth postoperative day, the right fundus was visible and a cherry-red spot and milky-white edema were seen. Fluorescein angiography showed an arterial filling defect. Four months later, her visual acuity was light perception. Our case shows that a central retinal artery occlusion can be a complication of a blow-out fracture of the lower orbital wall and can lead to severe visual loss even with early surgical repair.Keywords: central retinal artery occlusion, blow out fracture, trauma, young adult

Noriko Himori; Hiroshi Kunikata; Takaaki Otomo; Nobuo Fuse; Kohji Nishida

2009-01-01

98

Cerebro-retinal ischemia after bilateral occlusion of internal carotid artery  

Energy Technology Data Exchange (ETDEWEB)

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.

Bogousslavsky, J.; Regli, F.

1985-05-01

99

Calculation of central retinal artery diameters from non-invasive ocular haemodynamic measurements in type 1 diabetes patients.  

UK PubMed Central (United Kingdom)

PURPOSE: The aim of the study was to compare the diameter of the central retinal artery (CRA) between patients with diabetes mellitus and healthy subjects in vivo. CRA diameters were calculated from retinal haemodynamic parameters measured with noninvasive measurement techniques. METHODS: Sixteen patients with type 1 diabetes with no or mild diabetic retinopathy and 16 age-matched healthy controls were included in this study. Total retinal blood flow was assessed by combining bidirectional laser Doppler velocimetry in all veins entering the optic disc with measurements of retinal vessel diameters using a Dynamic Vessel Analyser. Blood flow velocity in the CRA was measured with colour Doppler imaging (CDI). The diameter of the CRA in the optic nerve was then calculated for each subject using the individual ocular haemodynamic data. RESULTS: Calculated CRA diameters were significantly larger in patients with diabetes (180 ± 13 ?m) compared with healthy controls (166 ± 10 ?m, p = 0.001). No significant differences were found in retinal blood flow, retinal artery or vein diameters or mean flow velocity of the CRA. CONCLUSION: The data of the present study show increased calculated CRA diameter in patients with type 1 diabetes with no or mild retinopathy. Blood flow velocity measurements in retrobulbar vessels using CDI need to be interpreted with caution in terms of retinal blood flow, because no information about vessel diameters is obtained by this technique.

Pemp B; Cherecheanu AP; Garhofer G; Schmetterer L

2013-08-01

100

A case of Churg-Strauss syndrome complicated with bilateral central retinal artery occlusion  

Directory of Open Access Journals (Sweden)

Full Text Available A 56-year-old Japanese woman treated for bronchial asthma came to our hospital because of sudden vision loss of the left eye and plantar numbness of the right foot. Central retinal artery occlusion (CRAO) was diagnosed. Vision loss of the right eye also appeared, and the numbness of the right foot worsened. She was diagnosed with Churg-Strauss syndrome (CSS) due to bronchial asthma, eosinophilia, and vasculitis (CRAO and numbness). Her symptoms were unresponsive to systemic corticosteroid therapy, but improved when cyclophosphamide pulse was added. Vision disorders are uncommon manifestations of CSS. Close co-ordination with ophthalmologists is important for diagnosis and treatment.

Ken Uchibori; Emi Shinohara; Haruhiko Furusawa; Shinichiro Tominaga; Ichiro Natsume; Minoru Ohkouchi

2013-01-01

 
 
 
 
101

[Cilioretinal artery occlusion and central retinal vein occlusion complicating hyperhomocysteinemia: A case report.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Hyperhomocysteinemia is known to be a risk factor in both retinal artery and retinal vein occlusions. We report the case of a young patient with combined occlusion of the cilioretinal artery and the central retinal vein due to hyperhomocysteinemia. PAIENTS AND METHODS: A 23-year-old patient without significant medical history, presented for sudden, painless visual loss in the right eye. Ophthalmologic examination revealed best-corrected visual acuity of the right eye 8/10 P2, and 10/10 P2 on the left. Anterior segment exam was normal in both eyes, while the right fundus revealed white, ischemic edema, centered around a cilioretinal artery, sparing the fovea, with some hemorrhagic spots and disc edema. Fluorescein angiography confirmed delayed filling of the right cilioretinal artery and revealed a normal disc on the left. Two weeks later, the clinical picture had evolved into a right ischemic CRVO, confirmed by a second angiogram, with a decrease in visual acuity to 3/10. RESULTS: A work-up was performed, including: a full lipid profile, serum electrolytes, ESR, CRP, a complete blood count (leukocytes, platelets, hemoglobin were normal), a coagulation work-up (PT, PTT, protein C, protein S, antithrombin III, factor V Leiden were normal), ANCA, antiphospholipid antibodies and antinuclear antibodies were negative, and finally cardiology studies (cardiac echo, carotid Doppler) and neurology (brain MRI) were ordered and came back normal. Otherwise, plasma homocysteine was moderately high on two samples, at 18.3?mol/L and 17.78?mol/L. Thyroid and renal work-ups were ordered. Urgent PRP was performed, and vitamin therapy (vitB12, vitB6, folic acid) was instituted. The subsequent course was remarkable for recovery of visual acuity to 10/10, P2 with persistence of an inferior altitudinal central scotoma. MTHFR C677T polymorphism was negative. DISCUSSION: Retinal vascular occlusions (RVO) are serious events, which require investigation for underlying systemic disease, which can be life-threatening. The clinical picture is variable depending on the location of the occlusion, the extent of the ischemic area and the degree of macular involvement. The etiologies of RVO are varied, requiring a thorough biological assessment in young subjects. The association between hyperhomocysteinemia and RVO is proven, while this association with the MTHFR C677T polymorphism was not found. Vitamin therapy reduces plasma levels of homocysteine by 25% but its role in the treatment and prevention of RVO remains to be demonstrated. CONCLUSION: Several cases of occlusion of the central retinal vein or one of its branches have been published. Combined occlusion of the central retinal vein and cilioretinal artery secondary to hyperhomocysteinemia does not appear to have been published, which would make our case unique.

Berkani Z; Kitouni Y; Belhadj A; Sifi K; Abbadi N; Bellatrache C; Hartani D; Kherroubi R

2013-05-01

102

[Cilioretinal artery occlusion and central retinal vein occlusion complicating hyperhomocysteinemia: A case report.  

Science.gov (United States)

INTRODUCTION: Hyperhomocysteinemia is known to be a risk factor in both retinal artery and retinal vein occlusions. We report the case of a young patient with combined occlusion of the cilioretinal artery and the central retinal vein due to hyperhomocysteinemia. PAIENTS AND METHODS: A 23-year-old patient without significant medical history, presented for sudden, painless visual loss in the right eye. Ophthalmologic examination revealed best-corrected visual acuity of the right eye 8/10 P2, and 10/10 P2 on the left. Anterior segment exam was normal in both eyes, while the right fundus revealed white, ischemic edema, centered around a cilioretinal artery, sparing the fovea, with some hemorrhagic spots and disc edema. Fluorescein angiography confirmed delayed filling of the right cilioretinal artery and revealed a normal disc on the left. Two weeks later, the clinical picture had evolved into a right ischemic CRVO, confirmed by a second angiogram, with a decrease in visual acuity to 3/10. RESULTS: A work-up was performed, including: a full lipid profile, serum electrolytes, ESR, CRP, a complete blood count (leukocytes, platelets, hemoglobin were normal), a coagulation work-up (PT, PTT, protein C, protein S, antithrombin III, factor V Leiden were normal), ANCA, antiphospholipid antibodies and antinuclear antibodies were negative, and finally cardiology studies (cardiac echo, carotid Doppler) and neurology (brain MRI) were ordered and came back normal. Otherwise, plasma homocysteine was moderately high on two samples, at 18.3?mol/L and 17.78?mol/L. Thyroid and renal work-ups were ordered. Urgent PRP was performed, and vitamin therapy (vitB12, vitB6, folic acid) was instituted. The subsequent course was remarkable for recovery of visual acuity to 10/10, P2 with persistence of an inferior altitudinal central scotoma. MTHFR C677T polymorphism was negative. DISCUSSION: Retinal vascular occlusions (RVO) are serious events, which require investigation for underlying systemic disease, which can be life-threatening. The clinical picture is variable depending on the location of the occlusion, the extent of the ischemic area and the degree of macular involvement. The etiologies of RVO are varied, requiring a thorough biological assessment in young subjects. The association between hyperhomocysteinemia and RVO is proven, while this association with the MTHFR C677T polymorphism was not found. Vitamin therapy reduces plasma levels of homocysteine by 25% but its role in the treatment and prevention of RVO remains to be demonstrated. CONCLUSION: Several cases of occlusion of the central retinal vein or one of its branches have been published. Combined occlusion of the central retinal vein and cilioretinal artery secondary to hyperhomocysteinemia does not appear to have been published, which would make our case unique. PMID:23731792

Berkani, Z; Kitouni, Y; Belhadj, A; Sifi, K; Abbadi, N; Bellatrache, C; Hartani, D; Kherroubi, R

2013-05-31

103

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

Science.gov (United States)

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. PMID:23929083

dos Apóstolos-Pereira, Samira Luiza; Kara-José, Lúcia B Passos; Marchiori, Paulo Euripedes; Monteiro, Mário Luiz Ribeiro

104

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

UK PubMed Central (United Kingdom)

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.

dos Apóstolos-Pereira SL; Kara-José LB; Marchiori PE; Monteiro ML

2013-05-01

105

Cerebral white matter and retinal arterial health in hypertension and type 2 diabetes mellitus.  

UK PubMed Central (United Kingdom)

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.

Yau PL; Hempel R; Tirsi A; Convit A

2013-01-01

106

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

Science.gov (United States)

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.

Yau, P. L.; Hempel, R.; Tirsi, A.; Convit, A.

2013-01-01

107

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

Directory of Open Access Journals (Sweden)

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

Kumano Y; Yoshida N; Fukuyama S; Miyazaki M; Enaida H; Matsui T

2012-01-01

108

Retinal vein occlusion  

Science.gov (United States)

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 ...

109

An Automatic Graph-based Approach for Artery/Vein Classification in Retinal Images.  

UK PubMed Central (United Kingdom)

The classification of retinal vessels into artery/vein (A/V) is an important phase for automating the detection of vascular changes, and for the calculation of characteristic signs associated with several systemic diseases such as diabetes, hypertension, and other cardiovascular conditions. This paper presents an automatic approach for A/V classification based on the analysis of a graph extracted from the retinal vasculature. The proposed method classifies the entire vascular tree by deciding on the type of each intersection point (graph nodes) and assigning one of two labels to each vessel segment (graph links). Final classification of a vessel segment as an artery or a vein is performed through the combination of the graph-based labeling results with a set of intensity features. The results of this proposed method are compared with manual labeling for three public databases. Accuracy values of 88.3%, 87.4% and 89.8% are obtained for the images of the INSPIRE-AVR, DRIVE and VICAVR databases, respectively. These results demonstrate that our method outperforms recent approaches for A/V classification.

Dashtbozorg B; Mendonca AM; Campilho A

2013-05-01

110

Branch Retinal Artery Occlusion in a Patient with Patent Foramen Ovale  

Science.gov (United States)

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.

Shoeibi, Nasser; Poorzand, Hoorak; Abrishami, Mojtaba

2013-01-01

111

Branch retinal artery occlusion in a patient with patent foramen ovale.  

UK PubMed Central (United Kingdom)

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.

Shoeibi N; Poorzand H; Abrishami M

2013-01-01

112

Recurrent Bilateral Branch Retinal Artery Occlusion with Hearing Loss and Encephalopathy: The First Case Report of Susac Syndrome in Korea  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report the first case of Susac syndrome in Koreans, in a 23-yr-old female patient who presented with sudden visual loss and associated neurological symptoms. Ophthalmic examination and fluorescein angiography showed multiple areas of branch retinal artery occlusion, which tended to recur in both ...

Joe, Soo Geun; Kim, June-Gone; Kwon, Sun Uck; Lee, Choong Wook; Lim, Hyun Woo; Yoon, Young Hee

113

Retinal Vessel Occlusion  

Science.gov (United States)

... be significantly disrupted. The blockage is called an occlusion. When this happens, the eye typically loses vision, often suddenly. The condition is painless. Retinal Artery Occlusion The retinal artery carries oxygen-rich blood to ...

114

Retinal protective effects of topically administered agmatine on ischemic ocular injury caused by transient occlusion of the ophthalmic artery  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Agmatine, an endogenous polyamine and putative neuromodulator, is known to have neuroprotective effects on various neurons in the central nervous system. We determined whether or not topically administered agmatine could reduce ischemic retinal injury. Transient ocular ischemia was achieved by intraluminal occlusion of the middle cerebral artery of ddY mice (30-35 g) for 2 h, which is known to also induce occlusion of the ophthalmic artery. In the agmatine group (N = 6), (more) a 1.0 mM agmatine-containing ophthalmic solution was administered four times daily for 2 weeks before occlusion. In the control group (N = 6), a 0.1% hyaluronic acid ophthalmic solution was instilled at the same times. At 22 h after reperfusion, the eyeballs were enucleated and the retinal sections were stained by terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL). Transient ocular ischemia induced apoptosis of retinal cells in the entire retinal layer, and topically administered agmatine can significantly reduce this ischemic retinal injury. The proportion of apoptotic cells was definitely decreased (P

Hong, S.; Hara, H.; Shimazawa, M.; Hyakkoku, K.; Kim, C.Y.; Seong, G.J.

2012-03-01

115

Combined central retinal artery and vein occlusion secondary to systemic non-Hodgkin?s lymphoma  

Directory of Open Access Journals (Sweden)

Full Text Available We report a rare case of low-grade systemic B-cell non-Hodgkin?s lymphoma (NHL) causing central retinal artery and vein occlusion, which was the only manifestation of disease recurrence. A young man with resolved systemic NHL underwent fluorescein angiography, magnetic resonance imaging and computed tomography to investigate a severe unilateral visual loss. A combined vascular occlusion was observed in the right eye. Neuroimaging detected optic nerve infiltration; but no systemic/ central nervous system involvement was observed. The patient was treated with high-doses of corticosteroids and optic nerve irradiation. The optic neuropathy and vascular occlusion were resistant to treatment. The subsequent neovascular glaucoma was treated by panretinal photocoagulation, which relieved the pain, but vision was not recovered. No further recurrence was observed over the following year.

Shukla Dhananjay; Arora Amit; Hadi Khazaei; Kumar Mahesh; Baddela Satish; Kim Ramasamy

2006-01-01

116

Bilateral central retinal arterial obstruction following head trauma: A very rare case report  

Directory of Open Access Journals (Sweden)

Full Text Available A 30-year-old patient presented at our outpatient department with complaints of severe loss of vision in both eyes following a head injury six days back. He also had a fracture at left side of the mandible and a few bruises over the left cheek. External ocular examination revealed subconjuctival hemorrhage in the left eye and bilateral sluggishly reacting pupils. Fundus examination showed white- out retina and a cherry red spot at the macula in both eyes. A clinical diagnosis of bilateral central retinal arterial obstruction (CRAO) was made which was later confirmed by fundus fluorescence angiography. Bilateral CRAO is a rare disease usually found in patients with cardiac embolic diseases, giant cell arteritis or systemic vascular inflammations. Our case is the second reported case in English literature of bilateral CRAO following head trauma.

Ghose Saumendranath; Subhabrata Parida

2011-01-01

117

Sudden visual loss in pseudotumor cerebri due to central retinal artery occlusion.  

UK PubMed Central (United Kingdom)

A patient with a 16-month history of papilledema from pseudotumor cerebri had sudden loss of vision in one eye because of a central retinal artery occlusion (CRAO). The CRAO was transient and visual acuity improved from light perception to 6/7.5 OS in long-term follow-up. A visual field abnormality and color-vision deficit have persisted. Both eyes demonstrated peripapillary neovascular membranes. The eye with CRAO had extensive chorioretinal folds extending from the disc through the macula. Thorough investigations failed to demonstrate a coagulation abnormality, hyperviscosity, or source of emboli. Although the mechanism remains unclear, we postulate that CRAO may have been caused by a local pathologic condition in the optic nerve.

Baker RS; Buncic JR

1984-12-01

118

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

DEFF Research Database (Denmark)

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.

Gesslein, Bodil; Håkansson, Gisela

2010-01-01

119

Relationship between retinal vascular caliber and coronary artery disease in patients with non-alcoholic fatty liver disease (NAFLD).  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD) patients without diabetes and hypertension. METHODS: Intention to treat study of individuals who underwent cardiac computed tomography (CT) during a two year period. Coronary artery disease (CAD) was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT); intima-media thickness (IMT) by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. RESULTS: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001), higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001), lower retinal arteriole-to-venule ratio (AVR) (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01), higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04), higher carotid plaques (60% vs. 40%, p < 0.001), higher homeostasis model assessment of insulin resistance (HOMA) (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005), and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005) than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01), IMT (OR 2.3 p < 0.001), and retinal AVR ratio (OR 1.5, p < 0.01) to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05). CONCLUSIONS: Patients with smaller retinal AVR (<0.7) are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes.

Josef P; Ali I; Ariel P; Alon M; Nimer A

2013-08-01

120

Relationship between Retinal Vascular Caliber and Coronary Artery Disease in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD) patients without diabetes and hypertension. Methods: Intention to treat study of individuals who underwent cardiac computed tomography (CT) during a two year period. Coronary artery disease (CAD) was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT); intima-media thickness (IMT) by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. Results: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001), higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001), lower retinal arteriole-to-venule ratio (AVR) (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01), higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04), higher carotid plaques (60% vs. 40%, p < 0.001), higher homeostasis model assessment of insulin resistance (HOMA) (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005), and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005) than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01), IMT (OR 2.3 p < 0.001), and retinal AVR ratio (OR 1.5, p < 0.01) to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05). Conclusions: Patients with smaller retinal AVR (<0.7) are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes.

Pikkel Josef; Ibrahim Ali; Prober Ariel; Marmor Alon; Assy Nimer

2013-01-01

 
 
 
 
121

Relationship between Retinal Vascular Caliber and Coronary Artery Disease in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD).  

Science.gov (United States)

Objective: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD) patients without diabetes and hypertension. Methods: Intention to treat study of individuals who underwent cardiac computed tomography (CT) during a two year period. Coronary artery disease (CAD) was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT); intima-media thickness (IMT) by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. Results: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001), higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001), lower retinal arteriole-to-venule ratio (AVR) (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01), higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04), higher carotid plaques (60% vs. 40%, p < 0.001), higher homeostasis model assessment of insulin resistance (HOMA) (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005), and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005) than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01), IMT (OR 2.3 p < 0.001), and retinal AVR ratio (OR 1.5, p < 0.01) to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05). Conclusions: Patients with smaller retinal AVR (<0.7) are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes. PMID:23924883

Josef, Pikkel; Ali, Ibrahim; Ariel, Prober; Alon, Marmor; Nimer, Assy

2013-08-06

122

Relationship between Retinal Vascular Caliber and Coronary Artery Disease in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD).  

UK PubMed Central (United Kingdom)

Objective: To evaluate the relationship between retinal vascular caliber and cardiovascular disease in non-alcoholic fatty liver disease (NAFLD) patients without diabetes and hypertension. Methods: Intention to treat study of individuals who underwent cardiac computed tomography (CT) during a two year period. Coronary artery disease (CAD) was defined as stenosis of >50% in at least one major coronary artery. Liver and spleen density were measured by abdominal (CT); intima-media thickness (IMT) by Doppler ultrasound; retinal artery and vein diameter by colored-retinal angiography; and metabolic syndrome by ATP III guidelines. Serum biomarkers of insulin resistance, inflammation, and oxidant-antioxidant status were assessed. Results: Compared with 22 gender and age matched controls, the 29 NAFLD patients showed higher prevalence of coronary plaques (70% vs. 30%, p < 0.001), higher prevalence of coronary stenosis (30% vs. 15%, p < 0.001), lower retinal arteriole-to-venule ratio (AVR) (0.66 ± 0.06 vs. 0.71 ± 0.02, p < 0.01), higher IMT (0.98 ± 0.3 vs. 0.83 ± 0.1, p < 0.04), higher carotid plaques (60% vs. 40%, p < 0.001), higher homeostasis model assessment of insulin resistance (HOMA) (4.0 ± 3.4 vs. 2.0 ± 1.0, p < 0.005), and higher triglyceride levels (200 ± 80 vs. 150 ± 60, p < 0.005) than controls. Multivariate analysis showed fatty liver (OR 2.5; p < 0.01), IMT (OR 2.3 p < 0.001), and retinal AVR ratio (OR 1.5, p < 0.01) to be strongly associated with CAD independent of metabolic syndrome (OR 1.2, p < 0.05). Conclusions: Patients with smaller retinal AVR (<0.7) are likely to be at increased risk for CAD and carotid atherosclerosis in patients with NAFLD even without hypertension or diabetes.

Josef P; Ali I; Ariel P; Alon M; Nimer A

2013-01-01

123

Obstrucción de rama macular de arteria central de la retina Occlusion of the macular branch of the central retinal artery  

Directory of Open Access Journals (Sweden)

Full Text Available We report a 54 years old female on oral anticoagulant treatment with a mitral valve disease, with a history of two transient ischemic attacks and a decreased visual acuity. She was assessed by an ophthalmologist and signs of retinal vascular disease were found. During follow up, the patient experienced an acute unilateral loss of vision in the left eye. Fundoscopy revealed an obstruction of a macular branch of central retinal artery. Aspirin was added to oral anticoagulants and one month later, the patient experienced an upper gastrointestinal bleeding. After four months of follow up, there is no recovery of left eye vision (Rev Méd Chile 2002; 130: 86-89)

Jorge Orellana R; Ricardo Garibaldi D; Fernando Leiva P; Gustavo Núñez C; César Vicencio T; Ana L Quiñones T

2002-01-01

124

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

Directory of Open Access Journals (Sweden)

Full Text Available Aim: To propose a hypothesis of causal association between central retinal artery occlusion (CRAO) and oral contraceptive pills (OCP)Case 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.

Nidhi Pancholi; Reema Rawal; Lalit Prabha Gupta

2013-01-01

125

Prevalência de hipertensão arterial em pacientes com oclusão do ramo da veia central da retina/ Prevalence of arterial hypertension in branch retinal vein occlusion patients  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVOS: Identificar em pacientes com oclusão do ramo da veia central da retina utilizando a monitorização ambulatorial da pressão arterial e medidas clínicas da pressão arterial: prevalência de hipertensão e o perfil noturno da pressão arterial. MÉTODOS: Prospectivamente, 93 olhos de 83 pacientes com oclusão do ramo da veia central da retina foram submetidos à avaliação oftalmológica. Após, os pacientes foram encaminhados para avaliação clínica e mon (more) itorização da pressão arterial. Pacientes sem descenso da pressão durante o sono ("non-dipper") foram definidos como um declínio na pressão arterial sistólica Abstract in english PURPOSE: To identify in patients with branch retinal vein occlusion using ambulatory blood pressure monitoring and clinical blood pressure measures: hypertension prevalence, and nocturnal profile of blood pressure. METHODS: Prospectively, 93 eyes of 83 patients with branch retinal vein occlusion were submitted to ophthalmological examination. Afterwards the patients were submitted to clinical evaluation and blood pressure monitoring. Non-dipper was defined as a fall in sy (more) stolic blood pressure

Rosa, Alexandre Antonio Marques; Ortega, Kátia Coelho; Mion Jr., Décio; Nakashima, Yoshitaka

2008-04-01

126

Central retinal artery occlusion in a 13-year-old child as a presenting sign of hyperhomocysteinemia together with high lipoprotein(a) level.  

UK PubMed Central (United Kingdom)

BACKGROUND: We describe a child with central retinal artery occlusion and hyperhomocysteinemia. METHODS: A 13-year-old girl developed sudden vision loss and was hospitalized for diagnosis and treatment. RESULTS: Her physical examination was normal except for her ophthalmologic examination. Her serum homocysteine level and lipoprotein(a) were elevated to 45.27 ?mol/L and 61 mg/dL 0-29 mg/dL, respectively. A homozygous mutation was identified for methylenetetrahydrofolate reductase at position C677T. CONCLUSION: This report documents central retinal artery occlusion associated with the risk factors of hyperhomocysteinemia caused by methylenetetrahydrofolate reductase C677 T mutation and high lipoprotein(a) level in a child. Retinal artery occlusion is rare in children. This patient emphasizes the need for a systemic evaluation for hyperhomocysteinemia and lipoprotein(a) levels in children with retinal vascular occlusion of uncertain etiology.

Coban-Karatas M; Erol I; Ozkale Y; Yaz?c? N

2013-08-01

127

ASSESSMENT OF VISION-RELATED QUALITY OF LIFE IN PATIENTS WITH CENTRAL RETINAL ARTERY OCCLUSION.  

UK PubMed Central (United Kingdom)

BACKGROUND:: Central retinal artery occlusion (CRAO) is a major cause for severe visual impairment. Its effect on vision-related quality of life has not yet been determined. The purpose of the present study was thus to assess vision-related quality of life in patients with CRAO using the 39-item National Eye Institute Visual Function Questionnaire. METHODS:: The case-control study comprised 26 patients with unilateral CRAO and a control group consisting of 26 control subjects, matched for age and sex. Vision-related quality of life was measured using the 39-item National Eye Institute Visual Function Questionnaire. RESULTS:: After Bonferroni correction, the median 39-item National Eye Institute Visual Function Questionnaire composite score was significantly lower in patients with CRAO than in those in the control group (Pcorr < 0.001). Patients with CRAO showed significantly lower median scores in 9 of 12 subscales: general vision (Pcorr < 0.001), peripheral vision (Pcorr < 0.001), difficulties with near-vision activities (Pcorr < 0.001), difficulties with distance-vision activities (Pcorr < 0.001), role difficulties as a result of vision problems (Pcorr < 0.001), dependency on others because of vision problems (Pcorr < 0.001), limitations in social functioning because of vision problems (Pcorr < 0.001), mental health symptoms because of vision problems (Pcorr < 0.001), and general health (Pcorr = 0.008). CONCLUSION:: Our data suggest that vision-related quality of life is reduced in patients with CRAO.

Weger M; Pichler T; Franke GH; Haas A; Thaler HV; Kraigher-Krainer N; Groselj-Strele A; Wedrich A; Rabensteiner DF

2013-08-01

128

Retinal arterial occlusion due to embolism of suspected cardiac tumors -- report on two patients and review of the topic.  

UK PubMed Central (United Kingdom)

BACKGROUND: Ophthalmic complications due to heart tumors are rare. PATIENTS: This case report describes two patients with ocular complications, caused by a suspected cardiac tumor. A 56-year-old woman with arterial hypertension had a severe episode of headache coinciding with an acute loss of vision in her right eye and left-sided hemiparesis. A 20-year-old woman noticed sudden transient visual loss in her right eye. RESULT: The 56-year-old woman had an infarction on the right side of the middle and posterior cerebral arteries and, simultaneously, a central retinal artery occlusion (CRAO) in her right eye. Echocardiography revealed a tumor in the left atrium. The tumor disappeared after treatment with phenprocoumon within a few days. The diagnosis of a cardiac thrombus was made. The 20-year-old woman noticed recurrent episodes of sudden, transient visual loss in her right eye. A branch retinal arterial occlusion (BRAO) in her right eye was diagnosed. Echocardiography revealed a myxoma in the left atrium. The tumor was successfully excised surgically. CONCLUSION: In any vascular disturbance in the eye suspected to be embolic in origin, echocardiography should be carried out in order to exclude the presence of a heart disease.

Schmidt D; Hetzel A; Geibel-Zehender A

2005-07-01

129

Subthreshold laser treatment versus threshold laser treatment for symptomatic retinal arterial macroaneurysm.  

UK PubMed Central (United Kingdom)

PURPOSE: This study was designed to compare the effects of subthreshold laser treatment (STLT) with threshold laser treatment (TLT) in patients affected by symptomatic retinal arterial macroaneurism (RAM). METHODS: Patients affected by symptomatic RAM, characterized by exudative manifestations involving the fovea and best-corrected visual acuity (BCVA) worse than 20/80 Snellen equivalent, were recruited. Patients were randomly assigned to STLT or TLT and regularly followed up for 12 months. Primary outcome measures were changes in central point thickness (CPT) at the end of the follow-up. Secondary outcome measures were changes in mean BCVA at the end of the follow-up and identification of postlaser alterations. RESULTS: In this single center, randomized, clinical trial, 12 patients were randomized to STLT and 13 to TLT. CPT in STLT was 332 ?m at baseline and changed to 249 ?m at the 12-month examination. CPT in TLT was 341 ?m and reduced to 226 ?m at the end of the follow-up. BCVA in STLT changed from 0.72 logMAR to 0.28 logMAR. BCVA in TLT changed from 0.76 logMAR to 0.26 logMAR. The statistical analyses revealed a significant difference comparing the baseline values for both CPT and BCVA in each subgroup from the third month (P < 0.001). No difference was found comparing the two subgroups at any point in time. Three eyes (23%) treated with TLT developed an epiretinal membrane with subjective metamorphopsia. CONCLUSIONS: This pilot randomized clinical trial shows that both STLT and TLT can achieve similar improvements in BCVA and CPT. The lower laser energy delivered by STLT can reduce the complication rate.

Battaglia Parodi M; Iacono P; Pierro L; Papayannis A; Kontadakis S; Bandello FM

2012-04-01

130

Endovascular coiling of the ophthalmic artery in pigs to induce retinal ischemia  

DEFF Research Database (Denmark)

The authors recently showed that the retinal circulation can be accessed by transfemoral endovascular catheterization. The purpose of this study was to examine whether endovascular coiling can be used to induce different degrees of ischemic injury. The possibility of creating occlusions at different sites in the vasculature to cause retinal ischemia with different degrees of severity was investigated.

Morén, Håkan; Gesslein, Bodil

2011-01-01

131

Prevalência de hipertensão arterial em pacientes com oclusão do ramo da veia central da retina Prevalence of arterial hypertension in branch retinal vein occlusion patients  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVOS: Identificar em pacientes com oclusão do ramo da veia central da retina utilizando a monitorização ambulatorial da pressão arterial e medidas clínicas da pressão arterial: prevalência de hipertensão e o perfil noturno da pressão arterial. MÉTODOS: Prospectivamente, 93 olhos de 83 pacientes com oclusão do ramo da veia central da retina foram submetidos à avaliação oftalmológica. Após, os pacientes foram encaminhados para avaliação clínica e monitorização da pressão arterial. Pacientes sem descenso da pressão durante o sono ("non-dipper") foram definidos como um declínio na pressão arterial sistólica PURPOSE: To identify in patients with branch retinal vein occlusion using ambulatory blood pressure monitoring and clinical blood pressure measures: hypertension prevalence, and nocturnal profile of blood pressure. METHODS: Prospectively, 93 eyes of 83 patients with branch retinal vein occlusion were submitted to ophthalmological examination. Afterwards the patients were submitted to clinical evaluation and blood pressure monitoring. Non-dipper was defined as a fall in systolic blood pressure < 10%, and dipper when this value was higher. RESULTS: Disease affected one eye in 73 (88%) patients. The temporal superior branch was the site of occlusion in 61 (65.6%) eyes, while in the others the infero-temporal branch was affected. Seventy six (92%) patients were diagnosed as hypertensive after clinical evaluation. Ambulatory blood pressure monitoring identified 76 hipertensives, 5 normotensives, 1 white-coat hypertensive and one masked hypertensive subjects. The two latter were excluded from the analysis. Of the 81 analyzed patients, forty (49%) were dippers and 41 (51%) were non-dippers. Among the HT (n=76), 36 (47%) were dippers and 40 (53%) were non-dippers. CONCLUSION: Prevalence of hypertension in our series was extremely high (92%) which suggests that physiopathology of the disease has a close relationship with changes promoted by hypertension. A little more than half of the hypertensives were non-dippers (n=40; 52,6%). These evidences suggest that a 24-hour sustained level of blood pressure may be an additional risk factor for branch retinal vein occlusion.

Alexandre Antonio Marques Rosa; Kátia Coelho Ortega; Décio Mion Jr.; Yoshitaka Nakashima

2008-01-01

132

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

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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 supplements and the condition was successfully controlled. Patients with retinal vascular obstruction should have their total plasma homocysteine levels measured, since this modifiable risk factor can be easily treated with dietary approaches including vitamin supplementation.

Alexandre Kazuo Misawa; Hisashi Suzuki; Otacílio de Oliveira Maia Júnior; Maria Teresa Brizzi Chizzotti Bonanomi; Carlos Sérgio Nascimento de Melo

2008-01-01

133

Monitoring of central retinal artery and vein with color doppler ultrasound during heart surgery as an alternative to transcranial doppler ultrasonography: A case report.  

UK PubMed Central (United Kingdom)

Cardiac surgery can have severe neurologic complications. The noninvasive monitoring of intracranial circulation during heart surgery is usually performed with transcranial Doppler ultrasonography. We present the case of a 66-year-old man who underwent elective cardiac surgery for aortic valve replacement and coronary artery bypass graft, in whom monitoring was performed by simultaneously assessing blood flow velocity in the central retinal artery and vein. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound, 2013;

Venturini M; Zambon M; Cristel G; Agostini G; Querques G; Colombo M; Benussi S; Landoni G; Zangrillo A; Del Maschio A

2013-04-01

134

Internal carotid artery pseudo occlusion with embolic cerebral ischemia and low flow in the central retinal artery: a diagnostic challenge  

Directory of Open Access Journals (Sweden)

Full Text Available We present a rare case of internal carotid artery pseudoocclusion (ICAPO) in a 60-yearold male Caucasian patient who experienced a reversible sudden loss of vision of the right eye for 10 min followed by recurrent blurring of vision as well as dysarthria and numbness in the left face. The referring ophthalmologist admitted the patient for suspicious occlusion of the internal carotid artery causing anterior ischemic optic neuropathy (AION).

Christoph Roehrer; Michael Ertl; Mathias Altmann; Piotr Kasprzak; Ulrich Bogdahn; Gerhard Schuierer; Felix Schlachetzki

2011-01-01

135

Tomografía óptica de coherencia en oclusión de arteria central de la retina Optical coherence tomography in central retinal artery occlusion  

Directory of Open Access Journals (Sweden)

Full Text Available Casos clínicos: Presentamos tres ojos afectados de obstrucción de arteria central de la retina (OACR). En todos ellos realizamos exploración con tomografía óptica de coherencia (OCT). Dependiendo del tiempo de evolución del cuadro clínico, los signos oftalmoscópicos de OACR eran más o menos evidentes. Sin embargo, la presencia de una banda hiporreflectante en las imágenes de OCT pudo objetivarse en todos los casos. Discusión: La presencia en las imágenes de OCT de una banda hiporreflectante por debajo de la retina neurosensorial en los casos de OACR, que persiste incluso meses después del inicio del cuadro clínico, resulta útil en el diagnóstico de esta patología retiniana.Clinical cases: Three eyes with central retinal artery occlusion (CRAO) have been studied. Optical coherence tomography (OCT) was performed in each of them. Ophthalmoscopic signs of CRAO were equivocal in the three eyes. However, the presence of a hyporeflective signal in the OCT scan could be seen clearly in each of them. Discussion: The presence of a hyporeflective band between the neurosensory retina and the retinal pigment epithelium in OCT images, that persist for several months after a CRAO episode, is useful in establishing the diagnosis in these patients.

A. Salinas-Alamán; A. García-Layana; H. Heras-Mulero; P.J. García-Gómez

2006-01-01

136

Recurrent bilateral branch retinal artery occlusion with hearing loss and encephalopathy: the first case report of Susac syndrome in Korea.  

UK PubMed Central (United Kingdom)

We report the first case of Susac syndrome in Koreans, in a 23-yr-old female patient who presented with sudden visual loss and associated neurological symptoms. Ophthalmic examination and fluorescein angiography showed multiple areas of branch retinal artery occlusion, which tended to recur in both eyes. Magnetic resonance imaging showed dot-like, diffusion-restricted lesions in the corpus callosum and left fornix, and audiometry showed low-frequency sensory hearing loss, compatible with Susac syndrome. She received immunosuppressive therapy with oral steroid and azathioprine. Three months later all the symptoms disappeared but obstructive vasculitis have been relapsing. This patient demonstrated the entire clinical triad of Susac syndrome, which tends to occur in young females. Although this disorder has rarely been reported in Asian populations, a high index of suspicion is warranted for early diagnosis and timely treatment.

Joe SG; Kim JG; Kwon SU; Lee CW; Lim HW; Yoon YH

2011-11-01

137

Recurrent bilateral branch retinal artery occlusion with hearing loss and encephalopathy: the first case report of Susac syndrome in Korea.  

