Subretinal new vessel recurrence in age-related macular degeneration

Laser photocoagulation with argon or krypton is currently used to treat selected patients with age-related macular degeneration and sudden visual loss from subretinal new vessel formation. In 102 consecutive cases, treated over two years, closure of the vessels was achieved without additional major visual loss in 79% when assessed at two months. Early failure occurred in 21% and was due either to selection of cases with central location or failure to close the new vessel. Later failures due to recurrent subretinal new vessel formation or progression of other macular degenerative changes has occurred in a further 28% so far. Although controlled clinical trials show a significant benefit of treatment, the overall impact of these few successes on the population with macular degeneration is small. Further understanding of the mechanism of subretinal new vessel formation is urgently required. Areas under investigation include the response of injured retinal pigment epithelium, choroid and retina and cellular production of facilitatory factors including proteases and fibronectin.     

视网膜下液脂质过氧化物含量及临床意义

用八木国夫TBA荧光法测定42例孔源性视网膜脱离病人视网膜下液和血清中脂质过氧化物含量。结果表明:视网膜下液中存在脂质过氧化代谢产物,其含量与增殖性玻璃体视网膜病变呈正线性相关(r=0.78),与病程呈非线性正相关(r=0.45)。视网膜的退行性变,继发性的抗过氧化能减低,可能导致脂质过氧化毒性作用占优势,促使脱离的视网膜发生一系例的病理改变。     

Aging macular degeneration. Clinical features of treatable disease

Argon laser treatment reduces visual loss in patients with aged macular degeneration and extrafoveal subretinal neovascular membranes (SRNVM). Ophthalmologists must now educate patients concerning the symptoms of subretinal neovascularization and give them an Amsler grid. If a patient develops symptoms he should be examined promptly. High quality fluorescein angiograms and meticulous contact lens examinations of the macula should be performed to detect subtle neovascularization. Ophthalmologists must be familiar with the clinical and fluorescein angiographic changes of drusen, retinal pigment epithelial atrophy, and retinal pigment epithelial detachments in order to differentiate them from subretinal neovascular membranes.     

氩激光诱发兔视网膜下新生血管的眼底荧光血管造影

探讨视网膜下新生血管的发病机理及发生，发展特点。用高强度氩激光光凝兔视网膜，经眼底镜及眼底荧光血管造影观察２，光斑出血发生率２７％。光凝后１周，ＦＦＡ脉络膜期及动脉早期８％的光斑有点汰荧光素渗漏。光凝后３周，６３％的光斑出现脉络膜新生血管形态。直至２个月，渗漏区逐渐扩大。     

Ocular coherence tomography findings with retained submacular perfluoron

Herein a case of retained perfluorocarbon liquid beneath the macula, following surgical repair of a complicated retinal detachment, is reported. The ocular coherence tomography findings were helpful in distinguishing retained perfluorocarbon liquid from residual subretinal fluid, macular cyst or cystoid macular oedema.     

Optical coherence tomographic pattern of fluorescein angiographic leakage site in acute central serous chorioretinopathy

PURPOSE: To study the optical coherence tomography (OCT) pattern of the fluorescein angiographic leakage in acute central serous chorioretinopathy (CSCR). METHODS: This is a non-interventional pilot case study. OCT line scan was performed over the fluorescein angiographic leak site in eyes clinically diagnosed acute CSCR. Clinical fundus photograph, site of leakage on fundus fluorescein angiography and corresponding OCT were analysed. RESULTS: The mean age of 10 consecutive patients was 38.8 +/- 6.9 years. Six patients were male and the mean duration of symptom was 7 days. Six eyes (60%) showed a characteristic dipping pattern of neurosensory retina with intervening hyper-reflective echoes suggestive of fibrin over the leakage site. All these eyes had ink-blot leak and subretinal fibrin. CONCLUSIONS: Ink-blot leak in acute CSCR with subretinal fibrin generates a dipping morphological pattern on OCT.     

Idiopathic Serous Detachment of the Choroid,Ciliary Body,and Retina (Uveal Effusion Syndrome)

Nine patients with bilateral idiopathic serous detachment of the peripheral choroid, ciliary body, and retina (uveal effusion syndrome)are presented. The following features are emphasized: (1) dilationof episcleral vessels, (2) vitreous cells, (3) characteristic leopardspot pigment epithelial changes, and (4) ultrasonic and angiographic findings. One patient presented with recurrent serous macular detachment and was misdiagnosed as idiopathic central serous choroidopathy. Although the pathogenesis of this syndrome is uncertain, the available clinical and histopathologic findings suggest that obstruction of the venous outflow of the uveal tract occurring predominantly in nanophthalmic or normal size eyes with abnormally thick sclera and vortex vein anomalies may be the primary cause of the uveal and retinal detachment.     

A modified Amsler grid. A self-assessment test for patients with macular disease

A Modified Amsler Grid, the size of a conventional credit card, has been developed as a suitable alternate to the full-scale version. The size of the grid makes it extremely convenient for patients in our highly mobile society. When viewed twice (vertically and horizontally), it corresponds well to the topography of the central macula. In this capacity the Modified Amsler Grid is a useful adjunct to the overall management of patients with macular diseases which may potentially be associated with exudative manifestations.     

Choroidal melanoma with massive retinal fibrosis and spontaneous regression of retinal detachment.

An unusual case of choroidal malignant melanoma with heterochromia iridis, massive subretinal hemorrhage and fibrosis, spontaneously resolving retinal detachment, and subretinal seeding is reported. Clinical and pathological findings are presented and discussed. The unusual aspects of the case are further considered by Drs. Andrew Ferry and Mark Tso.     

孔源性视网膜脱离患者视网膜下液蛋白质液相色谱分析

运用快速液相色谱仪对孔源性视网膜脱离患者视网膜下液蛋白质进行检测。结果表明经凝胶作用色谱柱后视网膜下液蛋白质可分成４个不同分子量级分，即：＞７０Ｋｄ，＞１０Ｋｄ，＜１０Ｋｄ及＜１ｋｄ；视网膜下液蛋白质浓度随增殖性玻璃体视网膜病变的加重而增加。