1,082 results on '"Vitreous Hemorrhage etiology"'
Search Results
102. Spontaneous Vitreous Hemorrhage in a Naval Aviator.
- Author
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Wallace SA
- Subjects
- Humans, Male, Vision Disorders, Pilots, Vitreous Hemorrhage etiology
- Abstract
BACKGROUND: Spontaneous vitreous hemorrhage is uncommon in the general population. Of cases, 1020% are idiopathic or due to occult causes and a majority of the remainder are associated with diabetic disease. The evaluation and disposition of an aviator has not been reported previously. This case will document the work-up and safe return to flight of a patient. CASE REPORT: A 33-yr-old male MH-60R pilot presented with acute blurred vision in the left eye and eye pain which began at his desk. His review of systems was otherwise negative. His medical history was noncontributory. On initial examination his vital signs and external ocular exam were normal. He was immediately referred to the optometry clinic, where a dilated funduscopic examination (DFE) with scleral depression demonstrated a large floater OS composed of streaks of blood and tobacco dust. His DFE was otherwise normal with no retinal tears or vitreous detachments. On repeated DFEs, his intraoccular pressures remained normal and his hemorrhage resorbed without decreased visual acuity or field deficits. A hematologic work-up was negative. After 4 mo of observation, the patient was returned to flight status without further recurrence. DISCUSSION: No known associations exist between aeronautical duties and spontaneous vitreous hemorrhages. The stressors aviators are subjected to, such as high vibrations and increased g forces, may make them more likely to suffer intraocular microvascular damage that could lead to retinal detachment, vitreous detachment, and bleeding. Further reports are needed to determine the risks of recurrence in aviators and their differences from typical spontaneous vitreous hemorrhage patients. Wallace SA. Spontaneous vitreous hemorrhage in a naval aviator . Aerosp Med Hum Perform. 2020; 91(11):904907.
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- 2020
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103. Photoreceptor damage following long-standing premacular hemorrhage in Terson syndrome.
- Author
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Kittur A, Daga J, Surve A, and Kumar V
- Subjects
- Humans, Retinal Hemorrhage diagnosis, Retinal Hemorrhage etiology, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology
- Abstract
Competing Interests: None
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- 2020
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104. Unilateral Terson-Like Syndrome in a Patient With a Perinatal Ischemic Stroke.
- Author
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Ebert JJ, Varma H, and Sisk RA
- Subjects
- Humans, Infant, Ischemic Stroke diagnosis, Magnetic Resonance Imaging methods, Male, Retinal Hemorrhage diagnosis, Retinal Hemorrhage surgery, Syndrome, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage surgery, Ischemic Stroke complications, Retinal Hemorrhage etiology, Visual Acuity, Vitrectomy methods, Vitreous Hemorrhage etiology
- Abstract
Terson syndrome typically presents with bilateral hemorrhagic retinopathy associated with acute intracranial bleeding. The authors present a case of neonatal hemispheric ischemic stroke with vasogenic edema and increased intracranial pressure creating a unilateral Terson-like syndrome. Magnetic resonance imaging indicated congenital occlusion of the left internal carotid artery, among other vascular abnormalities. Chronic submacular, peripheral subretinal, and vitreous hemorrhage were observed, suggesting a multilaminar hemorrhagic process resembling Terson syndrome without frank intracranial hemorrhage. The patient underwent successful lens-sparing vitrectomy of the left eye. A unilateral Terson-like syndrome can result from severe cerebral edema following neonatal stroke in the setting of multiple congenital cerebrovascular abnormalities. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:592-595.]., (Copyright 2020, SLACK Incorporated.)
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- 2020
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105. Vitreous haemorrhage caused by unusual giant macular tear: a case report.
- Author
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Lei C and Chen L
- Subjects
- Female, Humans, Middle Aged, Visual Acuity, Vitrectomy, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery, Retinal Perforations diagnostic imaging, Retinal Perforations surgery, Retinal Vein Occlusion
- Abstract
Macular tears rarely occur without trauma. Here, we describe a patient with vitreous haemorrhage, which was caused by an unusual giant macular tear secondary to existing branch retinal vein occlusion. A 60-year-old woman presented with vision loss in the right eye because of vitreous haemorrhage. She had a history of branch retinal vein occlusion and had been treated with retinal photocoagulation 3 years prior. As treatment for vitreous haemorrhage, the patient underwent 23-gauge pars plana vitrectomy combined with silicone oil tamponade. During the operation, a large jagged tear was observed in the macula. We presumed that stretching of the fibrous proliferating membrane secondary to branch retinal vein occlusion was responsible for the macular tear and vitreous haemorrhage. Eventually, the results of pars plana vitrectomy led to anatomical closure of the macular tear and partial restoration of visual acuity.
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- 2020
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106. Clinical observations and considerations in the treatment of Terson syndrome using 23G vitrectomy.
- Author
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Ju C, Li S, Huang C, Li Y, Kyungwan H, Zhou F, and Li J
- Subjects
- Humans, Retrospective Studies, Syndrome, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage surgery, Vitrectomy
- Abstract
Purpose: This retrospective study analyzed the results of 23G vitrectomy for the treatment of intraocular hemorrhage in patients with Terson syndrome. The pathogenesis of Terson syndrome and the timing of vitrectomy are discussed., Methods: Eight eyes of eight patients were included in the study. Intrasurgical images were acquired, and membranes peeled off during surgery were subjected to pathological staining. Postoperative examination included visual acuity, intraocular pressure, funduscopy, and optical coherence tomography angiography., Results: The course of visual impairment in the patients ranged from < 1 to 5 months; visual acuity ranged from light perception to 20/1000. Surgeries in the eight patients were all successful, and no severe complications were observed. Visual acuity improved in each operative eye. Pathological staining revealed only fibrous connective tissue, and no nerve fibers in the membranes peeled off during surgery. Optical coherence tomography angiography revealed no changes in blood vessel density in the inner layer of the retina of the operative eye compared with the non-operative eye in each patient., Conclusions: Timely surgical intervention is necessary for the treatment of intraocular hemorrhage in patients with Terson syndrome. Clinical findings support the theory that intraocular blood results from stasis or rupture of retinal superficial peripapillary vessels caused by elevated intracranial pressure.
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- 2020
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107. Rubber Bullet Ocular Trauma.
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Barnes AC, Hudson LE, and Jain N
- Subjects
- Eye Injuries diagnostic imaging, Female, Fractures, Comminuted diagnostic imaging, Humans, Orbital Fractures diagnostic imaging, Retina injuries, Rubber, Visual Acuity physiology, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Wounds, Gunshot diagnostic imaging, Wounds, Nonpenetrating diagnostic imaging, Young Adult, Eye Injuries etiology, Fractures, Comminuted etiology, Orbital Fractures etiology, Wounds, Gunshot etiology, Wounds, Nonpenetrating etiology
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- 2020
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108. In reply: Ocular ultrasonography in patients with subarachnoid hemorrhage and Terson syndrome.
- Author
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Denault AY, Palermo J, Bojanowski M, and Langevin S
- Subjects
- Humans, Intracranial Pressure, Point-of-Care Systems, Ultrasonography, Vitreous Hemorrhage diagnostic imaging, Vitreous Hemorrhage etiology, Subarachnoid Hemorrhage diagnostic imaging
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- 2020
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109. Ocular ultrasonography in patients with subarachnoid hemorrhage and Terson syndrome.
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Vitiello L, De Bernardo M, and Rosa N
- Subjects
- Humans, Intracranial Pressure, Point-of-Care Systems, Ultrasonography, Vitreous Hemorrhage diagnostic imaging, Vitreous Hemorrhage etiology, Subarachnoid Hemorrhage diagnostic imaging
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- 2020
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110. EVALUATION OF SURGICAL FACTORS AFFECTING VITREOUS HEMORRHAGE FOLLOWING PORT DELIVERY SYSTEM WITH RANIBIZUMAB IMPLANT INSERTION IN A MINIPIG MODEL.
