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PubMed1987

Blood-retinal barrier permeability versus diabetes duration and retinal morphology in insulin dependent diabetic patients.

The blood-retinal barrier permeability to fluorescein was quantitated in 54 patients (22 females and 32 males) with insulin dependent diabetes mellitus (IDDM) of different duration. Correlation was demonstrated between permeability and diabetes duration. A normal permeability was measured in patients with up to ten years diabetes duration. A pathologically increased permeability was measured with ten to 15 years diabetes duration and during the next decade the permeability increased rapidly to 5-10 times the normal value. Onset of diabetes in the decade before and after puberty did not change the pattern. However, the pathologically increased permeability after ten years duration of the disease could not be demonstrated in diabetics with onset of the disease after the age of 30 years. The permeability of the blood-retinal barrier correlated well with changes in retinal morphology as seen by ophthalmoscopy and fluorescein angiography. However, there was an overlap in permeability between groups with different retinal appearance. A significant factor was the presence of macular edema, which also apparently indicated a preproliferative state.

Adolescent↗

PubMed2001

Management of inferior retinal breaks during pars plana vitrectomy for retinal detachment.

AIMS: To determine whether it is necessary to support inferior retinal breaks with a scleral explant during pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RD). METHODS: A prospective study was carried out on nine eyes of nine consecutive patients undergoing PPV for primary RD with associated inferior retinal breaks and no significant proliferative vitreoretinopathy. RESULTS: Eight eyes were successfully reattached with a single operation. No cases presented with redetachment because of failed closure of the original inferior breaks. CONCLUSIONS: It is not necessary to support inferior retinal breaks with a scleral explant during PPV for primary RD repair in selected cases.

Adult↗

PubMed2001

RI in central retinal artery as assessed by CDI does not correspond to retinal vascular resistance.

The aim of the present study was to investigate the association between ultrasound Doppler measurements of resistive index (RI) in the central retinal artery and retinal vascular resistance (R) assessed with laser Doppler velocimetry, vessel size measurement, and calculation of ocular perfusion pressure (PP) in healthy subjects. An increase in vascular resistance was induced by inhalation of 100% O(2). During hyperoxia no significant changes in PP were observed. Mean flow velocity in main retinal veins was reduced by -27.5 +/- 2.0%. The average decrease in diameter was -11.5 +/- 1.0%. R, which was calculated as the ratio of PP to flow rate, increased by 97.6 +/- 7.7%. RI increased as well, but the effect was much smaller (6.6 +/- 2.2%). In addition, a negative correlation was found between baseline values of R and RI (r = -0.83). During hyperoxia R and RI were not associated. In conclusion, our data indicate that RI as assessed with color Doppler imaging in the central retinal artery is not an adequate measure of R.

Adult↗

PubMed2000

Retrobulbar optic neuritis and rhegmatogenous retinal detachment in a fourteen-year-old girl with retinitis pigmentosa sine pigmento.

A 14-year-old girl complained of a sudden decrease in right visual acuity. The patient had night blindness, a mottled retina but no pigments, extinguished scotopic electroretinographic response, central scotoma in the right eye and rhegmatogenous retinal detachment. She had initially received laser photocoagulation around the retinal tear and then corticosteroid therapy, cryoretinopexy and segmental buckling. Her right visual acuity increased to 1.0. The association of retinitis pigmentosa sine pigmento, retrobulbar optic neuritis and rhegmatogenous retinal detachment, as demonstrated in our patient, may be uncommon.

Adolescent↗

PubMed1992

Exudative retinal detachment subsequent to retinal vein occlusion.

Previous studies have shown the possible development of exudative retinal detachment (ERD) as a complication of retinal vein occlusion (RVO). Considering 473 consecutive cases of RVO, only 3 cases of ERD with peculiar clinical aspects were discovered. In the first case, the ERD followed a branch RVO, but it developed in the opposite quadrant, with a late occurrence of venous retinal collaterals. In the second case, the ERD developed after a central RVO, having a retinoschisis aspect, with the subsequent occurrence of optic disk collateral vessels. In the third case, the ERD was secondary to a hemicentral RVO and involved the entire macular area. The pathogenesis of the ERD subsequent to RVO is still debated. Our experience seems to indicate that the ERD pathogenesis is linked not only to an inability of the draining vascular system, but also to an impairment in the function of the retinal pigment epithelium.

