For years, diabetic retinopathy has been defined based on vascular lesions, and neural abnormalities were not regarded as important. This review summarizes evidence that the neural retina has important effects on the retinal vasculature under normal conditions, and the interaction between the retinal neuroglial cells and vascular function is altered in diabetes. Importantly, new evidence raises a possibility that abnormalities within retinal neuroglial cells (notably photoreceptors) might actually be causing or initiating the vascular disease in diabetic retinopathy.
Diabetes Mellitus ; Diabetic Retinopathy ; Neuroglia* ; Retina ; Retinaldehyde* ; Vascular Diseases

PURPOSE: To compare the image quality between swept-source optical coherence tomography (SS-OCT) and spectral domain optical coherence tomography (SD-OCT), especially in eyes with media opacity. METHODS: Forty eyes without media opacity and 60 eyes with media opacity (30 eyes with cataract, 20 eyes with vitreous opacity, and 10 eyes with corneal opacity) were included in this study. SD-OCT and SS-OCT 6 x 6 macular scans were taken by a single operator. For image quality analysis, a total of 200 OCT images were subjectively graded by two trained retina specialists and measured quantitatively using the image quality factor (QF) built into the OCT devices. RESULTS: Compared to conventional SD-OCT, SS-OCT had statistically significantly better subjective and objective grades in the normal group, as well as each of the media opacity groups (p-value < 0.001). In both the subjective and objective grades, there was no significant difference according to the types of media opacity (QF: p = 0.188, subject grading scale [SGS]: p = 0.635) and the degree of media opacity (Group I: 20 < or = QF < 50, Group II: 0 < or = QF < 20; QF: p = 0.088, SGS: p = 0.051) in the superiority of image quality of SS-OCT to SD-OCT. CONCLUSIONS: In this media opacity patient population, swept-source OCT is a superior diagnostic tool when compared with SD-OCT in both objective and subjective assessments, even in the ocular media opacity. This result may be useful in diagnosis and progression detection of retinal disease in media opacity eyes.
Cataract ; Diagnosis ; Humans ; Retina ; Retinal Diseases ; Specialization ; Tomography, Optical Coherence*

Objective: To characterize diabetic maculopathy seen in the Philippines, specifically, the associated factors, the various lesions seen on fluorescein angiography, and the visual acuity associated with these lesions Design: Descriptive study - cross sectional Participants: 127 patients (254 eyes) with diabetic retinopathy based on the fluorescein angiography done at the Eye Referral Center in 1993 Results: 116 (91.34 percent) patients have maculopathy, majority of which is bilateral (84.25 percent). Age (p=0.675), sex (p=0.357), hypertension (p=0.742), duration of diabetes (p=0.778) and myopia (p=0.742) were not significantly associated with maculopathy. However, severity of retinopathy (p=0.001) was significantly associated with it. Fluorescein angiographic findings are macular staining (83.86 percent), perifoveal capillary dropout or macular ischemia (10.76 percent), and preretinal traction and membrane (5.38 percent). Microaneurysm (72.65 percent) is the most common lesion associated with macular staining, followed by capillary leakage (4.04 percent), cystoid macular edema (3.59 percent), perifoveal capillary dropout with microaneursym (2.24 percent), and capillary with microaneursym leakage (1.34 percent). Exudates are associated with microaneurysm, perifoveal capillary dropout or their combination. Vision was found to be marginally statistically different between the normal and maculopathy group (p=0.0505). The worst vision was seen in macular ischemia and preretinal traction and membrane with mean visual acuity of 0.18 and 0.25 respectively Conclusion: Severity of the retinopathy is the only variable significantly associated with maculopathy in this study. Good vision does not necessarily indicate a normal macula. Detailed examination and fluorescein angiography regardless of duration of diabetes should be done.
Human ; Middle Aged ; Adult ; ANGIOGRAPHY ; DIABETIC RETINOPATHY ; RETINA,DISEASES

Ocular toxocariasis in human is a rare disease, which occurs by ingesting infective ova accidentally. Clinically, patients with ocular toxocariasis are divided into 3 groups: group 1 consisted of those with diffuse destructive endophthalmitis, group 2 included those focal posterior pole granuloma, group 3 was made up of those with peripheral inflammatory masses in a relatively quiet eye. We experienced a 17 year-old female whose left eye exhibited a dense white elevated inflammatory mass over the macular area and connective-tissue strands extending from the mass to vitreous and surrounding retina. We report this case with a review of literature, but we couldn't get the aid of the ELISA test for antibody of Toxocara canis.
Adolescent ; Endophthalmitis ; Enzyme-Linked Immunosorbent Assay ; Female ; Granuloma ; Humans ; Ovum ; Rare Diseases ; Retina ; Toxocara canis ; Toxocariasis*