Science.gov (United States)

We report the first case of Susac syndrome in Koreans, in a 23-yr-old female patient who presented with sudden visual loss and associated neurological symptoms. Ophthalmic examination and fluorescein angiography showed multiple areas of branch retinal artery occlusion, which tended to recur in both eyes. Magnetic resonance imaging showed dot-like, diffusion-restricted lesions in the corpus callosum and left fornix, and audiometry showed low-frequency sensory hearing loss, compatible with Susac syndrome. She received immunosuppressive therapy with oral steroid and azathioprine. Three months later all the symptoms disappeared but obstructive vasculitis have been relapsing. This patient demonstrated the entire clinical triad of Susac syndrome, which tends to occur in young females. Although this disorder has rarely been reported in Asian populations, a high index of suspicion is warranted for early diagnosis and timely treatment. PMID:22065912

Joe, Soo Geun; Kim, June-Gone; Kwon, Sun Uck; Lee, Choong Wook; Lim, Hyun Woo; Yoon, Young Hee

2011-10-27

138

Subretinal neovascularization following ruptured retinal arterial macroaneurysm: case report Neovascularização sub-retiniana secundária ao macroaneurisma arterial da retina rôto: relato de caso  

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Full Text Available A 51-year-old black woman was referred to our Retina Clinic for evaluation of loss of vision in her left eye. She was previously diagnosed with a ruptured retinal arterial macroaneurism (RAM) in the same eye. The ophthalmoscopic examination of the affected eye disclosed a subretinal lesion with some hemorrhage and exudation in the same area previously diagnosed with ruptured RAM. Fluorescein angiography revealed a gradually hyperfluorescent net of vessels located in the subfoveal region, consistent with the diagnosis of subretinal neovascular membrane. In this paper we stress the possibility of subretinal neovascularization following a ruptured RAM, even as a rare event.Paciente de 51 anos foi encaminhada ao Setor de Retina para avaliação de perda visual no olho esquerdo. A paciente apresentava o diagnóstico prévio de macroaneurisma arterial retiniano (MAR) rôto no referido olho. O exame oftalmológico revelou lesão sub-retiniana hemorrágica associada à exsudação na área previamente diagnosticada com MAR. A angiofluoresceinografia revelou hiperfluorescência gradual localizada na região subfoveal, consistente com o diagnóstico de membrana neovascular sub-retiniana (MNSR). Nosso artigo aponta para a possibilidade, embora rara, da formação de uma MNSR após MAR rôto.

Raul N. G. Vianna; Augusto Kassuga; Gabriela Onofre; Virginia Ecard; Miguel N. Burnier Jr.

2007-01-01

139

Subretinal neovascularization following ruptured retinal arterial macroaneurysm: case report/ Neovascularização sub-retiniana secundária ao macroaneurisma arterial da retina rôto: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Paciente de 51 anos foi encaminhada ao Setor de Retina para avaliação de perda visual no olho esquerdo. A paciente apresentava o diagnóstico prévio de macroaneurisma arterial retiniano (MAR) rôto no referido olho. O exame oftalmológico revelou lesão sub-retiniana hemorrágica associada à exsudação na área previamente diagnosticada com MAR. A angiofluoresceinografia revelou hiperfluorescência gradual localizada na região subfoveal, consistente com o diagnósti (more) co de membrana neovascular sub-retiniana (MNSR). Nosso artigo aponta para a possibilidade, embora rara, da formação de uma MNSR após MAR rôto. Abstract in english A 51-year-old black woman was referred to our Retina Clinic for evaluation of loss of vision in her left eye. She was previously diagnosed with a ruptured retinal arterial macroaneurism (RAM) in the same eye. The ophthalmoscopic examination of the affected eye disclosed a subretinal lesion with some hemorrhage and exudation in the same area previously diagnosed with ruptured RAM. Fluorescein angiography revealed a gradually hyperfluorescent net of vessels located in the s (more) ubfoveal region, consistent with the diagnosis of subretinal neovascular membrane. In this paper we stress the possibility of subretinal neovascularization following a ruptured RAM, even as a rare event.

Vianna, Raul N. G.; Kassuga, Augusto; Onofre, Gabriela; Ecard, Virginia; Burnier Jr., Miguel N.

2007-08-01

140

Re-evaluating Our Perspective on Retinal Artery Occlusion from Carotid Dissection: A Report of Three Cases and Review of the Literature.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVE: Retinal artery occlusion from carotid dissection is rare and classically considered a post-traumatic phenomenon occurring in young patients and associated with additional symptoms of dissection such as neck pain, headache, or focal neurological deficits. PATIENTS AND METHODS: The authors report three cases of retinal artery occlusion due to carotid artery dissection and briefly review the literature. RESULTS: Antecedent trauma or neck injury was reported in only 42% (five of 12) of previously reported cases and in none of the three cases presented here. All three patients in this series initially denied symptoms such as headache or neck pain; however, one patient's wife later recalled her husband experiencing minor neck soreness several days prior to visual loss. In 17% (two of 12) of previously reported cases, no additional symptoms of carotid dissection were reported. CONCLUSION: These cases highlight the importance of considering carotid dissection in young patients with retinal artery occlusion, even in the absence of a report of recent trauma or associated symptoms such as pain. [Ophthalmic Surg Lasers Imaging Retina. 2013;44:xxx-xxx.].

Patel M; Shah G; Davies JB; Mittra RA; Eliott D

2013-10-01

 
 
 
 
141

Retinal oximetry.  

UK PubMed Central (United Kingdom)

UNLABELLED: ABSTRACT.: 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 saturation in (1) light and dark in healthy volunteers, (2) central retinal vein occlusion, (3) branch retinal vein occlusion, (4) central retinal artery occlusion, (5) diabetic retinopathy, (6) patients undergoing glaucoma surgery and (7) patients taking glaucoma medication. METHODS: The retinal oximeter (Oxymap ehf., Reykjavik, Iceland) is based on a fundus camera. An attached image splitter allows the simultaneous capture of four images of the same area of the fundus. Two images are used for further analysis, one acquired with 586?nm light and one with 605?nm light. Light absorbance of retinal vessels is sensitive to oxygen saturation at 605?nm but not at 586?nm. Measurement of reflected light at these wavelengths allows estimation of oxygen saturation in the main retinal vessels. This is performed with custom-made analysis software. RESULTS: LIGHT AND DARK: After 30?min in the dark, oxygen saturation in retinal arterioles of healthy volunteers was 92?±?4% (mean?±?SD, n?=?15). After 5?min in 80?cd/m(2) light, the arteriolar saturation was 89?±?5%. The decrease was statistically significant (p?=?0.008). The corresponding values for retinal venules were 60?±?5% in the dark and 55?±?10% in the light (p?=?0.020). Similar results were found after alternating 5?min periods of darkness and light. In a second experiment (n?=?19), a significant decrease in retinal vessel oxygen saturation was found in 100?cd/m(2) light compared with darkness but 1 and 10?cd/m(2) light had no significant effect. CENTRAL RETINAL VEIN OCCLUSION: In patients with central retinal vein occlusion, the mean saturation in affected retinal venules was 49?±?12%, while the mean value for venules in the fellow eye was 65?±?6% (mean?±?SD, p?=?0.003, n?=?8). The retinal arteriolar saturation was the same in affected (99?±?3%) and the unaffected (99?±?6%) eyes. The venous oxygen saturation showed much variation between affected eyes. BRANCH RETINAL VEIN OCCLUSION: Median oxygen saturation in venules affected by branch retinal vein occlusion was 59% (range, 12-93%, n?=?22), while it was 63% (23-80%) in unaffected venules in the affected eye and 55% (39-80%) in venules in the fellow eye. The difference was not statistically significant (p?>?0.05). There was a significant difference between affected arterioles (median 101%; range, 89-115%) and unaffected arterioles (95%, 85-104%) in the affected eye (p?RETINAL ARTERY OCCLUSION: In a patient with a day's history of central retinal artery occlusion due to temporal arteritis, the mean arteriolar saturation was 71?±?9% and 63?±?9% in the venules. One month later, after treatment with prednisolone, the mean arteriolar saturation was 100?±?4% and the venous saturation 54?±?5%. DIABETIC RETINOPATHY: When compared with healthy volunteers (n?=?31), patients with all categories of diabetic retinopathy had on average 7-10 percentage points higher saturation in retinal arterioles (p?retinal arterioles increased by 2 percentage points on average (p?=?0.046, n?=?19) with surgery, which lowered intraocular pressure from 23?±?7?mmHg (mean?±?SD) to 10?±?4?mmHg (p?

Hardarson SH

2013-03-01

142

Efeito da tibolona sobre parâmetros doplervelocimétricos das artérias oftálmica e retiniana Tibolone's effect on retinal and ophthalmic arteries flowmetry  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: avaliar o efeito do uso da tibolona sobre os parâmetros doplervelocimétricos das artérias oftálmica e retiniana. MÉTODOS: realizou-se ensaio clínico, prospectivo, longitudinal, aleatorizado, controlado com placebo, duplo-cego, no qual dentre 100 mulheres na menopausa, 50 usaram o princípio ativo tibolona 2,5 mg (Grupo Tib) e 50, o placebo para formar o grupo controle (Grupo Plac). No Grupo Tib, das 50 mulheres que iniciaram o estudo, 44 retornaram após 84 dias para a finalização dos exames. No Grupo Plac retornaram 47 delas. As artérias oftálmica e retiniana foram estudadas, determinando-se o índice de resistência (IR), índice de pulsatilidade (IP) e relação sístole/diástole (S/D). As aferições foram feitas antes e 84 dias após a medicação. Utilizou-se o teste t de Student para amostras independentes na comparação das medianas entre os grupos e para amostras dependentes na comparação entre as medianas dentro do mesmo grupo. RESULTADOS: as características das mulheres nos dois grupos foram semelhantes em relação à idade, ao tempo de menopausa, ao índice de massa corporal, à pressão arterial, à paridade e à freqüência cardíaca. O Grupo Tib apresentou as seguintes medianas: IR(pré)=0,71±0,05, IR(pós)=0,72±0,08 (p=0,43); IP(pré)=1,29±0,22, IP(pós)=1,30±0,25 (p=0,4) e SD(pré)=3,49±0,77, SD(pós)=3,65±0,94 (p=0,32). Na artéria retiniana foram obtidas as seguintes medianas na artéria oftálmica: IR(pré)=0,67±0,09, IR(pós)=0,69±0,10 (p=0,7); IP(pré)=1,20±0,29, IP(pós)=1,22±0,3 (p=0,2) e SD(pré)=3,29±0,95, SD(pós)=3,30±1,07 (p=0,3). Os grupos tibolona e controle não apresentaram diferenças significantes nos índices quando avaliados ao final do estudo. CONCLUSÕES: a tibolona, na dose de 2,5 mg, não apresenta efeitos sobre os índices doppler das artérias oftálmica e retiniana.PURPOSE: to evaluate the effect of tibolone use on dopplervelocimetric parameters of ophthalmic and retinal arteries. METHODS: clinical, prospective, longitudinal, randomized, placebo-controlled, triple-blind study, in which among 100 menopausal women, 50 have used 2.5 mg of the active principle tibolone (Tib Group) and 50, placebo as a means to form the control-group (Plac Group). In the Tib Group, 44 of the 50 women returned after 84 days to finish the exams, and in the Plac Group, 47. The ophthalmic and retinal arteries were studied to determine the resistance index (RI), the pulsatility index (PI) and the systole/diastole ratio (S/D). Assessments have been done before and 84 days after medication. The t-Student test has been used for the comparison of means between the groups in independent samples, as well as for within-group comparisons in dependent samples. RESULTS: in both groups, the women's characteristics were similar in age, menopause duration, body mass index, arterial blood pressure, deliveries and cardiac rate. The Tib Group presented the following values in the ophthalmic artery: RI(pre)=0.71±0.05, RI(post)0.72±0.08 (p=0.43); PI(pre)=1.29±0.22, PI(post)=1.30±0.25 (p=0.4) and S/D(pre)=3.49±0.77, SD(post)=3.65±0.94 (p=0.32). In the retinal artery, the following values have been found: RI(pre)=0.67±0.09, RI(post)=0.69±0.10 (p=0.7); PI(pre)=1.20±0.29, PI(post)=1.22±0.3 (p=0.2) and SD(pre)=3.29±0.95, SD(post)=3.30±1.07 (p=0.3). Also, the tibolone and control groups did not show any significant difference in regard to the above indexes in the end of the study. CONCLUSIONS: the 2.5 mg dose of tibolone had no effect on the Doppler velocimetry indexes of the ophthalmic and retinal arteries.

Marco Aurélio Martins de Souza; Selmo Geber

2008-01-01

143

Efeito da tibolona sobre parâmetros doplervelocimétricos das artérias oftálmica e retiniana/ Tibolone's effect on retinal and ophthalmic arteries flowmetry  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVO: avaliar o efeito do uso da tibolona sobre os parâmetros doplervelocimétricos das artérias oftálmica e retiniana. MÉTODOS: realizou-se ensaio clínico, prospectivo, longitudinal, aleatorizado, controlado com placebo, duplo-cego, no qual dentre 100 mulheres na menopausa, 50 usaram o princípio ativo tibolona 2,5 mg (Grupo Tib) e 50, o placebo para formar o grupo controle (Grupo Plac). No Grupo Tib, das 50 mulheres que iniciaram o estudo, 44 retornaram após 8 (more) 4 dias para a finalização dos exames. No Grupo Plac retornaram 47 delas. As artérias oftálmica e retiniana foram estudadas, determinando-se o índice de resistência (IR), índice de pulsatilidade (IP) e relação sístole/diástole (S/D). As aferições foram feitas antes e 84 dias após a medicação. Utilizou-se o teste t de Student para amostras independentes na comparação das medianas entre os grupos e para amostras dependentes na comparação entre as medianas dentro do mesmo grupo. RESULTADOS: as características das mulheres nos dois grupos foram semelhantes em relação à idade, ao tempo de menopausa, ao índice de massa corporal, à pressão arterial, à paridade e à freqüência cardíaca. O Grupo Tib apresentou as seguintes medianas: IR(pré)=0,71±0,05, IR(pós)=0,72±0,08 (p=0,43); IP(pré)=1,29±0,22, IP(pós)=1,30±0,25 (p=0,4) e SD(pré)=3,49±0,77, SD(pós)=3,65±0,94 (p=0,32). Na artéria retiniana foram obtidas as seguintes medianas na artéria oftálmica: IR(pré)=0,67±0,09, IR(pós)=0,69±0,10 (p=0,7); IP(pré)=1,20±0,29, IP(pós)=1,22±0,3 (p=0,2) e SD(pré)=3,29±0,95, SD(pós)=3,30±1,07 (p=0,3). Os grupos tibolona e controle não apresentaram diferenças significantes nos índices quando avaliados ao final do estudo. CONCLUSÕES: a tibolona, na dose de 2,5 mg, não apresenta efeitos sobre os índices doppler das artérias oftálmica e retiniana. Abstract in english PURPOSE: to evaluate the effect of tibolone use on dopplervelocimetric parameters of ophthalmic and retinal arteries. METHODS: clinical, prospective, longitudinal, randomized, placebo-controlled, triple-blind study, in which among 100 menopausal women, 50 have used 2.5 mg of the active principle tibolone (Tib Group) and 50, placebo as a means to form the control-group (Plac Group). In the Tib Group, 44 of the 50 women returned after 84 days to finish the exams, and in the (more) Plac Group, 47. The ophthalmic and retinal arteries were studied to determine the resistance index (RI), the pulsatility index (PI) and the systole/diastole ratio (S/D). Assessments have been done before and 84 days after medication. The t-Student test has been used for the comparison of means between the groups in independent samples, as well as for within-group comparisons in dependent samples. RESULTS: in both groups, the women's characteristics were similar in age, menopause duration, body mass index, arterial blood pressure, deliveries and cardiac rate. The Tib Group presented the following values in the ophthalmic artery: RI(pre)=0.71±0.05, RI(post)0.72±0.08 (p=0.43); PI(pre)=1.29±0.22, PI(post)=1.30±0.25 (p=0.4) and S/D(pre)=3.49±0.77, SD(post)=3.65±0.94 (p=0.32). In the retinal artery, the following values have been found: RI(pre)=0.67±0.09, RI(post)=0.69±0.10 (p=0.7); PI(pre)=1.20±0.29, PI(post)=1.22±0.3 (p=0.2) and SD(pre)=3.29±0.95, SD(post)=3.30±1.07 (p=0.3). Also, the tibolone and control groups did not show any significant difference in regard to the above indexes in the end of the study. CONCLUSIONS: the 2.5 mg dose of tibolone had no effect on the Doppler velocimetry indexes of the ophthalmic and retinal arteries.

Souza, Marco Aurélio Martins de; Geber, Selmo

2008-11-01

144

Clinical significance of retinal emboli during diagnostic and therapeutic cardiac catheterization in patients with coronary artery disease  

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Full Text Available Abstract Background Cardiac catheterization may cause retinal embolization, a risk factor for cerebrovascular emboli and stroke. We describe the incidence of clinically silent and apparent retinal emboli following diagnostic and interventional coronary catheterization and associated risk factors. Methods Three hundred selected patients attending a tertiary referral center for diagnostic and therapeutic cardiac catheterization were studied. Retinal examination and examination of the visual field and acuity were done before and after catheterization by a retinal specialist. Results There were 5 case of retinal embolus before catheterization, and 19 patients (incidence 6.3%) developed new retinal arteriolar emboli after catheterization. Only 1 patient developed clinically apparent changes in vision. Two conventional risk factors (age and hypertension) were significantly associated with new retinal emboli. The risk of retinal emboli was also significantly associated with operator expertise. Conclusions Retinal embolism was found after coronary catheterization in 6.3% of our patients. This finding indicates that the retinal, and possibly the cerebral circulation, may be compromised more frequently than is clinically apparent as a complication of coronary catheterization. Age and hypertension are independent predictors of retinal embolism. Trial Registration NCT01157338

Kojuri Javad; Mehdizadeh Morteza; Rostami Hamed; Shahidian Danial

2011-01-01

145

Reduced retinal ganglion cell complex thickness in patients with posterior cerebral artery infarction detected using spectral-domain optical coherence tomography.  

UK PubMed Central (United Kingdom)

PURPOSE: To report a reduction in macular ganglion cell complex (GCC) thickness detected with spectral-domain optical coherence tomography (SD-OCT) in patients with homonymous hemianopia following acquired cerebral damage. METHODS: We analyzed case reports of three patients with unilateral posterior cerebral artery (PCA) infarction. Three patients (aged 66, 68, and 71 years) with left homonymous hemianopia due to infarction of the right PCA territory were studied using SD-OCT. The duration of the lesions from the onset ranged from 12 to 36 months. RESULTS: In all of these patients, although optic atrophy and retinal nerve fiber layer defects were not detected on funduscopy, GCC thinning was demonstrated in the hemiretinae corresponding to the affected hemifields. Macular GCC measurements showed the localized defects of retinal ganglion cells (RGCs) more clearly than circumpapillary retinal nerve fiber layer measurements. Total and outer retinal thicknesses were not found to be significantly affected. CONCLUSION: Our findings suggest that degeneration of RGCs can occur within a few years after PCA infarction.

Yamashita T; Miki A; Iguchi Y; Kimura K; Maeda F; Kiryu J

2012-09-01

146

Optical coherence tomography findings in acute phase of branch retinal artery occlusion: case report/ Achados da tomografia de coerência óptica na fase aguda da oclusão de ramo da artéria central da retina: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O objetivo é demonstrar alterações morfológicas retinianas por meio da tomografia de coerência óptica na oclusão de ramo de artéria central da retina na fase aguda. Homem de 27 anos apresentando escotoma súbito no campo superior de olho direito, com exame fundoscópico compatível com oclusão de ramo ínfero-temporal da artéria central da retina. A tomografia de coerência óptica revelou aumento da espessura e hiperrefletividade das camadas internas da retina, (more) com redução da refletividade das camadas de fotorreceptores e epitélio pigmentar da retina. Os achados na tomografia de coerência óptica são compatíveis com edema intracelular, e não com fluido extracelular secundário a extravasamento vascular, reforçando teorias histopatológicas da isquemia e necrose retiniana, que ocorrem após oclusão arterial retiniana. Abstract in english PURPOSE: to report a case of branch retinal artery occlusion in the acute phase, using optical coherence tomography to evaluate the morphologic changes. A 27 year-old man had a sudden superior scotoma in the right eye, with fundus examination compatible with inferior temporal branch retinal artery obstruction. The optical coherence tomography revealed increase in thickness and hyper-reflectivity of the inner retinal layers in affected area, with decreased reflectivity of (more) photoreceptor and retinal pigment epithelial layers. The optical coherence tomography findings are consistent with intracellular edema, and not with secondary vascular leakage of extracellular fluid, according to histopathological theories of retinal ischemia and necrosis that occurs after retinal artery occlusion.

Parcero, Cíntia Maria Felix Medrado; Freitas, Bruno de Paula; Marback, Eduardo Ferrari; Maia Júnior, Otacílio de Oliveira; Marback, Roberto Lorens

2010-04-01

147

Optical coherence tomography findings in acute phase of branch retinal artery occlusion: case report Achados da tomografia de coerência óptica na fase aguda da oclusão de ramo da artéria central da retina: relato de caso  

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Full Text Available PURPOSE: to report a case of branch retinal artery occlusion in the acute phase, using optical coherence tomography to evaluate the morphologic changes. A 27 year-old man had a sudden superior scotoma in the right eye, with fundus examination compatible with inferior temporal branch retinal artery obstruction. The optical coherence tomography revealed increase in thickness and hyper-reflectivity of the inner retinal layers in affected area, with decreased reflectivity of photoreceptor and retinal pigment epithelial layers. The optical coherence tomography findings are consistent with intracellular edema, and not with secondary vascular leakage of extracellular fluid, according to histopathological theories of retinal ischemia and necrosis that occurs after retinal artery occlusion.O objetivo é demonstrar alterações morfológicas retinianas por meio da tomografia de coerência óptica na oclusão de ramo de artéria central da retina na fase aguda. Homem de 27 anos apresentando escotoma súbito no campo superior de olho direito, com exame fundoscópico compatível com oclusão de ramo ínfero-temporal da artéria central da retina. A tomografia de coerência óptica revelou aumento da espessura e hiperrefletividade das camadas internas da retina, com redução da refletividade das camadas de fotorreceptores e epitélio pigmentar da retina. Os achados na tomografia de coerência óptica são compatíveis com edema intracelular, e não com fluido extracelular secundário a extravasamento vascular, reforçando teorias histopatológicas da isquemia e necrose retiniana, que ocorrem após oclusão arterial retiniana.

Cíntia Maria Felix Medrado Parcero; Bruno de Paula Freitas; Eduardo Ferrari Marback; Otacílio de Oliveira Maia Júnior; Roberto Lorens Marback

2010-01-01

148

Síndrome do anticorpo antifosfolípide causando oclusão bilateral de artérias e veias centrais da retina: relato de caso/ Antiphospholipid syndrome and bilateral retinal artery and vein occlusion: case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A síndrome do anticorpo antifosfolípide (SAF) tem sido associada a trombose de vasos arteriais e periféricos e de grande ou pequeno calibre. Também os vasos oculares estão sujeitos à ação destes auto-anticorpos que podem promover o aparecimento de perda visual transitória, diplopia, neuropatia óptica isquêmica e oclusão de artéria ou veia da retina. É descrito aqui, um caso de síndrome do anticorpo antifosfolípide com oclusão de vasos centrais arteriais e venosos da retina no intuito de chamar a atenção para este tipo de diagnóstico. Abstract in english The antiphospholipid syndrome (APS) has been related to venous and arterial thrombosis of large and small vessels. Ocular vessels can also be involved causing transient visual loss, diplopia, ischemic optic neuropathy and central artery and venous occlusion. We describe here a case of antiphospholipid syndrome with occlusion of central retinal artery and vein to call the attention to this diagnosis.

Beckhauser, Ana Paula; Arana, Luís Augusto; Skare, Thelma Larocca

2008-04-01

149

Síndrome do anticorpo antifosfolípide causando oclusão bilateral de artérias e veias centrais da retina: relato de caso Antiphospholipid syndrome and bilateral retinal artery and vein occlusion: case report  

Directory of Open Access Journals (Sweden)

Full Text Available A síndrome do anticorpo antifosfolípide (SAF) tem sido associada a trombose de vasos arteriais e periféricos e de grande ou pequeno calibre. Também os vasos oculares estão sujeitos à ação destes auto-anticorpos que podem promover o aparecimento de perda visual transitória, diplopia, neuropatia óptica isquêmica e oclusão de artéria ou veia da retina. É descrito aqui, um caso de síndrome do anticorpo antifosfolípide com oclusão de vasos centrais arteriais e venosos da retina no intuito de chamar a atenção para este tipo de diagnóstico.The antiphospholipid syndrome (APS) has been related to venous and arterial thrombosis of large and small vessels. Ocular vessels can also be involved causing transient visual loss, diplopia, ischemic optic neuropathy and central artery and venous occlusion. We describe here a case of antiphospholipid syndrome with occlusion of central retinal artery and vein to call the attention to this diagnosis.

Ana Paula Beckhauser; Luís Augusto Arana; Thelma Larocca Skare

2008-01-01

150

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

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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.

Trethowan Brian A; Gilliland Helen; Popov Aron F; Varadarajan Barathi; Phillips Sally-Anne; McWhirter Louise; Ghent Robert

2011-01-01

151

Doplervelocimetria das artérias oftálmica e central da retina em gestantes normais Dopplervelocimetry of ophthalmic and central retinal arteries in normal pregnancies  

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Full Text Available OBJETIVOS: avaliar os padrões dos índices doplervelocimétricos das artérias oftálmica e central da retina durante o segundo e terceiro trimestres da gestação normal e comparar os valores obtidos do olho direito e esquerdo das gestantes. MÉTODOS: estudo transversal no qual se avaliaram seis índices doplervelocimétricos das artérias central da retina e oftálmica em 51 gestantes normais, com idades gestacionais entre a 20ª e a 38ª semana. As variáveis analisadas foram os índices de resistência e pulsatilidade (IR, IP), os picos de velocidade sistólica e diastólica (PVS, PVD) e a razão entre picos de velocidade (RPV). A análise dos índices doplervelocimétricos dos olhos direito e esquerdo foi realizada utilizando-se a mediana dos valores. Para a comparação dos valores dos índices entre os dois olhos das gestantes, utilizou-se o teste t de Student para dados pareados. A associação entre a idade gestacional e os índices foi testada empregando-se o coeficiente de correlação linear de Pearson. Adotou-se o nível de significância de 5% para os testes estatísticos. RESULTADOS: a mediana dos índices doplervelocimétricos das artérias oftálmica e central da retina foram, respectivamente: IP=1,83; IR=0,78; PVS=34,20; PVD=6,80; RPV=0,48 e IP=1,34; IR=0,70; PVS=7,40; PVD=2,10. Não houve diferenças na análise comparativa dos índices doplervelocimétricos entre os olhos direito e esquerdo das gestantes normais. O coeficiente de correlação linear entre a idade gestacional e os índices de ambas as artérias não mostrou diferença significante durante a gestação normal. CONCLUSÃO: é factível a análise unilateral dos índices doplervelocimétricos das artérias oftálmica e central da retina no estudo de doenças maternas sistêmicas. Não há mudança significativa dos índices doplervelocimétricos das artérias oftálmica e central da retina ao longo da gestação normal entre a 20ª e a 38ª semana.PURPOSE: to evaluate ophthalmic and retinal central artery Doppler indices during the second and third trimesters of normal pregnancy and to compare the right with left eye Doppler indices of normotensive women. METHODS: a cross-sectional study which evaluated central retinal and ophthalmic artery Doppler velocimetry values of 51 normal pregnant women, in the 20th to 38th week of gestation. The following values were analyzed: pulsatility and resistance indexes (PI, RI), peak systolic and end-diastolic flow velocity (PSV, EDFV) and peak velocity ratio (PVR). The Doppler indices in the right and left eyes were studied by the median. The paired Student's t test was used to confront the right and left eye values and the Pearson linear correlation analysis was performed to study the value changes throughout the gestation, with the level of significance set at 5%. RESULTS: Doppler velocimetry indices of ophthalmic and central retinal arteries (median values) were, respectively: PI=1.83; RI=0.78; PSV=34.20; EDFV=6.80; PVR=0.48 and PI=1.34; RI=0.70; PSV=7.40; EDFV=2.10. There was no significant difference between the right and left side Doppler values. Linear correlation analysis showed no association between the arterial values and pregnancy age. CONCLUSION: the unilateral analysis of ophthalmic and central retinal artery Doppler velocimetry values can be used in systemic maternal disease. There is no significant change in ophthalmic and central retinal artery Doppler velocimetry values throughout normal pregnancy.

Angélica Lemos Debs Diniz; Antonio Fernandes Moron; Maria Célia dos Santos; Nelson Sass; Claudio Rodrigues Pires

2005-01-01

152

Doplervelocimetria das artérias oftálmica e central da retina em gestantes normais/ Dopplervelocimetry of ophthalmic and central retinal arteries in normal pregnancies  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese OBJETIVOS: avaliar os padrões dos índices doplervelocimétricos das artérias oftálmica e central da retina durante o segundo e terceiro trimestres da gestação normal e comparar os valores obtidos do olho direito e esquerdo das gestantes. MÉTODOS: estudo transversal no qual se avaliaram seis índices doplervelocimétricos das artérias central da retina e oftálmica em 51 gestantes normais, com idades gestacionais entre a 20ª e a 38ª semana. As variáveis analisad (more) as foram os índices de resistência e pulsatilidade (IR, IP), os picos de velocidade sistólica e diastólica (PVS, PVD) e a razão entre picos de velocidade (RPV). A análise dos índices doplervelocimétricos dos olhos direito e esquerdo foi realizada utilizando-se a mediana dos valores. Para a comparação dos valores dos índices entre os dois olhos das gestantes, utilizou-se o teste t de Student para dados pareados. A associação entre a idade gestacional e os índices foi testada empregando-se o coeficiente de correlação linear de Pearson. Adotou-se o nível de significância de 5% para os testes estatísticos. RESULTADOS: a mediana dos índices doplervelocimétricos das artérias oftálmica e central da retina foram, respectivamente: IP=1,83; IR=0,78; PVS=34,20; PVD=6,80; RPV=0,48 e IP=1,34; IR=0,70; PVS=7,40; PVD=2,10. Não houve diferenças na análise comparativa dos índices doplervelocimétricos entre os olhos direito e esquerdo das gestantes normais. O coeficiente de correlação linear entre a idade gestacional e os índices de ambas as artérias não mostrou diferença significante durante a gestação normal. CONCLUSÃO: é factível a análise unilateral dos índices doplervelocimétricos das artérias oftálmica e central da retina no estudo de doenças maternas sistêmicas. Não há mudança significativa dos índices doplervelocimétricos das artérias oftálmica e central da retina ao longo da gestação normal entre a 20ª e a 38ª semana. Abstract in english PURPOSE: to evaluate ophthalmic and retinal central artery Doppler indices during the second and third trimesters of normal pregnancy and to compare the right with left eye Doppler indices of normotensive women. METHODS: a cross-sectional study which evaluated central retinal and ophthalmic artery Doppler velocimetry values of 51 normal pregnant women, in the 20th to 38th week of gestation. The following values were analyzed: pulsatility and resistance indexes (PI, RI), p (more) eak systolic and end-diastolic flow velocity (PSV, EDFV) and peak velocity ratio (PVR). The Doppler indices in the right and left eyes were studied by the median. The paired Student's t test was used to confront the right and left eye values and the Pearson linear correlation analysis was performed to study the value changes throughout the gestation, with the level of significance set at 5%. RESULTS: Doppler velocimetry indices of ophthalmic and central retinal arteries (median values) were, respectively: PI=1.83; RI=0.78; PSV=34.20; EDFV=6.80; PVR=0.48 and PI=1.34; RI=0.70; PSV=7.40; EDFV=2.10. There was no significant difference between the right and left side Doppler values. Linear correlation analysis showed no association between the arterial values and pregnancy age. CONCLUSION: the unilateral analysis of ophthalmic and central retinal artery Doppler velocimetry values can be used in systemic maternal disease. There is no significant change in ophthalmic and central retinal artery Doppler velocimetry values throughout normal pregnancy.

Diniz, Angélica Lemos Debs; Moron, Antonio Fernandes; Santos, Maria Célia dos; Sass, Nelson; Pires, Claudio Rodrigues

2005-04-01

153

Use of intraaortic balloon counter pulsation in a patient with tortuous aorta  

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Full Text Available The intraaortic balloon pulsation (IABP) catheter is commonly used to treat left ventricular failure. The abnormality of the descending thoracic and abdominal aorta is considered as a relative contraindication for its insertion. We present here a patient with acute myocardial infarction with a post-infarct ventricular septal defect who presented with left ventricular failure. During coronary angiography, tortuous abdominal aorta was noted and IABP catheter was inserted under fluoroscopic guidance to support the cardiovascular system. This case is reported to encourage discussion on the use of IABP catheters in patients with tortuous aorta and avoidance of events described.

Chakravarthy Murali; Jawali Vivek

2008-01-01

154

Retinal blood flow evaluation.  

Science.gov (United States)

Much of our basic knowledge of retinal blood flow regulation is based on data obtained from animal experiments through the use of invasive techniques. However, during the last decades, major developments in the field of optics and lasers have led to a variety of noninvasive techniques, which have been applied to the human eye for the investigation of retinal hemodynamics, and more specifically the regulation of retinal blood flow in response to a number of physiological and pharmacological stimuli. The Retinal Vessel Analyzer has markedly simplified the measurement of the diameter of retinal vessels, as well as the change in this diameter evoked by various physiological stimuli (dynamic measurements). Bidirectional laser Doppler velocimetry allows the measurement of absolute red blood cell centerline velocity, which, when combined with the diameter allows the calculation of retinal blood flow in the main retinal vessels. Laser Doppler flowmetry and laser speckle flowgraphy are techniques that measure the velocities of blood in discrete areas of the retinal tissue microcirculation. Adding a scanning capability, a spatial map of velocities across the retinal tissue is obtained. The blue-field simulation technique allows the quantification of the velocity, number and velocity pulsatility of leukocytes moving in the retinal capillaries of the macular region. With color Doppler imaging, the peak systolic and end-diastolic values of blood velocity in the ophthalmic and central retinal artery are measured, from which a resistivity index is obtained. These techniques may help better understand the role of altered retinal blood flow and its regulation in the pathogenesis of retinal diseases of vascular origin. PMID:23257770

Pournaras, Constantin J; Riva, Charles E

2012-12-18

155

Retinal blood flow evaluation.  

UK PubMed Central (United Kingdom)

Much of our basic knowledge of retinal blood flow regulation is based on data obtained from animal experiments through the use of invasive techniques. However, during the last decades, major developments in the field of optics and lasers have led to a variety of noninvasive techniques, which have been applied to the human eye for the investigation of retinal hemodynamics, and more specifically the regulation of retinal blood flow in response to a number of physiological and pharmacological stimuli. The Retinal Vessel Analyzer has markedly simplified the measurement of the diameter of retinal vessels, as well as the change in this diameter evoked by various physiological stimuli (dynamic measurements). Bidirectional laser Doppler velocimetry allows the measurement of absolute red blood cell centerline velocity, which, when combined with the diameter allows the calculation of retinal blood flow in the main retinal vessels. Laser Doppler flowmetry and laser speckle flowgraphy are techniques that measure the velocities of blood in discrete areas of the retinal tissue microcirculation. Adding a scanning capability, a spatial map of velocities across the retinal tissue is obtained. The blue-field simulation technique allows the quantification of the velocity, number and velocity pulsatility of leukocytes moving in the retinal capillaries of the macular region. With color Doppler imaging, the peak systolic and end-diastolic values of blood velocity in the ophthalmic and central retinal artery are measured, from which a resistivity index is obtained. These techniques may help better understand the role of altered retinal blood flow and its regulation in the pathogenesis of retinal diseases of vascular origin.

Pournaras CJ; Riva CE

2013-01-01

156

Retinal vasculitis due to secondary syphilis.  

UK PubMed Central (United Kingdom)

BACKGROUND: Retinal vasculitis is one of the manifestations of ocular syphilis. CASE: A 29-year-old man was referred to our hospital with the complaint of sudden visual loss in the left eye lasting more than three weeks. OBSERVATIONS: Ophthalmoscopic examination showed retinal hemorrhages, edema, and sheathing of large retinal arteries and veins. Fluorescein angiography revealed extensive occlusion of the affected retinal arteries, veins, and capillaries. Little evidence of uveitis or vitritis was observed. The fluorescent treponemal antibody-absorption test was positive, and the Treponema pallidum hemagglutination titer was 1:10,240. The treatment with penicillin was effective, leading to resolution of the retinal hemorrhages and edema, although occlusion of the retinal vessels persisted. CONCLUSIONS: Vascular occlusion occurred simultaneously in large retinal arteries, arterioles, and capillaries as well as in segments of retinal veins, resulting in irreversible changes in the vascular walls.

Yokoi M; Kase M

2004-01-01

157

Central retinal artery occlusion associated with traumatic carotid cavernous fistula: case report Oclusão de artéria central da retina associada com fístula carótido-cavernosa traumática: relato de caso  

Directory of Open Access Journals (Sweden)

Full Text Available Carotid cavernous fistulas are a rare entity occurring as result of head trauma and also spontaneously. The authors report a rare case of central retinal artery occlusion complicating traumatic carotid-cavernous fistula, resulting in severe visual acuity loss. Spontaneous closure of the fistula was observed. The possible mechanisms responsible for this complication are discussed.Fístulas carótido-cavernosas são raras e ocorrem como resultado de trauma cefálico e também espontaneamente. Os autores relatam um caso raro de oclusão de artéria central da retina complicando fístula carótido-cavernosa traumática, resultando em perda grave da acuidade visual. Fechamento espontâneo da fístula foi observado. Os possíveis mecanismos responsáveis por esta complicação são discutidos.

