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Vitreous Hemorrhage (vitreous + hemorrhage)
Selected AbstractsAcute Glaucoma after Dilated Eye Exam in a Patient With Hyphema, Retinal Detachment, and Vitreous HemorrhageACADEMIC EMERGENCY MEDICINE, Issue 1 2009Gavin Budhram MD No abstract is available for this article. [source] Predictive factors of invasion in eyes with retinoblastoma enucleated after eye salvage treatmentsPEDIATRIC BLOOD & CANCER, Issue 3 2009Julia Balaguer MD Abstract Background The impact of chemotherapy, focal therapies, radiation and co-existing ocular morbidities on histology of eyes with retinoblastoma enucleated following chemoreduction is not well known. Procedure Twenty-five eyes (23 patients) with retinoblastoma enucleated after failing eye-salvage therapy were evaluated. Reasons for enucleation (tumor progression, subretinal or vitreous seeds) and co-morbid conditions (neovascular glaucoma, cataract, vitreous hemorrhage and retinal detachment) were documented. All specimens were reviewed for evidence of ciliary body, choroidal, optic nerve, and scleral invasion. Results The median age at diagnosis was 14 months (range, 1,37 months). Twenty eyes were classified as Reese-Ellsworth Group IV,V at diagnosis. Twenty-four eyes had recurrent disease at enucleation; one eye was enucleated for neovascular glaucoma and vitreous hemorrhage. Co-existing ocular morbidities at enucleation included vitreous hemorrhage (n,=,6), retinal detachment (n,=,9), neovascular glaucoma (n,=,9) and cataracts (n,=,3). Histologic findings included choroidal invasion (n,=,7), ciliary body invasion (n,=,4), optic nerve invasion (n,=,6) and scleral invasion (n,=,3). The median time from diagnosis to enucleation was 11 months. Co-existing retinal detachment and vitreous hemorrhage significantly increased the likelihood of optic nerve invasion (P,=,0.014 and P,=,0.011, respectively). Prolonged time to enucleation was significantly associated with the likelihood of choroidal (P,=,0.010) and ciliary body (P,=,0.021) invasion as well as invasion of multiple sites. Conclusion In eyes with retinoblastoma enucleated after chemoreduction, co-existing ocular morbidities and time to enucleation are predictive of extra-retinal extension. Pediatr Blood Cancer 2009;52:351,356. © 2008 Wiley-Liss, Inc. [source] 1263: Symptoms and signs of posterior uveitisACTA OPHTHALMOLOGICA, Issue 2010M KHAIRALLAH Purpose Posterior uveitis (PU) is an important anatomic form of uveitis in which the primary site of inflammation is the choroid or retina, with or without subsequent vitreous involvement. Methods Review of symptoms and signs of PU. Results The onset of PU can be sudden or less frequently insidious. Most common ocular symptoms include blurred vision, loss of vision, and floaters. Some patients with PU may have no symptoms, especially if inflammatory process is asymmetric. PU is usually associated with vitritis that can vary from mild to severe. Vitritis should be graded according to standardized grading systems. Other vitreous changes may include vitreous strands, vitreous hemorrhage, vitreous traction, and posterior vitreous detachment. Retinal and/or choroidal inflammation can be focal, multifocal, or more diffuse. It is important to distinguish between active and inactive chorioretinal disease. Retinal vasculitis can occur in the setting of several PU entities. It can involve retinal veins or arteries. It appears as focal, multifocal, or diffuse vascular cuffing or sheathing. Other retinal vasculitic changes include retinal hemorrhages, retinal vascular occlusion, retinal/optic disc neovascularization, and aneurysms. Maculopathy is common patients with PU. It may result from direct inflammatory infiltration, macular edema, serous retinal detachment, retinal ischemia, epiretinal membrane, or macular hole. Optic nerve involvement that can occur in association with PU include optic disc hyperemia/edema, optic neuritis, neuroretinitis, optic disc exudate, and optic disc granuloma. Conclusion Clinical examination is a key step in the diagnostic approach to PU. Clinician should be aware of the array of ocular symptoms of signs and their importance in orienting the differential diagnosis. [source] 4235: Vitreoretinal considerations in OOKPACTA OPHTHALMOLOGICA, Issue 2010E HUGHES Purpose To present the difficulties of managing vitreoretinal complications in patients with OOKP and open a discussion about future strategies to prevent and deal with these problems. Methods Retrospective review of cases. Results Vitreo-retinal complications occurred in 14 of 54 patients receiving OOKP surgery. These included vitreous hemorrhage (4 patients), rhegmatogenous retinal detachment (3 patients), endophthalmitis with retinal detachment (5 patients), endophthalmitis without retinal detachment (1 patient) and intraoperative choroidal hemorrhage (1 patient). Most cases of endophthalmitis presented late and may result from lamina resorption, leak and hypotony. The prognosis of retinal detachment in an eye with OOKP was poor with successful repair in 1 of 3 cases not related to endophthalmitis and 0 of 5 cases with endophthalmitis. Overall, pars plana vitrectomy was performed on 10 occasions (8 patients), of which 2 were endoscopic and 2 utilised a temporary keratoprosthesis. Conclusion There is a relatively high rate of posterior segment problems in OOKP patients and their management is challenging both in assessment (limited view and ultrasound amenability) and surgical approach. Surgical outcomes were poor for these complications. Other concepts in management, including endoscopic vitrectomy at stage I surgery should be considered, which will be discussed. [source] 4333: How does scleral buckling affect the anterior segment of the eye?ACTA OPHTHALMOLOGICA, Issue 2010FJ ASCASO Purpose To describe the modifications produced in the anterior segment of the eye after placing an encircling scleral buckling (SB) in terms of corneal morphology, biomechanics and intraocular pressure. Methods A prospective study of 15 eyes with rhegmatogenous retinal detachment who underwent pars plana vitrectomy combined with a scleral buckle (PPV/SB), and 12 eyes with vitreous hemorrhage treated with PPV alone. We measured preoperatively and 1-month after surgery the corneal biomechanical properties using the Ocular Response Analyzer (ORA), including corneal hysteresis (CH), corneal resistance factor (CRF), intraocular pressure (IOPg), and corneal compensated IOP (IOPcc). Moreover, we defined the corneal morphology by 4 parameters provided by the topographer Orbscan IIz: mean corneal power (dioptres), standard deviation, thinnest point (µm), and anterior chamber depth (ACD) (mm). Results Mean CH values were significantly diminished following PPV/SB (p=0.003). We found no significant changes in CRF. IOPg and IOPcc mean values were significantly increased only in the PPV/SB group (p=0.019 and p=0.010, respectively) but not in PPV group (p=0.715 and p=0.273, respectively). In PPV/SB group, IOPcc mean values were significantly higher than IOPg before (p=0.001) and after surgery (p=0.003), but not in the other group. None of the morphological parameters were modified after surgery in any of the two study groups (p>0.05) Conclusion Anterior segment morphology was not modified after placing a SB. Corneal biomechanical properties showed a reduction in CH, probably due to a vascular constriction and reduction of the eye compliance. PPV might be considered a less invasive approach for the repair of noncomplex retinal detachments than PPV/SB. [source] Longterm results after phacovitrectomy and foldable intraocular lens implantationACTA OPHTHALMOLOGICA, Issue 8 2009Wensheng Li Abstract. Purpose:, This study aimed to evaluate the longterm results of phacovitrectomy and foldable intraocular lens (IOL) implantation in eyes with significant cataract and co-existing vitreoretinal diseases. Methods:, We carried out a retrospective study of 186 eyes of 149 patients with various vitreoretinal abnormalities and visually significant cataracts. Vitreoretinal surgery was combined with phacoemulsification and foldable IOL implantation. Main outcome measures were visual acuity (VA), preoperative data, and intraoperative and postoperative complications. Results:, The most common indications for surgery were non-diabetic vitreous haemorrhage and proliferative diabetic retinopathy. Preoperative vision ranged from 0.6 to light perception; postoperative vision ranged from 1.2 to no light perception. Postoperatively, in 162 eyes (87.1%) VA improved by , 3 lines on the decimal chart. In 14 eyes (7.5%), vision remained within 3 lines of preoperative levels and in 10 eyes (5.3%), vision had decreased by the last follow-up. Postoperative complications included elevated intraocular pressure and posterior capsule opacification, corneal edema, macular edema, fibrinous reaction, vitreous hemorrhage, corneal epithelial defects, anterior chamber hyphema, choroidal detachment, persistent macular hole, posterior synechiae, recurrent retinal detachment, rubeosis iridis, neovascular glaucoma. Conclusions:, Combined vitreoretinal surgery and phacoemulsification with foldable IOL implantation is safe and effective in treating vitreoretinal abnormalities co-existing with cataract. Based on extensive experience with the combined procedure, we suggest that combined surgery is recommended in selected patients with simultaneous vitreoretinal pathological changes and cataract. [source] Uveal melanoma: management and outcome of patients with extraocular spreadACTA OPHTHALMOLOGICA, Issue 2009N CASSOUX Purpose Extraocular spread is thought to be a negative prognostic factor on survival of the patient with uveal melanoma. Depending on the size of the tumor and the type of extraocular extension conservative treatments can be employed. Methods 2256 patients were treated between 2000 and 2007 at the Institut Curie, Paris, France for an uveal melanoma. 