- Author
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Bantseev V, Schuetz C, Booler HS, Horvath J, Hovaten K, Erickson S, Bentley E, Nork TM, Freeman WR, Stewart JM, and Barteselli G
- Subjects
- Animals, Drug Implants, Follow-Up Studies, Homeostasis, Intraocular Pressure physiology, Male, Swine, Swine, Miniature, Vascular Endothelial Growth Factor A antagonists & inhibitors, Visual Acuity physiology, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage prevention & control, Angiogenesis Inhibitors administration & dosage, Disease Models, Animal, Drug Delivery Systems, Ranibizumab administration & dosage, Sclera surgery, Vitreous Body drug effects, Vitreous Hemorrhage etiology
- Abstract
Purpose: To develop an animal model of vitreous hemorrhage (VH) to explore the impact of surgical parameters on VH associated with insertion of the Port Delivery System with ranibizumab (PDS) implant., Methods: Ninety eyes from 45 treatment-naive male Yucatan minipigs received PDS implant insertion or a sham procedure. The effect of prophylactic pars plana hemostasis, scleral incision length, scleral cauterization, surgical blade type/size, and viscoelastic usage on postsurgical VH was investigated., Results: Postsurgical VH was detected in 60.0% (54/90) of implanted eyes. A systematic effect on VH was only detected for pars plana hemostasis before the pars plana incision. The percentage of eyes with VH was 96.6% (28/29) among eyes that did not receive prophylactic pars plana hemostasis and 42.4% (24/58) among eyes that did. There was no VH in eyes that received laser ablation of the pars plana using overlapping 1,000-ms spots; pars plana cautery or diathermy was less effective. The majority of all VH cases (83.3% [45/54]) were of mild to moderate severity (involving ≤25% of the fundus)., Conclusion: In this minipig surgical model of VH, scleral dissection followed by pars plana laser ablation before pars plana incision most effectively mitigated VH secondary to PDS implant insertion.
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- 2020
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111. Multiple factors in the prediction of risk of recurrent vitreous haemorrhage after sutureless vitrectomy for non-clearing vitreous haemorrhage in patients with diabetic retinopathy.
- Author
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Ding Y, Yao B, Hang H, and Ye H
- Subjects
- Humans, Postoperative Complications, Retrospective Studies, Vitrectomy, Vitreous Body, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery, Diabetes Mellitus, Diabetic Retinopathy complications, Diabetic Retinopathy surgery
- Abstract
Background: We aimed to analyse multiple factors in the prediction of risk of postoperative recurrent vitreous haemorrhage (RVH) for non-clearing vitreous haemorrhage in patients with diabetic retinopathy (DR) who underwent sutureless vitrectomy with 23- (23G) or 25-gauge (25G) narrow-gauge systems., Methods: A retrospective consecutive case series design was used. DR patients who underwent sutureless vitrectomy for non-clearing vitreous haemorrhage between June 2017 and October 2019 were enrolled. All operations were performed at a tertiary hospital. Patient demographics and risk factors, including age, gender, duration of diabetes, preoperative fasting blood sugar levels (FBSL), systolic blood pressure (SBP), serum creatinine (Cr), urea, triamcinolone acetonide (TA), electrical coagulation, air-fluid exchange, pan-retinal photocoagulation status (PRP), anti-vascular endothelial growth factor drug (anti-VEGF), and other factors, were recorded. Patients were divided into two groups based on the timing of their postoperative RVH: immediate postoperative RVH (within 2 weeks after operation) and delayed postoperative RVH (beyond 2 weeks after operation)., Results: Overall, 167 eyes (167patients) were enrolled. Seventy eyes were underwent 23G and 25G sutureless vitrectomy performed in 97 eyes, respectively. Postoperative RVH developed in 18 eyes (25.7%) in Group 23G and in 20 eyes (21.6%) in Group 25G (P = 0.540). Of these, 3 eyes (4.3%) had severed RVH in Group 23G compared with 5 eyes (5.2%) in Group 25G (P = 0.584). Delayed postoperative RVH occurred in 6 eyes (8.6%) in Group 23G and 8 eyes (8.2%) in Group 25G (P = 0.789). A binomial logistic regression analysis revealed that age, duration of diabetes, and Cr level were significantly associated with RVH in both Group 23G (P < 0.05) and Group 25G (P < 0.05)., Conclusions: The incidence and severity of RVH were 25.7 and 4.3%, respectively, in Group 23G and 21.6 and 5.2%, respectively, in Group 25G. Thus, the 23G sutureless vitrectomy approach was as safe as the 25G sutureless vitrectomy approach for treating vitreous haemorrhage in patients with DR. A younger age, shorter duration of diabetes, and higher Cr levels were risk factors for postoperative RVH in sutureless vitrectomy.
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- 2020
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112. A Case of Choroidal and Vitreous Hemorrhage Following Micropulse Transscleral Cyclophotocoagulation.
- Author
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Aldaas KM, Brasington C, and Zhang AY
- Subjects
- Aged, 80 and over, Choroid Hemorrhage drug therapy, Female, Glaucoma, Open-Angle surgery, Glucocorticoids therapeutic use, Humans, Intraocular Pressure physiology, Vitrectomy, Vitreous Hemorrhage surgery, Choroid Hemorrhage etiology, Ciliary Body surgery, Laser Coagulation adverse effects, Sclera surgery, Vitreous Hemorrhage etiology
- Abstract
Choroidal hemorrhages involve bleeding into the potential space between the choroid and sclera and are a serious ocular complication. Common causes of choroidal hemorrhages include intraocular surgeries, such as scleral buckling, cataract extractions, and glaucoma filtering procedures, or trauma. We report a case of choroidal and vitreous hemorrhage after micropulse cyclophotocoagulation. An 82-year-old female presented postoperative day 1 with blurry vision and pain in her right eye. Examination showed that she had a choroidal hemorrhage, 200 degrees of ciliary body swelling, and vitreous hemorrhage. Although the choroidal hemorrhage resolved with steroids, the vitreous hemorrhage required pars plana vitrectomy. To the best of our knowledge, this article discusses the first reported case of choroidal and vitreous hemorrhage due to micropulse cyclophotocoagulation.
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- 2020
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113. Migrated subconjunctival crystalline lens: a traumatic phacocele.
- Author
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Neupane S, Das D, and Korgaonkar S
- Subjects
- Eye Injuries complications, Female, Humans, Lens Subluxation diagnostic imaging, Lens Subluxation etiology, Lens, Crystalline diagnostic imaging, Lens, Crystalline injuries, Middle Aged, Treatment Outcome, Vitreous Hemorrhage diagnostic imaging, Vitreous Hemorrhage etiology, Lens Subluxation pathology, Lens, Crystalline pathology, Vitreous Hemorrhage pathology, Wounds, Nonpenetrating complications
- Abstract
Competing Interests: Competing interests: None declared.
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- 2020
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114. [Functional results and prognostic factors in open-globe ocular trauma with presenting visual acuity of no-light perception].
- Author
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Boucenna W, Taright N, Delbarre M, El Sanharawi M, Khawaja O, Jany B, Froussart-Maille F, and Milazzo S
- Subjects
- Adult, Aged, Aged, 80 and over, Blindness etiology, Blindness rehabilitation, Blindness surgery, Eye Injuries, Penetrating complications, Eye Injuries, Penetrating surgery, Female, Humans, Light, Male, Middle Aged, Prognosis, Retrospective Studies, Treatment Outcome, Visual Acuity physiology, Vitrectomy, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery, Blindness diagnosis, Eye Injuries, Penetrating diagnosis, Visual Perception physiology
- Abstract
Purpose: To analyse the clinical ocular characteristics and determine prognostic factors for functional recovery in eyes presenting with no light perception (NLP) after open globe ocular trauma., Materials and Methods: In this retrospective study were included all the patients with no light perception after open globe trauma who presented to Amiens University Hospital between October 2014 and June 2018., Results: Fifteen eyes of 15 patients were included in this study. The main mechanism of the trauma was globe rupture (80 %, n=12). The most common location was zone III (66 %, n=10). The wound size was greater than 10mm in 9 patients (60 %). The ocular lesions included expulsion of the crystalline lens or posterior chamber intraocular lens, hyphema, retinal detachment, vitreous hemorrhage and ciliochoroidal lesions. Damage to the ciliary body was a negative prognostic factor for functional recovery (P=0.04). Nine patients remained with no light perception, whereas 6 patients experienced an improvement in visual acuity (2.3 logMAR in 3 patients, 0.7 logMAR in 1 patient, 0.4 logMAR in 1 patient and 0.2 logMAR in 1 patient). These 6 patients had undergone posterior vitrectomy due to vitreoretinal involvement (P<0.001)., Conclusion: In the case of open globe trauma with no light perception on presentation, a functional recovery is possible if there is no irreversible anatomical damage., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
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- 2020
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115. Prognostic factors of revitrectomy for complications in eyes with proliferative diabetic retinopathy: a retrospective multicentre study.