Paulo de Tarso Ponte Pierre Filho; Flavio Mac Cord Medina; Fabrício Kafury Pereira Rodrigues; Clayton Rocha Lara Carrera

2007-01-01

158

Techniques for passing the PercuSurge Guardwire system through severe and tortuous stenotic lesions.  

UK PubMed Central (United Kingdom)

Distal embolism is one of the major causes of morbidity and mortality associated with treating stenotic lesions by endovascular procedures, such as percutaneous angioplasty and stenting. Many devices have been designed and used to prevent this complication. The PercuSurge Guardwire system is recognized as the best system available to prevent distal embolism during stenting. However, this system is sometimes hard to pass through severe stenotic, tortuous lesions because of the poor selectivity and support. The PercuSurge device was safely introduced into two cases of severe stenotic and tortuous lesions with a triple coaxial system and the buddy wire technique, and stenting was performed successfully. These techniques are very helpful for introducing and maintaining this system in the correct position across stenoses with unfavorable configurations.

Satow T; Nakazawa K; Ohta T; Hashimoto N

2005-02-01

159

Techniques for passing the PercuSurge Guardwire system through severe and tortuous stenotic lesions.  

Science.gov (United States)

Distal embolism is one of the major causes of morbidity and mortality associated with treating stenotic lesions by endovascular procedures, such as percutaneous angioplasty and stenting. Many devices have been designed and used to prevent this complication. The PercuSurge Guardwire system is recognized as the best system available to prevent distal embolism during stenting. However, this system is sometimes hard to pass through severe stenotic, tortuous lesions because of the poor selectivity and support. The PercuSurge device was safely introduced into two cases of severe stenotic and tortuous lesions with a triple coaxial system and the buddy wire technique, and stenting was performed successfully. These techniques are very helpful for introducing and maintaining this system in the correct position across stenoses with unfavorable configurations. PMID:15722613

Satow, Tetsu; Nakazawa, Kazutomo; Ohta, Tsuyoshi; Hashimoto, Nobuo

2005-02-01

160

Platelet size and density affect shear-induced thrombus formation in tortuous arterioles.  

UK PubMed Central (United Kingdom)

Thrombosis accounts for 80% of deaths in patients with diabetes mellitus. Diabetic patients demonstrate tortuous microvessels and larger than normal platelets. Large platelets are associated with increased platelet activation and thrombosis, but the physical effects of large platelets in the microscale processes of thrombus formation are not clear. Therefore, the objective of this study was to determine the physical effects of mean platelet volume (MPV), mean platelet density (MPD) and vessel tortuosity on platelet activation and thrombus formation in tortuous arterioles. A computational model of the transport, shear-induced activation, collision, adhesion and aggregation of individual platelets was used to simulate platelet interactions and thrombus formation in tortuous arterioles. Our results showed that an increase in MPV resulted in a larger number of activated platelets, though MPD and level of tortuosity made little difference on platelet activation. Platelets with normal MPD yielded the lowest amount of mural thrombus. With platelets of normal MPD, the amount of mural thrombus decreased with increasing level of tortuosity but did not have a simple monotonic relationship with MPV. The physical mechanisms associated with MPV, MPD and arteriole tortuosity play important roles in platelet activation and thrombus formation.

Chesnutt JK; Han HC

2013-08-01

 
 
 
 
161

Inner retinal oxygen extraction fraction in rat.  

UK PubMed Central (United Kingdom)

PURPOSE: Oxygen extraction fraction (OEF), defined by the ratio of oxygen consumption to delivery, may be a useful parameter for assessing the retinal tissue status under impaired circulation. We report a method for measurement of inner retinal OEF in rats under normoxia and hypoxia based on vascular oxygen tension (PO(2)) imaging. METHODS: Retinal vascular PO(2) measurements were obtained in 10 rats, using our previously developed optical section phosphorescence lifetime imaging system. Inner retinal OEF was derived from retinal vascular PO(2) measurements based on Fick's principle. Measurements of inner retinal OEF obtained under normoxia were compared between nasal and temporal retinal sectors and repeatability was determined. Inner retinal OEF measurements obtained under normoxia and hypoxia were compared. RESULTS: Retinal vascular PO(2) and inner retinal OEF measurements were repeatable (ICC ? 0.83). Inner retinal OEF measurements at nasal and temporal retinal sectors were correlated (R = 0.71; P = 0.02; n = 10). Under hypoxia, both retinal arterial and venous PO(2) decreased significantly as compared with normoxia (P < 0.001; n = 10). Inner retinal OEF was 0.46 ± 0.13 under normoxia and increased significantly to 0.67 ± 0.16 under hypoxia (mean ± SD; P < 0.001; n = 10). CONCLUSIONS: Inner retinal OEF is a promising quantitative biomarker for the adequacy of oxygen supply for metabolism under physiologically and pathologically altered conditions.

Teng PY; Wanek J; Blair NP; Shahidi M

2013-01-01

162

Inner Retinal Oxygen Extraction Fraction in Rat  

Science.gov (United States)

Purpose. Oxygen extraction fraction (OEF), defined by the ratio of oxygen consumption to delivery, may be a useful parameter for assessing the retinal tissue status under impaired circulation. We report a method for measurement of inner retinal OEF in rats under normoxia and hypoxia based on vascular oxygen tension (PO2) imaging. Methods. Retinal vascular PO2 measurements were obtained in 10 rats, using our previously developed optical section phosphorescence lifetime imaging system. Inner retinal OEF was derived from retinal vascular PO2 measurements based on Fick's principle. Measurements of inner retinal OEF obtained under normoxia were compared between nasal and temporal retinal sectors and repeatability was determined. Inner retinal OEF measurements obtained under normoxia and hypoxia were compared. Results. Retinal vascular PO2 and inner retinal OEF measurements were repeatable (ICC ? 0.83). Inner retinal OEF measurements at nasal and temporal retinal sectors were correlated (R = 0.71; P = 0.02; n = 10). Under hypoxia, both retinal arterial and venous PO2 decreased significantly as compared with normoxia (P < 0.001; n = 10). Inner retinal OEF was 0.46 ± 0.13 under normoxia and increased significantly to 0.67 ± 0.16 under hypoxia (mean ± SD; P < 0.001; n = 10). Conclusions. Inner retinal OEF is a promising quantitative biomarker for the adequacy of oxygen supply for metabolism under physiologically and pathologically altered conditions.

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

2013-01-01

163

Oclusão artério-venosa da retina após bloqueio retrobulbar: relato de dois casos Combined central retinal vein and artery occlusion after retrobulbar anesthesia: report of two cases  

Directory of Open Access Journals (Sweden)

Full Text Available São descritos dois casos de oclusão artério-venosa da retina após cirurgia intra-ocular. As duas pacientes foram submetidas à anestesia peribulbar. Devido à sensação dolorosa e à mobilidade ocular foi necessário a realização de bloqueio retrobulbar. Ao final da cirurgia, ambas receberam injeção subconjuntival de gentamicina associada à dexametasona. No primeiro dia pós-cirúrgico as pacientes apresentaram arreflexia pupilar e acuidade visual de percepção luminosa, sendo referidas para nosso serviço. A confirmação do diagnóstico de oclusão vascular retiniana mista foi feito por meio do exame de retinografia fluorescente. As pacientes não manifestaram, em nenhum momento, alterações neurológicas, porém a perda visual foi grave e permanente. Por meio da descrição cirúrgica, da história clínica e dos achados oftalmoscópicos e angiográficos discutem-se as possíveis causas desta grave lesão vascular retiniana, dando ênfase à presumida injeção de anestésico na bainha do nervo óptico durante o bloqueio retrobulbar. Ao mesmo tempo, abordam-se medidas preventivas para evitar tal complicação.Two cases of combined central retinal artery and vein occlusion after intraocular surgery are described. Both patients were submitted to peribulbar anesthesia. Due to the painful sensation and ocular mobility retrobulbar anesthesia was necessary. At the end of the surgery both patients received a subconjunctival injection of gentamicin associated with dexamethasone. On the very first day after the surgery the two patients showed pupillary areflexia and visual acuity of luminous perception when they were referred to our service. The confirmation of the diagnosis of combined vascular occlusion of the retina was obtained by fluorescein angiography test. The two patients never showed, any neurological alteration. However visual loss was severe and permanent. By means of surgical description, clinical history, fundus photography and fluorescein angiography we are able to discuss the possible causes of this severe retinal vascular injury emphasizing the presumed anesthesic injection that was given into the optical nerve during retrobulbar anesthesia. At the same time we discuss preventive measures to avoid such problem.

Rogil José de Almeida Torres; Andréa Luchini; Wilma Weis; Paulo Roberto Frecceiro; Marcelo Casella

2005-01-01

164

Central retinal vein occlusion following hypobaric chamber exposure.  

UK PubMed Central (United Kingdom)

BACKGROUND: Mountain climbers who ascend to a high altitude could suffer high altitude retinopathy, which varies from tortuous retinal vessels and hemorrhages to retinal vascular obstruction. As hypobaric chamber training could imitate a fast ascent and could lead to decompression sickness, a simulated flight could also lead to a high altitude retinopathy. CASE REPORT: This paper will present a case of central retinal vein occlusion that occurred after exposure to a hypobaric chamber and Valsalva maneuver. Although the patient was treated with an intravitreal bevacizumab injection, his macular edema was aggravated after a helicopter flight, which involved re-exposure to high altitudes and a Valsalva maneuver. DISCUSSION: Systemic evaluation including blood coagulation and carotid Doppler studies did not reveal any lesion. Notably, central retinal vein occlusion can occur in young, healthy individuals after hypobaric chamber exposure.

Lee KM; Yoo SJ; Woo SJ

2013-09-01

165

Retinal microscopy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Our research interest is focused on the disease mechanisms and therapeutic treatments for retinal degenerative diseases using animal models. Our work attempt to understand more about retinal degenerative diseases like retinitis pigmentosa and macular degeneration and provide tactics to design variou...

Cuenca Navarro, Nicolás

166

Tortuously structured polyvinyl chloride/polyurethane fibrous membranes for high-efficiency fine particulate filtration.  

Science.gov (United States)

Two-tier composite filtration medium exhibiting excellent filtration performance to airborne particulate was prepared by a facile deposition of electrospun polyvinyl chloride (PVC)/polyurethane (PU) fibers on a conventional filter paper support. The tortuous structure and composition of resultant fibrous membranes can be finely controlled by regulating the precursor solution composition. By employing the PU incorporation, the pristine PVC fibrous membranes were endowed with robust tensile strength approaching to 9.9 MPa. The plausible correlation between resultant blended fibrous structure and mechanical property of relevant membranes was discussed, and a three-step break mechanism upon the external stress was proposed. Additionally, quantitative pore size and porosity distribution analysis using the capillary flow porometry method has confirmed the tortuous structure of PVC/PU fibrous membranes. Furthermore, the as-prepared membranes with high abrasion resistance (134 cycles) and comparable air permeability (154.1mm/s) showed fascinating filtration efficiency (99.5%) and low pressure drop (144 Pa) performance for 300-500 nm sodium chloride aerosol particles, suggesting their use as a promising medium for variety of potential applications in air filtration. PMID:23489615

Wang, Na; Raza, Aikifa; Si, Yang; Yu, Jianyong; Sun, Gang; Ding, Bin

2013-02-22

167

Tortuously structured polyvinyl chloride/polyurethane fibrous membranes for high-efficiency fine particulate filtration.  

UK PubMed Central (United Kingdom)

Two-tier composite filtration medium exhibiting excellent filtration performance to airborne particulate was prepared by a facile deposition of electrospun polyvinyl chloride (PVC)/polyurethane (PU) fibers on a conventional filter paper support. The tortuous structure and composition of resultant fibrous membranes can be finely controlled by regulating the precursor solution composition. By employing the PU incorporation, the pristine PVC fibrous membranes were endowed with robust tensile strength approaching to 9.9 MPa. The plausible correlation between resultant blended fibrous structure and mechanical property of relevant membranes was discussed, and a three-step break mechanism upon the external stress was proposed. Additionally, quantitative pore size and porosity distribution analysis using the capillary flow porometry method has confirmed the tortuous structure of PVC/PU fibrous membranes. Furthermore, the as-prepared membranes with high abrasion resistance (134 cycles) and comparable air permeability (154.1mm/s) showed fascinating filtration efficiency (99.5%) and low pressure drop (144 Pa) performance for 300-500 nm sodium chloride aerosol particles, suggesting their use as a promising medium for variety of potential applications in air filtration.

Wang N; Raza A; Si Y; Yu J; Sun G; Ding B

2013-05-01

168

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  

Directory of Open Access Journals (Sweden)

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 an observational, longitudinal and prospective study evaluating 34 healthy and ovulatory women. All women were submitted to Doppler scan of the eye to evaluate the vascular resistance of the central retinal arteries, either lying down or on a seated position, during four phases of the menstrual cycle. Confirmation of ovulation was performed by measuring serum progesterone during the luteal phase. We analyzed the pulsatility and resistance index and the maximum, minimum and mean velocity. RESULTS: mean age was 29.7 years. No differences were observed between the indexes obtained in both eyes, therefore a mean index was used for comparisons. As the comparison between the positions used for the exams showed a higher PI for the seated position, the analyses were performed separately. The pulsatility index in the lying position was different among the different phases of the menstrual cycle. The arterial resistance was significantly lower during the intermediate follicular and the periovulatory phases, as compared to the early follicular and luteal phases. When the comparison was performed with the patient in the seated position, no differences were observed. CONCLUSIONS: Our results demonstrate a reduction in the vascular resistance of the cerebral microcirculation and a posterior reversal, as shown by changes in the PI.

Luiz Carlos Viana; Michelle Amorim Costa Burmann; Marcos Sampaio; Selmo Geber

2007-01-01

169

Oclusão artério-venosa da retina após bloqueio retrobulbar: relato de dois casos/ Combined central retinal vein and artery occlusion after retrobulbar anesthesia: report of two cases  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese São descritos dois casos de oclusão artério-venosa da retina após cirurgia intra-ocular. As duas pacientes foram submetidas à anestesia peribulbar. Devido à sensação dolorosa e à mobilidade ocular foi necessário a realização de bloqueio retrobulbar. Ao final da cirurgia, ambas receberam injeção subconjuntival de gentamicina associada à dexametasona. No primeiro dia pós-cirúrgico as pacientes apresentaram arreflexia pupilar e acuidade visual de percepção (more) luminosa, sendo referidas para nosso serviço. A confirmação do diagnóstico de oclusão vascular retiniana mista foi feito por meio do exame de retinografia fluorescente. As pacientes não manifestaram, em nenhum momento, alterações neurológicas, porém a perda visual foi grave e permanente. Por meio da descrição cirúrgica, da história clínica e dos achados oftalmoscópicos e angiográficos discutem-se as possíveis causas desta grave lesão vascular retiniana, dando ênfase à presumida injeção de anestésico na bainha do nervo óptico durante o bloqueio retrobulbar. Ao mesmo tempo, abordam-se medidas preventivas para evitar tal complicação. Abstract in english Two cases of combined central retinal artery and vein occlusion after intraocular surgery are described. Both patients were submitted to peribulbar anesthesia. Due to the painful sensation and ocular mobility retrobulbar anesthesia was necessary. At the end of the surgery both patients received a subconjunctival injection of gentamicin associated with dexamethasone. On the very first day after the surgery the two patients showed pupillary areflexia and visual acuity of lu (more) minous perception when they were referred to our service. The confirmation of the diagnosis of combined vascular occlusion of the retina was obtained by fluorescein angiography test. The two patients never showed, any neurological alteration. However visual loss was severe and permanent. By means of surgical description, clinical history, fundus photography and fluorescein angiography we are able to discuss the possible causes of this severe retinal vascular injury emphasizing the presumed anesthesic injection that was given into the optical nerve during retrobulbar anesthesia. At the same time we discuss preventive measures to avoid such problem.

Torres, Rogil José de Almeida; Luchini, Andréa; Weis, Wilma; Frecceiro, Paulo Roberto; Casella, Marcelo

2005-04-01

170

Novel Neuroprotective Strategies in Ischemic Retinal Lesions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Retinal ischemia can be effectively modeled by permanent bilateral common carotid artery occlusion, which leads to chronic hypoperfusion-induced degeneration in the entire rat retina. The complex pathways leading to retinal cell death offer a complex approach of neuroprotective strategies. In the pr...

Krisztina Szabadfi; Laszlo Mester; Dora Reglodi; Peter Kiss; Norbert Babai; Boglarka Racz; Krisztina Kovacs; Aliz Szabo

171

[Arteriovenous dissection for branch retinal vein occlusion].  

Science.gov (United States)

Arteriovenous dissection (AVD) is a surgical maneuver to separate the retinal artery and vein at the crossing site in patients with branch retinal vein occlusion (BRVO). The published studies showed an evidence level 3. AVD seems to be maintainable in patients with recent onset of BRVO and decimal visual acuity < or =0.4. PMID:18317778

Feltgen, N; Hattenbach, L-O; Mirshahi, A; Hansen, L

2008-04-01

172

Trigeminal neuralgia caused by the vertebral artery associated with primitive trigeminal artery and agenesis of the internal carotid artery.  

UK PubMed Central (United Kingdom)

A 69-year-old female presented with trigeminal neuralgia caused by tortuous vertebrobasilar artery associated with primitive trigeminal artery (PTA) and agenesis of the ipsilateral internal carotid artery (ICA). Left vertebral angiography showed marked elongation of the left vertebral artery and filling of the left ICA via the PTA. Bone window computed tomography suggested agenesis of the left ICA. Intraoperative findings showed that the vertebrobasilar junction had compressed the root entry zone of the trigeminal nerve. The neuralgia improved immediately after microvascular decompression. There has been no recurrence for 20 months. Trigeminal neuralgia may be caused by a tortuous vertebrobasilar system due to hemodynamic stress associated with PTA and agenesis of the ICA.

Fukuda M; Kameyama S; Takahashi H; Tanaka R

1998-06-01

173

Retinal cartography.  

UK PubMed Central (United Kingdom)

This paper analyses retinal cartography in terms of its reflection of anatomic data and its relation to several forms of geographic methods of map-making. It shows that the distances between anatomic landmarks of the eye are reasonably similar to the relative distances on the retinal drawing chart currently used. Two forms of geographic cartography--azimuth equidistant and orthographic--are described and compared with retinal cartography. The retinal drawing chart currently used most closely approximates an azimuth equidistant projection, which suffers from circumferential distortion, a fact that retinal surgeons must keep in mind. It is therefore recommended that the chart be modified to have equally spaced concentric circles and clearer identification of the ora serrata; the present accurate marking of anatomic landmarks, such as the equator and the posterior border of the ciliary body, should be preserved.

Mosier MA

1982-10-01

174

Retinal remodeling.  

Science.gov (United States)

Retinal photoreceptor degeneration takes many forms. Mutations in rhodopsin genes or disorders of the retinal pigment epithelium, defects in the adenosine triphosphate binding cassette transporter, ABCR gene defects, receptor tyrosine kinase defects, ciliopathies and transport defects, defects in both transducin and arrestin, defects in rod cyclic guanosine 3',5'-monophosphate phosphodiesterase, peripherin defects, defects in metabotropic glutamate receptors, synthetic enzymatic defects, defects in genes associated with signaling, and many more can all result in retinal degenerative disease like retinitis pigmentosa (RP) or RP-like disorders. Age-related macular degeneration (AMD) and AMD-like disorders are possibly due to a constellation of potential gene targets and gene/gene interactions, while other defects result in diabetic retinopathy or glaucoma. However, all of these insults as well as traumatic insults to the retina result in retinal remodeling. Retinal remodeling is a universal finding subsequent to retinal degenerative disease that results in deafferentation of the neural retina from photoreceptor input as downstream neuronal elements respond to loss of input with negative plasticity. This negative plasticity is not passive in the face of photoreceptor degeneration, with a phased revision of retinal structure and function found at the molecular, synaptic, cell, and tissue levels involving all cell classes in the retina, including neurons and glia. Retinal remodeling has direct implications for the rescue of vision loss through bionic or biological approaches, as circuit revision in the retina corrupts any potential surrogate photoreceptor input to a remnant neural retina. However, there are a number of potential opportunities for intervention that are revealed through the study of retinal remodeling, including therapies that are designed to slow down photoreceptor loss, interventions that are designed to limit or arrest remodeling events, and optogenetic approaches that target appropriate classes of neurons in the remnant neural retina. PMID:22644448

Jones, B W; Kondo, M; Terasaki, H; Lin, Y; McCall, M; Marc, R E

2012-05-30

175

Retinal remodeling.  

UK PubMed Central (United Kingdom)

Retinal photoreceptor degeneration takes many forms. Mutations in rhodopsin genes or disorders of the retinal pigment epithelium, defects in the adenosine triphosphate binding cassette transporter, ABCR gene defects, receptor tyrosine kinase defects, ciliopathies and transport defects, defects in both transducin and arrestin, defects in rod cyclic guanosine 3',5'-monophosphate phosphodiesterase, peripherin defects, defects in metabotropic glutamate receptors, synthetic enzymatic defects, defects in genes associated with signaling, and many more can all result in retinal degenerative disease like retinitis pigmentosa (RP) or RP-like disorders. Age-related macular degeneration (AMD) and AMD-like disorders are possibly due to a constellation of potential gene targets and gene/gene interactions, while other defects result in diabetic retinopathy or glaucoma. However, all of these insults as well as traumatic insults to the retina result in retinal remodeling. Retinal remodeling is a universal finding subsequent to retinal degenerative disease that results in deafferentation of the neural retina from photoreceptor input as downstream neuronal elements respond to loss of input with negative plasticity. This negative plasticity is not passive in the face of photoreceptor degeneration, with a phased revision of retinal structure and function found at the molecular, synaptic, cell, and tissue levels involving all cell classes in the retina, including neurons and glia. Retinal remodeling has direct implications for the rescue of vision loss through bionic or biological approaches, as circuit revision in the retina corrupts any potential surrogate photoreceptor input to a remnant neural retina. However, there are a number of potential opportunities for intervention that are revealed through the study of retinal remodeling, including therapies that are designed to slow down photoreceptor loss, interventions that are designed to limit or arrest remodeling events, and optogenetic approaches that target appropriate classes of neurons in the remnant neural retina.

Jones BW; Kondo M; Terasaki H; Lin Y; McCall M; Marc RE

2012-07-01

176

AUTOMATIC RETINAL VESSEL TORTUOSITY MEASUREMENT  

Directory of Open Access Journals (Sweden)

Full Text Available Retinal vascular vessels have the role to indicate the retinal diseases and for systematic diseases when there are any abnormalities in retinal vascular pattern. 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. In this study we suggest a novel mask filter to track the blood vessel along its course and measuring the blood vessels tortuosity over the entire human retinal vessel network in fundus eye image, by using the arc to chord ratio. The suggested algorithm tested with straight and curve hand drawing lines and gives high accurate results.

Nidhal Khdhair El Abbadi; Enas Hamood Al Saadi

2013-01-01

177

Intravitreal ranibizumab in retinal macroaneurysm.  

UK PubMed Central (United Kingdom)

PURPOSE: To present the effect of intravitreal ranibizumab (Lucentis®) therapy in a patient suffering from retinal macroaneurysm. METHODS: Case report. An 82-year-old female patient was diagnosed with retinal macroaneurysm of the inferior temporal artery with macular edema. Functional and morphological data at baseline and at 4 weeks, 3 months, and 5 months after the initiation of therapy with two intravitreal ranibizumab (Lucentis®) injections followed by focal argon laser coagulation surrounding the retinal macroaneurysm are presented. RESULTS: Best-corrected visual acuity improved from 20/50 at baseline to 20/20 at 3-month follow-up and maintained stable at 20/25 through 5-month follow-up. Central retinal thickness measured by optical coherence tomography decreased from 510 µm at baseline to 148 µm at 5-month follow-up. Fluorescein angiography demonstrated closure of the retinal macroaneurysm at 6-week follow-up. No ocular or systemic side effects were detected. CONCLUSIONS: Intravitreal ranibizumab (Lucentis®) therapy may close the retinal macroaneurysm leading to resolution of the associated macular edema and consequently visual improvement. To our knowledge, this is the first case of a retinal macroaneurysm benefiting from treatment with intravitreal ranibizumab (Lucentis®). The observed results warrant further investigation.

Wenkstern AR; Petersen H

2010-11-01

178

What do retinal vessels reveal about systemic disease? Retinal vessels and systemic disease--basic findings.  

UK PubMed Central (United Kingdom)

A number of systemic disorders are attended by distinct changes in blood vessels. The retinal vessels can easily be inspected with an ophthalmoscope. Some changes in retinal vessels allow us to draw direct conclusions about the status of blood vessels in the entire body. Major systemic diseases, such as diabetes or hypertension, can lead to typical changes in the retinal vessels with the resulting retinal pathology. Changes in the retinal vessels can also be an indicator for some specific ocular diseases. Early diagnosis and treatment of such diseases often prevent long-term damage or even blindness. Therefore, the evaluation of retinal arteries and veins should be a crucial part of an eye examination. In the following some basic principles of retinal findings and their correlation with systemic disease shall be discussed.

Grein HJ

2013-04-01

179

Retinal Detachment  

Science.gov (United States)

... history of retinal detachment Extreme nearsightedness (myopia) Previous eye surgery, such as cataract removal Previous severe eye injury ... ever experienced eye inflammation? Have you ever had eye surgery? Do you have any other medical conditions, such ...

180

Use of the AorfixTM stent graft in patients with tortuous iliac anatomy.  

UK PubMed Central (United Kingdom)

AIM: Iliac limb occlusion following endovascular repair (EVAR) may result in limb threatening acute ischemia. The incidence is reported at up to 10% and is known to be influenced by iliac angulation and kinking of the stent graft. The aim of this study was to evaluate the performance of the AorfixTM graft in tortuous iliac anatomy and examine the impact of the graft on the rate of iliac limb thrombosis following EVAR in a single UK centre METHODS: We performed a retrospective review of all EVAR performed from May 1998 to May 2010. From November 2007, patients with highly angulated iliac anatomy were treated with the AorfixTM(Lombard) stent graft, or when a ZenithTM(Cook) main body was chosen, the AorfixTM iliac limbs were used with the ZenithTM(Cook) device. We compared the rate of iliac limb occlusions before (group 1) and after (group 2) the adoption of this policy. RESULTS: Two hundred and sixty seven patients underwent EVAR (group 1 n=129; group 2 n=138). In group 1, eight patients had a unilateral iliac limb occlusion (6.2%). Six of the patients had >90 degrees iliac angulation, one had an unrecognised limb stenosis, and one patient had the stent landed in the external iliac. In group 2 there were no limb occlusions. Of the 138 patients, 25 had iliac angulation of >90 degrees . Of these 25, eighteen were treated with the AorfixTM stent graft system because of iliac angulation, and 7 were treated with AorfixTM legs and ZenithTM bodies. CONCLUSION: The rate of early iliac limb occlusion following EVAR in patients with angulated iliac anatomy can be substantially reduced by using the flexible Aorfix stent graft system.

Weale AR; Balasubramaniam K; Hardman J; Horrocks M

2010-08-01

 
 
 
 
181

Measurement of retinal oxygen saturation in patients with chronic obstructive pulmonary disease.  

UK PubMed Central (United Kingdom)

PURPOSE: There is growing evidence that disturbances in retinal oxygenation may trigger ocular diseases. New instruments allow for the noninvasive measurement of retinal oxygen saturation in humans. The present study was designed to investigate the retinal oxygen saturation in patients with chronic obstructive pulmonary disease (COPD). This was also done in an effort to test the validity of retinal oxygenation measurements with a retinal vessel analyzer. METHODS: In all, 16 patients with severe COPD grade 4 who were on long-term oxygen treatment were included in the study. For each patient two identical study days were scheduled. Measurements of retinal arterial and venous oxygen saturation were done using a commercially available instrument for retinal oxygen analysis. Peripheral arterial oxygen saturation values were analyzed with pulse oximetry and via a capillary blood sample drawn from the earlobe. Measurements were performed during oxygen treatment and during a period without oxygen supplementation. Analysis of all images for retinal oxygen saturation quantification was done by a masked investigator. Analysis was done using Pearson's correlation and a multivariate regression model. RESULTS: Arterial and venous retinal oxygen saturation decreased significantly after the cessation of the oxygen therapy. The arteriovenous oxygen difference was unchanged while breathing ambient air or pure oxygen-enriched air. With both Pearson's correlation and the multivariate model, we found significant positive correlation coefficients between retinal arterial and peripheral arterial oxygen saturation as assessed with pulse oximetry as well as between retinal arterial and peripheral arterial oxygen saturation measured in blood samples. The change of oxygen saturation after discontinuation of oxygen supplementation showed a good correlation between retinal arterial oxygen saturation and peripheral arterial oxygen saturation (r = 0.53, P < 0.05). Reproducibility on the two study days was high. DISCUSSION: The present study shows a good correlation between retinal arterial and peripheral arterial oxygen saturation indicating good validity of the technique. (ClinicalTrials.gov number, NCT00999024.).

Palkovits S; Lasta M; Boltz A; Schmidl D; Kaya S; Hammer M; Marzluf B; Popa-Cherecheanu A; Frantal S; Schmetterer L; Garhöfer G

2013-02-01

182

Vascular crossing patterns in patients with systemic arterial hypertension.  

UK PubMed Central (United Kingdom)

AIM: To identify the relationship of retinal arteries in a population with systemic arterial hypertension. METHODS: High resolution, dilated, digitised, fundus photographs of consecutive patients with a history of hypertension requiring pharmacologic therapy seen on the Wills Eye Hospital Retina Service were analysed. Included were photographs of the temporal retinal vascular arcades in which media clarity permitted good visualisation of third-order retinal vascular bifurcations. Each first- and second-order arteriovenous (AV) crossing was then examined to identify anatomic patterns at the sites where veins and arteries crossed. Eyes in patients without a history of hypertension were used as controls. RESULTS: Among the 71 patients (134 eyes), there were 430 first-order and second-order AV crossings, in which AV nicking was present at 126 sites. A retinal artery was located anterior to the retinal vein in 122 of the 126 sites (96.8%) at which AV nicking was noted, while nicking associated with the vein located anteriorly to the artery occurred in only 4 of 126 (3.2%) of AV crossings (p<0.001). An anatomical pattern of venous arching, or cascading of a retinal vein over a retinal artery, was noted predominantly when the vein was positioned anterior to the artery in both subjects and controls. Among the 43 venous arching sites in the study group, 41 (95.3%) demonstrated the retinal vein anterior to retinal artery (p<0.001). CONCLUSIONS: In patients with systemic arterial hypertension and hypertensive retinopathy, AV nicking of the retinal vein at the site of AV crossing is seen predominantly when the retinal artery lies anterior to the vein, but generally not when the vein lies anterior to the artery. The clinician should realise that when a retinal vein lies anterior to a retinal artery, the absence of AV nicking does not rule out more severe, chronic, retinopathic changes than observed with retinal arterial straightening only.

Waisbren EC; Salz DA; Brown MM; Brown GC

2013-06-01

183

Pure arterial malformation of the posterior cerebral artery: importance of its recognition.  

UK PubMed Central (United Kingdom)

The finding of dilated, elongated, and tortuous vessels on brain imaging should prompt clinicians to determine what vascular anomaly is present. Importantly, not all suspicious serpentine flow voids are manifestations of arteriovenous malformations or arteriovenous fistulas. Other types of intracranial vasculopathies should also be considered. The authors report a rare case of dilated, tortuous, and redundant left posterior communicating artery and left P2 segment of the posterior cerebral artery identified in a young healthy adult that remained stable over a 30-year period. Dynamic and 3D images were critical for determining the type of vascular anomaly and for guiding appropriate management. The authors propose that this case represents a pure arterial malformation and discuss its distinguishing features.

McLaughlin N; Raychev R; Duckwiler G; Martin NA

2013-09-01

184

Pure arterial malformation of the posterior cerebral artery: importance of its recognition.  

Science.gov (United States)

The finding of dilated, elongated, and tortuous vessels on brain imaging should prompt clinicians to determine what vascular anomaly is present. Importantly, not all suspicious serpentine flow voids are manifestations of arteriovenous malformations or arteriovenous fistulas. Other types of intracranial vasculopathies should also be considered. The authors report a rare case of dilated, tortuous, and redundant left posterior communicating artery and left P2 segment of the posterior cerebral artery identified in a young healthy adult that remained stable over a 30-year period. Dynamic and 3D images were critical for determining the type of vascular anomaly and for guiding appropriate management. The authors propose that this case represents a pure arterial malformation and discuss its distinguishing features. PMID:23746101

McLaughlin, Nancy; Raychev, Radoslav; Duckwiler, Gary; Martin, Neil A

2013-06-07

185

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

Energy Technology Data Exchange (ETDEWEB)

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.)

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

186

[Retinal vascular complications in systemic lupus erythematosus  

UK PubMed Central (United Kingdom)

An analysis of three women with retinal vaso-occlusive disease in systemic lupus erythematosus produced evidence for this most severe ophthalmic complication during the acute phase of the syndrome. Vaso-occlusive retinopathy appeared 5 years after the onset of systemic symptomatology in all of them. Association of central nervous system lupus and circulating anti-coagulants with increased occurrence of severe retinal vaso-occlusive disease are the subject of the present report. Unilateral extensive photocoagulation of two cases appeared to result in successful therapy of neovascular glaucoma after the central retinal artery occlusion in one patient. Lupus erythematosus is very serious systemic and ocular disease also in present time.

Streicher T; Spirková J

2001-09-01

187

An anatomical study of double brachial arteries – a case report  

Directory of Open Access Journals (Sweden)

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.

Krstonosic B; Srdic B; Maric D; Gudovic R; Mijatov S; Babovic SS

2010-01-01

188

[Branch retinal vein occlusion: high time for cardiovascular risk management].  

Science.gov (United States)

Cardiovascular risk management is common in patients suffering from manifest cardiovascular disease, hypertension, hyperlipidaemia and diabetes mellitus. It is generally accepted that medication is the most effective treatment for reducing cardiovascular morbidity and mortality in these patients. Remarkably, cardiovascular risk management is rare in patients suffering from branch retinal vein occlusion. This common retinal vascular disorder in middle aged and elderly people occurs where a thickened retinal artery compresses the affected vein. Although thrombosis is involved, procoagulant disorders are only present in selected cases. On the other hand, prior diabetes, hypertension, and peripheral artery disease are associated with an increased risk of developing branch retinal vein occlusion up to a decade later, and retinal vascular disorder is associated with an increased risk of subsequently developing hypertension, diabetes, congestive heart failure, and cerebrovascular disease later on. Therefore, branch retinal vein occlusion is a marker of developing cardiovascular disease and warrants adequate cardiovascular risk management. PMID:23693011

Bredie, Sebastian J H

2013-01-01

189

Unilateral central retinal artery occlusion as the sole presenting sign of Susac syndrome in a young man: case report/ Oclusão unilateral da artéria central da retina como único sinal de apresentação da síndrome de Susac em jovem do sexo masculino: relato de caso  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese Descrevemos um paciente de 24 anos, sexo masculino, que se apresentou com perda súbita da visão do olho esquerdo causado por oclusão da artéria central da retina. Ele foi submetido à investigação clínica detalhada sem encontrar uma causa. Três semanas depois, no entanto, desenvolveu surdez, encefalopatia e múltiplas oclusões de ramo arterial da retina no olho direito. Angiofluoresceinografia confirmou as oclusões de ramo arterial no OD e oclusão da artéria c (more) entral da retina no OE, sem qualquer sinal de vascutile. O exame neurológico revelou encefalopatia difusa, enquanto que o estudo efetuado por ressonância nuclear magnética mostrou várias áreas de enfarte do cérebro e a audiometria demonstrou perda auditiva neurosensorial bilateral. A síndrome de Susac foi diagnosticada e tratamento com metilprednisolona e ciclofosfamida instituido com melhora discreta, seguida de estabilização clínica. Este caso é importante para chamar a atenção de que nem todos os três critérios diagnósticos (encefalopatia, oclusão de ramo arterial retiniano e surdez) para a síndrome de Susac precisam estar presentes de início, o que pode causar confusão diagnóstica. O diagnóstico deve portanto ser incluído no diferencial de oclusão da artéria central da retina mesmo quando ocorre em homem sem outros sintomas associados. Abstract in english 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 di (more) ffuse 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.

Apóstolos-Pereira, Samira Luiza dos; Kara-José, Lúcia B. Passos; Marchiori, Paulo Euripedes; Monteiro, Mário Luiz Ribeiro

2013-06-01

190

Retinitis pigmentosa  

Directory of Open Access Journals (Sweden)

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).

Hamel Christian

2006-01-01

191

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

Energy Technology Data Exchange (ETDEWEB)

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.

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

2004-09-01

192

Coronary artery anatomy and variants  

International Nuclear Information System (INIS)

Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

2011-01-01

193

Catheter-induced brachial artery dissection during transradial angioplasty.  

UK PubMed Central (United Kingdom)

?The transradial approach is becoming a very popular technique in coronary and peripheral interventions because of its low vascular complication rate and improved patient comfort. Reported complications during the transradial approach are radial artery spasm, perforation, occlusion and formation of pseudoaneurysms. The kinking of the diagnostic catheter during catheter manipulation in a severely tortuous subclavian artery can occur very easily, and catheter movements at this point can cause barchial and subclavian artery dissection. We report a case of brachial and subclavian artery dissection during transradial diagnostic angiography, treated by angioplasty and stenting.

