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Subretinal Fluid (subretinal + fluid)
Selected AbstractsAlterations of intraretinal layers in acute central serous chorioretinopathyACTA OPHTHALMOLOGICA, Issue 5 2009Christian Ahlers Abstract. Purpose:, Optical coherence tomography (OCT) is restricted by its low scanning speed and limited resolution. High-definition raster-scanning OCT (HD-OCT) was used to evaluate changes in retinal microstructure in patients with acute central serous chorioretinopathy (CSCR) and to find new morphological features. Methods:, Eighteen patients with subretinal fluid accumulation caused by acute CSCR were imaged in a cross-sectional study design. High-speed frequency-domain HD-OCT was used to image an area of 6 × 6 mm in the macular retina. Three-dimensional analyses were performed using en-face imaging and section analysis of single HD-OCT scans. Results:, Detailed information about fluid accumulation can be obtained in all compartments. Discrete changes in reflectivity are visualized within the outer nuclear or plexiform layers in > 90% of patients. Subretinal fluid appears as a dome-shaped pool of fluid and is not associated with a loss of photoreceptor layer integrity. Deposits are demarcated beneath the outer cone segments. Multiple small pigment epithelial detachments are present in > 60% of patients. Conclusions:, High-definition OCT provides extensive information regarding precise topographic and layer-specific localization of discrete morphological changes. Along with well-known changes in the retinal microstructure, hyper-reflectivity can be imaged in the outer nuclear or plexiform layers and may represent intraretinal changes indicating the presence of subretinal pathologies or retinal maladjustment caused by the underlying pathology. [source] PaCE: a technique to avoid subretinal fluid drainage in retinal detachment surgeryACTA OPHTHALMOLOGICA, Issue 1 2006Manzar Saeed Abstract. Purpose:,Subretinal fluid (SRF) drainage and thus the potential complications of this procedure during scleral buckling can be avoided by inducing SRF absorption preoperatively. The technique described in this series is named PaCE (Pneumatic Cryo Explant). Methods:,A total of 22 eyes of 22 patients with primary bullous rhegmatogenous retinal detachment (RRD) were included in this prospective non-comparative case trial. All satisfied specific inclusion criteria similar to those used in previous pneumatic retinopexy (PR) studies. Under direct visualization, 0.3 ml C3F8 100% was injected into the vitreous cavity through the pars plana. Postoperative posturing was encouraged. Retinopexy with either cryotherapy or laser was performed, combined with scleral buckling (SB) when the SRF was absorbed. Avoidance of SRF drainage and persistent reattachment of the retina at the end of the 12-month follow-up was considered a successful outcome. A change in vision by one line (logMAR) was considered significant. Results:,Resolution of SRF before retinopexy and the SB procedure was achieved in 20 of 22 eyes (90.9%) and hence SRF drainage was not required. Visual improvement was achieved in 95% of cases. One eye (4.5%) lost vision due to a total RD after gas injection (further surgery was not carried out). Conclusion:,PaCE should be considered in any suitable case of primary RRD where SRF drainage is deemed necessary. The potential complications associated with this procedure are relatively less serious and it does not compromise the viability of subsequent procedures. [source] Diagnosis of ophthalmic tumoursACTA OPHTHALMOLOGICA, Issue 2009T KIVELÄ Purpose To summarise clinical methods used to diagnose ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results Conjunctival tumours are excised based on provisional clinical diagnosis or, if they are extensive, atypical or part of systemic disease such as lymphoma, first biopsied to obtain a histopathologic diagnosis. Useful methods to diagnose and stage conjunctival tumours are high frequency ultrasonography (US) or ultrasound biomicroscopy (UBM) to measure their thickness, in vivo confocal microscopy or impression cytology to chart their extent, and exfoliative cytology to get a provisional diagnosis. Ciliary body tumours are visualised by radical biomicroscopy, transillumination and indirect ophthalmoscopy with scleral indentation, supplemented with high frequency US or UBM. Binocular indirect ophthalmoscopy and US form the basis or diagnosing choroidal tumours. In addition to fluorescein and indocyanine green angiography in atypical cases, optical coherence tomography to detect subretinal fluid and autofluorescence to detect orange pigment are useful adjuncts in telling a small melanoma from a naevus. The mnemonic "To Find Small Ocular Melanomas" (from Thickness >2mm, subretinal Fluid, Symptoms, Orange pigment, Margin touching disc) is also useful in this respect. Clinical diagnosis of medium-sized to large melanomas is 99% accurate, whereas a fine needle or vitrectomy biopsy may be necessary to diagnose atypical tumours and is also used for cytogenetic analysis of uveal melanomas. Conclusion Conjunctival tumours are mostly diagnosed