- Author
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Takayama K, Someya H, Yokoyama H, Kimura T, Takamura Y, Morioka M, Sameshima S, Ueda T, Ogata N, Kitano S, Tashiro M, Sugimoto M, Kondo M, Sakamoto T, and Takeuchi M
- Subjects
- Diabetic Retinopathy complications, Diabetic Retinopathy diagnosis, Female, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Diabetic Retinopathy surgery, Reoperation methods, Visual Acuity, Vitrectomy methods, Vitreous Hemorrhage surgery
- Abstract
Purpose: To identify prognostic factors for revitrectomy in patients who underwent vitrectomy for complications with proliferative diabetic retinopathy (PDR) in multicentre study., Methods: Consecutive 452 eyes of 452 patients with PDR undergoing 25-gauge microincision vitrectomy system (MIVS) in seven centres were retrospectivity reviewed. Preoperative ocular factors (baseline visual acuity [VA], vitreous haemorrhage [VH], tractional retinal detachment [TRD] and retinal photocoagulation), general factors (sex, age, diabetes duration, HbA1c level, hypertension, anti-coagulant medication and estimated glomerular filtration rate), surgical procedures (preoperative anti-vascular endothelial growth factor injection, internal limiting membrane peeling, combined cataract surgery, retinal break, and tamponade), postoperative complications for revitrectomy and postoperative VA at 6 months were evaluated., Results: In the follow-up period of 6 months, revitrectomy was performed in 56 eyes (26.3%), and postoperative complications for revitrectomy were VH in 31 eyes (15%), TRD in 13 eyes (6.2%) and membrane proliferation in 12 eyes (5.2%). The mean LogMAR improvement from baseline to 6 months in revitrectomy group (0.39) was significantly worse than in single vitrectomy group (0.74). Diabetic duration, low baseline VA, less simple VH, TRD and air tamponade were statistical risk factors of revitrectomy, and logistic regression analysis identified low baseline VA and air tamponade also as prognostic factors of revitrectomy., Conclusion: Our results indicated that prognosis of VA was worse in PDR patients with revitrectomy and low baseline VA and air as the tamponade material were the potential prognostic factors of revitrectomy., (© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
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- 2020
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116. Vitreous hemorrhage in diabetes patients with proliferative diabetic retinopathy undergoing hemodialysis.
- Author
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Kameda Y, Hanai K, Uchigata Y, Babazono T, and Kitano S
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- Female, Humans, Male, Middle Aged, Peritoneal Dialysis adverse effects, Retrospective Studies, Diabetic Retinopathy complications, Diabetic Retinopathy epidemiology, Renal Dialysis adverse effects, Vitreous Hemorrhage epidemiology, Vitreous Hemorrhage etiology
- Abstract
Aims/introduction: For diabetes patients undergoing hemodialysis, vitreous hemorrhage seems to be a hemodialysis-induced hemorrhagic complication because of the effect of systemic anticoagulation. However, it is unclear whether hemodialysis is associated with vitreous hemorrhage in diabetes patients. We therefore carried out this cohort study to clarify the relationship between hemodialysis and vitreous hemorrhage in diabetes patients with proliferative diabetic retinopathy., Materials and Methods: This was a single-center, retrospective, cohort study. We compared the incidence of vitreous hemorrhage in non-vitrectomized proliferative diabetic retinopathy eyes between the hemodialysis group (145 eyes) and peritoneal dialysis group (36 eyes), which does not require the use of systemic anticoagulation (parallel-group study), and in hemodialysis patients in the 12-month period before and after the start of hemodialysis (before-after study). We also determined the risk factors for vitreous hemorrhage after the start of hemodialysis based on the patients' systemic and ophthalmic characteristics., Results: There was no significant difference in the first-year incidence of vitreous hemorrhage between the hemodialysis (23.4%) and peritoneal dialysis groups (22.2%, P = 1.000). The incidence of vitreous hemorrhage in the dialysis period (23.4%) was significantly lower than that in the predialysis period (35.2%, P = 0.008). Only application of panretinal photocoagulation within the 6 months immediately before hemodialysis was significantly associated with the incidence of vitreous hemorrhage after the start of hemodialysis (P < 0.001)., Conclusions: Hemodialysis therapy does not seem to be associated with a higher risk of vitreous hemorrhage in diabetes patients with proliferative diabetic retinopathy., (© 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)
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- 2020
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117. Ultrasound findings in optic nerve avulsion.
- Author
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Sindhu M, Bansal RK, and Goyal P
- Subjects
- Adult, Humans, Male, Papilledema etiology, Ultrasonography, Visual Acuity, Vitreous Hemorrhage etiology, Optic Nerve diagnostic imaging, Optic Nerve Injuries etiology, Wounds, Nonpenetrating complications
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- 2020
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118. Updated Systematic Review and Clinical Spectrum of Peripheral Exudative Hemorrhagic Chorioretinopathy.
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Badawi AH, Semidey VA, Magliyah M, and Al-Dhibi H
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- Angiogenesis Inhibitors therapeutic use, Coloring Agents administration & dosage, Cryotherapy, Fluorescein Angiography, Humans, Indocyanine Green administration & dosage, Intravitreal Injections, Laser Coagulation, Retinal Hemorrhage diagnosis, Retinal Hemorrhage therapy, Risk Factors, Tomography, Optical Coherence, Ultrasonography, Vascular Endothelial Growth Factor A antagonists & inhibitors, Vitrectomy, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage therapy, Retinal Hemorrhage etiology, Vitreous Hemorrhage etiology
- Abstract
Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a rare retinal vasculopathy that might cause subretinal and/or vitreous hemorrhages. Although the primary etiology is still unknown, choroidal neovascularization is mainly involved in the pathogenesis. The main risk factors are age and systemic hypertension. Ancillary testing such as fluorescein angiography, indocyanine green angiography and ultrasonography can be of great value for diagnosing this entity and distinguishing PEHCR from other lesions as choroidal melanoma and retinal vasoproliferative tumor. Various treatments have been reported including photocoagulation, cryotherapy, intravitreal injection of anti-vascular endothelial growth factor (Anti-VEGF) and surgical intervention as pars plana vitrectomy. This review handles an up-to-date perspective regarding PEHCR., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Middle East African Journal of Ophthalmology.)
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- 2020
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119. Intravitreal ranibizumab versus vitrectomy for recurrent vitreous haemorrhage after pars plana vitrectomy for proliferative diabetic retinopathy: a prospective study.
- Author
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Chatziralli I, Dimitriou E, Theodossiadis G, Bourouki E, Bagli E, Kitsos G, and Theodossiadis P
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- Aged, Angiogenesis Inhibitors administration & dosage, Female, Follow-Up Studies, Humans, Intravitreal Injections, Male, Middle Aged, Prospective Studies, Recurrence, Treatment Outcome, Vascular Endothelial Growth Factor A antagonists & inhibitors, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Diabetic Retinopathy surgery, Ranibizumab administration & dosage, Visual Acuity, Vitrectomy adverse effects, Vitreous Hemorrhage therapy
- Abstract
Purpose: To compare prospectively intravitreal ranibizumab treatment and pars plana vitrectomy (PPV) in patients with recurrent vitreous haemorrhage (VH) due to proliferative diabetic retinopathy (PDR), who were previously treated with PPV., Methods: Participants in this prospective study were 37 patients (37 eyes) with PDR, previously treated with PPV. All patients presented recurrent VH and were treated with either ranibizumab (n = 18) or PPV (n = 19). All participants were examined at week 2 post-treatment and every month thereafter for 1 year. Main outcomes were the need of PPV, the rate of recurrence of VH and the change in visual acuity by the end of the 12-month follow-up., Results: At month 12, there was statistically significant improvement in visual acuity in both groups compared to baseline, but the two groups did not differ regarding the change in visual acuity. In ranibizumab group, two patients presented recurrent VH during the follow-up and one patient needed PPV to clear the VH by month 12. In PPV group, two patients had mild recurrent VH, which cleared itself. No statistically significant difference was noticed regarding the rate of recurrent VH and the need of PPV between the two groups., Conclusion: Intravitreal ranibizumab seems to be a safe and effective treatment alternative in patients with recurrent VH secondary to PDR, who had been previously treated with PPV.
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- 2020
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120. Vitreous hemorrhage secondary to sickle cell trait.
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Fekih O, Abdeljelil A, Zgolli H, and Nacef L
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- Adult, Anemia, Sickle Cell complications, Anemia, Sickle Cell diagnosis, Diagnosis, Differential, Female, Fluorescein Angiography, Fundus Oculi, Humans, Vitreous Hemorrhage diagnosis, Sickle Cell Trait complications, Sickle Cell Trait diagnosis, Vitreous Hemorrhage etiology
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- 2020
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121. Bilateral Vitreous Haemorrhage and Peripheral Neovascularisation as Part of Occlusive Noninfectious HIV Microvasculopathy - Case Report.
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Oesterle L, Valmaggia C, and Todorova M
- Subjects
- Fluorescein Angiography, Humans, Neovascularization, Pathologic, HIV Infections complications, Vitreous Hemorrhage etiology
- Abstract
Competing Interests: The authors declare that they have no conflict of interest.