Ruzsa Z; Molnár L; Szabó G; Merkely B

2013-04-01

194

Retinal vessel caliber and risk factors for branch retinal vein occlusion.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the association between retinal vessel caliber and risk factors for branch retinal vein occlusion (BRVO). MATERIALS AND METHODS: We included 10,890 participants who underwent a health checkup at Kangbuk Samsung Hospital between January 2006 and December 2006. BRVO was diagnosed from retinal photographs taken for both eyes. Retinal vascular caliber measurements were performed using a computer-assisted program. Risk factors were assessed based on a patient-answered questionnaire and laboratory investigations. Logistic regression analyses were performed to identify potential risk factors for BRVO. RESULTS: The overall prevalence of BRVO was 0.8%. Among all BRVO patients, the mean central retinal artery equivalent (CRAE) was 142.59 µm (±14.63 µm), and the mean central retinal vein equivalent (CRVE) was 203.46 µm (±18.84 µm). The mean CRAE and CRVE of the control eyes were 148.15 µm (± 15.89 µm) and 211.12 µm (±18.54 µm), respectively. There were significant differences in mean CRAE and CRVE between the control group and the BRVO group (P?Arterial hypertension was an important risk factor for BRVO (OR: 1.02 (1.01-1.03). CONCLUSIONS: Eyes with BRVO had narrow CRAE and CRVE when compared with age- and gender-matched normal eyes. Generalized attenuation of retinal vessel caliber may be characteristic of eyes with BRVO. Emphasis on blood pressure control is needed for the prevention of BRVO.

Youm DJ; Ha MM; Chang Y; Song SJ

2012-04-01

195

Fast ion transport and phase separation in a mechanically driven flow of electrolytes through tortuous sub-nanometer nanochannels.  

UK PubMed Central (United Kingdom)

Both nanostructured materials and nanotubes hold tremendous promises for separation and purification applications, such as water desalination. By using molecular dynamics, herein, we compare the transport of aqueous electrolyte solutions through a Y-zeolite, which features interconnected, tortuous sub-nanometer nanopores, and a model silica nanotube, which has the same composition but is straight and has much lower surface complexity. In the Y-zeolite, ion transport is faster than the transport of water molecules, thus leading to a phenomenon of phase separation in which a gradient of salt concentration is generated along the flow direction. However, similar transport characteristics and phase separation are not found in the model silica nanotube. Detailed analysis suggests that, in nanochannels with complicated geometries, such as those of the Y-zeolite, the structural and flow characteristics of confined nanofluids are highly coupled, thus influencing the transport of ions and solvents and causing the phenomenon of phase separation.

Liu L; Chen X

2013-08-01

196

Fast ion transport and phase separation in a mechanically driven flow of electrolytes through tortuous sub-nanometer nanochannels.  

Science.gov (United States)

Both nanostructured materials and nanotubes hold tremendous promises for separation and purification applications, such as water desalination. By using molecular dynamics, herein, we compare the transport of aqueous electrolyte solutions through a Y-zeolite, which features interconnected, tortuous sub-nanometer nanopores, and a model silica nanotube, which has the same composition but is straight and has much lower surface complexity. In the Y-zeolite, ion transport is faster than the transport of water molecules, thus leading to a phenomenon of phase separation in which a gradient of salt concentration is generated along the flow direction. However, similar transport characteristics and phase separation are not found in the model silica nanotube. Detailed analysis suggests that, in nanochannels with complicated geometries, such as those of the Y-zeolite, the structural and flow characteristics of confined nanofluids are highly coupled, thus influencing the transport of ions and solvents and causing the phenomenon of phase separation. PMID:23649797

Liu, Ling; Chen, Xi

2013-05-03

197

Outer retinal tubulation in degenerative retinal disorders.  

UK PubMed Central (United Kingdom)

PURPOSE: To demonstrate outer retinal tubulation (ORT) in various degenerative retinal disorders. METHODS: This was a retrospective review of the multimodal imaging of 29 eyes of 15 patients with various retinal dystrophies and inflammatory maculopathies manifesting ORT. The morphologic features of ORT and its evolution over time were analyzed using spectral-domain optical coherence tomography data. RESULTS: Outer retinal tubulation was identified as round or ovoid structures with hyperreflective borders in pattern dystrophy (six eyes), acute zonal occult outer retinopathy (five eyes), retinitis pigmentosa (four eyes), Stargardt disease (four eyes), gyrate atrophy (two eyes), choroideremia (two eyes), and various other degenerative conditions. These structures appeared to develop from the invagination of photoreceptors at the junction of intact and atrophic outer retina. During follow-up, the number and distribution of ORT largely remained stable. As zones of atrophy enlarged, the frequency of ORT appeared to increase. The ORT structures were found in <10% of patients with retinitis pigmentosa, Stargardt disease, or pattern dystrophy. CONCLUSION: Outer retinal tubulation is found in various degenerative retinal disorders that share in common damage to the outer retina and/or retinal pigment epithelium. The presence of ORT may be an indicator of underlying disease stage and severity.

Goldberg NR; Greenberg JP; Laud K; Tsang S; Freund KB

2013-10-01

198

Morphologic and functional changes in retinal vessels associated with branch retinal vein occlusion.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study the morphologic and functional changes in retinal veins of eyes affected with branch retinal vein occlusion (BRVO) by thin sectioning with optical coherence tomography (OCT). DESIGN: Prospective, observational, cross-sectional study. PARTICIPANTS: Twenty-five consecutive patients (25 eyes) with acute BRVO. METHODS: Major retinal veins, arteries, and arteriovenous (A/V) crossing were examined by sequential thin sectioning by Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany). The retinal blood flow was mimicked in vitro and scanned with Spectralis HRA+OCT. MAIN OUTCOME MEASURES: Morphologic characteristics of normal and BRVO-affected retinal vessels seen in OCT sections. RESULTS: Cross-sectional OCT images revealed physiologic retinal vessels as oval configurations with 4 distinctive hyperreflectivities in a line. The vessel walls showed the innermost and outermost hyperreflectivity, and the blood flow showed internal paired hyperreflectivities with an hourglass shape. No eye with disturbed blood flow due to BRVO showed this internal hyperreflectivity pattern. In vitro, OCT sections of the blood within the glass tube without flow showed homogeneous reflectivities. Increased blood flow velocity resulted in the development of heterogeneous internal reflectivity and hourglass-shaped hyperreflectivities. In all eyes with acute BRVO, sequential sectioning with OCT visualized 3-dimensional vascular architecture and the intravascular conditions at the A/V crossing. At the affected A/V crossing, arterial overcrossing was seen in 17 eyes and venous overcrossing was seen in 8 eyes. In eyes with arterial overcrossing, the retinal vein seemed to run deep under the artery at the A/V crossing, and the venous lumen often appeared to be preserved even at the A/V crossing. In all eyes with venous overcrossing, the retinal vein appeared to be compressed and choked between the internal limiting membrane and the arterial wall at the A/V crossing. Optical coherence tomography sectioning showed intravenous thrombi in 21 eyes, and the thrombi were detected downstream of the A/V crossing in all the cases. The detection of thrombus was significantly associated with ischemic pattern in BRVO (P=0.036). CONCLUSIONS: In eyes with BRVO, sequential thin sections with OCT visualized 3-dimensional retinal vasculature. The present OCT findings suggest that BRVO may occur by 2 different mechanisms, depending on the relative anatomic positions of the crossing vessels. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Muraoka Y; Tsujikawa A; Murakami T; Ogino K; Kumagai K; Miyamoto K; Uji A; Yoshimura N

2013-01-01

199

Unusual retinal manifestations of cat scratch disease.  

UK PubMed Central (United Kingdom)

We report on 2 patients with unusual retinal manifestations of cat scratch disease (CSD), caused by Bartonella henselae. Case 1. A 42-year-old farmer presented with a 5-day history of blurred vision in his right eye. Right visual acuity was 20/25. Fundus examination of the right eye revealed mild vitreous hemorrhage and diffuse retinal hemorrhages in the mid-peripheral retina. Fluorescein angiography showed multiple vasculitic occlusions in the same area. A blood sample taken on the day of examination revealed the presence of immunoglobulin (Ig)M and IgG to B. henselae. Oral azithromycin was given for 8 days. One month later, right visual acuity was 20/20, the vitreous and retinal hemorrhages resolved, and arteriolar attenuation and sclerosis was observed in the peripheral temporal retina. Case 2. A 66-year-old craftsman with systemic hypertension and hypercholesterolemia complained of sudden visual loss (light perception) in his left eye. Fundus evaluation and fluorescein angiography revealed central retinal artery occlusion (CRAO) in the affected eye. About 2 weeks earlier, he had been bitten and scratched on his right hand by a stray cat. Serologic testing detected the presence of IgM to B. henselae. Oral azithromycin was given for 6 days. One month later, left visual acuity was hand motion. Ophthalmologists should be aware that unusual ocular complications associated with CSD include vitreous hemorrhage with retinal vasculitis and isolated CRAO. Vitreous hemorrhage and retinal vasculitis may be the only clinical manifestation of CSD.

Pinna A; Puglia E; Dore S

2011-04-01

200

Unusual retinal manifestations of cat scratch disease.  

Science.gov (United States)

We report on 2 patients with unusual retinal manifestations of cat scratch disease (CSD), caused by Bartonella henselae. Case 1. A 42-year-old farmer presented with a 5-day history of blurred vision in his right eye. Right visual acuity was 20/25. Fundus examination of the right eye revealed mild vitreous hemorrhage and diffuse retinal hemorrhages in the mid-peripheral retina. Fluorescein angiography showed multiple vasculitic occlusions in the same area. A blood sample taken on the day of examination revealed the presence of immunoglobulin (Ig)M and IgG to B. henselae. Oral azithromycin was given for 8 days. One month later, right visual acuity was 20/20, the vitreous and retinal hemorrhages resolved, and arteriolar attenuation and sclerosis was observed in the peripheral temporal retina. Case 2. A 66-year-old craftsman with systemic hypertension and hypercholesterolemia complained of sudden visual loss (light perception) in his left eye. Fundus evaluation and fluorescein angiography revealed central retinal artery occlusion (CRAO) in the affected eye. About 2 weeks earlier, he had been bitten and scratched on his right hand by a stray cat. Serologic testing detected the presence of IgM to B. henselae. Oral azithromycin was given for 6 days. One month later, left visual acuity was hand motion. Ophthalmologists should be aware that unusual ocular complications associated with CSD include vitreous hemorrhage with retinal vasculitis and isolated CRAO. Vitreous hemorrhage and retinal vasculitis may be the only clinical manifestation of CSD. PMID:21267628

Pinna, Antonio; Puglia, Ester; Dore, Stefano

2011-01-26

 
 
 
 
201

Internal carotid artery in zone IIb and its implications: A case report.  

UK PubMed Central (United Kingdom)

The potential for aberrant anatomy in the neck should be respected in order to avoid unexpected and potentially devastating injury during surgical and other procedures. Anatomic variations involving the internal carotid artery are believed to exist in as much as 6% of the population. We describe a case of a tortuous internal carotid artery that was found in zone IIb during a neck dissection in a 60-year-old man, and we discuss the implications of this anomaly.

Plonk DP; Browne JD

2013-03-01

202

Anomalous origin of the left coronary artery from the pulmonary artery detected by echocardiography in an asymptomatic adult.  

UK PubMed Central (United Kingdom)

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation. It is unusual for an ALCAPA patient to survive to adulthood. We present a case of an asymptomatic 54-year-old woman with this syndrome in which visualization of a markedly enlarged and tortuous right coronary artery and intercoronary collaterals by echocardiography raises suspicion for this disease and subsequently guides a step-by-step diagnosis. The patient lives well without surgery 3 years after diagnosis.

Tian Z; Fang LG; Liu YT; Zhang SY

2013-01-01

203

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... that a person is developing a retinal tear or detachment. When diagnosed early, most retinal problems are ... a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular ...

204

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... tear or break is usually treated with a laser. Some retinal tears do not need treatment. However, ... history of eye trauma and prior cataract surgery. Laser and cryoprobe treatments for retinal tears are very ...

205

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... layer of tissue in the back of the eye that is responsible for vision. It is attached ... retinal tear develops. Retinal detachment is a serious eye condition. If it is not treated, it can ...

206

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... back of the eye that is responsible for vision. It is attached to the choroid tissue, which ... With treatment, retinal problems usually do not affect vision very much. This reference summary explains what retinal ...

207

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... weak and will never heal. So it is best if retinal detachment is diagnosed and treated before ... or poor vision. This will give you the best chance of finding and treating retinal detachment before ...

208

Consumption of cannabis and cocaine: correct mix for arterial occlusions  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We present a case of a young Afro-Caribbean man who presented with sudden unilateral loss of vision due to central retinal artery occlusion. He was a cocaine and cannabis abuser for 6 years. Acute central retinal artery occlusion at such a young age is unusual. We discuss the possible pathogenesis a...

Sharma, Priyanka; Ramirez-Florez, Susana

209

Percutaneous coronary intervention by retrograde approach for chronic total occlusion of the proximal left anterior descending artery via a gastroepiploic artery graft.  

UK PubMed Central (United Kingdom)

Coronary arteries connecting to septal branch are often occluded in post-coronary artery bypass graft cases. A 70-year-old male had undergone CABG; radial artery graft to the LCX, and gastroepiploic artery (GEA) graft to the RCA. Coronary angiography revealed total occlusion in proximal LAD, while both graft vessels had good flow. Retrograde percutaneous coronary intervention (PCI) procedure from the septal channel via GEA graft to the RCA was performed for total occlusion of LAD. Despite the tortuous GEA, deep engagement with a 4-french guiding catheter ensured powerful back-up force. After retrograde wire crossing, two drug-eluting stents were implanted, successfully.

Mibiki Y; Kikuta H; Sumiyoshi T; Shibata M; Osawa N

2013-01-01

210

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnosis with CT Angiography.  

UK PubMed Central (United Kingdom)

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital anomaly. It is associated with early infant mortality and sudden death in adults. Traditionally, ALCAPA has been diagnosed by angiography or autopsy; however, the development of cardiac computed tomography (CT) and magnetic resonance imaging (MRI) has allowed noninvasive evaluation of the coronary anatomy by direct visualization of the origin of the left coronary artery (LCA) from the pulmonary artery. We report a case of 10-year-old girl who has been on follow up for dilated cardiomyopathy for 4 years. The definitive diagnosis of ALCAPA is reached by multislice computed tomography (MSCT). The MSCT scan showed an anomalous origin of LCA from the pulmonary trunk, with a tortuous and dilated right coronary artery and right-to-left collateralization. Consequently, the patient was successfully treated with surgery.

Oncel G; Oncel D

2013-01-01

211

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

International Nuclear Information System (INIS)

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.

2010-01-01

212

Multifocal posterior necrotizing retinitis.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the clinical features of an acute, inflammatory, and progressive retinal necrosis that affects primarily the posterior pole. DESIGN: Retrospective, interventional case series. METHODS: Twenty-seven eyes of 24 patients diagnosed with and treated for acute retinal necrosis (ARN) were categorized into two groups according to the predominant location of retinitis at presentation: either in the peripheral retina or in the posterior pole. Clinical features, disease progression, visual outcomes, and complications of these two groups were compared. RESULTS: Fifteen eyes demonstrated the known peripheral retinitis pattern, and 12 eyes exhibited a pattern of retinitis that affected mainly the posterior pole. Eyes with peripheral retinitis showed focal, well-demarcated areas of retinal necrosis in the periphery with rapid circumferential progression and rare involvement of the posterior pole. All eyes with posterior pole retinitis had multifocal deep lesions posterior to the vortex veins at presentation, and half of these eyes had lesions in the macula. These lesions progressed to patches of confluent retinitis in both the periphery and the posterior pole. There was no significant difference between the two groups in the incidence of anterior chamber and vitreous cells, vascular sheathing, retinal hemorrhages, or optic disk edema. Patients with posterior retinitis involvement seemed to have a worse visual outcome during the first two years after diagnosis. The Cox proportional hazards model suggested a higher incidence of retinal detachment in patients with posterior retinitis (P = .07). CONCLUSIONS: The authors report a pattern of herpetic retinitis that affects predominantly the posterior pole and may have a worse visual prognosis and a higher rate of retinal detachment.

Margolis R; Brasil OF; Lowder CY; Smith SD; Moshfeghi DM; Sears JE; Kaiser PK

2007-06-01

213

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

UK PubMed Central (United Kingdom)

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 velocity 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.

Feng X; Kedhar S; Bhoomibunchoo C

2013-01-01

214

Successful embolization of pancreaticoduodenal artery pseudoaneurysm in a patient with common hepatic arterial occlusion after modified pancreatoduodenectomy with preservation of arteries in the head of pancreas.  

Science.gov (United States)

Pancreaticoduodenectomy (PD) with preservation of the arcade in the head of the pancreas was performed in a 73-year-old male with ampullary adenocarcinoma associated with occlusion of the common hepatic artery (CHA) in another hospital. He developed active bleeding from his drain site, at 18 days after the operation. He was transferred to our hospital for emergent embolization. Celiac arteriogram showed complete occlusion of the CHA, posterior superior pancreaticoduodenal artery (PSPDA) pseudoaneurysm 1.7 cm in diameter and development of an enlarged tortuous dorsal pancreatic artery (DPA), posterior pancreatico-duodenal artery (PPDA), and gastroduodenal artery (GDA). Complete hemostasis was obtained without major complications by the transcatheter arterial embolization (TAE) with microcoils. PMID:19453067

Nonokuma, Masanari; Okazaki, Masatoshi; Higashibara, Hideyuki; Kimura, Shiro; Kora, Shinichi; Urakawa, Hiroshi; Shinagawa, Yoshinobu; Osame, Akinobu; Ueki, Toshiyuki; Nakayama, Toshimichi

215

n-Butyl cyanoacrylate-induced multiple retinal arteriolar occlusions.  

UK PubMed Central (United Kingdom)

We report a case of multiple retinal arteriolar occlusions due to delayed embolisation of N-butylcyanoacrylate glue, initially injected in the external carotid artery for the management of Carotid body tumour. Ocular massage and anterior chamber paracentesis were unfruitful and patient suffered irreversible visual loss in the affected eye. Embolisation of N-butyl cyanoacrylate glue into the retinal vasculature after intratumoral injection should be kept in mind as a rare but possible complication by radiologists and ophthalmologists.

Naithani P; Khanduja S; Sinha S; Khanduja N; Naithani P

2013-04-01

216

n-Butyl cyanoacrylate-induced multiple retinal arteriolar occlusions.  

UK PubMed Central (United Kingdom)

We report a case of multiple retinal arteriolar occlusions due to delayed embolisation of N-butylcyanoacrylate glue, initially injected in the external carotid artery for the management of Carotid body tumour. Ocular massage and anterior chamber paracentesis were unfruitful and patient suffered irreversible visual loss in the affected eye. Embolisation of N-butyl cyanoacrylate glue into the retinal vasculature after intratumoral injection should be kept in mind as a rare but possible complication by radiologists and ophthalmologists.

Naithani P; Khanduja S; Sinha S; Khanduja N; Naithani P

2013-10-01

217

n-Butyl cyanoacrylate-induced multiple retinal arteriolar occlusions.  

Science.gov (United States)

We report a case of multiple retinal arteriolar occlusions due to delayed embolisation of N-butylcyanoacrylate glue, initially injected in the external carotid artery for the management of Carotid body tumour. Ocular massage and anterior chamber paracentesis were unfruitful and patient suffered irreversible visual loss in the affected eye. Embolisation of N-butyl cyanoacrylate glue into the retinal vasculature after intratumoral injection should be kept in mind as a rare but possible complication by radiologists and ophthalmologists. PMID:23624692

Naithani, Prashant; Khanduja, Sumeet; Sinha, Subijoy; Khanduja, Neha; Naithani, Preeti

2013-04-27

218

Management of massive hemoptysis in pulmonary tuberculosis and bronchiectasis by bronchial arterial embolization  

International Nuclear Information System (INIS)

Objective: To probe into the angiographic signs and the variations of bronchial arteries for pulmonary tuberculosis or bronchiectasis with massive hemoptysis. Methods: 25 patients with pulmonary tuberculosis and 15 patients suffered from bronchiectasis accompanied by massive hemoptysis were undertaken bronchial arterial embolization (BAE). All patients were embolized with gelfoam including 32 with spring coils in addition. Results: 63 arteries demonstrated angiographic signs of hemoptysis in 40 patients. The immediate stanching rate was 92.5%(37/40). The bronchopulmonary shunt formation sign shown by angiograph was the major feature of tuberculosis (P=0.0528) and the enlarged tortuous arteries in bronchiectasis were more to be demonstrated than in tuberculosis (P

2005-01-01

219

Focal retinal phlebitis.  

UK PubMed Central (United Kingdom)

PURPOSE: To report three cases of solitary, focal retinal phlebitis. METHODS: An observational case series. RESULTS: Three eyes in three patients were noted to have unilateral decreased vision, macular edema, and a focal retinal phlebitis, which was not at an arteriovenous crossing. All three patients developed a branch retinal vein occlusion at the site of inflammation. These patients had no other evidence of intraocular inflammation, including vitritis, retinitis, retinal vasculitis, or choroiditis, nor was there any systemic disorder associated with inflammation, infection, or coagulation identified. CONCLUSION: Focal retinal phlebitis appears to be an uncommon and unique entity that produces macular edema and ultimately branch retinal vein occlusion. In our patients, the focal phlebitis and venous occlusion did not occur at an arteriovenous crossing, which is the typical site for branch retinal venous occlusive disease. This suggests that our cases represent a distinct clinical entity, which starts with a focal abnormality in the wall of a retinal venule, resulting in surrounding exudation and, ultimately, ends with branch retinal vein occlusion.

Hoang QV; Freund KB; Klancnik JM Jr; Sorenson JA; Cunningham ET Jr; Yannuzzi LA

2012-01-01

220

Branch retinal vein occlusion: epidemiology, pathogenesis, risk factors, clinical features, diagnosis, and complications. An update of the literature.  

UK PubMed Central (United Kingdom)

BACKGROUND/PURPOSE: Retinal vein occlusion is the second most common retinal vascular disorder after diabetic retinopathy and is considered to be an important cause of visual loss. In this review, the purpose is to make an update of the literature about the classification, epidemiology, pathogenesis, risk factors, clinical features, and complications of branch retinal vein occlusion (BRVO). METHODS: Eligible articles were identified using a comprehensive literature search of MEDLINE, using the terms "branch retinal vein occlusion," "pathogenesis," "epidemiology," "risk factors," "clinical features," "diagnosis," and "complications." Additional articles were also selected from reference lists of articles identified by the electronic database search. RESULTS: Classification, epidemiology, pathogenesis, risk factors, clinical features, and complications are analyzed. CONCLUSIONS: Branch retinal vein occlusion has an incidence of 0.5% to 1.2%. Several risk factors, such as hypertension, hyperlipidemia, diabetes mellitus, thrombophilia and hypercoagulation, systemic and inflammatory diseases, medications, and ocular conditions, have found to be associated with BRVO. The symptoms depended on the site and severity of the occlusion. The average reduction in visual acuity for ischemic BRVO is 20/50 and for nonischemic BRVO is 20/60. Acute BRVO can be detected by fundoscopy, where flame hemorrhages, dot and blot hemorrhages, cotton wool spots, hard exudates, retinal edema, and dilated tortuous veins can be observed. Chronic BRVO would be more subtle and characterized by the appearance of venous collateral formation and vascular sheathing, in addition to complications previously mentioned. Areas of ischemia can be evaluated using fluorescein angiography. The extent of macular edema and the presence of retinal detachment can be detected by fundoscopic examination or fluorescein angiography, although optical coherence tomography is considered to be the best method. As far as complications, the most common is macular edema, followed by retinal neovascularization, vitreous hemorrhage, or retinal detachment.

Jaulim A; Ahmed B; Khanam T; Chatziralli IP

2013-05-01

 
 
 
 
221

Electron beam CT diagnosis of coronary artery fistula: the clinical values  

International Nuclear Information System (INIS)

Objective: To study the electron beam CT (EBCT) findings of coronary artery fistula. Methods: EBCT findings of 10 cases of coronary artery fistula proved by surgery were studied retrospectively. The series included 7 male and 3 female patients, aged from 2 to 55 years (48 years in average). Enhanced scan in single slice mode was performed. Results: EBCT revealed dilated and tortuous right coronary artery in 6 patients out of 7. Among those 6 patients a communication between the right coronary artery and the enlarged ventricular cavity was detected in 5 patients, while in the rest patient the proximal right coronary artery was connected with pulmonary trunk. EBCT revealed that coronary artery fistula was from the left coronary artery in 4 patients. In a case, the left dilated and calcified diagonal branch was communicated to the left ventricle. The left conical branch connected with pulmonary trunk in 2 cases. In another case the dilated and calcified major left coronary artery and its circumflex branch were revealed, and the latter went across the pre-left atrial space into the right atrium through the posterior wall. Conclusion: Coronary artery fistula is the first consideration when EBCT demonstrates an abnormal communication between the dilated and tortuous coronary artery or its branch and cardiac chamber or blood vessel

2003-01-01

222

[A case of vasoocclusive retinal damage in moya-moya disease].  

UK PubMed Central (United Kingdom)

Retinal vessel occlusion and eye haemodynamics damage is described in moya-moya disease, a rare occlusive cerebrovascular condition characterized by progressing stenosis and occlusion of cerebral arteries with collateral development in basal vascular system. Data concerning neuroophthalmological features, diagnostic and treatment methods are presented. Necessity of MR-tomography and MR-angiography in ischemic retinal damage is emphasized.

Kiseleva TN; Vlasov SK; Shchegolova IV; Liutkevich EV

2011-03-01

223

Resolution of vitreomacular traction following intravitreal triamcinolone acetonide injection in an eye with branch retinal vein occlusion  

Directory of Open Access Journals (Sweden)

Full Text Available Göktu? Seymeno?lu,1 Özcan Kayikçio?lu,1 Bilge Öztürk ?ahin21Department of Ophthalmology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey; 2Department of Ophthalmology, Akhisar State Hospital, Akhisar, Manisa, TurkeyAbstract: A 60-year-old woman with a past medical history of branch retinal vein occlusion presented with decreased vision and metamorphopsia in her left eye. A fundus examination revealed a tortuous retinal vein with a few retinal hemorrhages in the inferotemporal quadrant. Optical coherence tomography revealed a partially separated posterior vitreous membrane pulling up the fovea. The patient refused surgical treatment so intravitreal triamcinolone acetonide (4 mg/0.1 mL) was administered. The patient reported resolution of symptoms in her left eye following this treatment, but her visual acuity did not show any improvement. Optical coherence tomography scanning revealed a complete detachment of the posterior hyaloid with release of the vitreomacular traction. In patients with vitreomacular traction and branch retinal vein occlusion, the combination of the possible vitreous liquefaction and mechanical increase of vitreous volume caused by an intravitreal injection with a degree of reduction in retinal thickness may play a role in the resolution of vitreomacular traction.Keywords: macular edema, vitreomacular traction syndrome, intravitreal injection, posterior vitreous detachment

Seymeno?lu G; Kayikçio?lu O; ?ahin BO

2012-01-01

224

Transient tractional retinal detachment in an eye with retinitis pigmentosa  

Directory of Open Access Journals (Sweden)

Full Text Available Shuichiro Hirahara, Yoshio Hirano, Tsutomu Yasukawa, Yuichiro OguraDepartment of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanAbstract: We present a case of retinitis pigmentosa with vitreoretinal traction-associated retinal detachment. The retinal detachment was detected in the nasal periphery. No retinal breaks and no active vascular leakage were observed by fundus scopy and fluorescein angiography, respectively. However, 8 months later, the tractional retinal detachment was spontaneously resolved with posterior vitreous detachment.Keywords: retinitis pigmentosa, vitreoretinal traction, retinal detachment

Shuichiro Hirahara; Yoshio Hirano; Tsutomu Yasukawa; et al

2010-01-01

225

Retinal vascular tortuosity in obstructive sleep apnea  

Directory of Open Access Journals (Sweden)

Full Text Available Amir Mohsenin,1 Vahid Mohsenin,2 Ron A Adelman1 1Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA; 2Yale Center for Sleep Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA Purpose: Endothelial dysfunction and vascular disease are common in obstructive sleep apnea (OSA). We sought to examine the retinal vascular manifestations of OSA. Methods: Nine consecutive patients with OSA underwent ophthalmic examination regardless of any ocular complaints. Seven patients without OSA matched for demographics were used as controls. Fundus photographs from both eyes were used to quantitate retinal vascular tortuosity of the temporal arterial and venous arcades using ImageJ digital analysis software. The tortuosity of each vessel from the optic disc rim to the crossing point of a 5 disc diameter (5DD) circle and 10 disc diameter (10DD) circle centered on the optic disc were quantitated. Results: The mean age of patients with OSA in the study was 52 years ± SD of 10 years and 67 years ± SD of 10 years in the control group. The apnea-hypopnea index in patients with OSA ranged from 12 to 102 events/hr of sleep. The nadir oxyhemoglobin saturation during sleep in patients with OSA ranged from 60% to 87%. There was no significant difference in the frequency of diabetes or hypertension between the groups. Total tortuosity was increased at the 5DD (P = 0.011) and 10DD (P = 0.004) marks. Arterial tortuosity was significantly increased at the 10DD mark (P = 0.016). Venular tortuosity was increased at both the 5DD (P = 0.001) and 10DD (P = 0.028) marks. Conclusion: Patients with OSA have increased retinal vascular tortuosity as compared to matched controls. Increased tortuosity of the retinal vasculature may be a novel association with OSA. A larger prospective study will be necessary to further explore this relationship and its clinical significance. Keywords: retinal vessel tortuosity, sleep apnea, retinal vasculature, retinal vascular tortuosity

Mohsenin A; Mohsenin V; Adelman RA

2013-01-01

226

Retinal vascular caliber is associated with renal function in apparently healthy subjects.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess the relation between retinal vascular caliber and renal function. PATIENTS AND METHODS: Eighty apparently healthy subjects screened for cardiovascular risk factors (mean age 47 years, 51% female, 36% hypertensive, without diabetes or renal dysfunction) were recruited. Retinal vascular calibers were measured from fundus photographs and expressed as central retinal artery and venular equivalent. Renal function was assessed by measurement of glomerular filtration rate (urinary clearance of 99mTc-DTPA) and urinary albumin/creatinine ratio. RESULTS: Mean glomerular filtration rate was 117 ml/min/1.73m(2). Overall, central retinal artery and venular equivalent were positively correlated with glomerular filtration rate (r = +0.31, p = 0.005 and r = +0.30, p = 0.006, respectively). In addition, central retinal artery equivalent was negatively correlated with urinary albumin/creatinine ratio (r = -0.34, p = 0.002). No significant relationship was found between central retinal venular equivalent and urinary albumin/creatinine ratio (r = +0.12, p = 0.32). The observed relations between retinal vascular calibers and renal function parameters remained significant after adjusting for potential confounding factors. CONCLUSION: In apparently healthy subjects with normal renal function, retinal arteriolar and venular calibers were negatively correlated with kidney function, suggesting common determinants of these preclinical target organ damages.

Daien V; Kawasaki R; Villain M; Ribstein J; Du Cailar G; Mimran A; Fesler P

2013-06-01

227

NORMATIVE VALUES AND PREDICTORS OF RETINAL OXYGEN SATURATION.  

UK PubMed Central (United Kingdom)

PURPOSE:: To determine normal retinal oxygen saturation (SO2) values measured with retinal oximetry in a multiethnic group of healthy subjects and to evaluate the association of retinal SO2 with demographic and clinical parameters. METHODS:: Retinal oximetry was performed in both eyes of 61 normal healthy subjects. Global and quadrant venous (SvO2) and arterial oxygen saturation (SaO2), arteriovenous difference in SO2, and venular and arteriolar width were measured. The association of SO2 parameters with age, gender, ethnicity, refraction, iris color, history of controlled systemic hypertension, and smoking was analyzed. RESULTS:: Average SvO2 and SaO2 were 55.3 ± 7.1% and 90.4 ± 4.3%, respectively. All average measurements were comparable in both eyes, both genders, and among ethnic groups. Inferonasal quadrant SaO2 was higher in Asians. Age was associated with decreased SvO2 (? = -0.19; P = 0.001) and SaO2 (? = -0.11; P = 0.003). History of controlled systemic hypertension was associated with an increase in arteriovenous difference in SO2 (? = 3.99; P = 0.013). CONCLUSION:: This is the first description of retinal SO2 in healthy, multiethnic subjects. Aging decreases SvO2 and SaO2 and should be accounted for when interpreting retinal oximetry measurements. Other demographic and clinical parameters studied did not seem to significantly influence retinal SO2 measurements.

Jani PD; Mwanza JC; Billow KB; Waters AM; Moyer S; Garg S

2013-07-01

228

Genetic loci for retinal arteriolar microcirculation.  

Science.gov (United States)

Narrow arterioles in the retina have been shown to predict hypertension as well as other vascular diseases, likely through an increase in the peripheral resistance of the microcirculatory flow. In this study, we performed a genome-wide association study in 18,722 unrelated individuals of European ancestry from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium and the Blue Mountain Eye Study, to identify genetic determinants associated with variations in retinal arteriolar caliber. Retinal vascular calibers were measured on digitized retinal photographs using a standardized protocol. One variant (rs2194025 on chromosome 5q14 near the myocyte enhancer factor 2C MEF2C gene) was associated with retinal arteriolar caliber in the meta-analysis of the discovery cohorts at genome-wide significance of P-value <5×10(-8). This variant was replicated in an additional 3,939 individuals of European ancestry from the Australian Twins Study and Multi-Ethnic Study of Atherosclerosis (rs2194025, P-value?=?2.11×10(-12) in combined meta-analysis of discovery and replication cohorts). In independent studies of modest sample sizes, no significant association was found between this variant and clinical outcomes including coronary artery disease, stroke, myocardial infarction or hypertension. In conclusion, we found one novel loci which underlie genetic variation in microvasculature which may be relevant to vascular disease. The relevance of these findings to clinical outcomes remains to be determined. PMID:23776548

Sim, Xueling; Jensen, Richard A; Ikram, M Kamran; Cotch, Mary Frances; Li, Xiaohui; MacGregor, Stuart; Xie, Jing; Smith, Albert Vernon; Boerwinkle, Eric; Mitchell, Paul; Klein, Ronald; Klein, Barbara E K; Glazer, Nicole L; Lumley, Thomas; McKnight, Barbara; Psaty, Bruce M; de Jong, Paulus T V M; Hofman, Albert; Rivadeneira, Fernando; Uitterlinden, Andre G; van Duijn, Cornelia M; Aspelund, Thor; Eiriksdottir, Gudny; Harris, Tamara B; Jonasson, Fridbert; Launer, Lenore J; Attia, John; Baird, Paul N; Harrap, Stephen; Holliday, Elizabeth G; Inouye, Michael; Rochtchina, Elena; Scott, Rodney J; Viswanathan, Ananth; Li, Guo; Smith, Nicholas L; Wiggins, Kerri L; Kuo, Jane Z; Taylor, Kent D; Hewitt, Alex W; Martin, Nicholas G; Montgomery, Grant W; Sun, Cong; Young, Terri L; Mackey, David A; van Zuydam, Natalie R; Doney, Alex S F; Palmer, Colin N A; Morris, Andrew D; Rotter, Jerome I; Tai, E Shyong; Gudnason, Vilmundur; Vingerling, Johannes R; Siscovick, David S; Wang, Jie Jin; Wong, Tien Y

2013-06-12

229

Genetic loci for retinal arteriolar microcirculation.  

UK PubMed Central (United Kingdom)

Narrow arterioles in the retina have been shown to predict hypertension as well as other vascular diseases, likely through an increase in the peripheral resistance of the microcirculatory flow. In this study, we performed a genome-wide association study in 18,722 unrelated individuals of European ancestry from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium and the Blue Mountain Eye Study, to identify genetic determinants associated with variations in retinal arteriolar caliber. Retinal vascular calibers were measured on digitized retinal photographs using a standardized protocol. One variant (rs2194025 on chromosome 5q14 near the myocyte enhancer factor 2C MEF2C gene) was associated with retinal arteriolar caliber in the meta-analysis of the discovery cohorts at genome-wide significance of P-value <5×10(-8). This variant was replicated in an additional 3,939 individuals of European ancestry from the Australian Twins Study and Multi-Ethnic Study of Atherosclerosis (rs2194025, P-value?=?2.11×10(-12) in combined meta-analysis of discovery and replication cohorts). In independent studies of modest sample sizes, no significant association was found between this variant and clinical outcomes including coronary artery disease, stroke, myocardial infarction or hypertension. In conclusion, we found one novel loci which underlie genetic variation in microvasculature which may be relevant to vascular disease. The relevance of these findings to clinical outcomes remains to be determined.

Sim X; Jensen RA; Ikram MK; Cotch MF; Li X; MacGregor S; Xie J; Smith AV; Boerwinkle E; Mitchell P; Klein R; Klein BE; Glazer NL; Lumley T; McKnight B; Psaty BM; de Jong PT; Hofman A; Rivadeneira F; Uitterlinden AG; van Duijn CM; Aspelund T; Eiriksdottir G; Harris TB; Jonasson F; Launer LJ; Attia J; Baird PN; Harrap S; Holliday EG; Inouye M; Rochtchina E; Scott RJ; Viswanathan A; Li G; Smith NL; Wiggins KL; Kuo JZ; Taylor KD; Hewitt AW; Martin NG; Montgomery GW; Sun C; Young TL; Mackey DA; van Zuydam NR; Doney AS; Palmer CN; Morris AD; Rotter JI; Tai ES; Gudnason V; Vingerling JR; Siscovick DS; Wang JJ; Wong TY

2013-01-01

230

Preretinal neovascularization induced by experimental retinal vein occlusion in albino rats.  

