Serous detachment of the retina a complication of branch retinal vein stenosis

The author reports a case of serous detachment of the retina, which has developed in an eye with veno-venous collaterals, secondary to stenosis of a branch of the central retinal vein near the optic disc. This complication has not previously been described in this retinal vascular obstructive disease. The author has stated that he does not have a significant financial interest or other relationship with any product manufacture or provider of services discussed in this article. The author also does not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Clinical implications in perimetry after photorefractive keratectomy

Through refractive surgery, it is now possible to correct various ametropias using new techniques such as photorefractive keratectomy (PRK). We hypothesized that patients submitting to PRK show higher peripheral thresholds attributable to poorer retinal quality than normal patients. However, no difference were found when comparing glaucoma with PRK patients. Thus, early glaucoma following PRK may be masked by the previous surgery. The author has stated that he does not have a significant financial interest or other relationship with any product manufacture or provider of services discussed in this article. The author also does not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Unusual Ocular Complications of the HELLP Syndrome: Persistent Macular Elevation and Localized Tractional Retinal Detachment

We report a case of HELLP syndrome with bilateral decreased vision at 25 weeks’ gestation. Fundus examination revealed serous retinal detachment involving the macula. Systemic steroid and oral dorzolamide therapy was initiated and visual acuity improved. At 2 months, peripheral localized tractional retinal detachment was present in the left eye and argon laser photocoagulation was performed. Macular elevation did not resolve; therefore, in the right eye intravitreal triamcinolone acetonide injection was performed. Drs. Taskapili, Kocabora, and Gulkilik are from the Eye Clinic, Vakıf Gureba Training and Research Hospital, Istanbul, Turkey. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Retinal vein occlusion. II. Clinical picture and photocoagulation therapy]

The author analyze in detail the clinical findings in occlusion of a branch or trunk of the retinal vein. Occlusion of a branch of the retinal vein has on the whole a favourable prognosis and the resulting vision is in about 60% 6/12 better. This depends in particular on three factors: site of occlusion, calibre of the occluded vein and grade of venous obstruction. In the remaining 40% of patients with occlusion of a branch the resulting vision is 6/18 or poorer and in half of the latter patients it is poorer than 6/60. The most frequent cause of unsatisfactory resulting vision in occlusion of a branch of the retinal vein are chronic macular oedema and neovascularization. In occlusion of the trunk of the retinal vein there is the danger that the residual vision will be lost in conjunction with the possible development of a neovascular glaucoma. The possibilities of a favourable therapeutic effect by using an argon laser are much greater in occlusion of a branch than in occlusion of the trunk of the retinal vein, where the author concentrates attention on prevention of a neovascular glaucoma.     

Horizontal and vertical micropsia following macula-off rhegmatogenous retinal-detachment surgical repair

Background Dysmetropsia or distorted image size perception (smaller: micropsia; larger: macropsia) is known to occur after successful surgical re-attachment for macula-off rhegmatogenous retinal detachment. However, the vertical and horizontal components of size distortion have not been previously quantified separately. The purpose of this article is to describe horizontal and vertical dysmetropsia occurring in patients following pars plana vitrectomy and gas treatment (octafluoropropane, C₃F₈ or sulfur hexafluoride, SF₆) for macula-off rhegmatogenous retinal detachment. Material and methods Four patients (mean±SD, 59±8 years; three women and one man) who had had pars plana vitrectomy and gas treatment for macula-off rhegmatogenous retinal detachment 6–7 months earlier underwent ocular examination, best corrected visual acuity test, threshold horizontal and vertical dysmetropsia measurement using a computerised version of the New Aniseikonia Test, slit-lamp examination and optical coherence tomography of the macula. Results All patients had binocular visual complaints including difficulty judging distances or reading, rivalry or asthenopia. The logMAR visual acuity (mean±SD) in the operated eye was 0.52±0.199 and 0.02±0.171 in the unaffected eye. All patients perceived the image as smaller (micropsia) with the affected eye, with differences ranging from −9 to 0%. Four patients showed 3% or more size difference between horizontal and vertical meridians. Conclusions Dysmetropsia does occur in symptomatic patients following successful surgical repair of macula-off rhegmatogenous retinal detachment by pars plana vitrectomy and gas treatment. The effect on image size is heterogenous across the retinal area affected. Presented at the annual meeting of the Association for Resarch into vision and ophthalmology (ARVO), Fort Lauderdale, Florida, 2005. The authors have no propietary interests.     

A horizontal stripe of displacement sensitivity in the human visual field

Displacement thresholds of peripheral sites in monocular human vision were obtained. The average of 12 directional thresholds at different visual field sites was used to define isometric lines of average displacement threshold about central vision. Isometric lines extended further into the temporal visual fields along the horizontal meridian than along other meridians. At any single site in the peripheral visual field the thresholds were not the same in all directions; they were larger toward and away from central vision. These two psychophysical findings vary in a qualitatively similar manner across the retinal field, as does the average size and the collected orientation bias of dendritic fields of retinal ganglion cells.     