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- 2020
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122. Terson's syndrome.
- Author
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Reale C, Brigandì A, Gorgoglione N, Laganà A, and Girlanda P
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- Female, Humans, Middle Aged, Syndrome, Aneurysm, Ruptured complications, Intracranial Aneurysm complications, Subarachnoid Hemorrhage etiology, Vitreous Hemorrhage etiology
- Abstract
Competing Interests: Competing interests: None declared.
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- 2020
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123. Clinical features and visual prognostic indicators after vitrectomy for Terson syndrome.
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Liu X, Yang L, Cai W, Gao L, and Li Y
- Subjects
- Humans, Prognosis, Retrospective Studies, Vitrectomy, Retinal Detachment surgery, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery
- Abstract
Purpose: To determine clinical characteristics and identify factors associated with better visual outcomes in patients who had vitrectomy for vitreous haemorrhage (VH) associated with Terson syndrome (TS)., Methods: The records of 48 patients (54 corresponding eyes) who underwent vitrectomy for VH associated with TS from January 2008 to December 2017 were retrospectively reviewed. The main outcome measure was the final postoperative visual acuity., Results: At the last visit, 34 eyes (63.0%) achieved a BCVA of 0.3 or better. Eyes associated with traumatic brain injury had a better visual outcome than those with primary intracerebral haemorrhage (P = 0.042). In the primary intracerebral haemorrhage group, patients with hypertension-induced intracranial haemorrhage (IH) showed poorer final visual acuities than the ruptured intracranial aneurysm group (P = 0.023). In the delayed vitrectomy group, epiretinal membrane and peripheral retina changes were more common (P < 0.05). However, the difference in final visual acuity between the early and delayed vitrectomy groups was not significant (P = 0.69)., Conclusion: Most of the patients obtained visual recovery after vitrectomy for TS. VH associated with ruptured intracranial aneurysm or traumatic brain injury or eyes without retinal haemorrhage are predictive of better prognosis. Although the timing of vitrectomy was not related to the final postoperative visual outcome, early vitrectomy by three months seems to suggest less epiretinal membrane formation, retinal tears, and retinal detachments.
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- 2020
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124. Point-of-care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and Terson syndrome: a description of two cases.
- Author
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Palermo J, Bojanowski M, Langevin S, and Denault AY
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- Female, Humans, Intracranial Pressure, Male, Prospective Studies, Ultrasonography, Intracranial Hypertension diagnostic imaging, Point-of-Care Systems, Vitreous Hemorrhage diagnostic imaging, Vitreous Hemorrhage etiology
- Abstract
Background: Ultrasound (US) examination of the eye can be used to detect and monitor elevated intracranial pressure (ICP) and its consequences. Elevated ICP is transmitted to the contiguous optic nerve and its sheath (dura mater), thus underlying the development of papilledema and a widened sheath diameter. The US measurement of the optic nerve sheath diameter (ONSD) has previously been validated to diagnose and monitor raised ICP. The occurrence of vitreous hemorrhage in association with subarachnoid hemorrhage (SAH)-i.e., Terson syndrome-can also be easily diagnosed using ophthalmic US. Because of its relevance in anesthesia and critical care, we describe how to perform the technique illustrated by two cases., Case Presentations: A 72-yr-old man with hydrocephalus secondary to a SAH developed raised ICP following the removal of an external ventricular drainage (EVD) system. Daily ONSD measurements using handheld US allowed us to diagnose and monitor the progression and resolution of the intracranial hypertension following the placement of a second EVD system. We also describe the steps used to obtain ONSD measurements during the ophthalmic US examination of a 53-yr-old woman who presented with a stage IV SAH with concomitant bilateral vitreous hemorrhages or Terson syndrome., Conclusion: Ophthalmic US using a handheld device to measure and monitor ONSD at the bedside is useful in diagnosing and monitoring the progression of intracranial hypertension following EVD removal in a patient with hydrocephalus secondary to SAH. Ophthalmic US can also be used to identify concomitant vitreous hemorrhage that is associated with a worse prognosis.
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- 2020
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125. Comparison of outcomes of four different treatment modalities for diabetic vitreous haemorrhage.
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Taskintuna I, Elsayed MEAA, Taskintuna K, Ahmad K, Khandekar R, Schatz P, and Kozak I
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- Adult, Aged, Humans, Intravitreal Injections, Middle Aged, Retrospective Studies, Vitreous Hemorrhage etiology, Bevacizumab administration & dosage, Diabetes Complications therapy, Vitrectomy, Vitreous Hemorrhage therapy
- Abstract
We compared outcomes of four different management modalities for diabetic VH. Patients with diabetic VH were identified in this retrospective study undertaken at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Eyes were grouped based on the treatment received: control (observation only), intravitreal bevacizumab (IVB) injection(s), pars plana vitrectomy (PPV), and preoperative single IVB injection before PPV. Best-corrected visual acuity (BCVA) and status of VH were noted at baseline and the last follow up (Minimum: 6 months, maximum: 29 months). The proportion of eyes with Snellen BCVA improvement by two lines or more and VH clearance at the last follow up were compared between groups. The four groups - Control, IVB, PPV, and IVB-before-PPV had 23, 29, 17, and 20 eyes, respectively. The proportion of eyes gaining ≥2 lines was substantially higher in the IVB-before-PPV and PPV groups (90% and 77%, respectively) compared with IVB and observation groups (41% and 22%, respectively). Surgical treatment was associated with a 2.38 times higher likelihood of gaining ≥2 lines than the non-surgical one (incidence ratio: 2.38, 95% CI 1.19, 4.78 P = 0.015) after adjusting for age, hyperglycemia and BCVA at presentation. Less invasive treatment such as IVB injections did not result in the same amount of improvement in vision as did PPV. Prospective randomized studies are needed to better define the role of IVB injections in the management of diabetic VH.
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- 2020
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126. The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study.
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Jiang T, Gu J, Zhang P, Chen W, and Chang Q
- Subjects
- Diabetic Retinopathy diagnosis, Female, Follow-Up Studies, Humans, Intravitreal Injections, Male, Middle Aged, Pilot Projects, Postoperative Hemorrhage diagnosis, Postoperative Hemorrhage etiology, Prospective Studies, Severity of Illness Index, Tomography, Optical Coherence, Vascular Endothelial Growth Factor A, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Diabetic Retinopathy surgery, Postoperative Hemorrhage prevention & control, Recombinant Fusion Proteins administration & dosage, Visual Acuity, Vitrectomy adverse effects, Vitreous Hemorrhage prevention & control
- Abstract
Background: To investigate the effect of intravitreal conbercept (IVC) injections on the incidence of postoperative vitreous hemorrhage (VH) in eyes undergoing surgery for severe proliferative diabetic retinopathy., Methods: This was a pilot prospective, comparative, and randomized study. Thirty patients, who underwent vitrectomy for severe proliferative diabetic retinopathy, were assigned randomly to either group 1 (intravitreal conbercept [IVC] injection at the end of pars plana vitrectomy) or group 2 (no IVC injection). Postoperative follow-up was performed on the first day, first week, first month, third month, sixth month and first year after surgery. The primary outcome was the incidence of postoperative VH. Secondary outcomes were the initial time of vitreous clearing (ITVC), best-corrected visual acuity (BCVA) and central retinal thickness (CRT) after surgery., Results: A total of 30 eyes, from 30 patients, were included. Fifteen eyes were enrolled in the IVC group and fifteen in the control group. The incidence of early and late postoperative VH was not significantly different between the control and IVC groups. ITVC was shorter in the IVC group than that in the control group, but this was not significant (7.38 ± 10.66 vs 13.23 ± 17.35, P = 0.31). Final BCVA, 1 year after surgery, showed significant improvement compared to baseline in both groups. However, analysis of the BCVA at any postoperative visit after surgery showed no significant differences between the two groups. There were two cases of recurrent VH identified at 3 and 6 months after surgery in each group, requiring a second round of surgery. Foveal thickness was significantly different between the two groups at the 3-month, 6-month and 1-year follow-up visits., Conclusions: In this pilot study, the effect of IVC injection in reducing the incidence of postoperative VH after diabetic vitrectomy at the end of vitrectomy was not shown., Trial Registration: The study was registered with the Chinese Clinical Trial Registry. (Reference Number: ChiCTR1800015751).
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- 2020
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127. Long-term Clinical Course after Vitrectomy for Breakthrough Vitreous Hemorrhage Secondary to Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy.