UK PubMed Central (United Kingdom)

Retinal ischemia and neovascularization have been demonstrated in several animal models. To determine 1) whether the retinal or preretinal neovascularization can be induced in albino rats by retinal vein occlusion and 2) the type and rate of occurrence on neovascularization, we occluded retinal veins in albino rats by photodynamic thrombosis. After anesthesia, each of 36 rats received an injection of rose bengal photosensitive dye, and their veins underwent argon green laser treatment. Half or all the major retinal veins were occluded in 12 eyes and in 24 eyes, respectively. Ten control rats underwent the same procedures but the laser beam was directed between major retinal vessels. In 46 control eyes, rose bengal dye was seen to have perfused without laser treatment. Retinal detachment developed in most vein occluded eyes within one day of venous occlusion, which was confirmed by fluorescein angiography. On follow-up at two weeks, only four of 24 eyes (16.7%) had undergone occlusion of all retinal veins showed new preretinal vessels on the optic disc. In these four eyes, severe disturbance of both retinal arterial and venous blood flow was observed, but no other eyes showed such severe combined disturbance. These data suggest that preretinal neovascularization in albino rats can be induced by this minimally traumatic method and that venous occlusion is severe enough to compromise arterial blood flow for a certain threshold period, thus inducing the development of preretinal neovascularization.

Ham DI; Chang K; Chung H

1997-06-01

231

Preretinal neovascularization induced by experimental retinal vein occlusion in albino rats.  

Science.gov (United States)

Retinal ischemia and neovascularization have been demonstrated in several animal models. To determine 1) whether the retinal or preretinal neovascularization can be induced in albino rats by retinal vein occlusion and 2) the type and rate of occurrence on neovascularization, we occluded retinal veins in albino rats by photodynamic thrombosis. After anesthesia, each of 36 rats received an injection of rose bengal photosensitive dye, and their veins underwent argon green laser treatment. Half or all the major retinal veins were occluded in 12 eyes and in 24 eyes, respectively. Ten control rats underwent the same procedures but the laser beam was directed between major retinal vessels. In 46 control eyes, rose bengal dye was seen to have perfused without laser treatment. Retinal detachment developed in most vein occluded eyes within one day of venous occlusion, which was confirmed by fluorescein angiography. On follow-up at two weeks, only four of 24 eyes (16.7%) had undergone occlusion of all retinal veins showed new preretinal vessels on the optic disc. In these four eyes, severe disturbance of both retinal arterial and venous blood flow was observed, but no other eyes showed such severe combined disturbance. These data suggest that preretinal neovascularization in albino rats can be induced by this minimally traumatic method and that venous occlusion is severe enough to compromise arterial blood flow for a certain threshold period, thus inducing the development of preretinal neovascularization. PMID:9283155

Ham, D I; Chang, K; Chung, H

1997-06-01

232

Retinal venous oxygen saturation increases by flicker light stimulation.  

UK PubMed Central (United Kingdom)

PURPOSE: Luminance flicker stimulation of the photoreceptors is known to increase retinal blood flow. Elevated blood velocity was determined using laser Doppler velocimetry, and increased vascular diameters during flicker were observed by measurements with a retinal vessel analyzer. Oxygen supply may be the target of the regulation of retinal blood flow. Thus, the oxygen saturation (SO(2)) in retinal arterioles and venules was investigated along with their diameters. METHODS: Dual-wavelength (548 nm and 610 nm) fundus images were taken in 19 healthy volunteers (mean age, 26 ± 2.5 years) before (baseline) and during luminance flicker stimulation (12.5 Hz; modulation depth, 1:25). Retinal vessel SO(2) (dual-wavelength optical oximetry) and diameters (central retinal arterial and venous equivalents [CRAE and CRVE]) were determined. RESULTS: CRAEs and CRVEs of 193 ± 20 ?m and 228 ± 20 ?m at baseline increased statistically significant to a maximum of 202 ± 19 ?m (P < 0.0005) and 242 ± 17 ?m (P < 0.0005), respectively, under flicker stimulation. Although the arterial SO(2) remained unchanged at 98%-99%, an increase of the venous saturation from 60% ± 5.7% to 64% ± 5.9% (P < 0.0005) was found. CONCLUSIONS: In agreement with earlier investigations, the vessel dilation found here indicates an elevation of retinal blood flow by luminance flicker stimulation. This increase of the flow should meet the enhanced metabolic need of the neural retina under a physiological stimulus. The augmentation of venous oxygenation may indicate a higher capillary oxygen concentration, necessary to provide a sufficient diffusion rate of oxygen from the capillaries to the inner retinal tissue.

Hammer M; Vilser W; Riemer T; Liemt F; Jentsch S; Dawczynski J; Schweitzer D

2011-01-01

233

A case of isolated susac occlusive retinal vasculitis.  

UK PubMed Central (United Kingdom)

: Susac syndrome is characterized by encephalopathy, sensorineural hearing loss, and branch retinal artery occlusion. Additional ocular findings include arteriolar wall hyperfluorescence and Gass plaques. We present a 51-year-old Caucasian woman with ophthalmologic findings indicative of Susac syndrome in the setting of tinnitus and migraine with aura.

Seamone ME; Fielden M

2013-09-01

234

The correlation between retinal blood flow velocity measured by the retinal function imager and various physiological parameters.  

UK PubMed Central (United Kingdom)

BACKGROUND AND OBJECTIVE: The retinal function imager (RFI) (Optical Imaging Ltd., Rehovot, Israel) measures retinal blood flow velocity non-invasively. The authors studied the reproducibility of these measurements and assessed the effect of physiological components on them. PATIENTS AND METHODS: Sixty-seven individuals with no retinal pathology were recruited. Velocity reproducibility was verified by comparing repeated RFI measurements. The correlation of the velocity with physiological parameters was assessed by mixed linear and Gaussian models. RESULTS: The average velocity was 4.2 ± 0.9 mm/sec arterial and 3.3 ± 0.8 mm/sec venous. Variability was 7.5% ± 3.7% and interclass correlation coefficient was r = 0.744. Venous velocity decreased after 40 years of age (0.32 mm/sec per decade, P < .01). Arterial velocity increased as mean arterial pressure increased (0.25 mm/sec per 10 mm Hg, P < .01). There was also a positive association between velocities and heart rate (arteries: 0.21 mm/sec per 10 bpm, P < .05; veins: 0.22 mm/sec per 10 bpm, P < .01). CONCLUSION: The RFI provides a reproducible, non-invasive technique to assess retinal velocities.

Burgansky-Eliash Z; Lowenstein A; Neuderfer M; Kesler A; Barash H; Nelson DA; Grinvald A; Barak A

2013-01-01

235

Radiation therapy: retinal tumors.  

UK PubMed Central (United Kingdom)

The major retinal tumor that requires radiotherapy (RT) is retinoblastoma (RB); to a lesser degree, RT is used for some cases of retinal capillary hemangioma and lymphoma of the retina. Although there are concerns about the risk of RT-induced second malignancy in patients who carry a germline mutation in the RB1 gene, RT remains a very important part of our approach to intra-ocular and extra-ocular RB. Technical innovations in RT allow more precise targeting of retinal tumors and decreased exposure of adjacent normal tissue, an advance that is particularly significant for patients with hereditary RB who are at risk of additional malignancies.

Sethi RV; Macdonald SM; Kim DY; Mukai S

2013-01-01

236

Retinal microvascular abnormalities and stroke: a systematic review.  

UK PubMed Central (United Kingdom)

BACKGROUND: Lacunar strokes account for 25% of ischaemic strokes, but their precise aetiology is unknown. Similarities between the retinal and cerebral small vessels mean that clarification of the exact relationship between retinal microvascular abnormalities and stroke, and particularly with stroke subtypes, may aid understanding of the aetiology of lacunar stroke and stroke risk. METHODS: A systematic review of the literature was performed by searching Medline and Embase to October 2007 for studies in humans that investigated the association between retinal microvascular abnormalities and prevalent or incident stroke. Data and calculated summary risk ratios (sRR) were extracted for associations between retinal microvascular abnormalities and stroke, including stroke subtypes where possible, adjusted for key variables. 37 papers from 22 different studies were included with 62 975 subjects (mean age 62 years) among whom there were 2893 strokes. Stroke identification and diagnosis methods varied. RESULTS: Retinopathy was associated with incident stroke (sRR 2.1, 95% CI 1.7 to 2.6) and prevalent stroke (sRR 2.5, 95% CI 1.4 to 4.3). Incident stroke was also associated with retinal artery embolism (sRR 2.9, 95% CI 1.6 to 5.1) and venular widening (sRR 1.4, 95% CI 1.1 to 1.7). There was significant heterogeneity between studies for some associations. There were no data on retinal microvascular abnormalities and haemorrhagic versus ischaemic stroke or ischaemic stroke subtypes. CONCLUSIONS: Retinal microvascular abnormalities are associated with stroke, but more data are required to clarify associations between specific types of retinal microvascular abnormality and stroke, as well as between different stroke subtypes. Future retinal-stroke studies should concentrate on carefully diagnosing and accurately sub-typing ischaemic stroke.

Doubal FN; Hokke PE; Wardlaw JM

2009-02-01

237

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... retinal tears and detachment. About 7 out of 10 people experience floaters at some point during their ... not harmful and things should look normal after 10 minutes or less. If the sensation lasts longer, ...

238

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... of the eye that is responsible for vision. It is attached to the choroid tissue, which supplies ... Retinal detachment is a serious eye condition. If it is not treated, it can lead to blindness. ...

239

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... discusses their symptoms, causes, diagnosis and treatment options. Anatomy It is important to recognize the parts of ... retinal tears and detachments. This section reviews the anatomy of the eye. Lens Cornea Iris Vitreous Retina ...

240

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... people are diagnosed with retinal detachment. There are clear warning signs that a person is developing a ... light passes through the pupil, it enters a clear lens that focuses the light onto the back ...

 
 
 
 
241

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... are signs of retinal tears and detachment. About 7 out of 10 people experience floaters at some ... Plain.com Last reviewed: 12/20/2012 ot070104 7 This allows the doctor to make sure the ...

242

Retinal Tear and Detachment  

Medline Plus

Full Text Available ... condition. If it is not treated, it can lead to blindness. Each year, thousands of people are ... during that time. Unfortunately, a retinal tear sometimes leads to detachment immediately. However, there may not be ...

243

Retinal Detachment Vision Simulator  

Science.gov (United States)

... Eye Health News Consumer Alerts Retinal Detachment Vision Simulator Tweet How does a detached or torn retina ... field of vision. How do I use this simulator? Drag the slider from left to right to ...

244

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  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

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

245

Retinal vein occlusion  

Directory of Open Access Journals (Sweden)

Full Text Available In this review of the retinal vein occlusion (RVO), I have summarized recent advances on several controversial and clinically important topics: classification of RVO into six distinct clinical entities; pathogeneses and demographic characteristics of various types of RVO; differentiation of non-ischemic from ischemic central retinal vein occlusion (CRVO); differentiation of hemi-CRVO (HCRVO) from major branch RVO (BRVO); and the course, complications and management of various types of RVO

Hayreh Sohan

1994-01-01

246

Pipeline Embolization Device: A New Source for Embolic Retinal Vascular Occlusion.  

UK PubMed Central (United Kingdom)

: A 57-year-old woman underwent treatment of a left internal carotid artery aneurysm with a Pipeline embolization device. She subsequently experienced multiple branch retinal artery occlusions in her left eye. Although rare, ophthalmic complications may follow this new technique in the treatment of intracranial aneurysms.

Sise AB; Osher JM; Kolsky MP; Stemer A; Bank WO; Garfinkel RA

2013-09-01

247

Retinal and choroidal intravascular spectral-domain optical coherence tomography.  

Science.gov (United States)

Purpose:? To examine retinal and choroidal blood vessels using spectral-domain optical coherence tomography (SD-OCT). Methods:? Retrospective case series. Results:? Scans through retinal blood vessels in healthy subjects demonstrated vessel wall reflexes and a tri-layer profile of the blood column on longitudinal scans and a figure-of-eight configuration on cross-sectional scans. Intravascular reflectivity decreased with increasingly oblique angles of observation and was absent when blood flow was parallel to the line of sight. The high blood flow in the choroidal vessels in healthy subjects and the low flow in the retinal vessels in patients with ocular ischaemic syndrome and central retinal artery occlusion were both associated with lower reflectivity of the blood and an unstructured intravascular SD-OCT profile. Discussion:? This qualitative in vivo study found a characteristically structured SD-OCT profile of the blood column in retinal vessels with normal blood flow. Both structure and total reflectivity faded when blood flow was lower or higher than normal or at oblique angles to the line of sight. In conclusion, SD-OCT scans of the vessels in the posterior pole of the eye may assist the clinical assessment of gross abnormalities of ocular blood flow, e.g. in carotid artery stenosis. PMID:23552098

Willerslev, Anne; Li, Xiao Q; Cordtz, Peter; Munch, Inger C; Larsen, Michael

2013-04-01

248

Decreased retinal-choroidal blood flow in retinitis pigmentosa as measured by MRI.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate retinal and choroidal blood flow (BF) using high-resolution magnetic resonance imaging (MRI) as well as visual function measured by the electroretinogram (ERG) in patients with retinitis pigmentosa (RP). METHODS: MRI studies were performed in 6 RP patients (29-67 years) and 5 healthy volunteers (29-64 years) on a 3-Tesla scanner with a custom-made surface coil. Quantitative BF was measured using the pseudo-continuous arterial spin-labeling technique at 0.5 × 0.8 × 6.0 mm. Full-field ERGs of all patients were recorded. Amplitudes and implicit times of standard ERGs were analyzed. RESULTS: Basal BF in the posterior retinal-choroid was 142 ± 16 ml/100ml/min (or 1.14 ± 0.13 ?l/mm(2)/min) in the control group and was 70 ±19 ml/100ml/min (or 0.56 ± 0.15 ?l/mm(2)/min) in the RP group. Retinal-choroidal BF was significantly reduced by 52 ± 8 % in RP patients compared to controls (P<0.05). ERG a- and b-wave amplitudes of RP patients were reduced, and b-wave implicit times were delayed. There were statistically significant correlations between a-wave amplitude and BF value (r=0.9, P<0.05) but not between b-wave amplitude and BF value (r =0.7, P=0.2). CONCLUSIONS: This study demonstrates a novel non-invasive MRI approach to measure quantitative retinal and choroidal BF in RP patients. We found that retinal-choroidal BF was markedly reduced and significantly correlated with reduced amplitudes of the a-wave of the standard combined ERG.

Zhang Y; Harrison JM; Nateras OS; Chalfin S; Duong TQ

2013-06-01

249

Homocysteine, MTHFR C677T gene polymorphism, folic acid and vitamin B 12 in patients with retinal vein occlusion  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Many available data have suggested that hyperhomocysteinaemia, an established independent risk factor for thrombosis (arterial and venous), may be associated with an increased risk of retinal vein occlusion (RVO). Aim of the study To evaluate homocy...

Ferrazzi Paola; Di Micco Pierpaolo; Quaglia Ilaria; Rossi Lisa; Bellatorre Alessandro; Gaspari Giorgio; Rota Lidia

250

[Retinal and retinal pigment epithelium hamartoma  

UK PubMed Central (United Kingdom)

Authors present four patients with combined hamartoma of the retina and retinal pigment epithelium who were observed for a period of 10 years. The significance of this entity lies primarily in its resemblance to malignant condition of the retina and choroid and in the vizual reduction. Clinical finding, diagnosis, natural history, histopathology, association with other diseases and therapy are discussed in this report as well.

Streicher T; Spirková J; Trizuljaková E; Stubna M

2002-11-01

251

Quantitative analysis of retinal structures using spectral domain optical coherence tomography in normal rabbits.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study is to quantify the normal retinal thickness (RT) and retinal nerve fiber layer thickness (RNFLT), and to obtain cross-sectional area measurements of the main retinal artery and vein in the rabbit animal model using spectral domain optical coherence tomography (SD-OCT). MATERIALS AND METHODS: Fifteen eyes of 15 adult rabbits were used to obtain SD-OCT scans. RT, RNFLT and cross-sectional areas of the main retinal artery and vein were measured with a custom-made software grading tool (OCTOR) on selected B-scans at the edge of the optic nerve head and at 1, 2, 3 and 4?mm from the nerve. Statistical comparisons were made using the analysis of variance test with post hoc comparison. RESULTS: In the nasal and temporal retina, the average RT and RNFLT decreased significantly with eccentricity from the optic disc. There was a statistically significant greater RT and RNFLT at the edge of the optic disc as compared with values at 1, 2, 3 and 4?mm from the disc edge (p?retinal vein was significantly larger than the retinal artery (p?retinal vessels in the rabbit retina with SD-OCT. These findings are novel anatomic features of the rabbit retina, which should be considered in any studies using this animal model.

Alkin Z; Kashani AH; López-Jaime GR; Ruiz García H; Humayun MS; Sadda SR

2013-02-01

252

[Ophthalmological manifestations of arterial hypertension].  

Science.gov (United States)

Systemic Arterial hypertension (AHT) is one of the most frequent diseases in the industrialised countries, with an incidence reaching 30%, a figure that is rising due to the greater life expectancy of the population. This rise in arterial tension causes, or accelerates, changes in the vascular wall of the target organs such as the kidney, brain, heart and eye. At the ocular level, AHT produces lesions in the retina, the choroids and optic nerve head; this can include a wide range of lesions, from slight vascular narrowing to severe visual loss due to ischaemic optical neuropathy. The primary response of the retinal arteries to systemic arterial hypertension is vascular narrowing and the manifestations that appear at the back of the eye in hypertensive retinopathy are diffuse or focal vasoconstriction, extravasation due to increased vascular permeability and arteriosclerosis with swelling of the wall of the vessels. These three entities are responsible for the appearance of different lesions that characterise the stages of the retinal disease, which are: arteriovenous crossings, hard and cotton-like exudates, thrombosis, embolisms, haemorrhages in the retinal parenchyma, vitreous detachment from the retina, papilla edema and ischaemic optical neuropathy in the more severe cases, such as in case malign arterial hypertension. PMID:19169291

Rodríguez, N A; Zurutuza, A

2008-01-01

253

Visible-light optical coherence tomography for retinal oximetry.  

UK PubMed Central (United Kingdom)

We applied a visible-light spectroscopic optical coherence tomography (vis-OCT) for in vivo retinal oximetry. To extract hemoglobin oxygen saturation (sO(2)) in individual retinal vessels, we established a comprehensive analytical model to describe optical absorption, optical scattering, and blood cell packing factor in the whole blood and fit the acquired vis-OCT signals from the bottom of each imaged vessel. We found that averaged sO(2) values in arterial and venous bloods were 95% and 72%, respectively.

Yi J; Wei Q; Liu W; Backman V; Zhang HF

2013-06-01

254

Renal Stenting from the Radial Artery: A Novel Approach  

International Nuclear Information System (INIS)

Purpose: To describe the technique and feasibility of renal artery angioplasty and stenting from the radial artery. Methods: A series of 19 patients were evaluated for transradial renal artery intervention. Procedures were performed using carbon dioxide gas (CO2) as the preferred angiographic contrast agent. Intervention was performed through a 5 Fr radial artery sheath using low-profile balloons and balloon-expandable stents. Results: Nineteen patients with 26 stenosed renal arteries were considered for treatment via the radial route. A negative Allen's test precluded radial puncture in two (11%). In one patient the descending aorta could not be catheterized. Stenting from the radial route was successful in 22 renal arteries in 16 patients. On an intention-to-treat basis 16 of the 19 (84%) were treatable from the radial route. In the 17 patients with radial access technical success was 94% (16 of 17) patients and 91% (21 of 23) of renal arteries. One patient experienced a cerebrovascular event during intervention. Conclusion: Transradial renal artery intervention is technically feasible using low-profile angioplasty balloons and stents.This route offers advantages in renal arteries with a caudal angulation and in patients with diseases or tortuous iliac arteries.

2003-01-01

255

Blood-retinal barrier.  

UK PubMed Central (United Kingdom)

The blood-ocular barrier system is formed by 2 main barriers: the blood-aqueous barrier and the blood-retinal barrier (BRB). The BRB is particularly tight and restrictive and is a physiologic barrier that regulates ion, protein, and water flux into and out of the retina. The BRB consists of inner and outer components, the inner BRB being formed of tight junctions between retinal capillary endothelial cells and the outer BRB of tight junctions between retinal pigment epithelial cells. The BRB is essential to maintaining the eye as a privileged site and is essential for normal visual function. Methods of clinical evaluation of the BRB are reviewed and new directions using optical coherence tomography are presented. Alterations of the BRB play a crucial role in the development of retinal diseases. The 2 most frequent and relevant retinal diseases, diabetic retinopathy and age-related macular degeneration (AMD), are directly associated with alterations of the BRB. Diabetic retinopathy is initiated by an alteration of the inner BRB and neovascular AMD is a result of an alteration of the outer BRB. Macular edema is a direct result of alterations of the BRB.

Cunha-Vaz J; Bernardes R; Lobo C

2011-01-01

256

Hypoxia-ischemia and retinal ganglion cell damage  

Directory of Open Access Journals (Sweden)

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-1? 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

Charanjit Kaur; Wallace S Foulds; Eng-Ang Ling

2008-01-01

257

Amino acids in retinitis pigmentosa  

Directory of Open Access Journals (Sweden)

Full Text Available Retinitis pigmentosa may be associated with amino acid? disorders; whether the association is incidental or consequential is not known. The present investigation on amino acids in retinitis pigmentosa indicates that the level of plasma amino acids does not differ significantly in pa-tients with retinitis pigmentosa compared to that of normal subjects, hence it has no etiological bearing.

Singh M

1988-01-01

258

Transcatheter closure of coronary artery fistulae: initial human experience with the Amplatzer Duct Occluder II.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the efficacy and safety of the new device Amplatzer Duct Occluder II (ADO II) for the closure of coronary artery fistulae (CAF) with coronary anomaly. BACKGROUND: Transcatheter device closure is an alternative treatment for selective patients with CAF. The currently available reports regarding the closure of CAF with the ADO II are limited. METHODS: From April 1, 2011 to July 15, 2012, 5 patients (3 males and 2 females) aged from 3 years to 27 years old (median age 5 years old) underwent CAF closure with the ADO II. The immediate and short-term outcomes were evaluated. RESULTS: ADO II was deployed via the femoral vein (2 cases), femoral artery (1 case), brachial artery (1 case), and radial artery (1 case). There were no complications during all the procedures. The median fluoroscopy and procedural times were 20 and 39 minutes, respectively. Immediate trivial and mild residual shunt was present in one patient, respectively, but disappeared 24 hours after the procedure, and there was no recanalization at a median follow-up of 6 months. CONCLUSIONS: The new device ADO II was safely deployed with complete resolution of CAF shunt with tortuous coronary artery to the drainage. The reduced sheath sizes and softer shape of this device allow for venous or arterial approach. The ADO II might be a preferable alternative device for closure of small-tortuous CAFs.

Zhao T; Lu M; So A; Wu W; Wang C; Xu Z; Jiang S; Tian L; Liu S; Zhao S

2013-08-01

259

Finding the retinal break in rhegmatogenous retinal detachment  

Directory of Open Access Journals (Sweden)

Full Text Available The development of subretinal fluid is governed by a limited number of anatomical factors and gravity. As a result, rhegmatogenous retinal detachments form in a predictable manner around the retinal break of their origin. The shape of the detachments points to the position of the break. The purpose of this review is to describe the characterstic contours of subretinal fluid in rhegmatogenous retinal detachments, and to highlight some rules and methodology which can help in the detection of the retinal break in phakic, psuedophakic and recurrent retinal detachments.

Saxena Sandeep; Lincoff Harvey

2001-01-01

260

Mammalian inner retinal photoreception.  

UK PubMed Central (United Kingdom)

It is now a decade since the first published reports that a small proportion of mammalian retinal ganglion cells are directly photoresponsive. These cells have been termed intrinsically photosensitive retinal ganglion cells (ipRGCs) and comprise a small proportion of the total population of retinal ganglion cells. The demonstration that these ganglion cells respond to light even when isolated from the rest of the retina established them as potentially autonomous photoreceptors, overturning the dogma that all visual information originates with rods and cones. It also provided a focus for what has developed into a new branch of visual science. Here we place the discovery of ipRGCs into context and review the development of this field over the last decade, with particular emphasis on prospects for practical application.

Lucas RJ

2013-02-01

 
 
 
 
261

Left main coronary artery bidirectional dissection caused by ejection of guideliner catheter from the guiding catheter.  

UK PubMed Central (United Kingdom)

The "Guideliner," a child catheter, aims to deliver stents in tortuous coronary lesions by deep engagement and providing better support. Coronary artery spiral dissection, which may be caused by deep-seated coronary catheters or noncoaxial engagement is one of the most seen percutaneous coronary intervention-related complications. In this case, Guideliner-related left main dissection occurred after successful revascularization of a chronic total occlusion at the left anterior descending artery and the left circumflex, which has not been previously reported. The Guideliner catheter is efficient in treating complex coronary lesions, but one should be aware of its related complications.

Chang YC; Fang HY; Chen TH; Wu CJ

2013-09-01

262

Left main coronary artery bidirectional dissection caused by ejection of guideliner catheter from the guiding catheter.  

Science.gov (United States)

The "Guideliner," a child catheter, aims to deliver stents in tortuous coronary lesions by deep engagement and providing better support. Coronary artery spiral dissection, which may be caused by deep-seated coronary catheters or noncoaxial engagement is one of the most seen percutaneous coronary intervention-related complications. In this case, Guideliner-related left main dissection occurred after successful revascularization of a chronic total occlusion at the left anterior descending artery and the left circumflex, which has not been previously reported. The Guideliner catheter is efficient in treating complex coronary lesions, but one should be aware of its related complications. PMID:23413132

Chang, Yi-Chih; Fang, Hsiu-Yu; Chen, Tien-Hsing; Wu, Chiung-Jen

2013-03-25

263

The accordion phenomenon of the left anterior descending(LAD) artery  

Directory of Open Access Journals (Sweden)

Full Text Available Accordion phenomenon , during routine angioplasty procedure, is produced by mechanical alteration of the geometry and curvature of a tortuous vessel by stiff PCI wire, resulting in invagination and shortening of the vessel wall. It has been described in all coronary arteries and left internal mammary artery graft but left anterior descending is very rare. Given the possible serious alternative diagnoses there cognition of the accordion effect is important and may prevent unnecessary interventions. [Cukurova Med J 2013; 38(2.000): 325-328

Ahmet Avci; Kenan Demir

2013-01-01

264

Retinal vasoproliferative tumor.  

UK PubMed Central (United Kingdom)

Retinal vasoproliferative tumor is a rare disease that has capillary hemangioma as the most frequent diferential diagnosis. The tumor is considered to be of reactive nature. It can be idiophatic or secondary to other ocular diseases such as: uveitis, retinitis pigmentosa, sickle cell disease, previous surgery and retinopathy of prematurity. Lesions with no exsudation or visual decrease can be observed. Lesions that need treatment can be managed by on or more modalities such as cryotherapy, a variety of lasers, surgical excision, radiation, and antiangiogenic intravitreal injections.

Marback EF; Guerra RL; Maia Junior Ode O; Marback RL

2013-06-01

265

Retinal vasoproliferative tumor.  

UK PubMed Central (United Kingdom)

Retinal vasoproliferative tumor is a rare disease that has capillary hemangioma as the most frequent diferential diagnosis. The tumor is considered to be of reactive nature. It can be idiophatic or secondary to other ocular diseases such as: uveitis, retinitis pigmentosa, sickle cell disease, previous surgery and retinopathy of prematurity. Lesions with no exsudation or visual decrease can be observed. Lesions that need treatment can be managed by on or more modalities such as cryotherapy, a variety of lasers, surgical excision, radiation, and antiangiogenic intravitreal injections.

Marback EF; Guerra RL; Maia Junior Ode O; Marback RL

2013-05-01

266

Retinal pigment epithelium.  

Science.gov (United States)

Retinal pigment epithelium (RPE) arises from neuroectoderm and plays a key role in support of photoreceptor functions. Several degenerative eye diseases, such as macular degeneration or retinitis pigmentosa, are associated with impaired RPE function that may lead to photoreceptor loss and blindness. RPE derived from human embryonic stem (hES) cells can be an important source of this tissue for transplantation to cure such degenerative diseases. This chapter describes differentiation of hES cells to RPE, its subsequent isolation, maintenance in culture, and characterization. PMID:17141036

Klimanskaya, Irina

2006-01-01

267

Retinal pigment epithelium.  

UK PubMed Central (United Kingdom)

Retinal pigment epithelium (RPE) arises from neuroectoderm and plays a key role in support of photoreceptor functions. Several degenerative eye diseases, such as macular degeneration or retinitis pigmentosa, are associated with impaired RPE function that may lead to photoreceptor loss and blindness. RPE derived from human embryonic stem (hES) cells can be an important source of this tissue for transplantation to cure such degenerative diseases. This chapter describes differentiation of hES cells to RPE, its subsequent isolation, maintenance in culture, and characterization.

Klimanskaya I

2006-01-01

268

Retinal blood flow velocity in metabolic syndrome.  

UK PubMed Central (United Kingdom)

BACKGROUND: Metabolic syndrome (MetS) is characterized by obesity, insulin resistance, dyslipidemia, and hypertension. The Retinal Function Imager (RFI) is a new technique for measuring retinal blood-flow velocity. This study aims to compare retinal blood flow velocity between MetS and healthy subjects. METHODS: Twenty eyes of 20 MetS males and 21 eyes of 21 aged-matched healthy males underwent RFI and carotid-femoral pulse wave velocity (PWV) measurement as well as assessment of MetS parameters. The results in MetS and healthy subjects were compared. RESULTS: The average venular velocity in the MetS patients was significantly higher than in the healthy subjects (2.7 ± 0.0 mm/sec versus 2.5 ± 0.0 mm/sec respectively, P=0.013), following adjustment for age, heart rate and systolic blood pressure. Carotid-femoral PWV was higher in the MetS population than the healthy controls (10.3 ± 1.2 mm/sec versus 9.3 ± 1.5 mm/sec respectively, P=0.005). The diastolic blood pressure and MAP were correlated strongly with the arterial blood flow velocities in healthy subjects (r=0.503, P=0.020 and r=0.474, P=0.030 respectively) but not in MetS subjects. CONCLUSIONS: The RFI was able to distinguish between the retinal blood flow of normal and MetS subjects. Higher venular blood flow velocity and the poor correlation between velocity and blood pressure of MetS subjects suggest that MetS causes microvascular damage.

Gutfreund S; Izkhakov E; Pokroy R; Yaron M; Yeshua H; Burgansky-Eliash Z; Barak A; Rubinstein A

2013-06-01

269

Dynamic focal retinal arteriolar vasospasm in migraine  

Directory of Open Access Journals (Sweden)

Full Text Available A 48-year-old man presented following an episode of sudden onset simultaneous inferior altitudinal visual loss in his left eye and visual obscuration with shimmering in the inferonasal quadrant of the right eye. Clinical examination demonstrated left superior hemiretinal artery occlusion and an area of focal dynamic spasm along the right superior temporal branch retinal artery, the arteriolar spastic cycle was about 2 sec in duration. Hematological (including complete blood count, thrombophilia screen, vasculitic screen and serum magnesium), carotid, and cardiac investigations were normal. He was given acetazolamide 500 mg orally, timolol maleate 0.5% eye drops once daily and sublingual amyl-nitrate 0.8 mg, and maintained on felodipine 10 mg/day and aspirin 100 mg/day. The area of focal arteriolar spasm in the right eye resolved over two months. To our knowledge there are no prior reports of photographically documented dynamic focal retinal vascular spasm on a MEDLINE and PUBMED search.

Abdul-Rahman Anmar; Gilhotra Jagjit; Selva Dinesh

2011-01-01

270

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

UK PubMed Central (United Kingdom)

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.

Euvrard G; Genevois O; Rivals I; Massin P; Collet A; Sahel JA; Paques M

2013-06-01

271

[Retinal damage and oral contraceptives].  

Science.gov (United States)

2 case histories of retinal damage in users of oral contraceptives (OCs) are discussed. The 1st, a 27-year-old woman who had used Eugynon for a year, had no history of cardiovascular disease of hemicrnaia. Ophthalmic examination showed vision in the right eye as less than 6/120, in the left 6/6, with indications of central serous chorio-retinpathy, with edematous center surrounded by small hemorrhages. After discontinuation of OCs, vision returned to 6/6 and paracentral scatoma disappeared. In the 2nd case a 37-year-old woman who had taken Eugynon and Ovulen for 1 year and Neolyndiol for 2 years complained of the appearance of a wedge-shaped shadow in her right eye. The patient had a history of metrorrhagia and hemicrania on the right side. Vision in both eyes was 6/6, but a paracentral scotoma in the right eye was present, a probable symptom of the patient's hypertensive spastic angiopathy. OCs were discontinued and propanol was administered, then discontinued due to symptoms of a scotoma in the left eye. The angiopathy disappeared but the ocular lesions remained. Ocular complications occur in about .07% of OC users. The damage results from arterial hypertension and changes in the macula lutea. Careful observation of blood pressure and ocular disturbances is the best preventative for ocular damage in OC users. PMID:1251482

Swane Lund, F N; Nielsen, N V

1976-01-19

272

Juvenile rhegmatogenous retinal detachment.  

Directory of Open Access Journals (Sweden)

Full Text Available PURPOSE: To review the clinical features, evaluate visual, and anatomical outcomes and potential complications following surgery for rhegmatogenous retinal detachment (RRD) in juveniles. METHODS: Retrospective, consecutive case series of children and young adults (birth through 18 years) who underwent surgerys for RRD between February 1999 and January 2002. RESULTS: The authors reviewed a consecutive series of 111 eyes of 105 juveniles [86 (77.47%) eyes belonged to male and 25 (22.52%) to female subjects] operated for RRD. The mean age of patients was 13.62 years. Bilateral retinal detachment was present in 12 (10.8%); 51 (46%) patients had some form of bilateral ocular pathology at initial presentation. The two most common aetiologies were non-penetrating trauma (45.04%) and myopia (41.44%). Decreased vision was the most frequent symptom. The mean duration of symptoms was 165.36 days. The commonest retinal break was a retinal hole (34.23%). Late diagnosis was common, evidenced by high frequency of macular detachment (97.29%) and proliferative vitreoretinopathy (PVR) (45.94%) at initial presentation. The most commonly performed primary surgery was scleral buckle (61.26%). The average postoperative follow-up after the first procedure was 10 months (range 8-19 months). Final retinal reattachment was accomplished in 78.37% (87/111) with a mean of 1.29 surgeries per eye. Improvement, no change and decline in vision was seen in 50 (48%), 32 (31%) and 22 (21%) eyes respectively. CONCLUSION: Non-penetrating injury and myopia were the most common cause for RRD in juveniles. Fellow eyes commonly had vision-threatening abnormalities. Final anatomical and visual recovery rates were encouraging despite late initial presentation and high rates of macular detachment, and PVR at initial presentation.

Nagpal M; Nagpal K; Rishi P; Nagpal Pran

2004-01-01

273

Impaired retinal vasodilator responses in prediabetes and type 2 diabetes.  

UK PubMed Central (United Kingdom)

Purpose:? In diabetes, endothelial dysfunction and subsequent structural damage to blood vessels can lead to heart attacks, retinopathy and strokes. However, it is unclear whether prediabetic subjects exhibit microvascular dysfunction indicating early stages of arteriosclerosis and vascular risk. The purpose of this study was to examine whether retinal reactivity may be impaired early in the hyperglycaemic continuum and may be associated with markers of inflammation. Methods:? Individuals with prediabetes (n?=?22), type 2 diabetes (n?=?25) and healthy age and body composition matched controls (n?=?19) were studied. We used the Dynamic Vessel Analyzer to assess retinal vasoreactivity (percentage change in vessel diameter) during a flickering light stimulation. Fasting highly sensitive c-reactive protein (hs-CRP), a marker of inflammation, was measured in blood plasma. Results:? Prediabetic and diabetic individuals had attenuated peak vasodilator and relative amplitude changes in retinal vein diameters to the flickering light stimulus compared with healthy controls (peak dilation: prediabetic subjects 3.3?±?1.8%, diabetic subjects 3.3?±?2.1% and controls 5.6?±?2.6%, p?=?0.001; relative amplitude: prediabetic subjects 4.3?±?2.2%, diabetic subjects 5.0?±?2.6% and control subjects 7.2?±?3.2%, p?=?0.003). Similar findings were observed in retinal arteries. Levels of hs-CRP were not associated with either retinal vessel response parameters. Conclusion:? Retinal reactivity was impaired in prediabetic and type 2 diabetic individuals in parallel with reduced insulin sensitivity but not associated with levels of hs-CRP. Retinal vasoreactivity measurements may be a sensitive tool to assess early vascular risk.

