Intravitreal bevacizumab to facilitate vitrectomy in idiopathic ischaemic retinal vasculitis

To describe the use of intravitreal bevacizumab in idiopathic retinal vasculitis prior to vitrectomy and delamination. A young healthy male presented with idiopathic retinal vasculitis. His condition was refractory to panretinal photocoagulation and systemic steroids. The progression of his condition necessitated vitrectomy and delamination. Intravitreal bevacizumab was used to facilitate the surgical procedure, with effective results. Intravitreal bevacizumab can be an adjunct to vitrectomy in idiopathic retinal vasculitis. However, caution must be taken due to its ability to promote fibrosis and to produce further tractional and/or rhegmatogenous retinal detachment. Further controlled studies are required to understand its benefits in managing complicated idiopathic retinal vasculitis.     

Unusual presentation of ocular tuberculosis: multiple chorioretinitis,retinal vasculitis and ischaemic central retinal vein occlusion

A 54‐year‐old male patient presented with a sudden painless visual loss in his left eye. Ophthalmic examinations revealed panuveitis, ischaemic central retinal vein occlusion, multiple chorioretinitis and retinal vasculitis. The diagnosis of tuberculosis was confirmed with anterior tap analysis and QuantiFERON‐TB test. Anti‐tuberculosis treatment and intravitreal anti‐vasculature endothelial growth factor therapy were performed.     

Neovascular glaucoma as a complication of retinal vasculitis in Crohn disease

PURPOSE: To report a case of neovascular glaucoma as a complication of retinal vasculitis in Crohn disease. METHODS: Case report with fluorescein angiogram. RESULTS: A 62-year-old man with biopsy-proven Crohn disease presented with bilateral uveitis, bilateral iris new vessels, and neovascular glaucoma in the left eye. Fluorescein angiography revealed signs of retinal vasculitis and capillary nonperfusion in both eyes. CONCLUSION: Crohn disease may be associated with retinal vasculitis and, thus, neovascular glaucoma. A satisfactory result can be achieved by using corticosteroids to control the retinal vascular inflammation, by applying panretinal photocoagulation and by controlling the increased intraocular pressure surgically.     

Recurrent bilateral retinal vasculitis as a manifestation of post-streptococcal uveitis syndrome

We report a case of post-streptococcal uveitis mainly presenting with bilateral recurrent retinal vasculitis in Korea. A 14-year-old Asian female presented with decreased visual acuity of 20 / 30 in the right eye and 20 / 25 in the left eye. The patient had a history of glomerulonephritis nine months before onset of uveitis. The manifestation of uveitis was predominantly retinal vasculitis. We presumed post-streptococcal uveitis because probable streptococcal infection was confirmed by anti-streptolysin O titer elevation. With topical and oral steroid treatments, the patient experienced complete vision recovery. Post-streptococcal uveitis occurs rarely and mostly involves young patients in the form of non-granulomatous anterior uveitis. However, as this case shows, it may primarily involve the posterior uvea without anterior inflammation and may recur.     

Airbag hit as a cause of retinal detachment--case report

PURPOSE: The aim of this paper is presentation of a patient with retinal detachment due to airbag hit in a car accident. MATERIAL AND METHODS: 50 years old woman with posttraumatic retinal detachment underwent cerclage and pars plana vitrectomy and silicone oil injection. Phacoemulsification and intraocular lens implantation followed. RESULTS: Final visual acuity of 0.5 was achieved. No postoperative complications were observed. CONCLUSIONS: Despite the complicated preoperative situation, good anatomic and functional results could be achieved. Airbag may be also cause of severe ocular trauma.     

Primary retinal vasculitis

CASE REPORT: We present the case of a 22-year-old Caucasian female who consulted because of a brief episode of blurred vision in her right eye. Funduscopic findings in right eye included marked venous tortuousness and roundish paramacular haemorrhages. A slight venous tortuousness in left eye. Fluorescein angiography showed a segmentary retinal vasculitis affecting medium calibre vessels of the posterior pole. Complementary examinations ruled out any systemic involvement. After therapy with oral corticoesteroids the case evolves to remission. DISCUSSION: The diagnosis of retinal vasculitis is achieved by the performance of ophthalmoscopy and fluorescein angiography. Prior studies have ruled out the need for complementary examinations to find any systemic involvement in patients.     