光感受器移植在视网膜退行性疾病中的应用研究进展

视网膜退行性疾病是影响人类视力的主要疾病，使人感光细胞受损，损害人的视力。而且哺乳动物的视网膜没有再生能力，一旦患病会严重影响人们的正常生活。目前尚未有明确的预防和减缓该类疾病的方法，但移植光感受器以补充视网膜中受损的感光细胞可以治疗视网膜疾病。本文将讨论光感受器移植方法在视网膜退行性疾病中恢复视力的现状和移植技术。     

Optical coherence tomography in the evaluation of incomplete visual acuity recovery after macula-off retinal detachments

PURPOSE: To determine whether pre and/or postoperative optical coherence tomography (OCT) evaluation of the fovea is useful in explaining delayed or incomplete visual acuity recovery after successful surgery for shallow macula-off retinal detachments. METHODS: Prospective study of 16 patients (10 female, 6 male; mean age 53+/-4 years) with a spontaneous rhegmatogenous retinal detachment with peripheral breaks and a shallow elevation of the fovea. Patients were examined by OCT preoperatively and at 1, 6, and 10-12 months after surgery. At 1 month after surgery, fluorescein angiography was also performed. Mean follow-up was 11.0+/-1.0 months. RESULTS: Preoperative OCT images could be classified into four categories according to the extent of retinal edema and presence of foveal depression. The extent of retinal edema in the detached macula did not correlate with preoperative or postoperative vision. In 11 cases, OCT images at 1 month after surgery showed a foveal detachment with residual subretinal fluid that was not visible clinically or on angiography. Long-term persistence of this fluid could be observed in eight cases at 6 months and in one case at 12 months, and was associated with incomplete recovery of visual acuity. CONCLUSIONS: Preoperative OCT of the detached macula can demonstrate widespread retinal edema, the extent of which does not appear to influence final postoperative vision. Delayed and incomplete visual recovery after successful reattachment of the retina may, however, be due to persistent circumscribed subfoveal fluid accumulation that is visible only on OCT not clinically or on fluorescein angiography.     

Comprehensive developmental glaucoma classification

A comprehensive classification of developmental glaucoma is presented. The term developmental glaucoma is preferable to congenital glaucoma. Glaucoma may be predetermined from birth as autosomal-dominant. This list is a comprehensive classification of developmental glaucoma that is predetermined from birth to occur. The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The author also does not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Pseudo-developmental glaucoma

A comprehensive classification of pseudo-developmental glaucoma with extensive bibliography is given. The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The author also does not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Poor vision for 2 days' duration and rapid visual recovery after treatment in a patient with branch retinal artery occlusion

An 82-year-old man complained of sudden onset of painless decreased vision in the left eye, which continued for 2 days. His left visual acuity was 0.03. Hypoperfusion of the inferotemporal retinal artery was visible by fluorescein angiography. He was treated with intravenous urokinase and intravenous alprostadil alfadex. On the day after starting treatment, his left visual acuity improved to 1.0. The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices.     

Ophthalmic chapters of serefeddin Sabuncuoglu's illustrated surgical book (Cerrahiyyetü'l Haniyye) in the 15th century

Serefeddin Sabuncuoglu wrote Cerrahiyyetü'l Haniyye (Imperial Surgery) in 1465. It was the first illustrated surgical textbook in the Turkish-Islamic medical literature. Only three handwritten copies exist. Cerrahiyyetü'l Haniyye consists of three chapters (412 pp.) covering a wide range of surgical specialties, including medical and surgical management of such ophthalmic diseases as chalazion, symblepharon, lymphangiectasia, pannus, proptosis, and hypopyon. The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The author also does not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.     

Visual–tactile shape perception in the visually restored with artificial vision

Retinal prostheses partially restore vision to late blind patients with retinitis pigmentosa through electrical stimulation of still-viable retinal ganglion cells. We investigated whether the late blind can perform visual–tactile shape matching following the partial restoration of vision via retinal prostheses after decades of blindness.We tested for visual–visual, tactile–tactile, and visual–tactile two-dimensional shape matching with six Argus II retinal prosthesis patients, ten sighted controls, and eight sighted controls with simulated ultra-low vision. In the Argus II patients, the visual–visual shape matching performance was significantly greater than chance. Although the visual–tactile shape matching performance of the Argus II patients was not significantly greater than chance, it was significantly higher with longer duration of prosthesis use. The sighted controls using natural vision and the sighted controls with simulated ultra-low vision both performed the visual–visual and visual–tactile shape matching tasks significantly more accurately than the Argus II patients. The tactile–tactile matching was not significantly different between the Argus II patients and sighted controls with or without simulated ultra-low vision.These results show that experienced retinal prosthesis patients can match shapes across the senses and integrate artificial vision with somatosensation. The correlation of retinal prosthesis patients’ crossmodal shape matching performance with the duration of device use supports the value of experience to crossmodal shape learning. These crossmodal shape matching results in Argus II patients are the first step toward understanding crossmodal perception after artificial visual restoration.     

Comprehensive ptosis classification

A comprehensive complete ptosis classification is presented. This author has stated that he does not have significant financial interest or other relationship with any product maufacturer or provider of services discussed in this article. The author also does not discuss the use of off-label products which includes unlabeled, unapproved, or investigative products or devices.     