Lott ME; Slocomb JE; Shivkumar V; Smith B; Quillen D; Gabbay RA; Gardner TW; Bettermann K

2013-06-01

274

Physical activity, television viewing time, and retinal vascular caliber.  

UK PubMed Central (United Kingdom)

PURPOSE: to examine the associations of physical activity and television (TV) viewing time with retinal vascular caliber in Australian adults. METHODS: a total of 2024 adults aged 25 yr or older without known diabetes in the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab, 1999-2000), a population-based cross-sectional study, were evaluated. Retinal vascular calibers (both arteriolar and venular calibers) were measured from digital retinal photographs using a computer-assisted method and were summarized into central retinal artery and vein equivalents. Self-reported physical activity time and TV viewing time were obtained using interviewer-administered questionnaires. RESULTS: for physical activity, no statistically significant multivariate relationships emerged for men or for women. After adjusting for confounders (age, sex, education, cigarette smoking, diet quality, waist circumference, systolic blood pressure, plasma glucose levels, serum fibrinogen, serum triglyceride, and physical activity time), men who watched TV for at least 2 h·d had a venular caliber that was 4.71 microm (95% confidence interval = 1.37-8.04 microm, P = 0.006) wider compared with those watching <2 h·d of TV. No significant association with venular caliber was noted in women. CONCLUSIONS: these findings provide the first evidence of an association between TV viewing time (a common, leisure time sedentary behavior) and retinal microcirculation. Further research is needed to examine these associations in different populations and by using more comprehensive physical activity and sedentary behavior measures.

Anuradha S; Dunstan DW; Healy GN; Shaw JE; Zimmet PZ; Wong TY; Owen N

2011-02-01

275

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

UK PubMed Central (United Kingdom)

Purpose:  To study intravascular characteristics of flowing blood in retinal vessels using spectral-domain optical coherence tomography (SD-OCT). Methods:  Examination of selected arterial bifurcations and venous sites of confluence in 25 healthy 11-year-old children recruited as an ad hoc subsample 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/confluences have distinctly different internal SD-OCT profiles, a figure-of-8 pattern in arteries and a figure figure-of-88 in veins that can be used to distinguish between the two vessel types. Conclusion:  This study verified the hypothesis that directions of blood flow at dichotomous vascular branchings can be determined using SD-OCT. This feature may assist the identification of flow reversal near sites of vascular occlusion, the analysis of blood flow near vascular malformations and the segmentation of retinal SD-OCT images.

Willerslev A; Li XQ; Munch IC; Larsen M

2013-07-01

276

Central retinal vein occlusion associated with cryofibrinogenemia in a young adult--study of skin dynamic capillaroscopy.  

UK PubMed Central (United Kingdom)

A 26-year-old woman presented with a 2-month history of intermittent dim vision in her right eye and a diagnosis of central retinal vein occlusion (CRVO) was made. Investigations revealed Raynaud's phenomenon and cryofibrinogenemia. Skin capillaroscopy revealed tortuous vessels and decreased capillary blood-cell velocity in the capillaries of her finger nail fold which coincided with the CRVO attack. After treatment with oral aspirin for 3 months, the CRVO subsided, the capillary blood-cell velocity in the nail fold improved, and serum cryofibrinogen was undetectable. The time course of the cryofibrinogenemia and skin capillaroscopic findings correlated well with her ocular presentations. Study of cryofibrinogen should be included in the evaluation of young adults with CRVO.

Tsai RK; Chang CH

1998-11-01

277

Central retinal vein occlusion associated with cryofibrinogenemia in a young adult--study of skin dynamic capillaroscopy.  

Science.gov (United States)

A 26-year-old woman presented with a 2-month history of intermittent dim vision in her right eye and a diagnosis of central retinal vein occlusion (CRVO) was made. Investigations revealed Raynaud's phenomenon and cryofibrinogenemia. Skin capillaroscopy revealed tortuous vessels and decreased capillary blood-cell velocity in the capillaries of her finger nail fold which coincided with the CRVO attack. After treatment with oral aspirin for 3 months, the CRVO subsided, the capillary blood-cell velocity in the nail fold improved, and serum cryofibrinogen was undetectable. The time course of the cryofibrinogenemia and skin capillaroscopic findings correlated well with her ocular presentations. Study of cryofibrinogen should be included in the evaluation of young adults with CRVO. PMID:9872035

Tsai, R K; Chang, C H

1998-11-01

278

Multi-slice spiral CT diagnosis of arterial sequestration  

International Nuclear Information System (INIS)

Objective: The purpose of this study was to present the characteristic features on MSCT angiography of arterial sequestration. Methods: The MSCT images of 5 patients with arterial sequestration were retrospectively reviewed. All patients underwent MSCT contrast-enhanced angiography. 3D rendering was made to evaluate the lung parenchyma, bronchial system, and vascular anatomy. Results: All 5 cases demonstrated the anomalous systemic artery (ASA) as an isolated and tortuous artery arising from the descending thoracic aorta, taking a sigmoid course and running along with airway, entering the basal segments of the left lowed lobe. The inferior pulmonary vein (IPV) was significantly engorged. The typical AS was diagnosed in 4 patients. Its ASA intercrossed with the IPV and two branches entering segments 7 and 8 over the IPV, and two branches entering segments 9 and 10 under the IPV. The volume of involved lung shrunk with the artery markedly engorged. A characteristic avascular section was found between the pulmonary artery supplying area and the ASA supplying area, and the bronchi did not accompany the arteries. One was diagnosed atypical AS because of coexistence with bronchial atresia. Conclusion: The arterial sequestration had characteristic MSCT findings. The typical type can be definitely diagnosed, but the atypical type needs further three-dimensional analysis. (authors)

2010-01-01

279

[Rete compensation in agenesis of the internal carotid artery  

UK PubMed Central (United Kingdom)

The term carotid rete mirabile refers to an anatomic structure common in several lower mammals (e.g., swine). The blood supply for the intracranial arteries originates from branches of the external carotid artery, predominantly the ascending pharyngeal and internal maxillary arteries. In these animals the intracranial internal carotid artery forms from a dense network of numerous converging, small-caliber vessels. An analogous structure is rarely found in humans. Associated with segmental agenesis of the internal carotid artery, so-called carotid rete mirabile can be observed. In it numerous tortuous vessels with a diameter of 1-2 mm are found along the expected course of the internal carotid artery and coming from branches of the external carotid artery. These vessels converge to the intradural paraclinoid segment of the internal carotid artery, which shows a normal diameter. This rare pattern of collateral supply to the brain is illustrated here on the basis of two clinical case histories. Both patients presented with aneurysmal subarachnoid hemorrhage. In one, histological examination of a vessel biopsy revealed medial fibromuscular dysplasia. In both patients the rete mirabile was found in only one carotid system. The affected carotid canal in the skull base was hypoplastic. Human carotid rete mirabile probably has no inherent pathologic significance, but its frequent association with other intra- and extracranial vascular pathologies should be kept in mind.

Henkes H; Reinartz J; Fischer S; Miloslavski E; Albes G; Kühne D

2007-08-01

280

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

Science.gov (United States)

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. PMID:21298100

Li, Suk-Yee; Yang, Di; Yeung, Chung-Man; Yu, Wing-Yan; Chang, Raymond Chuen-Chung; So, Kwok-Fai; Wong, David; Lo, Amy C Y

2011-01-26

 
 
 
 
281

Trombocitemia esencial y trombosis venosa retiniana/ Essential thrombocythemia and retinal vein thrombosis  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Casos Clínicos: La trombocitosis esencial es una enfermedad de las células madres hematopoyéticas que se caracteriza por un exceso de plaquetas. Se presentan dos casos, una mujer de 72 años con retina isquémica, venas tortuosas y convertidas en cordones blanquecinos en la retina superior y hemorragias difusas en la retina inferior con hemorragias puntiformes en la región ecuatorial en el ojo izquierdo y un varón de 62 años con oclusión de la vena central de la re (more) tina en el ojo izquierdo, como manifestaciones de trombocitemia esencial. Discusión: Estos casos clínicos son ejemplos de las posibles complicaciones de la trombocitosis esencial. Estos pacientes deberían ser controlados ante posibles complicaciones oclusivas retinianas, especialmente al reducir el recuento plaquetario por debajo de 10(6)/mm³. Abstract in english Case Report: Essential thrombocytosis is a disorder of the hematopoietic stem cell that causes proliferation of platelets. We report two cases: a 72-year-old woman with ischemic retina and tortuous and white veins in the superior retina and diffuse hemorrhages in the inferior retina with blot hemorrhages scattered throughout the equatorial region in the left eye; and a 62-year-old man with a central retinal vein occlusion in the left eye as signs of essential thrombocythe (more) mia. Discusion: These cases are examples of potential complications of essential thrombocytosis. Vulnerable patients should be monitored for retinal vascular occlusions, especially when platelet counts do not exceed 106/mm³.

Asensio Sánchez, VM; Manteca Jiménez, G; Cano Navarro, E

2004-12-01

282

Trombocitemia esencial y trombosis venosa retiniana Essential thrombocythemia and retinal vein thrombosis  

Directory of Open Access Journals (Sweden)

Full Text Available Casos Clínicos: La trombocitosis esencial es una enfermedad de las células madres hematopoyéticas que se caracteriza por un exceso de plaquetas. Se presentan dos casos, una mujer de 72 años con retina isquémica, venas tortuosas y convertidas en cordones blanquecinos en la retina superior y hemorragias difusas en la retina inferior con hemorragias puntiformes en la región ecuatorial en el ojo izquierdo y un varón de 62 años con oclusión de la vena central de la retina en el ojo izquierdo, como manifestaciones de trombocitemia esencial. Discusión: Estos casos clínicos son ejemplos de las posibles complicaciones de la trombocitosis esencial. Estos pacientes deberían ser controlados ante posibles complicaciones oclusivas retinianas, especialmente al reducir el recuento plaquetario por debajo de 10(6)/mm³.Case Report: Essential thrombocytosis is a disorder of the hematopoietic stem cell that causes proliferation of platelets. We report two cases: a 72-year-old woman with ischemic retina and tortuous and white veins in the superior retina and diffuse hemorrhages in the inferior retina with blot hemorrhages scattered throughout the equatorial region in the left eye; and a 62-year-old man with a central retinal vein occlusion in the left eye as signs of essential thrombocythemia. Discusion: These cases are examples of potential complications of essential thrombocytosis. Vulnerable patients should be monitored for retinal vascular occlusions, especially when platelet counts do not exceed 106/mm³.

VM Asensio Sánchez; G Manteca Jiménez; E Cano Navarro

2004-01-01

283

Temporal changes in retinal microvascular caliber and blood pressure during pregnancy.  

UK PubMed Central (United Kingdom)

The microvasculature plays an important role in regulating cardiovascular changes in pregnancy, but changes in microvasculature have been difficult to document in vivo. This study objectively quantifies changes in the maternal retinal arteriolar and venular caliber over the course of healthy pregnancy. Healthy pregnant women (n=53) were recruited from Royal Prince Alfred Hospital, Sydney, Australia. Retinal images and mean arterial blood pressures (MAP) were collected at 13, 19, 29, and 38 weeks of gestation and at 6-month postpartum. Retinal vessels were analyzed and summarized as the central retinal arteriolar equivalent and central retinal venular equivalent. Central retinal arteriolar equivalent and central retinal venular equivalent were corrected for MAP. Paired t tests were performed comparing consecutive time points, with a significance level of P<0.01. There was a decrease in MAP between 13- and 19-week gestation (P=0.001) followed by a return to baseline from 19 weeks to delivery. This was correlated by an increase in vessel caliber between 13- and 19-week gestation (central retinal arteriolar equivalent: P<0.001, central retinal venular equivalent: P=0.007) and a return to baseline from 19 weeks to delivery. There were no differences in the central retinal arteriolar equivalent or central retinal venular equivalent (both uncorrected and corrected for MAP) between nulliparous and parous women. The pattern of dilatation and constriction in the microvasculature mirrored the changes in MAP throughout pregnancy, reflecting changes in peripheral resistance. This study provides insights into physiological changes in the microvasculature throughout a healthy pregnancy. These results can be used as a baseline with which to compare the changes observed in pathological conditions of pregnancy.

Lupton SJ; Chiu CL; Hodgson LA; Tooher J; Lujic S; Ogle R; Wong TY; Hennessy A; Lind JM

2013-04-01

284

[Navigated retinal laser therapy].  

UK PubMed Central (United Kingdom)

Navigated laser therapy introduces for the first time computerized assistance systems for retinal laser therapy. The Navilas system offers high precision and safety and provides additional benefits regarding standardization of planning, execution, documentation and quality assurance. The current focus of clinical application for navigated laser therapy besides laser treatment after retinal vein occlusion and panretinal laser photocoagulation in proliferative diabetic retinopathy (PDR) is diabetic macular edema. Recent data indicate that combined initial anti-vascular endothelial growth factor (anti-VEGF) and navigated macular laser therapy allows achievement and maintenance of treatment success with a minimum number of interventions. Despite very promising results the current assessment of navigated laser therapy is still limited by the evidence available worldwide.

Kernt M; Ulbig M; Kampik A; Neubauer AS

2013-08-01

285

Retinal angiomatous proliferation.  

UK PubMed Central (United Kingdom)

Retinal angiomatous proliferation (RAP) is a distinct form of choroidal neovascularization which may complicate a wet age related macular degeneration (AMD). This exudative-AMD has a peculiar clinical history and prognosis. RAP accounts from 8% to 22% of newly diagnosed cases among patients previously diagnosed as exudative AMD, and up to 25% of the occult or minimally classic CNV. The disease is more prevalent in women (90% of cases) and in elderly patients (around 75 years), and is characterized by a very poor prognosis. The neovascular process, whose retinal or choroidal origin is still object of discussion, often hesitates in the formation of a disciform scar, that evolves into a severe loss of central vision. Treatment for RAP is not yet well established; herein are described the most used therapeutic strategies, starting from laser photocoagulation until the nearest anti VEGF. The opportunity of combination among various treatments to obtain a better effectiveness and a lower frequency of recurrence is also discussed.

Marticorena J; Di Leva V; Cennamo GL; de Crecchio G

2011-02-01

286

Placental growth factor contributes to micro-vascular abnormalization and blood-retinal barrier breakdown in diabetic retinopathy.  

UK PubMed Central (United Kingdom)

OBJECTIVE: There are controversies regarding the pro-angiogenic activity of placental growth factor (PGF) in diabetic retinopathy (DR). For a better understanding of its role on the retina, we have evaluated the effect of a sustained PGF over-expression in rat ocular media, using ciliary muscle electrotransfer (ET) of a plasmid encoding rat PGF-1 (pVAX2-rPGF-1). MATERIALS AND METHODS: pVAX2-rPGF-1 ET in the ciliary muscle (200 V/cm) was achieved in non diabetic and diabetic rat eyes. Control eyes received saline or naked plasmid ET. Clinical follow up was carried out over three months using slit lamp examination and fluorescein angiography. After the control of rPGF-1 expression, PGF-induced effects on retinal vasculature and on the blood-external barrier were evaluated respectively by lectin and occludin staining on flat-mounts. Ocular structures were visualized through histological analysis. RESULTS: After fifteen days of rPGF-1 over-expression in normal eyes, tortuous and dilated capillaries were observed. At one month, microaneurysms and moderate vascular sprouts were detected in mid retinal periphery in vivo and on retinal flat-mounts. At later stages, retinal pigmented epithelial cells demonstrated morphological abnormalities and junction ruptures. In diabetic retinas, PGF expression rose between 2 and 5 months, and, one month after ET, rPGF-1 over-expression induced glial activation and proliferation. CONCLUSION: This is the first demonstration that sustained intraocular PGF production induces vascular and retinal changes similar to those observed in the early stages of diabetic retinopathy. PGF and its receptor Flt-1 may therefore be looked upon as a potential regulatory target at this stage of the disease.

Kowalczuk L; Touchard E; Omri S; Jonet L; Klein C; Valamanes F; Berdugo M; Bigey P; Massin P; Jeanny JC; Behar-Cohen F

2011-01-01

287

Effect of regular smoking on flicker induced retinal vasodilatation in healthy subjects.  

UK PubMed Central (United Kingdom)

BACKGROUND: Habitual smoking is a risk factor for a variety of vascular diseases, including ocular pathologies. In the current study, we set out to investigate whether the regulation of retinal vascular tone is impaired in habitual smokers. For this purpose, vascular reactivity was tested during flicker light induced vasodilatation in smokers and in a non-smoking control group. METHODS: In this prospective, balanced, parallel group study 24 chronic smokers (28.1 ± 3.3 years) and 24 age-matched never-smoking volunteers (28.2 ± 4.0 years) were included. Flicker induced vasodilatation was measured in major retinal arteries and veins using a retinal vessel analyzer and flicker induced changes in retinal blood velocities were assessed in retinal veins by laser Doppler velocimetry. Three flicker periods of 60s were scheduled. Blood cotinine concentration was determined and a Fagerstrom questionnaire was performed to evaluate nicotine dependency. RESULTS: In non-smoking subjects, stimulation with flicker light increased retinal venous diameter by +7.7 ± 3.1%, +6.9 ± 2.9% and +7.1 ± 2.8% during the three flicker periods, respectively. Flicker induced vasodilatation in veins was significantly diminished in chronic smokers (+4.9 ± 2.4%, +6.3 ± 3.1% and +5.7 ± 3.4%, ANOVA between groups, p=0.032) as compared to the non-smoking control group. Calculated retinal blood flow in the measured veins increased by a maximum of +54 ± 21%, +43 ± 18% and +46 ± 19% during the three stimulation periods in the non-smoking subjects, respectively. The flicker induced increase in retinal blood flow as assessed in the veins was significantly reduced in chronic smokers as compared to the non-smoking control group (+19 ± 16%, +26 ± 14%, +24 ± 13%, ANOVA between groups, p=0.013). In retinal arteries, flicker stimulation increased retinal arterial diameters by 5.2 ± 3.8%, 5.8 ± 4.8% and 5.5 ± 5.6% during the three flicker periods in the non-smoking group. In smokers, the flicker induced arterial vasodilatation was not significantly different compared to non-smokers (4.6 ± 4.1%, 3.8 ± 3.7% and 4.8 ± 3.4%, ANOVA between groups, p=0.4). CONCLUSION: Our data indicate that the flicker induced hemodynamic response of retinal veins is reduced in chronic smokers as compared to age matched healthy volunteers. This supports the hypothesis that chronic smoking leads to vascular dysfunction in the eye.

Garhöfer G; Resch H; Sacu S; Weigert G; Schmidl D; Lasta M; Schmetterer L

2011-11-01

288

Sudden painless visual loss: retinal causes.  

UK PubMed Central (United Kingdom)

Sudden painless visual loss occurs in retinal disorders that reflect primary ocular disease, as well as systemic disease. This article reviews vitreous and retinal detachment and macular degeneration as ocular causes of sudden visual loss. Retinal changes that are caused by systemic disease, including infectious retinitis, occlusion of retinal vessels, and proliferative new vessel formation, are reviewed. In each instance, the retinal examination should provide the ocular or systemic diagnosis or lead to the diagnosis.

Whitmore PV

1999-02-01

289

Retinal Diseases and VISION 2020  

Directory of Open Access Journals (Sweden)

Full Text Available Historically, retinal disease has had a low priority in prevention of blindness programmes in developing countries. There are several reasons for this. Firstly, it was thought that retinal disease was an uncommon cause of blindness in the developing world; secondly, that the results of treating retinal disease did not justify the effort and expense involved; and, thirdly, that the equipment required was too costly and unreliable for use in a developing country environment. Finally, there is a lack of skilled personnel with sub-speciality training in retinal disease.

David Yorston

2003-01-01

290

Radiologic evaluation of coronary artery fistula in adult  

International Nuclear Information System (INIS)

[en] To evaluate the clinical and radiologic findings of coronary artery fistula (CAF) by reviwing adult patients in whom this condition had been diagnosed by coronary angiogram. We retrospectively analysed the clinical findings, chest X-rays and angiographic findings of 37 adult CAF patients treated at three institutes over a period of is 15 years. On coronary angiogram, the origin of CAF was found to be the left coronary artery (LCA) in 20 cases(54%), the right coronary artery (RCA) in five (14%), and both in 12(32%). By subdividing the coronary artery into four segments [RCA, left main coronary artery, left anterior descending artery(LAD), and left circumflex artery(LCX)], the origin of CAF (total 55 cases) was found to be the LAD in 23 cases(42%), the LCX in 12(22%), the left main coronary artery in three (5%), and the RCA in 17(31%). The draining site of CAF was the right heart [right atrium, right ventricle, and main pulmonary artery(MPA)] in 28 cases(75%) the left heart(left atrium and left ventricle) in 8(22%), and both in one (3%). The fistula drained to the cardiac chamber in 12 cases (33%), the MPA in 23(62%), and both in 2(5%). Among 55 cases, the total number of fistulas to the MPA was 35, and their origin was the RCA in nine instances (26%), and the left coronary artery in 26(74%). CAF to the MPA was classified into four types:Type I(single, tortuous and not dilated) was seen in six patients (17%), type II(single, tortuous and dilated) in three (9%), type III(multiple and fine plexus) in 21(60%), and type IV(multiple and dilated plexus)in five (14%). Eighteen cases (49%) were associated with the other cardiac disease. In these Korean adults, CAF originated most commonly from the LCA, especially from the LAD segment of this artery, and most frequently drained to the right cardic chamber, especially to the MPA. The morphology of the CAF to the MPA was mostly multiple and fine plexus. We suggest that to ensure the most suitable treatment, and for better prognosis, patients with other cardiac disease should be evaluated for the presence of CAF

1997-01-01

291

Stent-assisted coil embolization of a complex wide-neck splenic artery aneurysm.  

UK PubMed Central (United Kingdom)

We describe the endovascular treatment of a wide-neck splenic artery aneurysm (SAA) using a stent-assisted coil embolization technique. A 55-year-old woman who was admitted for intermittent epigastric pain was diagnosed with a wide-neck aneurysm of the intermediate splenic artery. The SAA had a maximum diameter of 2.2 cm and originated from a tortuous vessel. After percutaneous access through the left brachial artery, a self-expandable stent was initially deployed across the origin of the aneurysm using a 4-French platform. The aneurysm sac was subsequently filled with coils through a microcatheter. The procedure was successful with no postoperative clinical complications. Patency of splenic artery and complete exclusion of the aneurysm were confirmed by follow-up computed tomographic angiography 1 year after treatment. In challenging anatomic situations, stent-assisted coil embolization may represent a first-choice endovascular treatment option for the exclusion of SAAs.

Stella N; Palombo G; Taddeo C; Rizzo L; Taurino M

2013-11-01

292

Stent-assisted coil embolization of a complex wide-neck splenic artery aneurysm.  

Science.gov (United States)

We describe the endovascular treatment of a wide-neck splenic artery aneurysm (SAA) using a stent-assisted coil embolization technique. A 55-year-old woman who was admitted for intermittent epigastric pain was diagnosed with a wide-neck aneurysm of the intermediate splenic artery. The SAA had a maximum diameter of 2.2 cm and originated from a tortuous vessel. After percutaneous access through the left brachial artery, a self-expandable stent was initially deployed across the origin of the aneurysm using a 4-French platform. The aneurysm sac was subsequently filled with coils through a microcatheter. The procedure was successful with no postoperative clinical complications. Patency of splenic artery and complete exclusion of the aneurysm were confirmed by follow-up computed tomographic angiography 1 year after treatment. In challenging anatomic situations, stent-assisted coil embolization may represent a first-choice endovascular treatment option for the exclusion of SAAs. PMID:23988548

Stella, Nazzareno; Palombo, Giovanni; Taddeo, Christiana; Rizzo, Luigi; Taurino, Maurizio

2013-08-26

293

[Bronchial artery embolization with vascular ocluder device in a patient with hemoptysis].  

UK PubMed Central (United Kingdom)

BACKGROUND: Hemoptysis is a sign that can be secondary to various clinical entities. Depending on the amount of bleeding, it may even endanger the patient's life. The presence of a dilated and tortuous bronchial artery may explain the hemoptysis, whose treatment consists in closing the vessel. Our objective is to demonstrate the percutaneous closure of a disrupt of the bronchial artery which causes hemoptysis. CLINICAL CASE: A 49-years old woman with mild hemoptysis and the presence of an abnormal bronchial artery bleeding that underwent percutaneous closure device plug. The device was implanted without complications and it was not observed passage of dye into the bronchial artery occluded through the pigtail catheter angiography control. The patient had no further episodes of hemoptysis. Conclusions: pulmonary arteriovenous malformations can be treated successfully by the percutaneous route.

Vargas-Cruz A; López-Palomo Dde L; Robledo-Nolasco R

2013-01-01

294

Vertebral artery loop--a cause of cervical radiculopathy.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report a case of cervical radiculopathy caused by an anomalous vertebral artery (VA) and illustrate the efficacy of microvascular decompression by the anterolateral approach. METHODS: A 50-year-old woman was referred because of an 8-year history of progressive left C6 radiculopathy refractory to other forms of treatment, including C5-6 anterior cervical discectomy. Clinical and radiologic evaluation showed an abnormally tortuous loop of V2 causing direct neurovascular compression. RESULTS: A left cervical anterolateral approach was used to expose the anomalous loop. After a generous bony decompression, the loop was identified, and the artery was mobilized and ultimately separated from the C6 nerve root removing the direct pulsatile compression. CONCLUSIONS: Cervical root compression by an aberrant or anomalous extracranial VA is a rare cause of radiculopathy. The best management of such lesions is the anterolateral approach with bony and direct microvascular decompression.

Chibbaro S; Mirone G; Yasuda M; Marsella M; Di Emidio P; George B

2012-09-01

295

Retinal periphlebitis in ulcerative colitis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A man presented with unilateral visual blurring associated with bilateral retinal periphlebitis which was felt to be a complication of his biopsy-proven active ulcerative colitis. Retinal periphlebitis has been associated rarely with some forms of colitis but we can find no report of its occurrence ...

Kelly, IM; Frith, PA; Hyman, NM; Jewell, DP

296

Retinal detachment surgery without cryotherapy.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 th...

Chignell, A H; Markham, R H

297

Diplopia after retinal detachment surgery.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Diplopia following retinal detachment usually responds to simple measures. Fifteen out of 311 cases developed diplopia lasting more than three months after conventional retinal detachment surgery. Binocular single vision was restored in 12 of the 15 cases (80%). The mean follow-up was four years. Di...

Fison, P N; Chignell, A H

298

Cytomegalovirus Retinitis in infancy.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the presentation of cytomegalovirus retinitis (CMVR) in a series of infants. METHODS: Immunocompromised infants with either HIV or systemic cytomegalovirus (CMV) were examined for CMVR. Ocular involvement was recorded and monitored by digital imaging. RESULTS: Five infants were detected to have CMVR. All the infants demonstrated changes within the macula. One infant progressed from a fine granular pattern to fulminant CMVR. CONCLUSION: Infants under a year with CMVR have a predilection for the disease to present at the macula, in contrast to the presentation in adults, which tends to involve more peripheral parts of the retina.

Wren SM; Fielder AR; Bethell D; Lyall EG; Tudor-Williams G; Cocker KD; Mitchell SM

2004-04-01

299

Retinal lead toxicity  

Directory of Open Access Journals (Sweden)

Full Text Available A 35-year-old female who had suffered from acute lead poisoning when she was 22 years old, presented 13 years later with loss of vision in the right eye and normal vision in the left eye. She had a pale disc, narrowed arterioles and mid-peripheral heavy pigmentation, right eye being more affected than the left eye. Electrodiagnostic tests identified marked asymmetry of visual function. We would postulate lead retinal toxicity as the cause of the asymmetric findings.

Gilhotra J; Lany H; Sharp D

2007-01-01

300

Oclusão de ramo da veia central da retina Retinal vein branch occlusion  

Directory of Open Access Journals (Sweden)

Full Text Available As oclusões venosas retinianas são a segunda causa mais comum de doenças vasculares da retina, atrás apenas da retinopatia diabética. A obstrução venosa de ramo é definida como a oclusão focal de uma veia retiniana em nível de um cruzamento arteriovenoso, no qual a artéria passa anteriormente à veia. Serão revisto o estudo multicêntrico sobre o tratamento com fotocoagulação a "laser" para esta doença, bem como abordadas as novas terapêuticas cirúrgicas propostas.Retinal venous occlusions are the second most common retinal vascular diseases, behind diabetic retinopathy. The retinal vein branch occlusion is defined as a retinal vein focal occlusion at the level of an arteriovenous crossing, where the artery lies anterior to vein. The clinical trial with laser photocoagulation for this disease, as well as new proposed surgical therapeutic techniques will be reviewed.

Alexandre Antonio Marques Rosa

2003-01-01

 
 
 
 
301

Bromovinyldeoxyurdine treatment of outer retinal necrosis due to varicella-zoster virus: a case-report.  

UK PubMed Central (United Kingdom)

In December 1995, a 70-years old male was referred to us because of rapid visual loss in the right eye, one month after a central retinal artery occlusion in the left eye. This renal transplant patient, with limited renal function, was on immunosuppressive therapy. The diagnosis of bilateral progressive outer retinal necrosis (PORN) due to varicella-zoster virus (VZV) was confirmed by polymerase chain reaction (PCR) detection of VZV DNA in the aqueous fluid. As retinitis progressed despite of intravenous acyclovir administration, the antiviral therapy was switched to oral bromovinyldeoxyuridine (BVDU). This case-report demonstrates that oral BVDU can be a good alternative to acyclovir for the treatment of VZV retinal infections.

Dullaert H; Maudgal PC; Leys A; Dralands L; Clercq E

1996-01-01

302

Outer retinal tubulation in inherited retinal degenerative disease.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate the prevalence and characteristics of outer retinal tubulation (ORT) seen in inherited retinal degenerative diseases. METHODS: A total of 354 eyes of 177 patients were examined with spectral domain optical coherence tomography. One hundred and twelve patients had retinitis pigmentosa, 58 patients had cone dystrophy, and 7 patients had the Bietti crystalline dystrophy. The images obtained by horizontal and vertical scans were analyzed to explore the possible presence of ORT, estimate their prevalence, morphologic character, and their location in the retinal layers. RESULTS: With spectral domain optical coherence tomography, ORT was identified in 0 of 112 patients with retinitis pigmentosa, unilaterally in 3 of 58 patients with cone dystrophy, and bilaterally in 5 of 7 patients with the Bietti crystalline dystrophy. Outer retinal tubulation was detected under the fovea, and in the outer nuclear layer, ORT was detected in the Bietti crystalline dystrophy with a significantly higher frequency than in cone dystrophy (P < 0.001). CONCLUSION: There was a higher rate of ORT in the Bietti crystalline dystrophy among inherited retinal degenerative diseases.

Iriyama A; Aihara Y; Yanagi Y

2013-07-01

303

Reading Visual Braille with a Retinal Prosthesis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Retinal prostheses, which restore partial vision to patients blinded by outer retinal degeneration, are currently in clinical trial. The Argus II retinal prosthesis system was recently awarded CE approval for commercial use in Europe. While retinal prosthesis users have achieved remarkable visual im...

Lauritzen, Thomas Z.; Harris, Jordan; Mohand-Said, Saddek; Sahel, Jose A.; Dorn, Jessy D.; McClure, Kelly; Greenberg, Robert J.

304

Pathogenesis and Risk Factors In Retinal Vein Occlusions  

Directory of Open Access Journals (Sweden)

Full Text Available Retinal vein occlusions (RVO) are by far the most common cause of retinal vascular occlusive diseases especially in middle-aged and older individuals. Basically, there are two forms of RVO, namely, branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Even though mechanisms resulting in venous occlusion may differ, there are also similarities in the etiopathogenesis of these two types. Like other vascular occlusive diseases elsewhere in the body, it is very crucial to find out if there is an underlying cause and / or predisposing factor for RVO. Most researches show that the pathogenesis of RVO is multifactorial and the most common associated disease is arterial hypertension. Moreover, recent investigations have determined that numerous genetic and acquired disorders may predispose to RVO and thereby affect visual prognosis. In this review, it was aimed to consider the pathogenesis of RVO along with its local, systemic and haemostasis-related risk factors and to discuss well-known as well as new predisposing factors for thrombosis.

Koray Gümü?

2007-01-01

305

[Delayed diagnosis of ophthalmic artery obstruction due to atrial myxoma].  

UK PubMed Central (United Kingdom)

CASE REPORT: A 56 year old woman with atrial myxoma presented with a visual acuity of no light perception after acute ophthalmic artery obstruction (OAO) associated with stroke. She developed late retinal pigmentary changes due choroidal infarction, typical of the OAO. DISCUSSION: Simultaneous obstruction of the retinal and choroidal circulation was observed in the OAO. Atrial myxoma should be suspected in patients who suffer from OAO associated with stroke. Systemic studies should be performed to find the origin of OAO.

Sabater N; Alforja S; Rey A; Giralt J

2013-08-01

306

Retinal angiomatous proliferation.  

Science.gov (United States)

Retinal angiomatous proliferation (RAP) is a distinct form of choroidal neovascularization which may complicate a wet age related macular degeneration (AMD). This exudative-AMD has a peculiar clinical history and prognosis. RAP accounts from 8% to 22% of newly diagnosed cases among patients previously diagnosed as exudative AMD, and up to 25% of the occult or minimally classic CNV. The disease is more prevalent in women (90% of cases) and in elderly patients (around 75 years), and is characterized by a very poor prognosis. The neovascular process, whose retinal or choroidal origin is still object of discussion, often hesitates in the formation of a disciform scar, that evolves into a severe loss of central vision. Treatment for RAP is not yet well established; herein are described the most used therapeutic strategies, starting from laser photocoagulation until the nearest anti VEGF. The opportunity of combination among various treatments to obtain a better effectiveness and a lower frequency of recurrence is also discussed. PMID:20887242

Marticorena, J; Di Leva, V; Cennamo, G L; de Crecchio, G

2011-02-01

307

Acute retinal necrosis  

Directory of Open Access Journals (Sweden)

Full Text Available Purpose: Clinical features in a case of acute retinal necrosis are described as well as its diagnostic approach and response to early treatment.Methods: This is a descriptive and retrospective study case report of a 26 year old male patient who arrived to the emergency room with a three day history of sudden visual loss in the right eye (RE). At initial evaluation a visual acuity of hand movements in the RE, 20/15 in the left eye (LE) and a right relative afferent pupillary defect were found. Fundoscopy revealed profuse soft exudates and hemorrhages involving posterior pole, inferior hemiretina and superotemporal periphery. Infectious workup and fluoresceinic angiography were made and positive serologies for herpes virus types 1 and 2, without HIV, were found. A diagnosis of acute retinal necrosis was made and treatment with intravenous valgancyclovir for two weeks and intra-vitreous triamcinolone for severe vasculitis, was given. Then a 3 months treatment with oral antiviral agents was prescribed.Results: Patient’s evolution showed improvement with treatment and at two and a half months of follow up, visual acuity was 20/50 in the right eye, normal slit lamp examination, tonometry of 12 mm Hg and fundoscopy improved when compared to initial pictures.Conclusions: A high index of suspicion is needed for diagnosing ARN taking into account clinical findings. Prompt intravenous and intra-vitreous treatments are needed to achieve good clinical and functional outcomes and to avoid central nervous system complications.

Hugo Hernán Ocampo; Alexánder Maximiliano Martínez

2009-01-01

308

Comorbidity in patients with branch retinal vein occlusion : case-control study  

DEFF Research Database (Denmark)

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.

Bertelsen, Mette; Linneberg, Allan René

2012-01-01

309

Smooth muscle cell contraction increases the critical buckling pressure of arteries.  

UK PubMed Central (United Kingdom)

Recent in vitro experiments demonstrated that arteries under increased internal pressure or decreased axial stretch may buckle into the tortuous pattern that is commonly observed in aging or diseased arteries in vivo. It suggests that buckling is a possible mechanism for the development of artery tortuosity. Vascular tone has significant effects on arterial mechanical properties but its effect on artery buckling is unknown. The objective of this study was to determine the effects of smooth muscle cell contraction on the critical buckling pressure of arteries. Porcine common carotid arteries were perfused in an ex vivo organ culture system overnight under physiological flow and pressure. The perfusion pressure was adjusted to determine the critical buckling pressure of these arteries at in vivo and reduced axial stretch ratios (1.5 and 1.3) at baseline and after smooth muscle contraction and relaxation stimulated by norepinephrine and sodium nitroprusside, respectively. Our results demonstrated that the critical buckling pressure was significantly higher when the smooth muscle was contracted compared with relaxed condition (97.3mmHg vs 72.9mmHg at axial stretch ratio of 1.3 and 93.7mmHg vs 58.6mmHg at 1.5, p<0.05). These results indicate that arterial smooth muscle cell contraction increased artery stability.

Hayman DM; Zhang J; Liu Q; Xiao Y; Han HC

2013-02-01

310

Advances in Retinal Tissue Engineering  

Directory of Open Access Journals (Sweden)

Full Text Available Retinal degenerations cause permanent visual loss and affect millions world-wide. Current treatment strategies, such as gene therapy and anti-angiogenic drugs, merely delay disease progression. Research is underway which aims to regenerate the diseased retina by transplanting a variety of cell types, including embryonic stem cells, fetal cells, progenitor cells and induced pluripotent stem cells. Initial retinal transplantation studies injected stem and progenitor cells into the vitreous or subretinal space with the hope that these donor cells would migrate to the site of retinal degeneration, integrate within the host retina and restore functional vision. Despite promising outcomes, these studies showed that the bolus injection technique gave rise to poorly localized tissue grafts. Subsequently, retinal tissue engineers have drawn upon the success of bone, cartilage and vasculature tissue engineering by employing a polymeric tissue engineering approach. This review will describe the evolution of retinal tissue engineering to date, with particular emphasis on the types of polymers that have routinely been used in recent investigations. Further, this review will show that the field of retinal tissue engineering will require new types of materials and fabrication techniques that optimize the survival, differentiation and delivery of retinal transplant cells.