Acetazolamide↗

PubMed2006

Characterization of rhodopsin P23H-induced retinal degeneration in a Xenopus laevis model of retinitis pigmentosa.

PURPOSE: To investigate the pathogenic mechanisms that underlie retinal degeneration induced by the rhodopsin mutation P23H in a Xenopus laevis model of RP. METHODS: Transgenic X. laevis were generated that expressed the rhodopsin mutants rhoP23H and rhoP23H/K29R (a variant incapable of transducin activation). Using quantitative dot blot assay, transgenic rhodopsin levels and the extent of retinal degeneration were determined. The contribution of rhodopsin signal transduction to cell death was assessed by comparison of rhoP23H and rhoP23H/K296R effects and by dark rearing of rhoP23H tadpoles. Intracellular localization and the oligomeric state of rhoP23H were determined by confocal immunofluorescence microscopy and Western blot analysis. RESULTS: RhoP23H induced retinal degeneration in a dose-dependent manner whereas expression of a control rhodopsin did not, indicating that rod photoreceptor death was specific to the P23H mutation and was not caused by the overexpression of rhodopsin. Neither abolishment of rhoP23H photosensitivity and ability to activate transducin nor dark rearing rescued rod viability. RhoP23H was localized primarily to the endoplasmic reticulum (ER) of inner segments. Western blot analysis of transgenic retinas showed that rhoP23H was prone to form dimers and higher molecular weight oligomers. However, aggresomes were not observed in rhoP23H transgenic retinal sections, despite their being reported in cultured cells expressing rhoP23H. CONCLUSIONS: These results support a role for rhoP23H misfolding and inner segment accumulation in rod death, possibly by ER overload or other cellular stress pathways rather than by altered rhodopsin signal transduction or aggresome formation.

Animals↗

PubMedDate not supplied

Retinal surgery for treatment of central retinal vein occlusion.

Vitreous surgery with retinal vein cannulation and injection of tissue plasminogen activator was performed in 8 eyes of 8 patients with longstanding visual loss secondary to central retinal vein occlusion. A modest improvement in visual acuity was demonstrated in 4 of the 8 eyes, and 3 of the 8 eyes maintained the preoperative vision. Retinal vein cannulation may offer a new treatment option for patients with central retinal vein occlusion.

Aged↗

PubMed2001

[Outer retinal edema or multifocal choroiditis after retinal detachment surgery. A case report].

CASE REPORT: We describe a case of a woman who, in the postoperative period of retinal detachment, developed an ophthalmoscopic picture which could correspond to abnormal outer retinal swelling or multifocal choroiditis. Ophthalmoscopic appearance consists of multiple yellowish subretinal lesions in the temporal area of the posterior pole with a cobblestone appearance. DISCUSSION: The two entities are extremely rare complications of rhegmatogenous retinal detachment surgery, with very similar funduscopic appearance. The first one consists of localized pockets of subretinal fluid remaining after retinal detachment surgery. Multifocal choroiditis is an inflammatory process related to various causes.

Choroiditis↗

PubMedDate not supplied

Endophotocoagulation to retinal pigment epithelium as an adjuvant therapy in the management of retinal detachment caused by a highly myopic macular hole.

Retinal detachment secondary to a highly myopic macular hole remains a particular surgical challenge. Pars plana vitrectomy, endophotocoagulation at the base of a macular hole in conjunction with fluid-gas exchange was performed in 4 consecutive patients with a mean refraction of -13.8D (range, -8D-(-)18D). Mean axial length was 27.5 mm (range, 26.0-29.0 mm). Mild atrophy of the retinal pigment epithelium was present in 3 patients while 1 patient had moderate atrophy. The mean follow-up period was 12 months (range, 6-18 months). The overall primary anatomical success rate was 75%. All 3 eyes with mild retinal pigment epithelium atrophy had retinal reattachment after one operation.

Adult↗

PubMed2002

[The correlation between retinal circulation and function in branch retinal artery occlusion].