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Kim JH, Kim JW, Kim CG, and Lee DW
- Subjects
- Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Outcome Assessment, Health Care, Retrospective Studies, Choroid Diseases complications, Macular Degeneration complications, Vitrectomy, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery
- Abstract
To investigate the long-term clinical course after vitrectomy for breakthrough vitreous hemorrhage secondary to neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). This retrospective study included 45 eyes that underwent vitrectomy due to breakthrough vitreous hemorrhage secondary to neovascular AMD. The patients were divided into 2 groups: neovascular AMD group and PCV group. Within each group, the status of the eye within 6 months after the surgery and that at the final follow-up was identified. The visual acuity at the final visit was additionally compared between the 2 groups. The patients were followed up for a mean period of 39.9 ± 19.4 months after the surgery. In the neovascular AMD group (n = 17), re-bleeding requiring vitrectomy was noted in 4 eyes and extensive scar formation was noted in 6 eyes within 6 months after the surgery. At the final visit, treatment was discontinued due to poor visual outcome in 10 eyes. In the PCV group (n = 28), re-bleeding requiring vitrectomy was noted in 1 eye, and extensive scar formation was noted in 4 eyes within 6 months after the surgery. At the final visit, treatment was discontinued in 8 eyes. The visual acuity at the final visit was significantly better in the PCV group (P = 0.003). The long-term clinical course after vitrectomy for breakthrough vitreous hemorrhage was markedly different between neovascular AMD and PCV, showing significantly better long-term visual outcomes in PCV.
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- 2020
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128. Peripheral retinal neovascularization secondary to highly myopic superficial Retinoschisis: a case report.
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Luo M, Du H, Ding H, and Dai R
- Subjects
- Adult, Female, Fluorescein Angiography, Humans, Laser Coagulation, Multimodal Imaging, Myopia, Degenerative diagnosis, Retinal Neovascularization surgery, Retinoschisis diagnosis, Tomography, Optical Coherence, Vision Disorders etiology, Visual Acuity physiology, Vitreous Hemorrhage etiology, Myopia, Degenerative complications, Retinal Neovascularization etiology, Retinoschisis complications
- Abstract
Background: Peripheral Retinal neovascularization is well-described as a complication of X-linked retinoschisis, but less often observed in myopic and primary retinoschisis. We present a case of a myopic female who developed retinal microvascular abnormalities due to retinoschisis and subsequent vitreous hemorrhage which would cause severe visual damage without timely and proper treatment., Case Presentation: A 38-year-old highly myopic Chinese female complained of blurred vision in her right eye. Her best corrected visual acuitiy was 20/20 OU, and her refraction was - 9.00S OU. Dilated fundus examination revealed mild vitreous hemorrhage and abnormal vascular network nasal to the optic disc in her right eye. Optical Coherence Tomography (OCT)- angiography (OCTA) B-Scan showed superficial retinoschisis and well-depicted abnormal retinal microvascular network in inner retinal layer. Sectoral scatter laser photocoagulation was administered. Regression of most abnormal vessels was achieved in 1 month, but the patient experienced an unexpected episode of vitreous hemorrhage 3 months after the initial treatment, which was absorbed spontaneously in 2 weeks. Supplemental laser photocoagulation was applied and regular follow-up visit was suggested., Conclusion: Superficial retinoschisis in pathological myopia can be a driver of retinal microvascular abnormalities, possibly neovascularization, an extremely rare but severe complication which can be vision-threatening without timely and proper intervention.
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- 2020
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129. Sight threatening vitreous haemorrhage and retinal detachment in a patient with sickle cell disease.
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Shifa JZ and Gezmu AM
- Subjects
- Adult, Female, Humans, Ophthalmoscopy, Retinal Detachment etiology, Ultrasonography, Vision Disorders diagnosis, Vision Disorders etiology, Vitreous Hemorrhage etiology, Anemia, Sickle Cell complications, Retinal Detachment diagnosis, Vitreous Hemorrhage diagnosis
- Abstract
We report a case of sight threatening vitreous haemorrhage and retinal detachment as complication of sickle cell disease (SCD). A 35 years old female Nigerian patient had presented to ophthalmology clinic of Princess Marina Hospital, Botswana, with two weeks history of poor vision in the left eye. The loss of vision was due to vitreous haemorrhage and retinal detachment which was confirmed by direct and indirect ophthalmoscopy and B-Scan ultrasound. Prior to presentation, patient didn't have any follow up by an ophthalmologist as part of regular medical care for patients with SCD. We emphasize the importance of regular follow up for early detection, treatment and prevention of complication associated with sickle cell disease., Competing Interests: The authors declare no competing interests., (© Jemal Zeberga Shifa et al.)
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- 2020
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130. OUTCOME OF ACUTE NONTRAUMATIC VITREOUS HEMORRHAGE IN HEALTHY PATIENTS.
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Pighin MS, Berrozpe C, and Jürgens I
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- Acute Disease, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Complications, Retinal Perforations physiopathology, Treatment Outcome, Vitreous Detachment complications, Vitreous Detachment physiopathology, Vitreous Hemorrhage etiology, Vitreous Hemorrhage physiopathology, Scleral Buckling, Visual Acuity physiology, Vitrectomy, Vitreous Detachment surgery, Vitreous Hemorrhage surgery
- Abstract
Purpose: To compare outcomes in dense vitreous hemorrhage versus mild vitreous hemorrhage due to nontraumatic posterior vitreous detachment., Methods: We compared 315 eyes, divided into 2 patient groups, one with dense and the other with mild vitreous hemorrhage. The main outcome measures were final mean best-corrected visual acuity, number of retinal tears, number of retinal detachments, and the number of pars plana vitrectomy and/or scleral buckle surgeries., Results: In 33.4% of the patients, posterior vitreous detachment without complications was found. Retinal breaks after posterior vitreous detachment were found in 59% of the eyes. Rhegmatogenous retinal detachment was principally treated with pars plana vitrectomy and scleral buckle. In nonvisible fundus hemorrhage group, 44.4% of the patients underwent vitrectomy. In visible fundus hemorrhage group, 9.52% of the patients underwent pars plana vitrectomy. The mean final visual acuity was 20/25, without significant difference between groups (P = 0.064)., Conclusion: Acute, spontaneous, nontraumatic posterior vitreous separation with vitreous hemorrhage is associated with a high incidence of retinal complications. Close follow-up is necessary. We did not find significant differences in final visual acuity neither between the two groups nor among the treatments.
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- 2020
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131. Clinical profile and management of vitreous hemorrhage in tertiary eye care centre in Nepal.
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Manandhar LD, Thapa R, and Poudyal G
- Subjects
- Eye, Female, Humans, Male, Middle Aged, Nepal epidemiology, Retinal Vein Occlusion complications, Retinal Vein Occlusion diagnosis, Retinal Vein Occlusion epidemiology, Tertiary Care Centers, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage epidemiology, Vitreous Hemorrhage etiology
- Abstract
Introduction: Vitreous hemorrhage is one of the most common diseases presenting to emergency department and leading cause of painless vision loss., Objectives: To determine the profile of vitreous hemorrhage in patients presented to Outpatient Department (OPD) and emergency Department of Tilganga Institute of Ophthalmology (TIO)., Materials and Methods: This is a hospital based observational non interventional descriptive study. Total 198 patients were enrolled who visited OPD and Emergency department of TIO from August 1st 2012 to July 30th 2013., Result: Total 198 patients (201 eyes) were enrolled for the study, out of which 144 were male and 54 females. 195 were unilateral and 3 bilateral cases. Most common age group of presentation of vitreous hemorrhage was 51-60 years (24.75%). Most common presenting complaint was sudden onset of decreased vision (95%). Most common etiology of vitreous hemorrhage was branch retinal vein occlusion (22.38%). Among the total subjects, 57.7% of the patient were managed with medical therapy, 35.8% surgically and 6.47 % with combined medical and surgical treatment., Conclusion: Branch retinal vein occlusion (BRVO) is the most common cause of vitreous hemorrhage. Diabetes and hypertension are the most commonly associated systemic illnesses., (© NEPjOPH.)
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- 2020
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132. The use of pan-retinal photocoagulation to treat recurrent vitreous haemorrhage with neovascularisation in the context of Epstein syndrome: an MYH9-related disorder.