histopathologically, whereas diagnosis of uveal tumours is usually based on clinical examination. While clinical diagnosis is usually reliable, biopsy of uveal tumours is increasingly used for prognostic purposes. [source] Technical Note: Method for estimating volume of subretinal fluid in cases of localized retinal detachment by OCT ophthalmoscopyOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 5 2007Hideto Nakajima Abstract The volume of the subretinal fluid can be used to assess the condition of different types of retinal and macular disorders. The purpose of this report is to introduce a method to measure the volume of the subretinal fluid with the images of the optical coherence tomography (OCT) Ophthalmoscope in three cases of central serous chorioretinopathy and one case of retinal pigment epithelial detachment. We used the topography-mode program of the OCT Ophthalmoscope and measured the average height of the retinal detachment. By multiplying the size of the area of the retinal detachment and the average height of the retinal detachment, the volume of subretinal fluid could be determined. Examples are given to show the results of volume measurement of subretinal fluid in cases of localized retinal detachments. [source] Photodynamic therapy for chronic central serous chorioretinopathyACTA OPHTHALMOLOGICA, Issue 3 2010José M. Ruiz-Moreno Abstract. Purpose:, This study aimed to evaluate the efficacy of photodynamic therapy (PDT) in treating chronic central serous chorioretinopathy (CSC). Methods:, We describe a non-randomized, multicentre, interventional case series. A total of 82 eyes of 72 patients with chronic CSC were treated by conventional PDT. LogMAR best corrected visual acuity (BCVA) (ETDRS charts) and central foveal thickness (CFT) measured by optical coherence tomography before and after PDT, number of PDT treatments and complications were used as outcome indicators. Results:, Mean follow-up was 12 ± 10 months and mean age was 46 ± 10 years. Mean logMAR BCVA changed from 0.53 (standard deviation [SD] 0.43) before PDT to 0.38 (SD 0.41) at 3 months and 0.48 (SD 0.50) at 6 months (p < 0.0001 and p = 0.007, respectively, Student's t- test for paired data). Mean BCVA at the end of follow-up was 0.37 (SD 0.45; p < 0.0001 from baseline). Macular detachment was resolved and subretinal fluid (SRF) disappeared in all cases. Central foveal thickness decreased from 325 ,m (SD 95), to 229 ,m (SD 70) at 1 month after PDT, 206 ,m (SD 68) at 3 months, and 202 ,m (SD 76) at 6 months (all p < 0.0001, Student's t- test for paired data). No cases developed severe visual loss or complications derived from PDT. Reactive retinal pigment epithelium hypertrophy appeared in nine cases after PDT. Conclusions:, Photodynamic therapy with verteporfin may be useful in chronic CSC for improving BCVA and reducing SRF and CFT. Randomized studies with longer follow-up are needed to assess the real role of this treatment in chronic CSC. [source] Time-course and characteristic morphology of retinal changes following combination of verteporfin therapy and intravitreal triamcinolone in neovascular age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 2 2010Shilla Lie Abstract. Purpose:, To identify characteristic morphological changes of the retina over time and the association with visual function after combined photodynamic therapy (PDT) and intravitreal triamcinolone (IVTA). Methods:, In this retrospective study, 40 patients (40 eyes) were treated with PDT and same-day IVTA. Optical coherence tomography (OCT), fluorescein angiography (FA) and evaluation of distance visual acuity (VA) were performed. The anatomical changes within intra- and subretinal compartments and their detailed analysis and grading were the main outcome measures. Results:, Intraretinal fluid (IRF) and subretinal fluid (SRF) by OCT decreased until 3 months (p < 0.01). At month 3, intraretinal cystoid spaces (ICS) had resolved or decreased in 84% of eyes, SRF in 58% and pigment epithelial detachment (PED) in 50%. Mean best-corrected VA (BCVA) improved significantly at month 1 (p < 0.01). Mean central retinal thickness (CRT) increased from 334 ,m at baseline to 439 ,m at day 1 (p = 0.03) before decreasing to 286 ,m at day 7 (p = 0.06), 233 ,m at month 1 (p = 0.001) and 255 ,m at month 3 (p = 0.001). Conclusion:, Combined verteporfin/IVTA therapy induces distinct time-related effects on the retina within the different intra- and subretinal compartments. [source] Diagnosis of ophthalmic tumoursACTA OPHTHALMOLOGICA, Issue 2009T KIVELÄ Purpose To summarise clinical methods used to diagnose ophthalmic tumours. Methods Personal experience of the author as a member of the European Ophthalmic Oncology Group. Results Conjunctival tumours are excised based on provisional clinical diagnosis or, if they are extensive, atypical or part of systemic disease such as lymphoma, first biopsied to obtain a histopathologic diagnosis. Useful methods to diagnose and stage conjunctival tumours are high frequency ultrasonography (US) or ultrasound biomicroscopy (UBM) to measure their thickness, in vivo confocal microscopy or impression cytology to