Successful macular translocation with temporary scleral infolding using absorbable sture

PURPOSE: To describe successful macular translocation with temporary scleral infolding in a series of patients with small subfoveal choroidal neovascularization due to age-related macular degeneration or ocular histoplasmosis syndrome. METHODS: Ten eyes of 10 consecutive patients were studied in a prospective, nonrandomized clinical trial. Macular translocation with scleral infolding (MTSI) was performed. Absorbable polyglactin suture was used to create temporary scleral infolding. Distance and stability of retinal translocation, corneal topography, visual acuity, and rates of complications were measured. RESULTS: The median distance of translocation in the early postoperative period was 1,700 microm (range, 680-3,200) and did not regress after resolution of the scleral infolding. Induced postoperative oblique corneal astigmatism resolved, coinciding with the disappearance of peripheral retinal elevation due to scleral infolding. Three patients gained more than two lines of vision, two patients were within two lines of preoperative vision, and five patients lost more than two lines of vision. Complications were similar to previously published reports. CONCLUSION: Temporary scleral infolding is an effective technique in MTSI. The distance of translocation is comparable to that achieved with nonabsorbable suture or scleral resection, and does not regress after resolution of the scleral infolding. Induced postoperative corneal astigmatism appears to resolve.     

Intraocular cilia associated with perforating injury

PURPOSE: To report a case series of penetrating injury complicated by occurrence of intraocular cilia. METHODS: Retrospective analysis of charts of 11 eyes of 11 patients with penetrating injury and intraocular cilia, presenting between September 1978 and November 1998. Ten eyes underwent surgery for trauma-related problems such as cataract, vitritis, retinal detachment etc., at which time intraocular cilia were removed. One eye did not have surgery and continues to harbour cilia at the posterior perforation site. RESULTS: Metallic wire was responsible for injury in 6 of 11 eyes with intraocular cilia. Five eyes had significant intraocular inflammation. The cilia were located in the anterior segment in 4 eyes; in the posterior segment in 6 eyes and in both in one eye. At the last follow up, 72.7% had 6/18 or better vision. Poor vision in the rest was due to recurrent retinal detachment (2 eyes) and macular scarring (1 eye). CONCLUSION: Intraocular cilia are more commonly associated with injury by a metallic wire. The presentation and management of an injured eye does not seem to be influenced by the presence of cilia in the eye.     

Functional outcome of macular edema in different retinal disorders

Macular edema accompanies many ocular pathologies, affecting visual function and is an important factor in treatment decisions and disease outcome. Though visual acuity is commonly used to evaluate patient vision it does not always provide a complete estimate of their visual abilities or reflect their own visual perception. Furthermore, different pathologies result in macular edema causing a variable effect on visual function, related to the rate of fluid accumulation and accompanying ocular changes. Use of complementary visual function tests, such as retinal contrast sensitivity on microperimetry and reading speed provide additional information that can be used to evaluate patients and assist in treatment choices. Here we explore the effect of macular edema on visual function in different retinal pathologies, namely diabetic retinopathy, retinal vein occlusion and uveitis, examine its influence on the various vision tests and discuss the factors underlying this variable response.     

Idiopathic macular telangiectasia type 2 (idiopathic juxtafoveolar retinal telangiectasis type 2A,Mac Tel 2)

Macular telangiectasia type 2—also known as idiopathic perifoveal telangiectasia and juxtafoveolar retinal telangiectasis type 2A or Mac Tel 2—is an acquired bilateral neurodegenerative macular disease that usually manifests itself during the fourth to sixth decades of life and is characterized by minimal dilatation of the parafoveal capillaries with graying of the retinal area involved, a lack of lipid exudation, right-angled retinal venules, refractile deposits in the superficial retina, hyperplasia of the retinal pigment epithelium, foveal atrophy, and subretinal neovascularization (SRNV). Optical coherence tomography images typically demonstrate intraretinal hyporeflective spaces that are usually not related to retinal thickening or fluorescein leakage. The typical fluorescein angiographic finding is a deep intraretinal hyperfluorescent leakage in the temporal parafoveal area. With time the leakage may involve the whole parafovea, but does not extend to the center of the fovea. Long-term prognosis for central vision is variable and depends on the development of SRNV or macular atrophy. Pathogenesis remains unclear, but Müller cells and macular pigment appear to play a central role. Currently there is no known treatment for the underlying cause of this condition, but treatment of the SRNV may be beneficial.     

A case of epidermal inclusion cyst occurring under the bulbar conjunctiva

A tumor of the upper corneal limbus was detected in a 56-year-old male approx 2 months after an upper lid incision. After the tumor was extracted, pathological tests revealed it to be an epidermal inclusion cyst. Although acquired characteristics could be considered the cause of the cyst, because it was noticed only after the injury, this is doubtful because the tumor increased in size within a very short period of time after the operation. The author has stated that he does not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The author also does not discuss the use of off-label products, which include unlabeled, unapproved, or investigative products or devices.