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Sanders FWB, Thompson E, Roberts H, and Gupta N
- Subjects
- Female, Fluorescein Angiography, Hearing Loss, Sensorineural complications, Hearing Loss, Sensorineural genetics, Hearing Loss, Sensorineural pathology, Humans, Mutation, Myosin Heavy Chains genetics, Neovascularization, Pathologic diagnostic imaging, Neovascularization, Pathologic etiology, Recurrence, Retina pathology, Retinal Diseases pathology, Retinal Hemorrhage etiology, Thrombocytopenia complications, Thrombocytopenia genetics, Thrombocytopenia pathology, Thrombocytopenia therapy, Treatment Outcome, Vitreous Body pathology, Vitreous Hemorrhage etiology, Hearing Loss, Sensorineural therapy, Light Coagulation methods, Neovascularization, Pathologic therapy, Thrombocytopenia congenital, Vitreous Hemorrhage therapy
- Abstract
A female patient presented with stable chronic thrombocytopaenia with large platelets, sensorineuronal deafness and renal impairment. Her treatment was refractory to intravenous immunoglobulins (IVIG) and steroids for a putative diagnosis of immune thrombocytopaenic purpura (ITP). She underwent genetic testing which revealed a MYH9 mutation in-keeping with a diagnosis of Epstein Syndrome. Subsequently to this she developed globally constricted fields on Goldmann visual field testing. MRI pituitary was unremarkable but she was diagnosed with a pituitary microprolactinoma secondary to raised prolactin in the blood responsive to carbegoline therapy. She subsequently developed retinal haemorrhages and recurrent vitreous haemorrhages due to neovascularisation. Fluorescein angiography revealed the extent of the neovascularisation and microvascular ischaemia. She underwent pan-retinal photocoagulation (PRP) to treat the ischaemic stimulus which resulted in regression of the new vessels and cessation of vitreous haemorrhages. There are no previous reported cases of microvascular retinal disease in the literature in the context of Epstein Syndrome, and this is the first report of successful treatment with PRP., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2019
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133. Incidence of Terson Syndrome in Treated Subarachnoid Hemorrhage in South Korea: a National Health Insurance Database Study.
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Hong EH, Seong M, Yeom H, Choi S, Choi KS, Kang MH, Cho H, and Shin YU
- Subjects
- Adolescent, Adult, Age Distribution, Aged, Aged, 80 and over, Female, Fundus Oculi, Humans, Incidence, Male, Middle Aged, Republic of Korea epidemiology, Subarachnoid Hemorrhage mortality, Syndrome, Vitrectomy, Vitreous Hemorrhage mortality, Vitreous Hemorrhage surgery, Young Adult, Databases, Factual, National Health Programs, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage therapy, Vitreous Hemorrhage epidemiology, Vitreous Hemorrhage etiology
- Abstract
The aim of this study is to investigate the incidence and mortality of Terson syndrome in patients with treated subarachnoid hemorrhage (SAH) in South Korea. In this nationwide, population-based study, we used the National Health Insurance(NHI) database (2011-2015) to identify patients aged ≥18 years. Newly diagnosed non-traumatic SAH, treated using clipping or coil embolization, were identified, and Terson syndrome was defined as newly diagnosed retinal or vitreous hemorrhage within 3 months of SAH diagnosis. We identified 22,864 patients with treated SAH (tSAH), 196 of whom had Terson syndrome, with the cumulative incidence during 5 years of 0.86% (95% CI: 0.74-0.98): 1.10% (95% CI: 0.88-1.33) in men and 0.71% (95% CI, 0.58-0.85) in women. The cumulative incidence of Terson syndrome in patients aged under 40 was higher than in those aged 40 or over (1.41% vs. 0.81%; p = 0.007). The mortality rate of Terson syndrome in patients with tSAH was not different from that in those without Terson syndrome (4.08% vs. 7.30%; p = 0.089). This was the first nationwide epidemiological study of Terson syndrome using a population-based database. The incidence of Terson syndrome in patients with tSAH was higher in those age under 40 than in those aged 40 or over.
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- 2019
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134. False positive for β2-transferrin in rhinorrhoea. Ocular trauma.
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García-Callejo FJ, Martínez Expósito F, Pallarés Martí B, Rubio Fernández A, Oishi N, and Alba García JR
- Subjects
- Adult, Aqueous Humor, Biomarkers analysis, Cerebrospinal Fluid Rhinorrhea diagnostic imaging, False Positive Reactions, Female, Fistula diagnostic imaging, Humans, Tomography, X-Ray Computed, Vitreous Hemorrhage etiology, Eye Injuries, Penetrating diagnostic imaging, Transferrin analysis
- Abstract
Ocular perforations require an action depending on the findings observed. Additionally, the closeness of the orbit to the nasal cavity and the anterior cranial fossa requires any collateral damage in these spaces to be ruled out. The presence of a penetrating ocular injury associated with ipsilateral rhinorrhoea in which the presence of β2-transferrin -a highly specific and sensitive marker to identify cerebrospinal fluid- is detected, obliges to suspect and locate any possible leakage. A case is presented in which this unbound protein is detected in post-traumatic rhinorrhoea with an origin in the eyeball, making the diagnosis of a CSF leak into a false positive., (Copyright © 2019. Publicado por Elsevier España, S.L.U.)
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- 2019
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135. Vitrectomy for Vitreous Hemorrhage from Vitreous Operculum over Retinocytoma.
- Author
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Grassi P, Chawla A, and Rundle P
- Subjects
- Adult, Electrocoagulation methods, Humans, Laser Therapy methods, Male, Pasteurization, Retinal Neoplasms diagnosis, Retinal Neoplasms surgery, Vitreous Body diagnostic imaging, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Retinal Neoplasms complications, Visual Acuity, Vitrectomy methods, Vitreous Body surgery, Vitreous Hemorrhage surgery
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- 2019
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136. Intraoperative Optical Coherence Tomography-Guided Retrolenticular Vitreous Peeling in Diabetic Vitreous Hemorrhage.
- Author
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Muqit MMK
- Subjects
- Adult, Diabetic Retinopathy diagnosis, Female, Humans, Male, Vitreous Body surgery, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Diabetic Retinopathy complications, Surgery, Computer-Assisted methods, Tomography, Optical Coherence methods, Vitrectomy methods, Vitreous Body diagnostic imaging, Vitreous Hemorrhage surgery
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- 2019
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137. Swept source optical coherence tomography in globe perforation.
- Author
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Dubey D, Shanmugam M, Ramanjulu R, Mishra KCD, and Doshi B
- Subjects
- Eye Injuries, Penetrating complications, Eye Injuries, Penetrating surgery, Female, Follow-Up Studies, Humans, Laser Therapy methods, Middle Aged, Retinal Hemorrhage diagnosis, Retinal Hemorrhage surgery, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage surgery, Choroid pathology, Eye Injuries, Penetrating diagnosis, Retina pathology, Retinal Hemorrhage etiology, Tomography, Optical Coherence methods, Vitreous Hemorrhage etiology
- Abstract
Competing Interests: There are no conflicts of interest.
- Published
- 2019
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138. Bilateral proliferative retinopathy and ischemic optic neuropathy in a patient with atypical hemolytic-uremic syndrome: A case report.
- Author
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Lin IH, Chen YJ, Chang PY, Hsiao PW, Weng TH, and Chang YH
- Subjects
- Humans, Male, Young Adult, Atypical Hemolytic Uremic Syndrome complications, Retinal Detachment etiology, Vitreous Hemorrhage etiology
- Abstract
Rationale: To report a rare case of severe atypical hemolytic-uremic syndrome (HUS) in a patient who presented with vitreous hemorrhage and tractional retinal detachment (TRD) in both eyes. To our knowledge, this is the first reported case of atypical HUS complicated with bilateral TRD in the literature., Patient Concerns: A 20-year-old man with atypical HUS demonstrated bilateral visual acuity of hand motion at 30 cm., Diagnoses: Dilated fundus examination revealed diffuse intraretinal hemorrhage with vascular engorgement, neovascularization of the disc, and neovascularization elsewhere bilaterally. Fluorescein angiography revealed bilateral proliferative retinopathy, retinal hemorrhage, and a large nonperfusion area with extensive neovascularization. Intravitreal antivascular endothelial growth factor (ranibizumab) injection was administered in both eyes, but his ophthalmic condition did not improve, and TRD developed bilaterally. Therefore atypical HUS complicated with bilateral TRD was diagnosed., Interventions: Pars plana vitrectomy was performed with panretinal photocoagulation and silicone oil tamponade in the right eye., Outcomes: After the pars plana vitrectomy of right eye, the retina was well-attached after surgery, but visual acuity remained poor. Visual evoked potential examination showed poor waveforms bilaterally, which suggested ischemic optic neuropathy., Lessons: Atypical HUS can cause systemic thrombotic microangiopathy, resulting in ischemic retinal changes. These ischemic retinal changes can then cause hypoxia, which triggers production of angiogenic factors and subsequently causes retinal vascular hyperpermeability, retinal and vitreous neovascularization, fibrovascular proliferation, vitreous hemorrhage, and TRD, in a manner similar to that of other ischemia-induced proliferative retinopathies. Despite successful surgery in the right eye, our patient's visual acuity did not improve, possibly because of severe and generalized ischemia of intraocular tissue, which resulted in ischemic optic neuropathy.