chart their extent, and exfoliative cytology to get a provisional diagnosis. Ciliary body tumours are visualised by radical biomicroscopy, transillumination and indirect ophthalmoscopy with scleral indentation, supplemented with high frequency US or UBM. Binocular indirect ophthalmoscopy and US form the basis or diagnosing choroidal tumours. In addition to fluorescein and indocyanine green angiography in atypical cases, optical coherence tomography to detect subretinal fluid and autofluorescence to detect orange pigment are useful adjuncts in telling a small melanoma from a naevus. The mnemonic "To Find Small Ocular Melanomas" (from Thickness >2mm, subretinal Fluid, Symptoms, Orange pigment, Margin touching disc) is also useful in this respect. Clinical diagnosis of medium-sized to large melanomas is 99% accurate, whereas a fine needle or vitrectomy biopsy may be necessary to diagnose atypical tumours and is also used for cytogenetic analysis of uveal melanomas. Conclusion Conjunctival tumours are mostly diagnosed histopathologically, whereas diagnosis of uveal tumours is usually based on clinical examination. While clinical diagnosis is usually reliable, biopsy of uveal tumours is increasingly used for prognostic purposes. [source] What is the consequence of retinal detachment on anatomy and function?ACTA OPHTHALMOLOGICA, Issue 2009C CREUZOT Purpose To present the structural and functional consequences on retina after retinal detachment Methods Author will show the consequences of experimental retinal detachment in animal models. These changes prevent retinal cells from a normal post-operative functioning. However, these conditions have to be differentiated from post-operative visual loss due to macular edema, long-standing subretinal fluid, epiretinal membrane or macular hole formation. Results Retinal detachment leads to severe changes on retinal cells: outer segment shortening, fibrosis, glial proliferation. This situation is the target of neuroprotective treatment. By contrast, some situations where the bad recevoery is due to an associated disease (edema, membrane...) illustrated by clinical cases can need surgical treatment. Conclusion Bad functional recovery after retinal detachment can be explained by anatomic consequences on photoreceptors with subclinical fibrosis or some associated complications. [source] Retinal detachment in phakic patientsACTA OPHTHALMOLOGICA, Issue 2009C CHIQUET Purpose this review aims to summarize risk factors, preoperative evaluation and principles of operative methods of retinal detachment of phakic eyes Methods Preoperative evaluation includes detailed examination of the retina, the identification of retinal breaks and classification of proliferative retinopathy. Main operative methods will be presented with ab externo or ab interno techniques. Results after a detailed characterization of the retinal detachment, the more appropriate surgical methods will be explained for the search, the treatment (laser or cryotherapy), closure (scleral buckling materials) of retinal breaks, management of subretinal fluid (drainage) and the choice of the intraocular tamponnade (gas or silicone). Conclusion this review will discuss the main advantages of each surgical technique and examples of management will be presented (simple phakic detachment, associated cataract, giant tears, high myopia). [source] Intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization in age-related macular degenerationACTA OPHTHALMOLOGICA, Issue 4 2009Claudio Furino Abstract. Purpose:, This study aimed to evaluate the efficacy of multiple injections of intravitreal bevacizumab for treatment-naïve subfoveal occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods:, Twelve eyes of 12 patients (mean age 76 ± 6 years) with mean best corrected visual acuity (BCVA) of 20/100 and occult subfoveal CNV at fluorescein angiography (FA), indocyanine-green (ICG) angiography and optical coherence tomography (OCT), showing intra- or subretinal fluid with or without retinal pigment epithelial detachment (PED), underwent multiple intravitreal injections (mean 2.4 ± 0.7) of 1.25 mg (0.05 ml) bevacizumab. Visual acuity and OCT findings were assessed at the end of follow-up. Results:, After a mean follow-up of 5.7 ± 2 months, BCVA improved from 20/100 (range 20/50,20/303) to 20/60 (range 20/28,20/200) (p = 0.038). Five eyes (42%) increased BCVA by , 3 lines, six eyes (50%) increased BCVA by < 3 lines and one eye (8%) remained stable. Macular thickness decreased from 298 ± 71 ,m to 223 ± 72 ,m (p = 0.017). No ocular or systemic side-effects were observed. Conclusions:, Short-term results suggest that multiple intravitreal injections of 1.25 mg bevacizumab are well tolerated and associated with significant improvements in BCVA and decreased retinal thickness by OCT in most patients with treatment-naïve occult CNV. Further evaluation of intravitreal bevacizumab for the treatment of occult CNV is warranted. [source] Minor surgery for the repair of retinal detachment emanating from retinoschisisACTA OPHTHALMOLOGICA, Issue 3 2009Harvey Lincoff Abstract. Purpose:, To propose a mechanism for the development