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At least 343 records · Page 19Linked to original sources
PubMed1982

Bilateral acute retinal necrosis. Clinical and ultrastructural study.

In a 28-year-old man with bilateral acute retinal necrosis, a severe, bilateral panuveitis, necrotizing retinitis, and retinal vasculitis developed. Severe vitreous traction on atrophic retina resulted in bilateral giant retinal tears with an inoperable retinal detachment in the right eye. A retinal detachment developed in the left eye that was reattached after a pars plana vitrectomy and two scleral buckling procedures, but ultimately became inoperable. Large numbers of lymphocytes in the vitreous aspirate and depressed serum complement levels may indicate that an immune mechanism was involved in the necrotizing retinitis. We present the first electron microscopic evidence, to our knowledge, that preretinal membranes occurring in rhegmatogenous retinal detachment due to bilateral acute retinal necrosis arise from retinal pigment epithelium.

Acute Disease↗
PubMed1996

Endoscopic fluorescein angiography.

BACKGROUND AND OBJECTIVE: To assess features of various retinal and choroidal disorders by endoscopic fluorescein angiograms (EFAs) obtained intraoperatively. PATIENTS AND METHODS: One hundred patients undergoing vitrectomy were studied intraoperatively by injecting 5 ml of 10% fluorescein intravenously. Up to 110 degrees field of view high-resolution angiograms were obtained endoscopically. Characteristics of diabetic retinopathy, retinal vein occlusion, retinal vasculitis, exudative macular degeneration, and neovascular glaucoma were recorded. RESULTS: Capillary nonperfusion, retinal vascular occlusion or incompetence, and neovascularization of the disc, retina, subretinal space, and posterior iris could be delineated. CONCLUSION: EFA defines pathologic retinal/choroidal areas intraoperatively, which may permit more selective surgical management during vitrectomy.

Choroid Diseases↗
PubMed1992

Behçet's disease: activated T lymphocytes in retinal perivasculitis.

A 38-year-old man who died from systemic Behçet's disease had previously suffered from severe, recurrent bilateral retinal vasculitis, and anterior uveitis for 10 years. Immunopathological examination of the eyes postmortem revealed marked hyaline thickening of the retinal and optic nerve vessels. The vessels had an intramural and perivascular infiltrate of T lymphocytes which stained positively for CD4 and IL2 receptor surface markers. Small numbers of cells in the optic nerve head, retinal vascular endothelium, and retinal pigment epithelium were HLA DR positive.

Adult↗
PubMed1992

Retinal involvement in Wucheria bancrofti filariasis.

We report the first case of inflammation of the retinal pigment epithelium and retinal vasculities presumably caused by microfilaria of Wucheria bancrofti and discuss its possible pathogenesis. Therapy with diethyl carbamazine citrate resulted in rapid resolution of the inflammation.

Adult↗
PubMed1979

Patterns of cell proliferation in the developing retina of the clawed frog in relation to blood supply and position of the choroidal fissure.

The pattern of retinal vasculative is described and the position at which cell proliferation at the ventral retinal margin is maximal was shown to be at the point of entry of the ventral blood vessels. To test whether there is a causal relation between retinal blood supply and retinal cell production, surgical inversion of the eye, transplantations and excisions of retina were done to change the pattern of retinal vasculature. The growth pattern of inverted eyes was normal with respect to the internal axes of the eyes. After excision of part of the retina or after fusion of retinal fragments to form compound eyes, the pattern of retinal cell proliferation was not correlated with the distribution of retinal blood vessels, but was correlated with the position(s) of the choroidal fissure(s).

Animals↗
PubMed1995

Bilateral bullous exudative retinal detachment complicating idiopathic central serous chorioretinopathy during systemic corticosteroid therapy.