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- 2019
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139. Vitreous haemorrhage a rare manifestation of retinal astrocytic hamartoma: a paediatric case report.
- Author
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Salazar-Quiñones L, Arcos-Villegas G, Valverde-Megías A, Flores-Moreno I, Méndez-Fernández R, and Díaz-Valle D
- Subjects
- Astrocytes pathology, Child, Fluorescein Angiography, Hamartoma pathology, Humans, Male, Retinal Diseases pathology, Slit Lamp Microscopy, Tomography, Optical Coherence, Hamartoma diagnosis, Retinal Diseases diagnosis, Vitreous Hemorrhage etiology
- Abstract
Introduction: Retinal astrocytic hamartoma is generally an asymptomatic benign tumour that may or may not be associated with the tuberous sclerosis complex. Haemorrhage is a rare presentation., Case Report: The case concerns a 12-year-old patient with "a black spot" vision in the upper temporal hemifield of the right eye, who referred a similar episode 2 years ago. The anterior pole was normal in the slit lamp. A mass of translucent white-yellow peri-papillary appearance and vitreous peri-papillary haemorrhage was observed in funduscopy. The autofluorescence, fluorescence angiography, and optical coherence tomography characteristics were all compatible with retinal astrocytic hamartoma. Complementary studies (serology and X-rays) and the complete clinical examination rule out associated systemic involvement. The patient was followed-up closely until the vitreous haemorrhage was reabsorbed., Conclusion: Vitreous haemorrhage is a rare complication of Retinal astrocytic hamartoma and funduscopic exploration is difficult. Systemic involvement should be ruled out., (Copyright © 2019 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2019
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140. Post-traumatic suprachoroidal dislocation of crystalline lens and its management.
- Author
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Shanmugam MP, Shah P, Rajesh R, Mishra DK, Sagar P, and Sheemar A
- Subjects
- Adult, Eye Injuries diagnosis, Humans, Lens Subluxation etiology, Lens Subluxation surgery, Lens, Crystalline diagnostic imaging, Male, Ultrasonography, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery, Eye Injuries complications, Lens Subluxation diagnosis, Lens, Crystalline injuries, Vitrectomy methods
- Abstract
Competing Interests: None
- Published
- 2019
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141. Recurrent pre-retinal haemorrhages associated with coagulation factor VII deficiency.
- Author
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Gutiérrez-Montero O and Reche-Sainz JA
- Subjects
- Factor VII Deficiency diagnosis, Female, Fundus Oculi, Humans, Lasers, Solid-State therapeutic use, Recurrence, Retinal Hemorrhage diagnostic imaging, Retinal Hemorrhage surgery, Vitreous Hemorrhage diagnostic imaging, Young Adult, Blindness etiology, Factor VII Deficiency complications, Retinal Hemorrhage etiology, Vitreous Hemorrhage etiology
- Abstract
The case concerns a 20 year-old woman with a sudden visual loss in her left eye. In the fundus examination, a focal pre-retinal haemorrhage was observed in the superior temporal vascular branch with accompanying vitreous haemorrhage. There was a favourable spontaneous outcome. Eighteen months later, she presented with a new visual loss in the same eye, showing a sub-hyaloid pre-macular haemorrhage that was satisfactorily drained by hyaloidotomy using a Nd-YAG laser. The patient had also presented with an upper digestive tract haemorrhage and menorrhagia. A haemostasis study was performed that showed a coagulation factor VII deficiency. This is a very uncommon disorder that has not been previously described in association with the appearance of pre-retinal haemorrhages., (Copyright © 2019 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2019
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142. OCT angiography of persistent hyaloid artery: a case report.
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Jeon H, Kim J, and Kwon S
- Subjects
- Adolescent, Fundus Oculi, Humans, Male, Persistent Hyperplastic Primary Vitreous complications, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Fluorescein Angiography methods, Persistent Hyperplastic Primary Vitreous diagnosis, Retinal Vessels diagnostic imaging, Tomography, Optical Coherence methods, Visual Acuity
- Abstract
Background: A persistent hyaloid artery is a rare fetal remnant. Several complications such as amblyopia, vitreous hemorrhage, and retinal detachment have been reported. Here, we present a case of vitreous hemorrhage with a persistent hyaloid artery., Case Presentation: A healthy 16-year-old male presented with blurred vision in his left eye. Vitreous hemorrhage occurred and absorbed spontaneously. Slit-lamp examination demonstrated a Mittendorf's dot and fundus examination revealed a persistent hyaloid artery. Optical coherence tomography (OCT) showed a Bergmeister's papilla. The blood flow of the persistent hyaloid artery via the Bergmeister's papilla was found by OCT angiography., Conclusion: The persistent hyaloid artery should be considered as a cause of spontaneous vitreous hemorrhage of young healthy patient. The OCT angiography will be a useful noninvasive approach to confirm the patency of the persistent hyaloid artery.
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- 2019
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143. Inadvertent Globe Penetration with Posterior Sub-Tenon Triamcinolone Injection and Subsequent Laser Barricade.
- Author
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Oh DJ, Jiang Y, and Chau FY
- Subjects
- Adult, Eye Injuries, Penetrating etiology, Glucocorticoids administration & dosage, Humans, Male, Needlestick Injuries etiology, Papilledema drug therapy, Retinal Detachment drug therapy, Retinal Hemorrhage etiology, Retinal Hemorrhage surgery, Vitreous Hemorrhage etiology, Vitreous Hemorrhage surgery, Eye Injuries, Penetrating surgery, Injections, Intraocular adverse effects, Laser Therapy, Needlestick Injuries surgery, Sclera injuries, Tenon Capsule drug effects, Triamcinolone administration & dosage
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- 2019
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144. Optic disk hemorrhage and vitreous hemorrhage after phacoemulsification in a normal tension glaucoma patient: A case report.
- Author
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Hu R, Shen L, and Wang X
- Subjects
- Aged, 80 and over, Humans, Male, Glaucoma complications, Optic Disk, Phacoemulsification adverse effects, Postoperative Complications etiology, Retinal Hemorrhage etiology, Vitreous Hemorrhage etiology
- Abstract
Rationale: Optic disk hemorrhage has been closely correlated with glaucoma for its development and progression. Phacoemulsification surgery results in large intraocular pressure (IOP) fluctuation. We report a case of optic disk hemorrhage and consequently progressive vitreous hemorrhage after an unsuccessful phacoemulsification surgery in an advanced normal tension glaucoma (NTG) patient., Patient Concerns: An advanced NTG patient of 82 years old with chronic hypertension underwent an unsuccessful phacoemulsification surgery complicated by posterior capsule rupture. During the postoperative 2 weeks, recurrent episodes of fresh hyphema occurred and B ultrasonography scan revealed the progressive vitreous hemorrhage. The IOP went out of control under the maximum tolerable IOP-lowering medications., Diagnosis: Vitreous hemorrhage after phacoemulsification in an advanced NTG patient., Interventions: Vitrectomy was performed to search for the cause of the progressive vitreous hemorrhage. After removal of the thick vitreous hemorrhage, a fresh spot of optic disk hemorrhage was detected at the nasal margin of the significantly-cupping disk., Outcomes: Postoperatively, the hemorrhagic vitreous opacity gradually resolved and the IOP remained stable at 10 ∼13 mmHg with topical prostaglandin analogue drops. Fundus examination revealed the dilated disk vessel with localized angiomatous change at the nasal disk margin., Lessons: Severe optic disk hemorrhage may occur after phacoemulsification in advanced glaucoma patients. Systemic vascular factors, such as chronic hypertension and old age, and surgical complications, such as posterior capsule rupture and postoperative IOP elevation, would further increase the risk. For phacoemulsification in advanced glaucoma cases, extra care should be taken to control intraoperative IOP fluctuations and monitor postoperative IOP.
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- 2019
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145. Intravitreal ranibizumab injection at the end of vitrectomy for diabetic vitreous hemorrhage (Observational Study).