of the outer layer retinal tears that occur with retinoschisis and the detachment emanating from it that is consistent with the limited extent of the detachment and the response to binocular occlusion and local buckles. Methods:, A consecutive series of 24 patients with retinoschisis, collected over 15 years, was analysed. Seven patients developed a symptomatic retinal detachment emanating from breaks in the outer layers of retinoschisis. The detachments responded to binocular occlusion, a sponge buckle, or a temporary balloon buckle and laser coagulation to the edges of the breaks. Results:, Two retinas attached completely after 48 hr of binocular occlusion, four responded to local sponge buckles and one to a temporary balloon buckle. All attached without drainage of subretinal fluid. Final visual acuity was 20/20 in six eyes and 20/25 in one eye. Conclusion:, The detachment emanating from retinoschisis responds to ocular rest or a local buckle to breaks in the outer layers. It is proposed that the mechanism for the detachment that emanates from retinoschisis is intraretinal traction by residual transretinal fibres at the edge of the schisis cavity. [source] Submacular fluid after encircling buckle surgery for inferior macula-off retinal detachment in young patientsACTA OPHTHALMOLOGICA, Issue 1 2009Hana Abouzeid Abstract. Purpose:, Characterization of persistent diffuse subretinal fluid using optical coherence tomography (OCT) after successful encircling buckle surgery for inferior macula-off retinal detachment in young patients. Methods:, Institutional retrospective review of six young patients (mean age 31 ± 6 years; five female, one male) with spontaneous inferior rhegmatogenous macula-off retinal detachment. All patients were treated with encircling buckle surgery and five out of six underwent additional external drainage of subretinal fluid. Mean follow-up was 37 ± 25 months (range 17,75 months) and included complete ophthalmic and OCT examination. Results:, At 6 months, 100% of patients showed persistence of subretinal fluid on OCT. Four patients had diffuse fluid accumulation, whereas two patients showed a ,bleb-like' accumulation of fluid. This fluid was present independent of whether or not patients had been treated with external fluid drainage. Subretinal fluid only started to disappear on OCT between 6 and more than 12 months after surgery. Conclusion:, Young patients with inferior macula-off retinal detachments and a marginally liquefied vitreous may show persisting postoperative subclinical fluid under the macula for longer periods of time than described previously. [source] Fundus autofluorescence imaging of choroidal tumorsACTA OPHTHALMOLOGICA, Issue 2008E PILOTTO Purpose To investigate the different pattern of fundus autofluorescence imaging of choroidal tumors generated with short-wavelength and near-infrared Methods Thirty-one eyes of 31 consecutive patients affected by choroidal tumor performed standard fundus autofluorescence with short-wavelength (SW FAF) and fundus autofluorescence with near-infrared (NIR FAF). Fundus photography, A and B scan ultrasound and OCT were performed. Autofluorescence features of choroidal tumor and overlying retinal pigment epithelium (RPE) were correlated with clinical features. Results Twelve of 31 choroidal tumors were choroidal melanoma, 8 choroidal nevus, 5 circumscribed choroidal hemangioma and one was choroidal granuloma. Different pattern of SW FAF and NIR FAF were detected related to the presence of pigment, drusen, RPE atrophy and hyperplasia, RPE detachment and subretinal fluid over or around the lesion. Conclusion Standard autofluorescence (SW FAF) and NIR FAF provide different information on intrinsic autofluorescence of choroidal tumor and on the related RPE and retinal changes [source] Bilateral diffuse uveal melanocytic proliferation and uterine cancer.ACTA OPHTHALMOLOGICA, Issue 3 2000A case report ABSTRACT. Purpose: To report a case of bilateral diffuse uveal melanocytic proliferation (BDUMP), a rare paraneoplastic syndrome causing visual loss in patients with systemic carcinoma. Results: A 70-year-old woman developed visual symptoms 13 months after surgery and local irradiation therapy for uterine cancer. Following bilateral external beam irradiation supplemented with subsequent drainage of subretinal fluid in the left eye, the visual acuity improved from 0.01 to 0.15 in this eye only. The visual acuity remained at this level until she died 4 1/4 years after the onset of eye symptoms. Conclusion: This is the fourth case that survived longer than 24 months after the onset of visual symptoms of the 22 previously reported cases with BDUMP. It demonstrates that radiotherapy may have a vision-preserving effect in this group of patients. The patient also developed two different paraneoplastic phenomena , a nephrotic syndrome before and BDUMP after treatment for uterine cancer. [source] Ocular coherence tomography findings with retained submacular perfluoronCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2006Brian C Joondeph MD FACS Abstract 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. [source] | ||||||||||