PURPOSE: To investigate retinal circulation and function in eyes with branch retinal artery occlusion(BRAO) using a scanning laser Doppler flow-meter (SLDF) and multifocal electroretinogram (mERG). METHODS: In juxtapapillary and paramacular areas close to the occluded artery of the affected eye and the corresponding area of the fellow eye, the mean flow measured by SLDF, indicating microcirculation, and the p-wave amplitude in the response of mERG, indicating retinal function, were determined in three patients with BRAO at the period of reperfusion. The ratios of the affected eye to fellow eye(a/f ratio) were calculated, and the ratios of the mean flow (Fa/f) were compared with those of the p-wave amplitude(Pa/f). RESULTS: In the juxtapapillary area, both Fa/f and Pa/f decreased consistently, but in the paramacular area, Pa/f were lower than Fa/f in all cases. CONCLUSIONS: Functional recovery is likely to be later in the paramacular area than in the juxtapapillary area in the course of recovery of retinal circulation.

Adult↗

PubMedDate not supplied

Macular hole secondary to branch retinal vein occlusion diagnosed by Retinal Thickness Analyzer.

The Retinal Thickness Analyzer is a laser slit biomicroscopy imaging device that produces accurate measurements of retinal thickness and displays the images in a two-dimensional pattern, superimposed on a fundus image. This article reports a patient with decreased vision following branch retinal vein occlusion in whom the Retinal Thickness Analyzer was used to establish the diagnosis of a macular lamellar hole that was not apparent clinically.

Diagnostic Techniques, Ophthalmological↗

PubMedDate not supplied

[Intraoperative diagnosis of retinal ruptures in rhegmatogenous retinal detachment in avitreous eyes by using a coloring agent].

Sixteen patients were operated for regmatogene retinal detachment developed at different time periods after a previously made vitrectomy; no retinal ruptures were found in preoperative examinations. The method of colouring with subretinal fluid, 0.1% fluorescence solution, was intraoperatively used for the detection of such ruptures. The coloured fluid escaped from the subretinal cavity through a retinal rapture into the vitreal cavity, which ensured an easy visualization of ruptures. Retinal ruptures could be detected in all 16 (100%) patients. They were located in 8 (50%) cases in the zone of previously made sclerotomy and were regarded as an outcome of the local proliferative vitreoretinopathy on the remains of the basic vitreous elements.

Female↗

PubMed1991

[Retinal photocoagulation in hemorrhagic retinal branch vein thrombosis. A new treatment technique].

In branch vein occlusions involving the macula, the loss of macular function cannot be due to hypoperfusion of the involved capillaries, because if this were so the uninvolved part of the macula would presumably be unimpaired. The impairment of the macula is explained as follows. Congestion of the blood caused by the thrombosis means that the capillaries are exposed to high blood pressure. In the border zone of the thrombotic area capillaries that are normally drained are exposed to capillary hypertension. For this reason, the border zone of a retinal thrombosis is also affected. The perifoveal capillary network is usually in this border zone. We treated branch vein occlusions by perimacular photocoagulations on the blood in the inner retinal layer within the zone of the thrombosis. Our explanation for the gain in visual acuity following this procedure is that we occlude the retinal capillaries that are, passing on the high pressure into the perifoveal capillaries. Our proposed photocoagulation procedure is restricted to cases in which hemorrhage has led to enough blood in the inner retinal layer to coagulate. The destruction of the nerve fiber layer by this kind of photocoagulation has to be taken into account. The possible gain of visual acuity has to be balanced against the loss of function caused by destruction of parts of the nerve fiber layer.

Blood Pressure↗

PubMed1989

Visual results and complications after retinal reattachment in the acute retinal necrosis syndrome. The influence of operative technique.

The authors compare the complications and visual results encountered in a consecutive series of 16 eyes undergoing retinal reattachment surgery for retinal detachment associated with the acute retinal necrosis syndrome. Eight eyes were treated with scleral buckling, vitrectomy, and cryotherapy with or without gas injection. Eight consecutive eyes (with one exception) were treated by the combination of vitrectomy, gas injection and laser photocoagulation with or without primary lensectomy and not subjected to scleral buckling as a primary procedure. The final reattachment rate was 93.8% (15 of 16 eyes) with no significant difference between the primary scleral buckle group (87.5%) and the non-buckle group (100%). Retinal reoperation and complication rates were higher in the primary buckle group and final visual acuities better in the non-buckle group despite comparable preoperative characteristics.

Adolescent↗

PubMed1986

The role of induced choroidal retinal adhesion in retinal detachment surgery.