视网膜血管炎的临床分析

目的探讨视网膜血管炎的患病因素及治疗效果。方法回顾性分析视网膜血管炎患者14例（16只眼）的临床表现、检查、诊治和随访结果。结果所有患者眼后段均有不同程度的炎性改变,经过药物治疗、激光和手术治疗后,最终视力提高共10只眼（62．5％）。结论本病眼底表现复杂,以血管白鞘、视网膜出血和黄斑水肿最为多见,病因尚不明确,诊断以临床表现为主,早期、足量的抗病毒、皮质类固醇激素的应用,以及预防性视网膜光凝、必要联合玻璃体手术是控制病变的关键。     

视网膜血管炎的研究进展

视网膜血管炎主要累及青壮年视网膜静脉,动脉累及较少,致盲率较高.积极防治此病意义重大.其发生可能与感染、免疫机制、氧化反应、全身性疾病等有关,通过荧光素眼底血管造影、超声、实验室检查可提高诊断正确率.针对不同的病程,采用药物、激光、玻璃体视网膜手术等治疗措施可改善视功能.就此病的定义、病因、分类、基础研究、诊断及治疗等方面的最新进展进行综述.     

Interferon and retinal vasculitis

The treatment of noninfectious posterior uveitis can lead to severe vision loss, and the first-line conventional treatment includes systemic steroids. When the prednisone doses necessary to control intraocular inflammation are above 0.3mg/day, a therapeutic association is proposed in order to lower the daily prednisone dose. The combined drugs are immunosuppressive or immunomodulative. The side effects of immunosuppressive drugs are oncogenic, infectious, and hematological, and can involve reproductive troubles, associated with specific toxic effects depending on the drug used. Recently adding polyclonal or monoclonal antibodies and the interferons to immunomodulative drugs has been suggested. Interferon alpha has been shown to be effective in Beh?et's disease. The efficacy of interferon needs to be evaluated in other etiologies of retinal vasculitis through randomized studies.     

Potent retinal arteriolar traction as a possible cause of myopic foveoschisis

PURPOSE: To report retinal microfold formation after vitrectomy for myopic foveoschisis (MF). DESIGN: Prospective observational study. METHODS: We observed 21 eyes of 17 patients who had undergone vitrectomy for MF with optical coherence tomography (OCT) in this institutional study. We also evaluated the three-dimensional retinal architecture using the OCT-ophthalmoscope in selected cases. Vitrectomy included core vitrectomy, vitreous cortex removal, internal limiting membrane (ILM) peeling with indocyanine green, and gas tamponade. RESULTS: Horizontal linear folds were commonly observed postoperatively. The folds, which were 1,000 to 2,000 microm superior, inferior, or both superior and inferior to the fovea, were detected only by OCT and not by conventional slit-lamp-based biomicroscopy. The microfolds were found in only five eyes (24%) 1 month postoperatively. The incidence increased over time, however, and a microfold was detected in nine eyes (43%) 3 months after surgery and in 13 (62%) 6 months after surgery. OCT-ophthalmoscope examination confirmed the location of the microfold coincided exactly with that of retinal arteriole. The presence of microfolds was not significantly related to the postoperative visual acuity. CONCLUSIONS: Retinal microfolds are common in eyes with MF after vitrectomy with ILM peeling, and they seem to be generated as the result of insufficient flexibility of the sclerotic retinal arteriole during axial length elongation in highly myopic eyes. This finding suggests that the inward tractional force on the retina along the arteriole may be closely related to the pathogenesis of vitreoretinal diseases specific to high myopia, including MF or paravascular microhole formation.     

Proliferative vitreoretinopathy as a cause of early recurrence of retinal detachment]

Analysed were the results of surgical treatment, causes of the failure and early recurrence in 108 patients with retinal detachment in whom was performed an indentation of the sclera by means of a balloon (1st group--50) or by an episcleral implant (2d group--58). In the first group the apposition was achieved in 92 p.c., in the 2d group in 90 p.c. An early recurrence (2 weeks to 2 months) was observed in 9 eyes which were operated again achieving an apposition of the retina in 6 eyes. There were following causes of the failure: the existence of a second hole, rupture of the balloon, PVR before surgery and traction of the retina in the region of the hole. An early recurrence occurred in the consequence of intensification of the PVR together with inaccurate localization of the implant, existence of the PVR before the operation and traction of the retina in the vicinity of the hole, formation of a new hole.