Matthew Trese; Caio V. Regatieri; Michael J. Young

2012-01-01

311

The use of bevacizumab in a multilevel retinal hemorrhage secondary to retinal macroaneurysm: a 39-month follow-up case report  

Directory of Open Access Journals (Sweden)

Full Text Available Dimitrios Tsakpinis1, Mayssa B Nasr1,2, Paris Tranos3, Nikos Krassas1, Theodoros Giannopoulos2, Chrysanthos Symeonidis1, Stavros A Dimitrakos1, Anastasios GP Konstas212nd University Department of Ophthalmology, Papageorgiou Hospital; 2Glaucoma Unit, 1st University, Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece; 3Retina Eye Center, Thessaloniki, GreecePurpose: The evaluation of long-term visual outcome after the use of bevacizumab for the management of multilevel hemorrhage due to retinal arterial macroaneurysm (MA).Case report: A 71-year-old hypertensive female presented with sudden reduction of visual acuity in her left eye (OS). Fundoscopy revealed an arterial macroaneurysm with preretinal and subretinal hemorrhage in the eye. Due to significant macular involvement, the patient received two intravitreal injections of bevacizumab within 2 months.Results: Significant visual and anatomical recovery was observed 2 months later, which was confirmed by fluorescein angiography. At the end of a follow-up period (39 months) visual acuity and visual field were at normal levels.Conclusion: Retinal MA is a relatively rare condition. Anti-vascular endothelial growth factor therapy appears a safe and effective treatment option for selected symptomatic individuals that may offer faster visual rehabilitation. Herein we report, for the first time, a 39-month follow-up of a retinal MA treated with anti-vascular endothelial growth factor therapy.Keywords: arterial retinal macroaneurysm, anti-VEGF, bevacizumab, multilevel hemorrhage

Tsakpinis D; Nasr MB; Tranos P; Krassas N; Giannopoulos T; Symeonidis C; Dimitrakos SA; Konstas AGP

2011-01-01

312

A novel sling technique for microvascular decompression of a rare anomalous vertebral artery causing cervical radiculopathy.  

Science.gov (United States)

Cervical radiculopathy secondary to compression from congenital anomalous vertebral arteries (VAs) is a known entity. Patients present with a variety of symptoms ranging from upper-extremity numbness to true occipital neuralgia. Treatment options for extracranial tortuous VAs include conservative management or some form of surgical microvascular decompression (MVD). The authors report on a patient with a congenital anomalous VA loop causing cervical nerve root compression. Successful MVD was conducted with relief of the patient's symptoms. A novel sling technique was used for mobilization of the VA. To the authors' knowledge, this is the first MVD described utilizing this technique. PMID:23991815

Tandon, Adesh; Chandela, Sid; Langer, David; Sen, Chandranath

2013-09-01

313

Gelatine and hydroxyl ethyl starch hypervolemic hemodilution – Effect on hemorheology and retinal circulation in a pig model  

Directory of Open Access Journals (Sweden)

Full Text Available The present study was designed to determine the effects of hemodilution with gelatine (GEL) and hydroxyethyl starch (HES) on hematocrit, blood viscosity, systemic hemodynamics, and central retinal arterial blood flow in anaesthetized pigs. 20 pigs were studied. Hypervolemic hemodilution was induced by 30 ml kg-1h-1 GEL (n=10) or HES (n=10) infused over 30 min. The hematocrit decreased comparably in both groups. Plasma viscosity was higher after HES than after GEL. Systolic central retinal blood flow and resistance index increased and were higher after HES than after GEL. Despite a greater plasma viscosity HES increases retinal microcirculation during hypervolemic hemodilution.

M. Grossherr; A. Hager; T. Gerriets; E. G. Kraatz; M. Misfeld; K. F. Klotz

2008-01-01

314

HLA typing and retinitis pigmentosa.  

UK PubMed Central (United Kingdom)

Retinitis pigmentosa is a disease whose pathogenesis remains largely obscure. A lot of evidences support the hypothesis that auto-immunity is involved, but no HLA antigen has ever been associated with retinitis pigmentosa. Ten patients with autosomal recessive retinitis pigmentosa were tissue typed for class I and II HLA antigens. The results of the study show a significant increase in the frequency of the antigens Cw4, Cw6 and DR11. High values of relative risk were found also for some class I antigens, but the size of the group of patients with these loci precluded a meaningful statistical analysis.

Castagna I; Famà F; Pettinato G; Palamara F; Trombetta CJ

1996-01-01

315

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

Directory of Open Access Journals (Sweden)

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)

Tolga Altu? ?en; Ay?egül Bükülmez; Re?it Köken; Hamide Melek; Tevfik Demir; Ramazan Albayrak

2008-01-01

316

Flexible retinal electrode array  

Science.gov (United States)

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.

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

2006-10-24

317

Idiopathic juxtafoveolar retinal telangiectasis.  

UK PubMed Central (United Kingdom)

Twenty-seven healthy adult patients had visual loss in one or both eyes because of exudation from juxtafoveolar retinal capillary telangiectasis of uncertain cause. These patients were subdivided as follows: group 1, men with uniocular involvement, intraretinal lipid exudation, and telangiectasis largely confined to the temporal half of the juxtafoveolar area; group 2, mostly men with symmetric areas of telangiectasis affecting the temporal half of the juxtafoveolar areas and minimal intraretinal exudation; group 3, both sexes with symmetric involvement of all of the parafoveolar capillary bed an minimal exudation; and group 4, one case of telangiectasis with occlusive perifoveolar capillary changes and familial optic disc pallor. The visual acuity prognosis in groups 1 through 3 is relatively good. Photocoagulation may be of some value in the treatment of patients in group 1.

Gass JD; Oyakawa RT

1982-05-01

318

Idiopathic juxtafoveolar retinal telangiectasis.  

Science.gov (United States)

Twenty-seven healthy adult patients had visual loss in one or both eyes because of exudation from juxtafoveolar retinal capillary telangiectasis of uncertain cause. These patients were subdivided as follows: group 1, men with uniocular involvement, intraretinal lipid exudation, and telangiectasis largely confined to the temporal half of the juxtafoveolar area; group 2, mostly men with symmetric areas of telangiectasis affecting the temporal half of the juxtafoveolar areas and minimal intraretinal exudation; group 3, both sexes with symmetric involvement of all of the parafoveolar capillary bed an minimal exudation; and group 4, one case of telangiectasis with occlusive perifoveolar capillary changes and familial optic disc pallor. The visual acuity prognosis in groups 1 through 3 is relatively good. Photocoagulation may be of some value in the treatment of patients in group 1. PMID:7082207

Gass, J D; Oyakawa, R T

1982-05-01

319

[New retinal imaging techniques].  

UK PubMed Central (United Kingdom)

Retinal imaging techniques progress rapidly. In many cases, the diagnosis of macular diseases can be done by the combination of fundus photography (color, monochromatic or autofluorescence images) and optical coherence tomography (OCT). Fluorescein or indocyanine green angiography remains useful when the other exams are not conclusive. Fundus angiography can be coupled with OCT. Other new investigation methods have appeared such as wide-field retinography on the one hand, or adaptive optics on the other hand which allows visualising photoreceptors in a very small field. Screening for diabetic retinopathy is based on color fundus photos. When the diagnostic of diabetic retinopathy is obvious, a more comprehensive fundus examination is warranted to decide on the treatment and follow-up.

Gaudric A

2013-01-01

320

Hybrid retinal image registration.  

Science.gov (United States)

This work studies retinal image registration in the context of the National Institutes of Health (NIH) Early Treatment Diabetic Retinopathy Study (ETDRS) standard. The ETDRS imaging protocol specifies seven fields of each retina and presents three major challenges for the image registration task. First, small overlaps between adjacent fields lead to inadequate landmark points for feature-based methods. Second, the non-uniform contrast/intensity distributions due to imperfect data acquisition will deteriorate the performance of area-based techniques. Third, high-resolution images contain large homogeneous nonvascular/texureless regions that weaken the capabilities of both feature-based and area-based techniques. In this work, we propose a hybrid retinal image registration approach for ETDRS images that effectively combines both area-based and feature-based methods. Four major steps are involved. First, the vascular tree is extracted by using an efficient local entropy-based thresholding technique. Next, zeroth-order translation is estimated by maximizing mutual information based on the binary image pair (area-based). Then image quality assessment regarding the ETDRS field definition is performed based on the translation model. If the image pair is accepted, higher-order transformations will be involved. Specifically, we use two types of features, landmark points and sampling points, for affine/quadratic model estimation. Three empirical conditions are derived experimentally to control the algorithm progress, so that we can achieve the lowest registration error and the highest success rate. Simulation results on 504 pairs of ETDRS images show the effectiveness and robustness of the proposed algorithm. PMID:16445258

Chanwimaluang, Thitiporn; Fan, Guoliang; Fransen, Stephen R

2006-01-01

 
 
 
 
321

Retinal findings in Takayasu's arteritis.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe unusual as well as typical ocular findings in eight patients with Takayasu's disease. METHODS: The ophthalmic manifestations and clinical courses of eight patients with Takayasu's disease were evaluated. RESULTS: All patients had clinical and angiographic evidence of pulseless disease. Typical findings included retinal venous congestion, fluorescein staining, capillary drop-out, microaneurysms and arteriovenous shunting. Unusual findings included cotton wool spots, anterior ischemic neuropathy and retinal emboli. In one case microaneurysms disappeared after carotid bypass surgery. Several patients had profound, transient, visual loss with changes in head posture. CONCLUSION: Takayasu's disease can cause a variety of retinal manifestations. Less common findings include cotton wool spots, anterior ischemic optic neuropathy and retinal emboli.

Karam EZ; Muci-Mendoza R; Hedges TR 3rd

1999-04-01

322

If I Had - Retinitis Pigmentosa  

Medline Plus

Full Text Available ... If I Had... Universities and Hospitals By Disease or Symptom View QuickTime Video Talk About This Elsewhere: ... are known to ultimately result in one form or another of retinitis pigmentosa. What is noticed is ...

323

Semi-automated retinal vessel analysis in nonmydriatic fundus photography.  

UK PubMed Central (United Kingdom)

PURPOSE: Funduscopic assessment of the retinal vessels may be used to assess the health status of microcirculation and as a component in the evaluation of cardiovascular risk factors. Typically, the evaluation is restricted to morphological appreciation without strict quantification. Our purpose was to develop and validate a software tool for semi-automated quantitative analysis of retinal vasculature in nonmydriatic fundus photography. METHODS: matlab software was used to develop a semi-automated image recognition and analysis tool for the determination of the arterial-venous (A/V) ratio in the central vessel equivalent on 45° digital fundus photographs. Validity and reproducibility of the results were ascertained using nonmydriatic photographs of 50 eyes from 25 subjects recorded from a 3DOCT device (Topcon Corp.). Two hundred and thirty-three eyes of 121 healthy subjects were evaluated to define normative values. RESULTS: A software tool was developed using image thresholds for vessel recognition and vessel width calculation in a semi-automated three-step procedure: vessel recognition on the photograph and artery/vein designation, width measurement and calculation of central retinal vessel equivalents. Mean vessel recognition rate was 78%, vessel class designation rate 75% and reproducibility between 0.78 and 0.91. Mean A/V ratio was 0.84. Application on a healthy norm cohort showed high congruence with prior published manual methods. Processing time per image was one minute. CONCLUSIONS: Quantitative geometrical assessment of the retinal vasculature may be performed in a semi-automated manner using dedicated software tools. Yielding reproducible numerical data within a short time leap, this may contribute additional value to mere morphological estimates in the clinical evaluation of fundus photographs.

Schuster AK; Fischer JE; Vossmerbaeumer U

2013-07-01

324

Cytomegalovirus retinitis mimicking intraocular lymphoma  

Directory of Open Access Journals (Sweden)

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

Patrick Gooi; James Farmer; Bernard Hurley; Elliott Brodbaker

2008-01-01

325

Focal posterior pole viral retinitis.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the clinical features of an atypical form of viral retinitis in immunocompetent patients. METHODS: This was a retrospective noncomparative case series. The charts of 8 patients diagnosed with and treated for focal posterior viral retinitis were reviewed. Clinical and demographic features were evaluated. All the patients had extensive laboratory tests, fundus fluorescein angiography, optical coherence tomography of macula, and polymerase chain reaction of vitreous. RESULTS: All the patients were referred to our Uveitis Service from other hospitals, as their uveitis symptoms deteriorated in spite of treatment. The mean age of 4 male and 4 female patients was 32.1 years (range, 22-42 years). The mean follow-up period was 10 months (range, 6-18 months). All of the patients had unilateral disease. Polymerase chain reaction analysis of vitreous specimen was positive for herpes simplex virus-1 in 5 patients and varicella zoster virus in 3 patients. Retinitis resolved after systemic acyclovir treatment in all patients. CONCLUSIONS: Viral etiology must be borne in mind in the differential diagnosis of atypical retinitis. It can be a milder form of viral retinitis like focal viral retinitis, as mentioned in this study. The prognosis of this disease is better than the other forms of necrotizing retinopathies involving a larger area of retina.

Hazirolan D; Sungur G; Demir N; Kasim R; Duman S

2010-09-01

326

Is quality of diet associated with the microvasculature? An analysis of diet quality and retinal vascular calibre in older adults.  

UK PubMed Central (United Kingdom)

It is unknown whether diet quality is associated with microvascular structure. The present study aimed to investigate the relationship between diet quality, reflecting adherence to dietary guidelines, with retinal microvascular calibre in older adults. The dietary data of 2720 Blue Mountains Eye Study participants, aged 50+ years, were collected using a semi-quantitative FFQ. A modified version of the Healthy Eating Index for Australians was developed to determine total diet scores (TDS). Fundus photographs were taken and retinal vascular calibre measured using computer-assisted techniques and summarised. After adjusting for age, sex, BMI, mean arterial blood pressure, smoking, serum glucose, leucocyte count and history of diagnosed stroke or CHD, persons with higher TDS had healthier retinal vessels cross-sectionally, with wider retinal arteriolar calibre (by approximately 3 ?m, comparing the highest with the lowest quartile of TDS, Ptrend = 0·0001) and narrower retinal venular calibre (by approximately 2·5 ?m; Ptrend = 0·02). In younger subjects aged ?65 years, increasing TDS (lowest to the highest quartile) was associated with healthier retinal vessels: approximately 4·4 ?m wider retinal arteriolar (Ptrend < 0·0001) and approximately 2·3 ?m narrower venular calibre (Ptrend = 0·03). After multivariable adjustment, however, baseline TDS were not associated with retinal arteriolar (Ptrend = 0·89) or venular calibre (Ptrend = 0·25), 5 years later. Also, baseline TDS were not associated with the 5-year change in retinal arteriolar (? = 0·14; P=0·29) or venular calibre (? = - 0·26; P=0·07). Greater compliance with published dietary guidelines (higher diet quality) was cross-sectionally associated with wider retinal arterioles and narrower venules, indicating better retinal microvascular health.

Gopinath B; Flood VM; Wang JJ; Rochtchina E; Wong TY; Mitchell P

2013-08-01

327

Retinal hemorrhage as a unique ophthalmic manifestation of cerebral hyper perfusion syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Cerebral hyperperfusion syndrome (CHPS) is a rare, complication of carotid artery revascularization. Acute retinal hemorrhage is a very rare entity previously described as a manifestation of CHPS following carotid artery stenting (CAS), but to the best of our knowledge, not yet described as a complication of carotid surgery. An Ascending Aorta to bilateral Carotid bypass was performed in a 35-year-old woman with active Takayasu arteritis and 95% symptomatic stenosis of both common carotid arteries. Severe retinal hemorrhage appeared on the second post operative day combined with high blood pressure, brain edema on CT scan and grand mal seizures. It seems that fundoscopic examination following carotid revascularization of tight can be helpful in identifying those patients who develop symptoms suggesting of CHPS.

Eitan Heldenberg; Arie Bass

2013-01-01

328

Retinal hemorrhage as a unique ophthalmic manifestation of cerebral hyper perfusion syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Cerebral hyperperfusion syndrome (CHPS) is a rare disease with complications of carotid artery revascularization. Acute retinal hemorrhage is a very rare entity that has been previously described as a manifestation of CHPS followed by the carotid artery stenting (CAS), but to the best of our knowledge, not yet described as a complication of carotid surgery. An Ascending Aorta to bilateral Carotid bypass was performed in a 35 years old woman with active Takayasu arteritis and 95% symptomatic stenosis of both common carotid arteries. Severe retinal hemorrhage appeared on the second post operative day combined with high blood pressure, brain edema on CT scan and grand mal seizures. It seems that fundoscopic examination followed by the carotid revascularization of tightness can be helpful in identifying those patients who develop symptoms suggesting of CHPS.

Eitan Heldenberg; Arie Bass

2013-01-01

329

The ovarian and uterine arteries in the chinchilla (Chinchilla lanigera).  

UK PubMed Central (United Kingdom)

The purpose of this study was to describe arteries supplying the ovaries and uterus in the chinchilla. Five healthy adult female chinchillas were used. In order to reveal the arterial network by dissecting under a stereoscopic microscope, latex coloured with red ink was injected through the common carotid artery. The ovaries of the chinchilla are supplied by the arteriae ovaricae which formed end-to-end anastomoses with the cranial termination of the arteria uterina. Soon after leaving the aorta abdominalis, the arteriae ovaricae extended 2-3 mm caudolaterally, then released 1 branch and extended caudally and bifurcated into 2 further branches. One of these supplied branches to fat tissue. The other branch coursed caudally and anastomosed with the arteria circumflexa ilium profunda and dispersed into fat tissue. The arteria ovarica further subdivided into 2 rami ovaricae. The origins of the uterine arteries were exclusively from the left arteria iliaca externa. The arteria uterina gave a branch to the arteria umbilicalis and consecutive branches which supplied to the ureter, urinary bladder and cranial aspects of the vagina. It also gave rise to 2-3 branches to the cervix and further supplied 10-12 meandering branches to the uterine horns. The arteria uterina gave rise to many tortuous arteries to the uterus and provided 2 further branches to the ovary.

Cevik-Demirkan A; Ozdemir V; Demirkan I

2010-03-01

330

The ovarian and uterine arteries in the chinchilla (Chinchilla lanigera)  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this study was to describe arteries supplying the ovaries and uterus in the chinchilla. Five healthy adult female chinchillas were used. In order to reveal the arterial network by dissecting under a stereoscopic microscope, latex coloured with red ink was injected through the common carotid artery. The ovaries of the chinchilla are supplied by the arteriae ovaricae which formed end-to-end anastomoses with the cranial termination of the arteria uterina. Soon after leaving the aorta abdominalis, the arteriae ovaricae extended 2-3mm caudolaterally, then released 1 branch and extended caudally and bifurcated into 2 further branches. One of these supplied branches to fat tissue. The other branch coursed caudally and anastomosed with the arteria circumflexa ilium profunda and dispersed into fat tissue. The arteria ovarica further subdivided into 2 rami ovaricae. The origins of the uterine arteries were exclusively from the left arteria iliaca externa. The arteria uterina gave a branch to the arteria umbilicalis and consecutive branches which supplied to the ureter, urinary bladder and cranial aspects of the vagina. It also gave rise to 2-3 branches to the cervix and further supplied 10-12 meandering branches to the uterine horns. The arteria uterina gave rise to many tortuous arteries to the uterus and provided 2 further branches to the ovary.

A. Cevik-Demirkana; V. Ozdemira; I. Demirkan

2012-01-01

331

The ovarian and uterine arteries in the chinchilla (Chinchilla lanigera)  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english The purpose of this study was to describe arteries supplying the ovaries and uterus in the chinchilla. Five healthy adult female chinchillas were used. In order to reveal the arterial network by dissecting under a stereoscopic microscope, latex coloured with red ink was injected through the common carotid artery. The ovaries of the chinchilla are supplied by the arteriae ovaricae which formed end-to-end anastomoses with the cranial termination of the arteria uterina. Soon (more) after leaving the aorta abdominalis, the arteriae ovaricae extended 2-3 mm caudolaterally, then released 1 branch and extended caudally and bifurcated into 2 further branches. One of these supplied branches to fat tissue. The other branch coursed caudally and anastomosed with the arteria circumflexa ilium profunda and dispersed into fat tissue. The arteria ovarica further subdivided into 2 rami ovaricae. The origins of the uterine arteries were exclusively from the left arteria iliaca externa. The arteria uterina gave a branch to the arteria umbilicalis and consecutive branches which supplied to the ureter, urinary bladder and cranial aspects of the vagina. It also gave rise to 2-3 branches to the cervix and further supplied 10-12 meandering branches to the uterine horns. The arteria uterina gave rise to many tortuous arteries to the uterus and provided 2 further branches to the ovary.

Çevik-Demirkan, A; Özdemir, V; Demirkan, I

2010-01-01

332

Twelve-hour reproducibility of retinal and optic nerve blood flow parameters in healthy individuals.  

UK PubMed Central (United Kingdom)

PURPOSE: The aim of the present study was to investigate the reproducibility and potential diurnal variation of optic nerve head and retinal blood flow parameters in healthy individuals over a period of 12 hr. METHODS: We measured optic nerve head and retinal blood flow parameters in 16 healthy male non-smoking individuals at five time-points during the day (08:00, 11:00, 14:00, 17:00 and 20:00 hr). Outcome parameters were perimacular white blood cell flux (as assessed with the blue field entoptic technique), blood velocities in retinal veins (as assessed with bi-directional laser Doppler velocimetry), retinal arterial and venous diameters (as assessed with the retinal vessel analyser), optic nerve head blood flow, volume and velocity (as assessed with single point and scanning laser Doppler flowmetry) and blood velocities in the central retinal artery (as assessed with colour Doppler imaging). The coefficient of variation and the maximum change from baseline in an individual were calculated for each outcome parameter. RESULTS: No diurnal variation in optic nerve head or retinal blood flow was observed with any of the techniques employed. Coefficients of variation were between 1.6% and 18.5% for all outcome parameters. The maximum change from baseline in an individual was much higher, ranging from 3.7% to 78.2%. CONCLUSION: Our data indicate that in healthy individuals the selected techniques provide adequate reproducibility to be used in clinical studies. However, in patients with eye diseases and reduced vision the reproducibility may be considerably worse.

Luksch A; Lasta M; Polak K; Fuchsjäger-Mayrl G; Polska E; Garhöfer G; Schmetterer L

2009-11-01

333

Retinal blood flow in healthy young subjects.  

UK PubMed Central (United Kingdom)

PURPOSE: To characterize total retinal blood flow in a group of healthy subjects. METHODS: Included in this study were 64 healthy volunteers. Retinal venous diameters were measured using a dynamic vessel analyzer. Retinal blood velocities were measured using bidirectional laser Doppler velocimetry. All vessels with a diameter of >60 ?m entering the optic nerve head were measured. Total retinal blood flow was measured by summing up all data from the individually measured vessels. In a subgroup of 10 healthy subjects measurements were also taken from the arterioles, and results obtained for total retinal blood flow as measured both from retinal venules and from retinal arterioles were compared. RESULTS: Total retinal blood flow was 44.0 ± 13.3 ?L/min. Retinal blood flow was highest in the temporal inferior quadrant, followed by the temporal superior quadrant, the nasal inferior quadrant, and the nasal superior quadrant (P < 0.001 each). In all quadrants retinal blood velocities were linearly correlated to vessel diameters. Retinal blood flow as measured in retinal venules (42.1 ± 13.0 ?L/min) and in retinal arterioles (43.3 ± 12.1 ?L/min) was similar (P = 0.16). CONCLUSIONS: The present study provides reference values for total retinal blood flow in 64 healthy subjects. The interindividual variability in retinal blood flow is high, making it unlikely that individual diagnostics can be based on measurements of retinal blood flow. Total retinal blood flow, however, may be important in risk stratification, which needs to be proven in future studies.

Garhofer G; Werkmeister R; Dragostinoff N; Schmetterer L

2012-02-01

334

Isolated retinal cotton wool spot after coronary angiography  

Science.gov (United States)

Visual symptoms after coronary angiography are rarely encountered and mostly related to contrast induced transient cortical blindness or retinal artery occlusions. We report an intriguing case of a 50-year-old woman, who presented with vision deterioration in her right eye 12 h after coronary angiography for cardiac palpitation. Fundoscopy and optical coherence tomography scan revealed an isolated parafoveal cotton wool spot in her right eye that has totally resolved 6 weeks after initial presentation. This is the first case report of this rare post coronary angiography complication.

Kopsachilis, Nikolaos; Brar, Manpreet; Marinescu, Anca I. C.; Sivaprasad, Sobha

2013-01-01

335

Isolated retinal cotton wool spot after coronary angiography.  

UK PubMed Central (United Kingdom)

Visual symptoms after coronary angiography are rarely encountered and mostly related to contrast induced transient cortical blindness or retinal artery occlusions. We report an intriguing case of a 50-year-old woman, who presented with vision deterioration in her right eye 12 h after coronary angiography for cardiac palpitation. Fundoscopy and optical coherence tomography scan revealed an isolated parafoveal cotton wool spot in her right eye that has totally resolved 6 weeks after initial presentation. This is the first case report of this rare post coronary angiography complication.

Kopsachilis N; Brar M; Marinescu AI; Sivaprasad S

2013-01-01

336

A study on the normal variation of anterior cerebral artery in Korean  

International Nuclear Information System (INIS)

Normal anatomic variation of anterior cerebral artery are analyzed in 100 normal carotid arteriogram (male;73, female;27) which were done at Department of Radiology, Seoul National University Hospital during period of August 1965 to June 1971. With lateral view of arteriogram, the anterior cerebral artery is divided to 4 parts. Part I of the anterior cerebral artery begins at its derivation from internal carotid artery and ends before the vessel enclose the genu of corpus callosum. Part II surrounds the genu of the corpus callosum. Part III begins after the curve of part III is completed, and continues to the first sign of tortuousity in the pericallosal artery. Part IV extends to the most distal part of that vessel. The configuration of each part and origin of branches are analyzed as follows; Part I shows superior and posterior convexity in 82%, semivertical straight course in 9%, and straight horizontal course in 8%. Part II shows gentle curve in 51%, acute angulation in 14%, wide curve in 19%, and squre pig nose form in 16%. Par III forms a round and smooth course with its convexity upward in 77%, smooth curve with convexity downward in 16%, and horizontal straigh course in 7%. Part IV is biphasic or triphasic in about equal incidence. The branches of anterior cerebral artery arise from the variable sites. The frontopolar artery arises from the part I of anterior cerebral artery in 47%, from the part II in 11%, and from callosomarginal artery in 22%. The callosomarginal artery arise from the part I in 15%, from the part II in 83%, and part III in 2%. The paracentral lobule is supplied by only one vessel, callosomarginal artery, in 51%; and by two arteries, paracentral branch of pericallosal artery and callosomarginal artery, in 46%.

1972-01-01

337

[Retinal implants. Patients' expectations  

UK PubMed Central (United Kingdom)

The "Pro Retina" Society and the "Retina Implant" Foundation, two patients associations with the goal of "preventing blindness," view the "Retina Implant" project as a possibility for providing blind individuals a modicum of restored vision. Both patients associations cultivated a cooperative relationship with researchers and policy makers already during the research phase, introducing the wishes and concerns of patients into considerations and providing information and the groundwork for acceptance in society and among those who may potentially benefit from the method. An initial survey of patients, the visually impaired, and blind people revealed that recovery of sight not only represents a medical and technical problem but that it also involves numerous psychosocial implications. By adhering to ethical standards in implantations, in particular by taking patient autonomy into consideration, anxieties and fears can be reduced. It would appear from early positive results in a short-term clinical study that soon successful chronic retinal implantation can be expected. The dedication displayed by physicians, researchers, and the industry as well as the willingness of the Federal Ministry for Research to take the risk are appreciated and greatfully accepted by the patients and their relatives.

Gusseck H

2005-10-01

338

[Retinal implants. Patients' expectations].  

Science.gov (United States)

The "Pro Retina" Society and the "Retina Implant" Foundation, two patients associations with the goal of "preventing blindness," view the "Retina Implant" project as a possibility for providing blind individuals a modicum of restored vision. Both patients associations cultivated a cooperative relationship with researchers and policy makers already during the research phase, introducing the wishes and concerns of patients into considerations and providing information and the groundwork for acceptance in society and among those who may potentially benefit from the method. An initial survey of patients, the visually impaired, and blind people revealed that recovery of sight not only represents a medical and technical problem but that it also involves numerous psychosocial implications. By adhering to ethical standards in implantations, in particular by taking patient autonomy into consideration, anxieties and fears can be reduced. It would appear from early positive results in a short-term clinical study that soon successful chronic retinal implantation can be expected. The dedication displayed by physicians, researchers, and the industry as well as the willingness of the Federal Ministry for Research to take the risk are appreciated and greatfully accepted by the patients and their relatives. PMID:16132993

Gusseck, H

2005-10-01

339

Retinal pigment epithelial fine structure in the bobtail goanna (Tiliqua rugosa).  

UK PubMed Central (United Kingdom)

The retinal pigment epithelium (RPE), the choriocapillaris and Bruch's membrane (complexus basalis) have been studied by light and electron microscopy in the bobtail goanna (Tiliqua rugosa) an Australian diurnal lizard. The RPE consists of a single layer of cuboidal cells which display very deep and tortuous basal (choroidal) infoldings as well as numerous apical (vitreal) processes which interdigitate with the photoreceptor cells. The lateral cell borders are relatively smooth and joined by basally located tight junctions. Internally smooth endoplasmic reticulum is abundant while rough endoplasmic reticulum is not. The RPE cell nucleus is large and vesicular and basally located in the light-adapted state. Polysomes, mitochondria and myeloid bodies are present and widely distributed. Melanosomes are plentiful in the apical region of the epithelial cells in light-adaptation. Bruch's membrane is pentalaminate with the basal lamina of the choriocapillaris being exceptionally thick. The choriocapillaris is a single layer of large-caliber capillaries with thin but only moderately fenestrated endothelium. Numerous dense granules are always present within these endothelial cells.

Braekevelt CR

1989-07-01

340

Retinal pigment epithelial fine structure in the bobtail goanna (Tiliqua rugosa).  

Science.gov (United States)

The retinal pigment epithelium (RPE), the choriocapillaris and Bruch's membrane (complexus basalis) have been studied by light and electron microscopy in the bobtail goanna (Tiliqua rugosa) an Australian diurnal lizard. The RPE consists of a single layer of cuboidal cells which display very deep and tortuous basal (choroidal) infoldings as well as numerous apical (vitreal) processes which interdigitate with the photoreceptor cells. The lateral cell borders are relatively smooth and joined by basally located tight junctions. Internally smooth endoplasmic reticulum is abundant while rough endoplasmic reticulum is not. The RPE cell nucleus is large and vesicular and basally located in the light-adapted state. Polysomes, mitochondria and myeloid bodies are present and widely distributed. Melanosomes are plentiful in the apical region of the epithelial cells in light-adaptation. Bruch's membrane is pentalaminate with the basal lamina of the choriocapillaris being exceptionally thick. The choriocapillaris is a single layer of large-caliber capillaries with thin but only moderately fenestrated endothelium. Numerous dense granules are always present within these endothelial cells. PMID:2520465

Braekevelt, C R

1989-07-01

 
 
 
 
341

Alternative splicing and retinal degeneration.  

UK PubMed Central (United Kingdom)

Alternative splicing is highly regulated in tissue-specific and development-specific patterns, and it has been estimated that 15% of disease-causing point mutations affect pre-mRNA splicing. In this review, we consider the cis-acting splice site and trans-acting splicing factor mutations that affect pre-mRNA splicing and contribute to retinal degeneration. Numerous splice site mutations have been identified in retinitis pigmentosa (RP) and various cone-rod dystrophies. Mutations in alternatively spliced retina-specific exons of the widely expressed RPGR and COL2A1 genes lead primarily to X-linked RP and ocular variants of Stickler syndrome, respectively. Furthermore, mutations in general pre-mRNA splicing factors, such as PRPF31, PRPF8, and PRPF3, predominantly cause autosomal dominant RP. These findings suggest an important role for pre-mRNA splicing in retinal homeostasis and the pathogenesis of retinal degenerative diseases. The development of novel therapeutic strategies to modulate aberrant splicing, including small molecule-based therapies, has the potential to lead to new treatments for retinal degenerative diseases.

Liu MM; Zack DJ

2013-08-01

342

Rhegmatogenous retinal detachment treatment guidelines.  

UK PubMed Central (United Kingdom)

This paper outlines general guidelines following the initial diagnosis of rhegmatogenous retinal detachment. These include preoperative evaluation, treatment, possible intra- and post-operative complications, retinal re-detachment, and all therapeutic options available for each case. Treatment of the traumatic retinal detachment is also described, due to its importance and peculiarities. Treatment or prophylactic guidelines are suggested for the different types of retinal detachment described. These are based on both the experience of the ophthalmologists that have participated in preparing the guidelines, and also on evidence-based grading linked to bibliographical sources. However, these guidelines should not be interpreted as being mandatory. Given that there is a wide spectrum of options for treatment of retinal detachment, the surgeons' experience with one or other surgical technique will be of utmost importance in obtaining the best surgical result. As guidelines, they are intended as an additional aid to the surgeon during the decision-making process, with the expectation that the final choice will still be left to the surgeon's judgment and past experience.

García-Arumí J; Martínez-Castillo V; Boixadera A; Blasco H; Marticorena J; Zapata MÁ; Macià C; Badal J; Distéfano L; Rafart JM; Berrocal M; Zambrano A; Ruíz-Moreno JM; Figueroa MS

2013-01-01

343

Automated retinal robotic laser system.  

UK PubMed Central (United Kingdom)

Researchers at the University of Texas and the USAF Academy have worked toward the development of a retinal robotic laser system. The overall goal of this ongoing project is to precisely place and control the depth of laser lesions for the treatment of various retinal diseases such as diabetic retinopathy and retinal tears. Separate low speed prototype subsystems have been developed to control lesion depth using lesion reflectance feedback parameters and lesion placement using retinal vessels as tracking landmarks. Both subsystems have been successfully demonstrated in vivo on pigmented rabbits using an argon continuous wave laser. Recent efforts have concentrated on combining the two subsystems into a single prototype capable of simultaneously controlling both lesion depth and placement. We have designated this combined system CALOSOS for Computer Aided Laser Optics System for Ophthalmic Surgery. Following the dual-use concept, this system is being adapted for clinical use as a retinal treatment system as well as a research tool for military laser-tissue interaction studies.

Barrett SF; Wright CH; Jerath MR; Lewis RS 2nd; Dillard BC; Rylander HG 3rd; Welch AJ

1995-01-01

344

[Review of researches on retinal model].  

UK PubMed Central (United Kingdom)

Retinal model is an essential part in the retinal prosthesis. Based on the retinal physiology and the experimental data, the model is able to simulate the information processing in the retina, and can be used to investigate the relation between the input image and the neuron firing. We can categorize the models into circuit realization and algorithm realization. This article is a state-of-art review of different types of retinal models.

Nin X; Tong S; Zhu Y; Qiu Y

2008-08-01

345

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

UK PubMed Central (United Kingdom)

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 consisted of normal individuals and groups B-D consisted of type 2 diabetic patients matched for diabetes duration, age, and gender, and characterized by: Group B no retinopathy, Group C mild retinopathy, Group D maculopathy not requiring laser treatment. The diameter changes of a large retinal arteriole 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 isometric exercise in normal persons (diameter response: -0.70+/-0.48%) and in patients with no retinopathy (-1.15+/-0.44%), but dilated in patients with mild retinopathy (0.41+/-0.49%) and diabetic maculopathy (0.54+/-0.44%), p=0.01. Retinal thickness was normal in Group A (260+/-5.0 microm), Group B (257+/-4.5 microm), and Group C (253+/-4.4 microm), but was significantly (p=0.006) increased in Group D (279+/-5.3 microm). CONCLUSIONS: The diameter response was reduced in type 2 diabetic patients with retinopathy, whereas retinal thickness was increased in patients with diabetic maculopathy. This suggests that impairment of diameter response in retinal arterioles precedes the development of diabetic macular edema.

Frederiksen CA; Jeppesen P; Knudsen ST; Poulsen PL; Mogensen CE; Bek T

2006-10-01

346

Bilateral carotid and vertebral rete mirabile presenting with subarachnoid hemorrhage caused by the rupture of spinal artery aneurysm.  