67 patients (3.0%) presented an extraocular extension. A retrospective study was performed to evaluate the patients outcome with regard to tumour recurrence and their survival. Results Results: Eye-conserving treatment was employed in 38 (52.8%) patients. An enucleation was performed in 29 (47.2%) patients. The median follow-up was 38 (range 7 - 79) months with an overall survival rate at 5-years of 40.4% in enucleated patients and 79.3% in the eye- conserving treatment group (protons n=19, iodine-125 plaque n = 19) (p = 0.01; Kaplan- Meier analysis). No tumor recurrence was observed in any group. Degree of extraocular spread as well as the clinical characteristics tumor location, retinal detachment, ciliary body involvement (p < 0.01; Chi-square test) and tumor thickness (p = 0.04; Chi-square test) influenced the choice of treatment. Age, tumor diameter, involving optic nerve, vitreous hemorrhage, achromic lesion was without any influence. Conclusion Conclusion: No tumor recurrence and no lower survival rate were observed in patients receiving an eye-conserving treatment. They may represent thus a therapeutic option in selected patients with extraocular spread. [source] IL-8 vitreous levels in proliferative diabetic retinopathyACTA OPHTHALMOLOGICA, Issue 2007M GLOBOCNIK PETROVIC Purpose: To determine the levels of interleukin 8 (IL-8) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and the role of IL-8 as a marker of visual prognosis after vitrectomy. Methods: Vitreous fluid samples were obtained at vitreoretinal surgery from 71 patients with diabetes type 2 and PDR, and from 17 age-matched non-diabetic patients with a macular hole (control group). PDR was classified as active and inactive, and subdivided according to the extent of large vessel gliotic obliteration. The cytokine levels were measured by Cytometric Bead Array method. To determine the role of IL-8 as visual prognostic marker after vitrectomy we investigated whether the vitreous levels of IL-8 were associated with poor visual outcome. Poor outcome was defined by visual acuity less than 20/200 at least 8 months after vitrectomy. Clinical and preoperative eye characteristics (visual acuity, iris neovascularisation, vitreous hemorrhage, macular detachment, macular edema, active neovascularisation, neovascularisation of the disk, and the presence of panretinal photocoagulation) were additionally analyzed. Results: The vitreous levels of IL-8 were significantly higher in patients with PDR in comparison to the control (P<0.001), in eyes with higher extent of large vessel gliotic obliteration (P<0.001) and was not significantly higher in eyes with active neovascularisation (P=0.9). After multiple logistic regression analysis, vitreous level of IL-8 (P=0.028) and macular detachment (P=0.039) were predictors for the poor visual outcome after vitrectomy. Conclusions: The vitreous level of IL-8 was associated with the higher extent of large vessel gliotic obliteration and with the poor visual outcome after vitrectomy. [source] Hemostatic effects of SF6 after diabetic vitrectomy for vitreous hemorrhageACTA OPHTHALMOLOGICA, Issue 1 2001CH. N. Koutsandrea ABSTRACT. Purpose: To investigate the hemostatic effects of SF6 gas in preventing postoperative vitreous hemorrhage in diabetic vitrectomy. Methods: A prospective, randomized study of 33 diabetic eyes with vitreous hemorrhage, treated by vitrectomy. In 17 of our cases SF6 20% was injected into the eye at the end of the operation, while in 16 cases BSS remained in the vitreous cavity. Results: The incidence of vitreous hemorrhage recurrence was 17.6% for the SF6 group and 12.5% for the BSS group (statistically not significant). Progression of lens opacities was observed in 23.5% of the SF6 group, and in 18.8% of the BSS group (statistically not significant, with a higher incidence in the SF6 group). Conclusions: SF6 gas did not show hemostatic effects in the cases studied. Furthermore, it may have contributed to cataract progression. Therefore we suggest that the use of SF6 is not recommended as a treatment modality in preventing new vitreous hemorrhage after diabetic vitrectomy. [source] | ||||||||||