Hemorrhage in patients who have received transpupillary thermotherapy for subfoveal choroidal neovascularization.
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Biomedical subjects
Wico W Lai
Publications and source records attributed to Wico W Lai.
Magnetic resonance imaging in the diagnosis of subretinal cysticercosis.
PURPOSE: To report a case of ocular cysticercosis and associated magnetic resonance imaging (MRI) findings. DESIGN: Interventional case report. METHODS: A 56-year-old woman from Ecuador presented with decreased vision and an exudative retinal detachment in the left eye. Subretinal cysticercosis was suspected. RESULTS: In the left eye, a subretinal cyst evident on fundus examination was investigated with B-scan ultrasonography. Ultrasonography showed a cystic structure, and MRI of the orbit confirmed the suspicion for cysticercosis. Magnetic resonance imaging of the brain also revealed a small parenchymal lesion in the left occipital lobe of the brain. CONCLUSIONS: Magnetic resonance imaging is a useful adjunct to B-scan ultrasonography in the diagnosis of ocular cysticercosis. Magnetic resonance imaging is superior to computed tomography in the demonstration of cystic structures in the eye and central nervous system. This finding has important therapeutic implications, as any viable cysticercus in the eye or cerebral parenchyma can be treated surgically or medically, respectively.
Cysticercosis↗
Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy.
We present a technique, vitrectorhexis, in which a vitrector-cut capsulotomy is used to treat anterior capsule contraction syndrome. A vitrector handpiece is used to remove all fibrous capsule tissue and residual lens epithelial cells from the anterior chamber. Vitrectorhexis may be an alternative to neodymium:YAG laser capsulotomy as it decreases the risk of radial tear extension to the zonules and of secondary IOL decentration. The technique was used in a 77-year-old man with capsulorhexis contraction syndrome and extensive fibrosis after phacoemulsification with silicone piggyback intraocular lens implantation. One day postoperatively, visual acuity improved from 20/60 to 20/30 and the anterior chamber reaction was minimal. At 1 month, best corrected visual acuity was 20/20. The IOL was well centered at 6 months.
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Intermediate uveitis.
The cause of intermediate uveitis remains unknown. It is important to rule out other causes of the condition before initiating therapy. Many patients presenting with a mild form of the disease and who have good visual acuity may not require treatment. Those with decreased vision because of inflammation or cystoid macular edema may require periocular injections or systemic administration of corticosteroids (Fig. 2). Those who develop recalcitrant disease and those who experience severe side effects from the steroid therapy may require other immunosuppressive agents. Close monitoring of systemic side effects is required. Laser photocoagulation or cryotherapy of the peripheral retina is useful in patients who develop neovascularization of the vitreous base, in those who are not responsive to periocular injections, and in those who develop severe side effects from corticosteroids. This should be considered before starting systemic immunosuppressive agents. Pars plana vitrectomy with or without cryotherapy or laser photocoagulation is indicated in patients with marked vitreous debris, cystoid macular edema, and in those who develop a vitreous hemorrhage.
Humans↗
Chorioretinal topography and histopathology in laser-induced choroidal neovascularization.
OBJECTIVE: To investigate the correspondence between topographic mapping of the vitreoretinal and chorioretinal surfaces in vivo and histopathology findings. MATERIALS AND METHODS: Choroidal neovascularization was induced in the retina of a primate by an argon laser. Serial optical section images of the retina were obtained using an optical imaging system based on the Retinal Thickness Analyzer. Topography of the vitreoretinal and chorioretinal surfaces was mapped. The animal was killed and the eyes enucleated for histopathologic examination. RESULTS: In the normal retina, the topography of the vitreoretinal surface showed a depression at the center of the fovea while the chorioretinal surface was relatively flat, corresponding to normal anatomy. In the retina with choroidal neovascularization, the topography of the vitreoretinal surface indicated a smooth elevation while there were irregular elevations in the topography of the chorioretinal surface. Histological sections displayed focal serous retinal detachment, metaplasia of retinal pigment epithelium, and choroidal neovascularization. CONCLUSION: Topographic mapping of the vitreoretinal and chorioretinal surfaces in vivo corresponds with histological findings and shows promise for quantitative evaluation of pathologic alterations caused by chorioretinal diseases.
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