- Author
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Liang X, Zhang Y, Wang JX, Wang LF, Huang WR, and Tang X
- Subjects
- Adult, Diabetic Retinopathy complications, Female, Humans, Intravitreal Injections statistics & numerical data, Male, Middle Aged, Reoperation, Retrospective Studies, Treatment Outcome, Visual Acuity, Vitreous Hemorrhage etiology, Diabetic Retinopathy therapy, Ranibizumab administration & dosage, Vitrectomy methods, Vitreous Hemorrhage therapy
- Abstract
To evaluate the outcomes and complications of intravitreal injections of ranibizumab in patients during pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. This retrospective, observational, comparative study included 103 patients (103 eyes) who underwent pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. Sixty-six patients received an intravitreal injection of 0.05 mg (0.05 cc) of ranibizumab at the end of surgery. Main outcome measures were the occurrence of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, best corrected visual acuity. Mean follow-up time was 6 months. The rate of rebleeding in the intravitreal ranibizumab (IVR) group was 6.1% (4 eyes), which is significantly lower than the control group (24.3%, 9 eyes, P < .01). The incidence of postoperative diabetic vitreous hemorrhage (PDVH) was significantly lower in the IVR group than the control group, OR=0.26, 95% CI= (0.06, 0.95). Visual acuity 6 months after operation was better in IVR group (P<.01) There was no difference in mean intraocular pressure between the 2 groups (P=.56). The present clinical study suggests that intravitreal injection of ranibizumab is effective in the prevention of postoperative diabetic vitreous hemorrhage in eyes undergoing pars plana vitrectomy for the treatment of diabetic vitreous hemorrhage.
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- 2019
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146. Vitreous hemorrhage as the presenting feature of peripheral exudative hemorrhagic chorioretinopathy in Indian eyes.
- Author
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Goel N
- Subjects
- Aged, Aged, 80 and over, Choroid Diseases diagnosis, Choroid Diseases surgery, Exudates and Transudates, Female, Fluorescein Angiography, Fundus Oculi, Humans, India, Male, Middle Aged, Retinal Hemorrhage diagnosis, Retinal Hemorrhage surgery, Tomography, Optical Coherence, Vitrectomy, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage surgery, Choroid Diseases complications, Macula Lutea pathology, Retinal Hemorrhage complications, Visual Acuity, Vitreous Hemorrhage etiology
- Abstract
Five Indian patients presenting with unilateral vitreous hemorrhage (VH) underwent pars plana vitrectomy (PPV) and were found to have lesions suggestive of peripheral exudative hemorrhagic chorioretinopathy (PEHCR). All eyes had extensive sub-retinal hemorrhage; three also showed an elevated mass lesion. The temporal retina anterior to the equator was the most commonly affected site. Exudative manifestations were absent in all. No recurrences occurred over a mean follow-up of 17.5 months. Although PEHCR is reported to be rare in Asians, this series demonstrates that it can present as VH in Indians as well. Unless the macula has irreversible damage, a favorable outcome can be obtained with PPV alone., Competing Interests: None
- Published
- 2019
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147. Soloist performance of vitrectomy probe in proliferative diabetic retinopathy.
- Author
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Elwan MM, Hagras SM, and Kasem MA
- Subjects
- Adult, Aged, Diabetic Retinopathy complications, Diabetic Retinopathy diagnosis, Female, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Diabetic Retinopathy surgery, Microsurgery methods, Visual Acuity, Vitrectomy, Vitreous Hemorrhage surgery
- Abstract
Purpose:: To evaluate the feasibility and outcomes of the sole use of 23g pars plana vitrectomy in cases with diabetic vitreous hemorrhage with vitreoretinal traction., Methods:: Prospective interventional case series involving patients between January 2013 and January 2018. All eyes underwent 23g pars plana vitrectomy with internal tamponade. Intraoperative parameters including ancillary instruments, the methods used for hemostasis and complications were all recorded. Postoperative parameters including anatomic success rate, functional success, and postoperative complications were recorded and analyzed. Patients were followed up for at least 12 months., Results:: A total of 68 eyes of 66 patients were included. Intraoperative ancillary instruments were required in 5 (7.4%) eyes. None of the cases required the use of chandelier illumination, endodiathermy, or scissors. Mean best-corrected visual acuity improved significantly from LogMAR 1.67 ± 0.63 preoperative to 1.22 ± 0.38 at 1-year follow-up (P = 0.005). Functional success was achieved in 37 (54.4%) eyes at 1-year follow-up. Iatrogenic breaks occurred in 3 (4.4%) eyes, vitreous hemorrhage in 4 (5.9%) eyes, and epiretinal membranes in 3 (4.4%) eyes. Repeated vitrectomy was done in 3 (4.4%) eyes., Conclusion:: The 23g vitrectomy probe proved to be a safe, effective, and beneficial single tool that could accomplish the diabetic vitrectomy mission exclusively with minimal aid from other instruments in cases with vitreous hemorrhage associated with vitreoretinal traction.
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- 2019
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148. [The comet-tail artifact: A useful ultrasound sign].
- Author
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Laaribi N, Abdellaoui T, Qariani H, Mouzari Y, Bami Y, El Asri F, Reda K, and Oubaaz A
- Subjects
- Adult, Diagnosis, Differential, Firearms, Humans, Male, Meteoroids, Orbit diagnostic imaging, Orbit injuries, Retinal Detachment diagnosis, Retinal Detachment etiology, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Artifacts, Eye Foreign Bodies diagnosis, Lead, Ultrasonography, Wounds, Gunshot diagnosis
- Published
- 2019
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149. Sub-hyaloid and sub-internal limiting membrane macular hemorrhage after laser exposure at music festival: a case report.
- Author
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Perez-Montaño CR, Palomares-Ordoñez JL, Ramirez-Estudillo A, Sanchez-Ramos J, and González-Saldivar G
- Subjects
- Electroretinography, Eye Injuries diagnostic imaging, Eye Injuries surgery, Holidays, Humans, Male, Retinal Hemorrhage diagnostic imaging, Retinal Hemorrhage surgery, Tomography, Optical Coherence, Visual Acuity physiology, Vitrectomy, Vitreous Hemorrhage diagnostic imaging, Vitreous Hemorrhage surgery, Young Adult, Eye Injuries etiology, Lasers adverse effects, Retina injuries, Retinal Hemorrhage etiology, Vitreous Body injuries, Vitreous Hemorrhage etiology
- Abstract
Purpose: To describe the first case of a combined sub-hyaloid and sub-internal limiting membrane macular hemorrhage after recreational laser exposure., Methods: A 23-year-old patient presented with an acute loss of vision in his right eye (OD) immediately after a brief exposure to a laser beam at a music festival. Color photography, spectral-domain optical coherence tomography (SD-OCT), and multifocal electroretinogram (mfERG) were performed for diagnosis and follow-up., Results: On presentation, visual acuity was 20/400 in the OD and 20/20 in the left eye. Posterior segment examination of his OD revealed a preretinal hemorrhage at the macula. SD-OCT images exposed a combined sub-hyaloid and sub-internal limiting membrane localization. Successful VPP with ILM peeling was carried out. Although sequential mfERG displayed almost complete restoration of the P1 amplitude 6 months posterior to VPP, SD-OCT demonstrated permanent damage to outer retinal layers. Final BCVA on OD was 20/30., Conclusion: The expanding and unregulated use of lasers in everyday life has created an increasing amount of cases of laser-induced retinopathy in recent years. Much more attention should be addressed in laser safety and awareness to prevent future ocular injuries. In acute phases of sub-hyaloid hemorrhages blocking direct visualization of the posterior pole, mfERG is a valuable tool to address initial macular pathology.
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- 2019
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150. SURGICAL MANAGEMENT OF TRACTIONAL RETINOSCHISIS ASSOCIATED WITH VITREOUS HEMORRHAGE IN RETINOPATHY OF PREMATURITY.
- Author
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Todorich B, Thanos A, Yonekawa Y, Korot E, Trese MT, Drenser KA, and Capone A Jr
- Subjects
- Humans, Infant, Newborn, Male, Retinopathy of Prematurity surgery, Retinoschisis diagnosis, Retinoschisis etiology, Vitreous Hemorrhage diagnosis, Vitreous Hemorrhage etiology, Retinopathy of Prematurity complications, Retinoschisis surgery, Visual Acuity, Vitrectomy methods, Vitreous Hemorrhage surgery
- Abstract
Purpose: The tractional retinoschisis is a poorly understood, rare, and likely underappreciated entity in retinopathy of prematurity. The purpose of this article is to describe clinical findings and surgical management of tractional retinoschisis in retinopathy of prematurity, masquerading as Stage 4 retinopathy of prematurity retinal detachment., Methods: A retrospective review of a single case with literature review and case discussion., Results: In this report, we describe a child with retinopathy of prematurity and tractional schisis, who initially presented with vitreous hemorrhage and was effectively managed by vitrectomy and inner wall retinectomy. At 5 months after vitrectomy, the child demonstrated complete collapse of the retinoschisis with intact posterior pole and brisk light perception., Conclusion: Vitrectomy with or without inner wall retinectomy is effective in the management of tractional retinoschisis.
- Published
- 2019
- Full Text
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