PURPOSE: To present evidence that systemic corticosteroid therapy may cause bilateral bullous serofibrinous exudative retinal detachment in some patients with idiopathic central serous chorioretinopathy. BACKGROUND: Idiopathic central serous chorioretinopathy usually causes mild, transient loss of central vision, usually in otherwise healthy men with a type A personality. A few patients have permanent visual loss because of chronic and recurrent retinal detachment. The clinical findings in these patients may lead to incorrect diagnoses and use of corticosteroid therapy. METHODS: The clinical and photographic records of three patients in whom bilateral bullous serofibrinous exudative retinal detachment associated with idiopathic central serous chorioretinopathy developed after treatment with systemic corticosteroids were reviewed. RESULTS: Systemic corticosteroid treatment was instituted (1) as a prophylaxis to prevent exacerbation of the disease while undergoing surgery in the fellow eye, and (2) as the result of misdiagnoses of multifocal choroiditis and retinal vasculitis (Eales disease). Two of the patients had a history of chronic recurrent retinal detachments before institution of corticosteroid treatment. In one of these patients, bilateral chronic inferior retinal detachment developed, causing peripheral retinal vascular nonperfusion, retinal neovascularization, and vitreous hemorrhage. All three patients had severe permanent visual loss in one or both eyes. CONCLUSION: The findings in these patients provide further evidence that systemic corticosteroid treatment may cause severe exacerbation of retinal detachment and lasting visual loss in some patients with idiopathic central serous retinopathy. Recognition of the atypical presentations of this disorder is important to avoid incorrect diagnoses and treatment.

Adrenal Cortex Hormones↗
PubMed1994

[Varicella zoster virus infections of the retina in patients with and without immune suppression].

BACKGROUND: Infections of the retina with the varicella-zoster virus can lead to severe visual impairment. Patients with immunodeficiency are particularly predisposed to viral infections, and the alterations of the immune system may lead to a modified clinical picture. PATIENTS: Two cases of infections of the retina with the varicella-zoster virus in an immunocompromised and an immunocompetent patient are presented. The first otherwise healthy patient showed the typical clinical picture of the "acute retinal necrosis syndrome" with orbital pain and decrease of vision. He had inflammatory infiltration of the vitreous and the anterior chamber, retinal vasculitis, optic disc edema and whitening of the peripheral retina with full thickness retinal necrosis. The second patient with AIDS presented with a history of sudden painless loss of vision in one eye. He had a swollen optic disc, inflammatory infiltrates in the choroid and virtually no cellular infiltration of the vitreous or the anterior chamber. The diagnosis of varicella-zoster virus infection of the retina was confirmed in both patients by polymerase chain-reaction of aqueous and vitreous humor, by determination of intraocular antibody titers and immunohistochemistry on retinal biopsy material, respectively. In both patients no inflammation in the fellow eye developed under therapy with aciclovir. The first patient regained full vision after vitrectomy with membrane dissection. CONCLUSIONS: Varicella-zoster virus infections of the retina can present with different clinical pictures in immunocompromised and immunocompetent patients. Early diagnosis and adequate medical and surgical therapy can significantly improve visual prognosis.

AIDS-Related Opportunistic Infections↗
PubMed1989

[Intermediate uveitis].

Intermediate uveitis defines the group of diseases formerly called pars planitis or chronic cyclitis. Its frequency amounts to 10-20% of all uveitis cases. The anamnesis is vague. The clinical symptoms mainly involve the vitreous. The visual acuity is variable, depending of the involvement of the retina. A slight inflammation of the anterior chamber is possible, but no synechiae are present. The vitreous shows a positive Tyndall and cells, snow balls, eventual plaques on the pars plana. Serious cases are complicated by a retinal vasculitis, which often leads to cystic macular edema and papillary edema. Schisis and retinal holes are more seldom. A complicated cataract can develop. The most valuable complementary tests are fluorescein angiography and electroretinography, useful to detect retinal damage. Aetiological investigations give mostly poor results and are not very useful. Differential diagnosis has to be made, among others, from Fuchs' heterochromic cyclitis and from acute cellular infiltration of the vitreous in case of retinochoroiditis or candida endophthalmitis. Treatment of intermediate uveitis can be only local and discrete when only the vitreous is involved. If the retina is damaged, systemic steroids or immunodepressive cytostatic drugs might be indicated. Despite the duration of the disease, its prognosis remains rather good. Only about 15% of the cases end up with visual impairment to 1/10 or less, while more than half of the cases maintain a visual acuity higher than 0.6, even after three years of disease progress.

Diagnosis, Differential↗
PubMed1984

Intra-arterial BCNU chemotherapy for treatment of malignant gliomas of the central nervous system.