The use of induced adhesion in retinal and vitreous surgery is considered. A follow-up report on a series of cases of retinal detachment treated with buckling only shows that there is a risk of late re-detachment from the original hole as the buckle height diminishes. Cryotherapy is therefore necessary to prevent redetachment but as it is not necessary for reattachment it is reasonable to confine its application to the immediate vicinity of the retinal hole. An adhesion is advised in most cases of retinal detachment treated by vitrectomy, exceptions being small holes at the posterior pole.

Choroid↗

PubMed1979

Permeability of retinal capillaries in rats with inherited retinal degeneration.

The permeability of retinal capillaries in RCS rats with inherited retinal degeneration was investigated with horseradish peroxidase used as a tracer. Five-week-old rats showed typical degeneration of photoreceptor cells and accumulation of outer segment debris, but retinal capillaries were not permeable to peroxidase. At 10 weeks of age, capillaries in the inner retina appeared normal, but many in the outer retina were leaky. Peroxidase activity in these latter vessels was demonstrable in the basal laminae of endothelial cells and pericytes and in vesicles on the luminal and abluminal sides of the endothelium. Tracer also permeated the intercellular spaces in the surrounding area. The number of leaky capillaries in the outer retina increased during the course of the dystrophy. The site of the leak in permeable capillaries has not yet been established; it may be due to an alteration of the endothelial cell junctions or of transcellular vesicular transport. In the choriocapillaris, peroxidase permeated Bruch's membrane and the basal infoldings between adjacent pigment epithelial cells; tracer progression along the intercellular spaces was blocked at the zonulae occludens at the apicolateral border. The RCS rat may be a useful model for studying the morphological basis of changes in capillary permeability associated with retinal degeneration.

Animals↗

PubMed1982

[Changes in the blood uric acid levels in patients with retinitis pigmentosa and in rats with hereditary retinal degeneration].

The content of uric acid was measured in the blood of patients suffering from retinitis pigmentosa, as well as in the blood, retina, brain, liver and urine of rats with inherited retinal degeneration in the course of postnatal development. It was found that in the patients with retinitis pigmentosa, the concentration of uric acid in the blood serum was 50% higher as compared to normals. On the 8th day of life the content of uric acid in the blood of the sick rats was equal to 150% as compared to the normal animals. This difference persisted during the subsequent postnatal life. In the rats with inherited retinal degeneration, the content of this purine in the retina, brain and liver was approximately the same as that seen in the normal animals in all the studied periods of life. Meanwhile statistically significant changes in the uric acid content in the sick animals' urine appeared at an age of 1.5-2 months. It is believed that the identical line of changes in the uric acid content in the blood of the sick persons and rats points to similarity of the experimental disease of the animals to the disease in humans.

Animals↗

PubMed1995

Changes in the organization and expression of cytoskeletal proteins during retinal degeneration induced by retinal detachment.

PURPOSE: The goal of this study was to determine the changes in the organization of the retinal cytoskeleton after experimental retinal detachment. METHODS: Cat retinas were detached from the retinal pigment epithelium and then processed for Western blot analysis and fluorescence microscopy. Proteins examined included glial fibrillary acidic protein (GFAP), vimentin, tubulin, and actin. Sections were viewed using a laser scanning confocal microscope. RESULTS: GFAP and vimentin: At 1 day after detachment, there was an aggregation of intermediate filaments in the endfoot of Müller cells. At 3 days, intermediate filament containing Müller cell processes could be detected within the subretinal space, and, at 28 days, these processes formed large glial scars in the subretinal space. beta-tubulin: At 3 days after detachment, an increase in immunolabeling could be detected within the Müller cell endfoot and in Müller cell processes within the subretinal space. Actin: At 3 days after detachment, rhodamine-phalloidin staining decreased in the inner segments, the photoreceptor synaptic terminals, and the outer limiting membrane. CONCLUSIONS: The decrease in labeling of the photoreceptor inner segment and synaptic terminal cytoskeleton may be a key indicator of early changes in photoreceptors after detachment. The increase in cytoskeletal proteins GFAP, vimentin, and tubulin within the retinal Müller cells after detachment may help to stabilize this cell type as it hypertrophies during glial scar formation. Inhibition of this response may aid in the treatment of diseases in which Müller cell hypertrophy plays a role.

Animals↗