UK PubMed Central (United Kingdom)

Rete mirabile (or carotid rete) is a normal structure that plays physiological roles in the lower mammals. However, the rete does not exist in the normal carotid circulation of humans. Carotid rete mirabile (CRM) is a rare condition compensating for congenital dysplastic internal carotid artery. Arterial plexus at the cavernous region, which supplies intradural internal carotid artery instead of the aplastic cavernous portion of internal carotid artery, looks like the "rete mirabile" seen in the lower mammals, and is a characteristic angiographical finding of CRM. In addition to the CRM, existence of segmental occlusion and tortuous collaterals of vertebral artery, so-called carotid and vertebral rete mirabile (CVRM), is a very rare condition. We report a 70-year-old female patient with bilateral CVRM presenting with subarachnoid hemorrhage (SAH) caused by the rupture of a cervical spinal artery aneurysm. Our patient is the oldest, compared with the previously reported four patients with CVRM. Moreover, this is the first report of ruptured spinal artery aneurysm as a cause of SAH associated with CRM/CVRM. To avoid rebleeding in the patient, we successfully treated the patients by performing coil embolization of the remaining spinal aneurysms. In patients with CVRM, aneurysm formation of the cervical spinal artery may be a reasonable consequence because of the hemodynamic stress on the spinal artery as a collateral pathway. Detailed evaluation of the cervical spinal arteries should be performed to detect or to rule out ruptured aneurysm in patients with SAH associated with CVRM.

Nagahata M; Kondo R; Mouri W; Sato A; Ito M; Sato S; Itagaki H; Yamaki T; Nagahata S; Saito S; Kayama T

2013-01-01

347

Delayed appearance of high altitude retinal hemorrhages  

Digital Repository Infrastructure Vision for European Research (DRIVER)

When closely examined, a very large amount of climbers exhibit retinal hemorrhages during exposure to high altitudes. The incidence of retinal hemorrhages may be greater than previously appreciated as a definite time lag was observed between highest altitude reached and development of retinal bleedi...

Barthelmes, D; Bosch, M M; Merz, T M; Petrig, B L; Truffer, F; Bloch, K E; Holmes, T A; Cattin, P; Hefti, U; Sellner, M

348

Dolicho-right coronary artery emptying in coronary sinus: a rare, 'snake-like', giant coronary fistula.  

UK PubMed Central (United Kingdom)

A 41-year-old asymptomatic Italian male underwent cardiologic screening before blood donation. A transthoracic echocardiogram showed a huge right coronary artery (RCA) aneurysm continuing into a very twisted, worm-like channel, apparently draining into the right atrium (RA), suggesting the diagnosis of RCA-RA coronary fistula. Multidetector computed tomography showed a mild dilatation of the proximal RCA that gave rise to a giant 'snake-like' aneurysm (6.6?×?7?cm) followed by a long, tortuous and circumvolved channel spreading all over the right atrium and right ventricular free wall and finally draining into the coronary sinus.

Rossi G; D'Alto M; Santoro G; Muto R; Piro O; Pisacane C; Calabrò R; Russo MG

2013-07-01

349

Diameters of retinal blood vessels in a healthy cohort as measured by spectral domain optical coherence tomography.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe a method for measuring the diameters of large retinal blood vessels by means of spectral domain optical coherence tomography. METHODS: Prospective cohort study of 29 healthy subjects (58 eyes) who underwent a spectral domain optical coherence tomography examination. Two cubes of horizontal scans were placed at the superior and inferior borders of the disk to include the large temporal retinal vessels. Vessels diameters were measured, and an artery-to-vein ratio was calculated at 10 measurement points (480-1440 ?m superiorly and inferiorly from the optic disk border). RESULTS: The mean age of the study subjects was 41.45 ± 15.53 years. Patients had no ocular or systemic pathologies. The mean diameter of the retinal artery was 135.73 ± 15.64 ?m and of the vein 151.32 ± 15.22 ?m at the measurement point of 480 ?m, with a gradual decrease to 123.01 ± 13.43 ?m and 137.69 ± 13.84 ?m, respectively, at 1440 ?m. The artery-to-vein ratio was ?0.9 at all points of measurement. CONCLUSION: This is a new noninvasive method for retinal blood vessels diameter measurement using the spectral domain optical coherence tomography imaging modality. This method may aid in evaluation of retinal and systemic vascular diseases.

Goldenberg D; Shahar J; Loewenstein A; Goldstein M

2013-10-01

350

Exploring the retinal connectome.  

UK PubMed Central (United Kingdom)

PURPOSE: A connectome is a comprehensive description of synaptic connectivity for a neural domain. Our goal was to produce a connectome data set for the inner plexiform layer of the mammalian retina. This paper describes our first retinal connectome, validates the method, and provides key initial findings. METHODS: We acquired and assembled a 16.5 terabyte connectome data set RC1 for the rabbit retina at ? 2 nm resolution using automated transmission electron microscope imaging, automated mosaicking, and automated volume registration. RC1 represents a column of tissue 0.25 mm in diameter, spanning the inner nuclear, inner plexiform, and ganglion cell layers. To enhance ultrastructural tracing, we included molecular markers for 4-aminobutyrate (GABA), glutamate, glycine, taurine, glutamine, and the in vivo activity marker, 1-amino-4-guanidobutane. This enabled us to distinguish GABAergic and glycinergic amacrine cells; to identify ON bipolar cells coupled to glycinergic cells; and to discriminate different kinds of bipolar, amacrine, and ganglion cells based on their molecular signatures and activity. The data set was explored and annotated with Viking, our multiuser navigation tool. Annotations were exported to additional applications to render cells, visualize network graphs, and query the database. RESULTS: Exploration of RC1 showed that the 2 nm resolution readily recapitulated well known connections and revealed several new features of retinal organization: (1) The well known AII amacrine cell pathway displayed more complexity than previously reported, with no less than 17 distinct signaling modes, including ribbon synapse inputs from OFF bipolar cells, wide-field ON cone bipolar cells and rod bipolar cells, and extensive input from cone-pathway amacrine cells. (2) The axons of most cone bipolar cells formed a distinct signal integration compartment, with ON cone bipolar cell axonal synapses targeting diverse cell types. Both ON and OFF bipolar cells receive axonal veto synapses. (3) Chains of conventional synapses were very common, with intercalated glycinergic-GABAergic chains and very long chains associated with starburst amacrine cells. Glycinergic amacrine cells clearly play a major role in ON-OFF crossover inhibition. (4) Molecular and excitation mapping clearly segregates ultrastructurally defined bipolar cell groups into different response clusters. (5) Finally, low-resolution electron or optical imaging cannot reliably map synaptic connections by process geometry, as adjacency without synaptic contact is abundant in the retina. Only direct visualization of synapses and gap junctions suffices. CONCLUSIONS: Connectome assembly and analysis using conventional transmission electron microscopy is now practical for network discovery. Our surveys of volume RC1 demonstrate that previously studied systems such as the AII amacrine cell network involve more network motifs than previously known. The AII network, primarily considered a scotopic pathway, clearly derives ribbon synapse input from photopic ON and OFF cone bipolar cell networks and extensive photopic GABAergic amacrine cell inputs. Further, bipolar cells show extensive inputs and outputs along their axons, similar to multistratified nonmammalian bipolar cells. Physiologic evidence of significant ON-OFF channel crossover is strongly supported by our anatomic data, showing alternating glycine-to-GABA paths. Long chains of amacrine cell networks likely arise from homocellular GABAergic synapses between starburst amacrine cells. Deeper analysis of RC1 offers the opportunity for more complete descriptions of specific networks.

Anderson JR; Jones BW; Watt CB; Shaw MV; Yang JH; Demill D; Lauritzen JS; Lin Y; Rapp KD; Mastronarde D; Koshevoy P; Grimm B; Tasdizen T; Whitaker R; Marc RE

2011-01-01

351

Retinal vasculitis with multifocal retinochoroiditis.  

UK PubMed Central (United Kingdom)

We found a multifocal retinochoroiditis in 16 patients (13 female, 3 male). Patients also showed vitreous cells, in some cases pronounced retinal vasculitis, cystoid macular edema and papilledema. The patients ranged in age from 62 to 77 years. The anterior segment was involved in 13 cases. One patient demonstrated subretinal neovascularisation in both eyes. Fluorescein angiograms showed leakage from the retinal vessels, papilledema, macular edema and subretinal neovascularisation. A convincing classification of the described changes within any known disease entity was impossible. The findings most closely resembled a disease described by Dreyer and Gass in 1984 as 'multifocal choroiditis and panuveitis'.

Schenck F; Böke W

1990-10-01

352

Retinal vasculature enhancement using independent component analysis  

Directory of Open Access Journals (Sweden)

Full Text Available Retinal vasculature is a network of vessels in the retinal layer. In ophthalmology, information of retinal vasculature in analyzing fundus images is important for early detection of diseases related to the retina, e.g. diabetic retinopathy. However, in fundus images the contrast between retinal vasculature and the background is very low. As a result, analyzing or visualizing tiny retinal vasculature is difficult. There-fore, enhancement of retinal vasculature in digital fundus image is important to provide better visualization of retinal blood vessels as well as to increase accuracy of retinal vasculature segmentation. Fluorescein angiogram overcomes this imaging problem but it is an invasive procedure that leads to other physiological problems. In this research work, the low contrast problem of retinal fundus images ob-tained from fundus camera is addressed. We develop a fundus image model based on probability distribution function of melanin, haemoglobin and macular pigment to represent melanin, retinal vasculature and macular region, respectively. We determine retinal pigments makeup, namely macular pigment, melanin and haemoglobin using independent component analysis. Independent component image due to haemoglobin obtained is used since it exhibits higher contrast retinal vasculature. Contrast of reti-nal vasculature from independent component image due to haemoglobin is compared to those from other enhancement methods. Results show that this approach outperforms other non-invasive enhancement methods, such as contrast stretching, histogram equalization and CLAHE and can be beneficial for retinal vasculature segmentation. Contrast enhancement factor up to 2.62 for a digital retinal fundus image model is achieved. This improvement in contrast reduces the need of applying contrasting agent on patients.

Ahmad Fadzil M. Hani; Hanung Adi Nugroho

2009-01-01

353

Arterial ageing.  

Science.gov (United States)

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 modifiable causes of the arterial ageing process. Also, novel treatment targets derived from the disease models such as the Hutchinson Gilford Progeria Syndrome were reviewed. PMID:23508642

Lee, Seung-Jun; Park, Sung-Ha

2013-02-28

354

Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage  

Energy Technology Data Exchange (ETDEWEB)

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.

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

2004-01-01

355

Uterine artery embolization: an effective treatment for intractable obstetric haemorrhage  

International Nuclear Information System (INIS)

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 ?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.

2004-01-01

356

Stem Cells Therapy for Retinal Degeneration  

Directory of Open Access Journals (Sweden)

Full Text Available Stem cell therapy is widely considered as a therapeutic approach for retinal degeneration. Retinal injury results in permanent visual disturbance or blindness. Repair of such damage by stem cells is one of the most feasible types of central nervous system repair. In this review, we consider how stem cells might be optimized for use as donor cells. We discuss the benefits of stem cells for transplantation in retinal degenerative disease. A wide range of stem cells from different sources is being investigated for the treatment of retinal degeneration. This study reviews the recent and old achievements about stem cells for retinal repair.

M. Safari

2010-01-01

357

Visual loss with inner retinal dysfunction, after snake bite: two case reports.  

UK PubMed Central (United Kingdom)

PURPOSE: To report two cases of visual loss following snake bite. METHOD: Retrospective review of medical records including history, examination finding, fundus details and investigation reports (visual field, electroretinogram, visual evoked potential and optical coherence tomogram) at two centers. RESULT: Two cases of snake bite presented to us with reduction of vision at 1 and 3 months after the incident. The subnormal b wave and abnormal pattern electroretinography in one case pointed at inner retinal dysfunction and neurotoxicity as the cause of visual loss in an apparently normal-looking fundus. The electronegative b wave in the other gave us a clue that the optic atrophy was consecutive (secondary to inner retinal dysfunction due to central retinal artery occlusion). CONCLUSION: When presented late, diagnosis of visual loss secondary to snake bite becomes difficult and puzzling due to the absence of classical findings. Electrophysiological tests in such cases give us important clue to reach at a definite diagnosis.

Jalali S; Padhi TR; Bansal R; Sahoo K; Basu S; Mathai A

2013-05-01

358

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

International Nuclear Information System (INIS)

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.

2008-01-01

359

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

Energy Technology Data Exchange (ETDEWEB)

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.

Wang, Chaohua; Yan, Qing; Xie, Xiaodong; Li, Jiangtao; Zhou, Dong [West China Hospital, Sichuan University, Chengdu (China)

2008-04-15

360

Dorzolamide increases retinal oxygen tension after branch retinal vein occlusion  

DEFF Research Database (Denmark)

PURPOSE: 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. METHODS: Experimental BRVO was induced by diathermy close to the optic disc. RPO(2) was measured with an oxygen-sensitive electrode 0.5 mm above the BRVO-affected area, which was compared to the retinal areas not affected by BRVO. In one group of five pigs, RPO(2) was measured at baseline, 1 and 3 hours after BRVO, and after intravenous injection of 500 mg dorzolamide. In a second group of five pigs, RPO(2) was measured 1 week after the BRVO, both before and after intravenous injection of 500 mg dorzolamide. RESULTS: The average baseline RPO(2) was 2.64 +/- 0.09 kPa (mean +/- SD). In the BRVO-affected areas, RPO(2) decreased significantly (by 0.67 +/- 0.29 and 0.94 +/- 0.13 kPa) at 1 hour and 3 hours after BRVO induction. In the non-BRVO areas RPO(2) increased significantly (by 0.51 +/- 0.14 kPa) 1 hour after BRVO induction, but subsequently decreased and reached baseline 3 hours after BRVO induction. One week after BRVO induction, RPO(2) was 0.67 +/- 0.29 kPa lower in affected areas when compared with the non-BRVO areas. In the BRVO-affected areas, dorzolamide increased RPO(2) significantly (by 0.36 +/- 0.21 kPa at 3 to 4 hours and by 0.67 +/- 0.40 kPa) 1 week after BRVO induction. CONCLUSIONS: Retinal hypoxia induced by experimental BRVO remained significant 1 week after BRVO. Dorzolamide increased retinal oxygen tension in the BRVO-affected areas both at 4 hours and 1 week after experimental BRVO in pigs Udgivelsesdato: 2008/3

Noergaard, Michael Hove; Bach-Holm, Daniella

2008-01-01

 
 
 
 
361

Risk factor profile in retinal detachment  

Directory of Open Access Journals (Sweden)

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.

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

1988-01-01

362

Acute arterial occlusion - kidney  

Science.gov (United States)

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

363

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

International Nuclear Information System (INIS)

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.)

2008-01-01

364

Doppler flow parameters in orbital arteries in gestational diabetes mellitus patients.  

UK PubMed Central (United Kingdom)

Abstract Objective: To evaluate the blood flow in orbital arteries in patients with gestational diabetes mellitus (GDM). Material: We have examined 65 GDM patients and 38 healthy pregnant women at 28-32 wks. Doppler parameters were assessed in ophthalmic, central retinal and short posterior ciliary arteries. Results: In ophthalmic arteries V2 was significantly higher and RI lower in GDM. In the subgroup treated with insulin V1 and V2 in ciliary artery and V2 in central retinal artery were significantly lower and PI in ciliary artery was higher when compared to subgroup on diet. Conclusion: Doppler examination can be useful in detection of pre-clinical ophthalmological changes in GDM patients.

Moneta-Wielgos J; Golebiewska J; Brydak-Godowska J; Ciszewska J; Bomba-Opon D; Wegrzyn P; Kecik D

2013-10-01

365

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

International Nuclear Information System (INIS)

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)

2008-01-01

366

The effect of pars plan vitrectomy on oxygen saturation in retinal vessels - a pilot study.  

UK PubMed Central (United Kingdom)

Purpose:? To determine the effect of pars plana vitrectomy (PPV) on oxygen saturation in retinal vessels. Methods:? We performed a prospective consecutive interventional case series of 20 eyes of 20 patients with macular hole or epiretinal membrane. We performed automatic retinal oximetry (Oxymap Inc., Reykjavik, Iceland) in each patient 24?hr prior to and 45?days (range 42-49) after PPV (classic 20G or sutureless 23G). We analysed oxygen saturations in retinal arteries and veins. Vessel segments of first or second degree were selected. The same segment was analysed before and after PPV. Oximetry data were compared by paired two-tailed t-test. Results:? Pars plana vitrectomy did not alter arterial haemoglobin saturation with oxygen (98?±?2% prior to the surgery and 98?±?3% after the procedure, p?=?0.549). The mean venous haemoglobin saturation with oxygen increased after vitrectomy from 63?±?10% to 66?±?8% (p?=?0.012). Conclusions:? Oxygen saturation is higher in retinal veins after pars plana vitrectomy. Further studies are needed to unveil the mechanism of how vitrectomy affects oxygen metabolism in the retina.

Sín M; Sínová I; Chrapek O; Pracha?ová Z; Karhanová M; Langová K; Rehák J

2013-07-01

367

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

DEFF Research Database (Denmark)

PURPOSE: To examine variations in retinal vessel diameters during acclimatization of native highlanders to normobaric normoxia at sea level. METHODS: Fifteen healthy residents of the greater La Paz region in Bolivia (3600 m above sea level) were examined thrice over a 72-day period, after having 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 diameters were indistinguishable from baseline after 72 days. No funduscopic signs of retinopathy were observed. Arterial blood pressure remained stable throughout the study. CONCLUSIONS: Although a 16% reduction in hematocrit occurred between days 2 and 72 after arrival at sea level, the only significant excursion observed was that the diameter of the veins was larger at day 23 than at days 2 and 72. Retinal vessel diameters demonstrated a wide homeostatic range during acclimatization-driven hematocrit variation.

Kofoed, Peter Kristian; Sander, Birgit

2009-01-01

368

Central Retinal Artery Occlusion Following Peribulbar Anesthesia for Pterygium Excision  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Pterygium is a common ocular surface pathology in tropical environments. In the early stages, it may be managed medically with topical anti-inflammatory agents and ocular lubricants. However as the disease progresses, surgical excision becomes necessary and several anaesthetic methods may be used to...

Gyasi, M E; Kodjo, R A; Amoaku, W M

369

Arterial embolism.  

Science.gov (United States)

Surgical and intensive care patients are at a heightened risk for arterial embolization due to pre-existing conditions such as age, hypercoagulability, cardiac abnormalities and atherosclerotic disease. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds where they cause arterial occlusion, ischemia, and potentially infarction. Other emboli form on the surface of eroded arterial plaque or within its lipid core. Thromboemboli are large clots that dislodge from the surface of athesclerotic lesions and occlude distal arteries causing immediate ischemia. Atheroemboli, which originate from fracturing the lipid core tend to cause a process of organ dysfunction and systemic inflammation, termed cholesterol embolization syndrome. The presentation of arterial emboli depends on the arterial bed that is affected. The most common manifestations are strokes and acute lower limb ischemia. Less frequently, emboli target the upper extremities, mesenteric or renal arteries. Treatment involves rapid diagnosis, which may be aided by precise imaging studies and restoration of blood flow. The type of emboli, duration of presentation, and organ system affected determines the treatment course. Long-term therapy includes supportive medical care, identification of the source of embolism and prevention of additional emboli. Patients who experienced arterial embolism as a result of clots formed in the heart should be anticoagulated. Arterial emboli from atherosclerotic disease of the aorta or other large arteries should prompt treatment to reduce the risk for atherosclerotic progression, such as anti-platelet therapy and the use of statin drugs. The use of anticoagulation and surgical intervention to reduce the risk of arterial embolization from atherosclerotic lesions is still being studied. PMID:23724391

Lyaker, Michael R; Tulman, David B; Dimitrova, Galina T; Pin, Richard H; Papadimos, Thomas J

2013-01-01

370

Arterial embolism.  

UK PubMed Central (United Kingdom)

Surgical and intensive care patients are at a heightened risk for arterial embolization due to pre-existing conditions such as age, hypercoagulability, cardiac abnormalities and atherosclerotic disease. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds where they cause arterial occlusion, ischemia, and potentially infarction. Other emboli form on the surface of eroded arterial plaque or within its lipid core. Thromboemboli are large clots that dislodge from the surface of athesclerotic lesions and occlude distal arteries causing immediate ischemia. Atheroemboli, which originate from fracturing the lipid core tend to cause a process of organ dysfunction and systemic inflammation, termed cholesterol embolization syndrome. The presentation of arterial emboli depends on the arterial bed that is affected. The most common manifestations are strokes and acute lower limb ischemia. Less frequently, emboli target the upper extremities, mesenteric or renal arteries. Treatment involves rapid diagnosis, which may be aided by precise imaging studies and restoration of blood flow. The type of emboli, duration of presentation, and organ system affected determines the treatment course. Long-term therapy includes supportive medical care, identification of the source of embolism and prevention of additional emboli. Patients who experienced arterial embolism as a result of clots formed in the heart should be anticoagulated. Arterial emboli from atherosclerotic disease of the aorta or other large arteries should prompt treatment to reduce the risk for atherosclerotic progression, such as anti-platelet therapy and the use of statin drugs. The use of anticoagulation and surgical intervention to reduce the risk of arterial embolization from atherosclerotic lesions is still being studied.

Lyaker MR; Tulman DB; Dimitrova GT; Pin RH; Papadimos TJ

2013-01-01

371

C1-C2 instability with severe occipital headache in the setting of vertebral artery facet complex erosion.  

UK PubMed Central (United Kingdom)

PURPOSE: An exact understanding of patient vertebral artery anatomy is essential to safely place screws at the atlanto-axial level in posterior arthrodesis. We aim to report a case of erosion of the left vertebral artery into the C1-C2 facet complex with resultant rotatory and lateral listhesis presenting with severe occipital headache. This represents a novel etiology for this diagnosis and our report illustrates technical considerations when instrumenting the C1-C2 segment. METHODS: We report a case of severe occipital headache due to C1-C2 instability with resultant left C2 nerve compression in the setting of erosion of the vertebral artery into the C1-C2 facet complex. RESULTS: A 68-year-old woman presented with a 12-month history of progressively debilitating headache and neck pain with atlanto-axial instability. Computed tomography (CT) angiography demonstrated erosion of the left vertebral artery into the left C1-C2 facet complex. In addition, the tortuous vertebral arteries had eroded into the C2 pedicles, eliminating the possibility for posterior pedicle screw placement. The patient underwent posterior arthrodesis of C1-C2 utilizing bilateral lateral mass fixation into C1 and bilateral trans-laminar fixation into C2 with resolution of all preoperative complaints. CONCLUSIONS: This study constitutes the first report of a tortuous vertebral artery causing the partial destruction of a C1-C2 facet complex, as well as instability, with the clinical presentation of severe occipital headache. It hereby presents a novel etiology for both the development of C1-C2 segment instability as well as the development of occipital headache. Careful evaluation of such lesions utilizing CT angiography is important when formulating a surgical plan.

Taher F; Bokums K; Aichmair A; Hughes AP

2013-04-01

372

C1-C2 instability with severe occipital headache in the setting of vertebral artery facet complex erosion.  

Science.gov (United States)

PURPOSE: An exact understanding of patient vertebral artery anatomy is essential to safely place screws at the atlanto-axial level in posterior arthrodesis. We aim to report a case of erosion of the left vertebral artery into the C1-C2 facet complex with resultant rotatory and lateral listhesis presenting with severe occipital headache. This represents a novel etiology for this diagnosis and our report illustrates technical considerations when instrumenting the C1-C2 segment. METHODS: We report a case of severe occipital headache due to C1-C2 instability with resultant left C2 nerve compression in the setting of erosion of the vertebral artery into the C1-C2 facet complex. RESULTS: A 68-year-old woman presented with a 12-month history of progressively debilitating headache and neck pain with atlanto-axial instability. Computed tomography (CT) angiography demonstrated erosion of the left vertebral artery into the left C1-C2 facet complex. In addition, the tortuous vertebral arteries had eroded into the C2 pedicles, eliminating the possibility for posterior pedicle screw placement. The patient underwent posterior arthrodesis of C1-C2 utilizing bilateral lateral mass fixation into C1 and bilateral trans-laminar fixation into C2 with resolution of all preoperative complaints. CONCLUSIONS: This study constitutes the first report of a tortuous vertebral artery causing the partial destruction of a C1-C2 facet complex, as well as instability, with the clinical presentation of severe occipital headache. It hereby presents a novel etiology for both the development of C1-C2 segment instability as well as the development of occipital headache. Careful evaluation of such lesions utilizing CT angiography is important when formulating a surgical plan. PMID:23616203

Taher, Fadi; Bokums, Kristaps; Aichmair, Alexander; Hughes, Alexander P

2013-04-25

373

High-resolution optical coherence tomography retinal imaging: a case series illustrating potential and limitations.  

Science.gov (United States)

Purpose. To present a series of retinal disease cases that were imaged by spectral domain optical coherence tomography (SD-OCT) in order to illustrate the potential and limitations of this new imaging modality. Methods. The series comprised four selected cases (one case each) of age-related macular degeneration (ARMD), diabetic retinopathy (DR), central retinal artery occlusion (CRAO), and branch retinal vein occlusion (BRVO). Patients were imaged using the Heidelberg Spectralis (Heidelberg Engineering, Germany) in SD-OCT mode. Patients also underwent digital fundus photography and clinical assessment. Results. SD-OCT imaging of a case of age-related macular degeneration revealed a subfoveal choroidal neovascular membrane with detachment of the retinal pigment epithelium (RPE) and neurosensory retina. Using SD-OCT, the cases of DR and BRVO both exhibited macular edema with cystoid spaces visible in the outer retina. Conclusions. The ability of SD-OCT to clearly and objectively elucidate subtle morphological changes within the retinal layers provides information that can be used to formulate diagnoses with greater confidence. PMID:21969910

Puzyeyeva, Olena; Lam, Wai Ching; Flanagan, John G; Brent, Michael H; Devenyi, Robert G; Mandelcorn, Mark S; Wong, Tien; Hudson, Christopher

2011-09-29

374

High-resolution optical coherence tomography retinal imaging: a case series illustrating potential and limitations.  

UK PubMed Central (United Kingdom)

Purpose. To present a series of retinal disease cases that were imaged by spectral domain optical coherence tomography (SD-OCT) in order to illustrate the potential and limitations of this new imaging modality. Methods. The series comprised four selected cases (one case each) of age-related macular degeneration (ARMD), diabetic retinopathy (DR), central retinal artery occlusion (CRAO), and branch retinal vein occlusion (BRVO). Patients were imaged using the Heidelberg Spectralis (Heidelberg Engineering, Germany) in SD-OCT mode. Patients also underwent digital fundus photography and clinical assessment. Results. SD-OCT imaging of a case of age-related macular degeneration revealed a subfoveal choroidal neovascular membrane with detachment of the retinal pigment epithelium (RPE) and neurosensory retina. Using SD-OCT, the cases of DR and BRVO both exhibited macular edema with cystoid spaces visible in the outer retina. Conclusions. The ability of SD-OCT to clearly and objectively elucidate subtle morphological changes within the retinal layers provides information that can be used to formulate diagnoses with greater confidence.

Puzyeyeva O; Lam WC; Flanagan JG; Brent MH; Devenyi RG; Mandelcorn MS; Wong T; Hudson C

2011-01-01

375

Vision loss after maxillary artery embolization secondary to compressive optic neuropathy.  

UK PubMed Central (United Kingdom)

The authors report a case of no light perception (NLP) vision in a patient with sinonasal melanoma after maxillary artery embolization secondary to presumptive compressive optic neuropathy. Two reports of NLP vision occurring after maxillary artery embolization are reported in the literature,, both occurring secondary to collateral blood flow to the ophthalmic artery resulting in central retinal artery occlusion. In the current case report, the presumed mechanism of vision loss is secondary to compressive optic neuropathy from local edema occurring after maxillary artery embolization.

Finnerty KN; Mancini R

2013-07-01

376

Retinal blood flow in nonischemic central retinal vein occlusion.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The authors studied the changes in retinal blood flow (RBF) and oxygen reactivity in a major temporal vein in patients with central retinal vein occlusion (CRVO). PARTICIPANTS: Eleven patients with nonischemic CRVO approximately 7 weeks from onset of disease. INTERVENTION: Laser Doppler velocimetric measurement of RBF and vessel reactivity to inhaling 60% oxygen. Measurements were performed at baseline and 3 months. RESULTS: Flow velocity in the affected eye had increased significantly by 3 months, from 1.6 +/- 0.4 cm/second to 2.0 +/- 0.4 cm/second (P = 0.02). Retinal blood flow, however, remained unchanged (13.7 +/- 5.8 microl/minute versus 15.0 +/- 6.5 microl/minute). The two comparable RBF values, despite differing velocity values, suggest that the relatively normal baseline value was achieved through higher intravascular pressure at baseline (Bernoulli's principle). This is supported by the fact that oxygen reactivity had improved from 2.1% +/- 3.6% at baseline to 3.8% +/- 3.1% (P = 0.001) at 3 months, which suggests an improved ability to respond to hyperoxia from reduced intravascular pressure. CONCLUSION: Intravascular pressure in CRVO appears to continue to decrease during the first 5 months after the onset of CRVO, indicating continuing reduction in the degree of outflow obstruction during this time.

Chen HC; Gupta A; Wiek J; Kohner EM

1998-05-01

377

Phenotypic and genetic correlation of blood pressure and body mass index with retinal vascular caliber in children and adolescents: the Guangzhou twin eye study.  

UK PubMed Central (United Kingdom)

PURPOSE: To examine the phenotypic and genetic associations of blood pressure and body mass index (BMI) with retinal vascular caliber. METHODS: A total of 657 monozygotic and 378 dizygotic twin pairs aged 7 to 19 years were recruited from the Guangzhou Twin Registry. All twins underwent digital retinal photography and measurement of retinal vascular caliber. The genetic correlations between the traits were estimated by applying a multivariate Cholesky model. RESULTS: In traditional regression analyses, participants with a higher mean arterial pressure (MAP) and a higher BMI were significantly more likely to have narrower retinal arterioles, whereas participants with a higher BMI level were more likely to have a wider retinal venule (all P < 0.001). In multivariate Cholesky models, only 1% to 2% of the phenotypic variation in retinal arteriole was shared with those in MAP and BMI, although the majority of these phenotypic variations were explained by shared genetic components. The phenotypic variation in retinal venule was not shared with those in MAP and BMI. CONCLUSIONS: Retinal vascular caliber is significantly but weakly associated with MAP and BMI in children and young adolescents. These phenotypic correlations are mainly attributable to genetic components.

Zheng Y; Huang W; Zhang J; He M

2013-01-01

378

Retinal Image Preprocessing: Background and Noise Segmentation  

Directory of Open Access Journals (Sweden)

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.

Usman Akram

2012-01-01

379

Current perspectives of herpesviral retinitis and choroiditis.  

Science.gov (United States)

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

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

2004-10-01

380

The progressive outer retinal necrosis syndrome.  

UK PubMed Central (United Kingdom)

The progressive outer retinal necrosis (PORN) syndrome is a recently described clinical variant of necrotizing herpetic retinopathy in patients with the acquired immunodeficiency syndrome (AIDS). It is caused by varicellazoster virus infection of the retina. Its course and clinical features distinguish it from the acute retinal necrosis syndrome and CMV retinopathy. Early disease is characterized by multifocal deep retinal opacification. Lesions rapidly coalesce and progress to total retinal necrosis over a short period of time. Despite aggressive therapy with intravenous antivirial drugs, prognosis is poor; disease progression and/or recurrence is common, and the majority of patients develop no light perception vision. Total retinal detachments are common. Prophylaxis against retinal detachment using laser retinopexy has not been useful in most cases. PORN syndrome is an uncommon, but devastating complication of AIDS.

Holland GN

1994-01-01

 
 
 
 
381

Current perspectives of herpesviral retinitis and choroiditis.  

UK PubMed Central (United Kingdom)

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.

Madhavan HN; Priya K; Biswas J

2004-10-01

382

[Agenesis of the internal carotid artery--report of a case combined with arachnoid cyst in a child  

UK PubMed Central (United Kingdom)

A case of agenesis of the internal carotid artery combined with arachnoid cyst is reported. This 11-year-old boy had occasionally complained headache and nausea since he was of 9 years old. He was admitted to our hospital because of an epileptic seizure. Physical and neurological examinations on admission were normal. A CT scan showed a cystic mass in retrocerebellar region. MRI suggested absence of flow void area indicating internal carotid artery in the cavernous sinus on left side. Left common carotid angiogram showed absence of the internal carotid artery. Bilateral A2 segments were supplied by right A1 with tortuous anterior communicating artery. Left middle cerebral artery and left ophthalmic artery were supplied via dilated left posterior communicating artery on left vertebral angiogram. Thin slice, axial target image of the CT revealed absence of the left bony carotid canal. MRI by 3D TOF method confirmed no blood flow in this area. MR angiography provided sufficient information about cervical vessels non-invasively. 123I-IMP SPECT image ascertained no hypoperfusion area in left cerebral hemisphere. Convulsion was controlled with sodium valproate. Association of agenesis of the internal carotid artery and arachnoid cyst could be a coincidence.

Kidooka M; Okada T; Handa J

1992-04-01

383

Reversible carotid artery narrowing in morning glory disc anomaly.  

Science.gov (United States)

A 14-year-old boy with morning glory disc anomaly (MGDA) and normal visual and neurologic function displayed marked carotid artery narrowing on magnetic resonance angiography (MRA). This narrowing disappeared on a follow-up MRA six months later. Optic coherence tomography and scanning laser polarimetry disclosed a normal retinal nerve fiber layer in the eye with MGDA. MGDA has been reported in association with irreversible carotid artery stenosis leading to moya moya disease. This case suggests that mild cases of MGDA may be associated with reversible carotid artery narrowing owing to vasospasm. PMID:16148627

Murphy, Marjorie A; Perlman, Elliot M; Rogg, Jeffrey M; Easton, J Donald; Easton, Donald J; Schuman, Joel S

2005-09-01

384

Ultrasound and computerized tomography in the evaluation of arterial aneurysms  

International Nuclear Information System (INIS)

A clinical diagnosis of aneurysm may be made on the basis of the physical examination, particularly for the abdominal aorta and the femoral and popliteal arteries. However, sometimes these physical findings can be unreliable, since aortic aneurysms can be missed in obese patients and since overlying retroperitoneal and other visceral masses may simulate aneurysms in the abdomen, especially in thin patients with easily transmitted aortic pulsations. Moreover, a tortuous aorta or iliac arteries may mimic an aneurysm. Thus to avoid surgery, it is critical to obtain independent and objective confirmation of the diagnosis. In addition, more detailed information concerning the size and configuration of abdominal aneurysms increases the data base from which a decision for surgery may be made, particularly in poor-risk patients with small, asymptomatic aneurysms. Conventional contrast, digital subtraction, and isotope angiograms have been advocated for the diagnosis and characterization of abdominal aortic aneurysms. However, all angiographic studies define only the inner lumen of the aneurysm and may provide grossly inaccurate data regarding the overall aneurysmal size. Further, conventional contrast angiography is invasive and expensive and has a small but definite complication rate. Therefore, angiography should bot be performed as a primary diagnostic procedure for most aneurysms, but rather as a preoperative investigation, when indicated, after surgery has definitely been decided upon. The purpose of the angiogram is to further delineate the anatomy of paraaneurysmal structures, with particular emphasis on renal artery and visceral vessel lesions, the presence of iliac aneurysms, and the distribution of iliofemoral occlusive disease

1987-01-01

385

[Retinal vasculitis with multifocal chorioretinitis  

UK PubMed Central (United Kingdom)

Multifocal retinochoroiditis was diagnosed in 16 patients (13 female, 3 male). The patients also had cells in the vitreous, and in some cases pronounced retinal vasculitis, cystoid macular edema and papilledema. The patients' ages ranged from 62 to 77 years. There was anterior segment involvement in 13 cases. One patient had subretinal neovascularization in both eyes. Fluorescein angiograms revealed leaks from the retinal vessels, papilledema, and macular edema. So far, the authors have not succeeded in classifying the changes described as belonging to a known disease entity. The findings most closely resembled a disease described by Dreyer and Gass in 1984 as "multifocal choroiditis and panuveitis". Similar changes were seen by Tiedemann in 1987, in patients with Epstein-Barr viral antibodies.

Schenck F; Böke W

1990-11-01

386

Retinal complications after damaging the vitreolenticular barrier.  

UK PubMed Central (United Kingdom)

This article gives an overview of the vitreal anatomy and its changes in ageing, which have a significant impact on the two main retinal complications after damage of the vitreolenticular barrier, namely retinal detachment and cystoid macular edema. The possible reasons and pathomechanisms for this entity of retinal diseases in the context of anterior segment interaction are highlighted, and a summary of references is provided showing the epidemiology and consequences of such interventions.

Framme C; Wolf S

2012-01-01

387

Retinal complications after damaging the vitreolenticular barrier.  

Science.gov (United States)

This article gives an overview of the vitreal anatomy and its changes in ageing, which have a significant impact on the two main retinal complications after damage of the vitreolenticular barrier, namely retinal detachment and cystoid macular edema. The possible reasons and pathomechanisms for this entity of retinal diseases in the context of anterior segment interaction are highlighted, and a summary of references is provided showing the epidemiology and consequences of such interventions. PMID:21952101

Framme, Carsten; Wolf, Sebastian

2011-09-22

388

Prothrombin time in retinitis pigmentosa  

Directory of Open Access Journals (Sweden)

Full Text Available The prothrombin time was recorded for 87 primary retinitis pigmentosa (RP) patients belonging to three different clinical categories. All categories showed prothrombin time higher than normal. There was no correlation between the age of onset and the prothrombin time, nor between duration of disease and