Because of the rapid systemic clearance of BCNU (1,3-bis-(2-chloroethyl)-1-nitrosourea), intra-arterial administration should provide a substantial advantage over intravenous administration for the treatment of malignant gliomas. Thirty-six patients were treated with BCNU every 6 to 8 weeks, either by transfemoral catheterization of the internal carotid or vertebral artery or through a fully implantable intracarotid drug delivery system, beginning with a dose of 200 mg/sq m body surface area. Twelve patients with Grade III or IV astrocytomas were treated after partial resection of the tumor without prior radiation therapy. After two to seven cycles of chemotherapy, nine patients showed a decrease in tumor size and surrounding edema on contrast-enhanced computerized tomography scans. In the nine responders, median duration of chemotherapy response from the time of operation was 25 weeks (range 12 to more than 91 weeks). The median duration of survival in the 12 patients was 54 weeks (range 21 to more than 156 weeks), with an 18-month survival rate of 42%. Twenty-four patients with recurrent Grade I to IV astrocytomas, whose resection and irradiation therapy had failed, received two to eight courses of intra-arterial BCNU therapy. Seventeen of these had a response or were stable for a median of 20 weeks (range 6 to more than 66 weeks). The catheterization procedure is safe, with no immediate complication in 111 infusions of BCNU. A delayed complication in nine patients has been unilateral loss of vision secondary to a retinal vasculitis. The frequency of visual loss decreased after the concentration of the ethanol diluent was lowered.

Adult↗
PubMed1997

New ophthalmic manifestations of presumed rifabutin-related uveitis.

Rifabutin-related uveitis has been reported in AIDS patients who take a daily dose of 300 to 1800 mg of this drug. Presumed rifabutin-related uveitis is characterized by unilateral or bilateral anterior chamber inflammation with hypopyon accompanied by hyperemia, pain, photophobia, and vitritis. However, retinal manifestations or vitreous cytology of this entity have never been reported. This report describes a patient who had retinal vascular changes associated with uveitis while being treated with oral rifabutin. Fundus photographs and fluorescein angiograms documented resolved retinal vasculitis. Vitreous cytology of this case showed acute inflammatory cells. To the authors' knowledge, this is the first report of retinal vasculopathy in a patient with rifabutin-related uveitis and the first analysis of the vitreous cytologic aspects of this disease.

AIDS-Related Opportunistic Infections↗
PubMed1994

Adult Kawasaki disease. Report of two cases treated with intravenous gamma globulin.

There are 36 reports in the English-language literature of Kawasaki disease in adults. We present two additional cases, in one of which retinal vasculitis developed, a previously unreported complication antemortem. We report the first use of intravenous gamma globulin in the United States for treatment of adult-onset Kawasaki disease and review the pertinent literature.

Adolescent↗
PubMed1992

[Is A29, B12 vasculitis caused by the Q fever agent? (Coxiella burnetii)].

The authors describe the first two cases, to their knowledge, of retinal vasculitis, associated with Q fever. The first case was a chronic infection induced by Coxiella burnetii associated with HLA group A29 and B12; in the second case, the phenotype was B12. The authors tried to determine whether this agent could be the "Birdshot chorioretinopathy" promoting factor. Several epidemiologic findings tend to prove that Q fever is not the only cause. On the other hand, its similarity with rickettsia, the fact that it is found in patients with vasculitis, suggest that it could be one of the initial causal factors.

Adult↗
PubMed2000

Labial adenocarcinoma after treatment with cyclosporin a in a patient with panuveitis.

PURPOSE: To report a case of labial basal cell adenocarcinoma in a patient with uveitis on treatment with cyclosporin A. METHOD: Case report. A 73-year-old woman with panuveitis and retinal vasculitis presented with a lump on her lip after 52 months of treatment with cyclosporin A. RESULT: Excision biopsy showed a labial adenocarcinoma. CONCLUSION: Malignancy can occur after long-term cyclosporin A treatment for uveitis.

Adenocarcinoma↗
PubMedDate not supplied

Color Doppler ultrasound in ocular Behçet's disease.

The purpose of this study was to evaluate the hemodynamic changes occurring in the ophthalmic vasculature of eyes with Behçet's disease in a controlled clinical trial. Both eyes of patients with retinal involvement due to Behçet's disease were consecutively evaluated and were established as having mild or severe retinal vasculitis according to the ophthalmoscopic and fundus fluorescein angiographic findings. One eye from each patient was randomly selected and 25 eyes with mild to moderate and 25 eyes with severe vasculitis were identified. Color Doppler imaging (CDI) was used to quantitate blood flow velocities and vascular resistance in the ophthalmic artery (OA), central retinal artery (CRA) and central retinal vein (CRV) of these patients and those of 25 healthy volunteers. All three groups were age- and sex-matched. In the OA, peak systolic, end diastolic and average flow velocities were significantly higher in patients with Behçet's disease than in the control group (p < 0.05). CRA blood flow velocities of patients with severe retinal involvement were significantly lower than those with mild to moderate vasculitis and control groups and the average vascular resistance was significantly higher than in the control group (p < 0.05). Additionally, the average blood flow velocities in the CRV of patients with severe vasculitis were significantly lower than in mild to moderate vasculitis and control patients. Marked circulatory changes were seen in the ophthalmic vasculature of eyes with Behçet's disease. Although larger studies are required to define the true sensitivity and specificity of this technique, these initial results suggest that CDI could play a major part in the assessment of patients with ocular Behçet's disease.

Adult↗
PubMed1986

Severe retinal vaso-occlusive disease in systemic lupus erythematous.

Retinopathy in systemic lupus erythematosus generally consists of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report data from 11 patients with SLE and severe retinal vaso-occlusive disease. Visual outcome was often poor, with 55% of the involved eyes suffering visual loss, frequently to an acuity of worse than 20/200. The systemic feature significantly associated with severe retinal vascular disease was central nervous system involvement (CNS lupus), present in eight (73%) of the 11 patients vs an overall prevalence of 37%. The association of CNS lupus with severe retinal vaso-occlusive disease probably reflects a similar pathogenetic mechanism and microangiopathy.

Adult↗
PubMed1996

Leptospiral antibodies in patients with recurrent ophthalmic involvement.

Leptospiral antibodies could be demonstrated by microscopic agglutination test in 14 of 15 (93%) patients with acute panuveitis and retinal vasculitis in a preliminary study undertaken during the postmonsoon period at Madurai in Tamilnadu, India. The predominant serogroup was Pomona followed by Autumnalis, Australis and Javanica, the titres being between 1:160 and 1:10240. Titres in the normal controls were 1:20 to 1:80 in 8 of 20 mostly to the endemic serogroup Autumnalis. The involvement of leptospires particularly Pomona as a cause of ophthalmic complications in the patients studied is likely.

Adult↗
PubMed1997

[Risk factors for retinal occlusive diseases].

Retinal vascular occlusions are the second most common retinal vascular diseases following diabetic retinopathy. Central retinal artery occlusion and branch retinal artery occlusion are most often caused by emboli. The mean age of patients with retinal artery occlusion and branch retinal artery occlusion is 62 and 58 years, respectively. The most common risk factors are arterial hypertension (65%), diabetes mellitus (25%), valvular diseases of the heart (25%), and carotid artery stenosis or plaques (45%). Rare causes are arteritis and vascular spasm. The pathogenesis of retinal branch vein occlusion and central retinal vein occlusion remains speculative. Two different mechanisms have been postulated, i.e. thrombosis in the vein due to a compression by atherosclerotic changes in the adjacent artery and a local alteration of the blood flow due to unfavourable physiologic factors. Retinal vein occlusion manifests at a mean age of 65 years. The most common risk factors are arterial hypertension in 34-75% and primary open angle glaucoma in 2.1-82%. In 5.6% of the patients with retinal branch vein occlusion retinal vasculitis is present.

Humans↗
PubMed1993

[Ocular involvement in rheumatoid arthritis].

The authors evaluated ocular involvement in 23 patients affected by rheumatoid arthritis (RA) according to ARA criteria. Slit-lamp biomicroscopic examination showed signs of keratoconjunctivitis sicca in one patient (4%), while a positive bilateral Schirmer test was found in six subjects (26%). Fluorescein angiography, carried out in 11 of the 23 RA patients, showed retinal vasculitis in 18% of the patients examined, even if no clinical and ophthalmoscopic signs of retinal vessel inflammation were present. The authors suggest that fluorescein angiography should be performed in patients affected by particularly active RA, with recent onset of the disease (< 12 months), high titres of classical IgM rheumatoid factor and raised concentrations of circulating immune complexes. The study confirmed moreover the uncommon ocular toxicity related to the drugs frequently employed in RA treatment (antimalarials, gold salts, glucocorticoids). Indeed, only one case (4%) of posterior subcapsular cataract clearly related to steroid therapy was found.

Adult↗