Folding of the choroid, Bruchs membrane, and the overlying retina may occur in a variety of ocular and orbital diseases and after certain surgical procedures. A 34-year-old man experienced the decreased visual acuity and the protrusion and displacement in the right eye for at least 4 years. The protrusion of the patient was 13mm in the right eye and 6mm in the left eye with the aid of Hertels exophthalmometer. The right eye appeared downward deviation about 15 prism. The tumor located outside the muscle cone in the computed tomography and ultrasonography seemed to make the large choroidal folds involving the macula region. The retinal pigment epithelial atrophy was noted along long-standing choroidal folds. The tumor was removed by the lateral orbitotomy. The size of tumor was 20 x 15x 10mm. The postoperative protrusion was 6mm in the both eye. After removal of tumor, changes in the corneal refraction, visual acuity, and choroidal folds with the retinal pigment epithelial atrophy did not occur in comparison with the preoperative state.
Adult ; Atrophy ; Bruch Membrane ; Choroid* ; Humans ; Orbit* ; Orbital Diseases ; Retina ; Retinaldehyde ; Ultrasonography ; Visual Acuity

PURPOSE: The aim of this study is to evaluate the effect of radiotherapy for the patients with Graves' orbitopathy who were intolerable to corticosteroid therapy. METHODS: From December 1995 to June 2000, We reviewed medical records of thirteen patients who had received orbital radiation delivering 2000 cGy in 10 fractions over 2 weeks. RESULTS: Compressive optic neuropathy was improved in 3 of 4 patients (75%), and soft tissue swelling was improved in eight of 9 patients (88%). Proptosis was reduced in 3 of 13 (30%) patients. However, diplopia and ocular motility responded poorly and was improved only in 2 of 10 (20%) patients. No adverse effects of radiotherapy occurred in any patient. Specifically there was no sign of radiation-induced injury to optic nerve, retina, or lens. CONCLUSIONS: Radiotherapy was successful in patients with acute Graves' orbitopathy especially who had compressive optic neuropathy or soft tissue swelling. This modality was useful for those who showed intolerable side effects from the use of corticosteroid or the recurrence with corticosteroid treatment.
Diplopia ; Exophthalmos ; Humans ; Medical Records ; Optic Nerve ; Optic Nerve Diseases ; Orbit ; Radiotherapy ; Recurrence ; Retina ; Thyroid Gland*

OBJECTIVETo investigate the incidence of myopic retinopathy and its risk factors.

METHODSThe fundus of 1449 patients (2879 eyes) with myopia were retrospectively examined. The clinical relationship between myopic retinopathy and diopter, age, and sex was analyzed.

RESULTSMyopic retinopathy was detected in 413 eyes (14.35%). Posterior pole retinal lesions were detected in 22 eyes (0.76%). Peripheral retinal lesions were found in 396 eyes (13.75%). According to their diopters, the myopic patients were divided into four groups: low, medium, high and super high myopia The incidence of peripheral retinal lesions was 4.18%, 8.72%, 19.18%, and 37.44% in these four groups, which significantly different (chi2 = 178.594, P<0.001). By age these patients were divided into three groups: I group, age <25; II group, age 25-34; III group, age >34. The incidences of peripheral retinal lesions in these three groups were 8.11%, 15.34%, and 24.59%, which were significantly different (chi2 = 76.090, P<0.001). The incidence of retinal lesion in male and female was 9.32% and 16.07%, respectively, which was significantly different (chi2 = 24.886, P<0.001). Posteriorpole retinal lesions were only detected in the highly or super highly myopic patients, all of them were more than 25 years. The incidence of posteriorpole retinal lesions in the highly and super highly myopia group was 0.86% and 6.67% respectively, which was significantly different (chi2 = 31.898, P<0.001). The incidence of posteriorpole retinal lesions in group II and group III was 0.55% and 3.55% respectively, which was significantly different (chi2 = 22.523, P<0.001).

CONCLUSIONSThe prevalence of retinal lesions in myopic patients is higher than that of emmetropia. The incidence of peripheral retinal lesions increases in patients with deeper diopters. Posterior pole retinal lesions usually occur in the myopic patients whose age are more than 25 years and diopter more than - 6.00 D. Careful examination of fundus is essential for early detection and timely treatment.

Adult ; Female ; Humans ; Male ; Myopia ; complications ; Retina ; pathology ; Retinal Diseases ; complications ; pathology ; Retrospective Studies ; Young Adult

BACKGROUNDIt is very common for professional divers to have damage on the retinas. Severe retinal lesions can profoundly affect athletes' training efficacy and their daily lives. At present, it is not clear if there is effective preventive action. Thus, in our study, we continuously tracked the ocular changes in athletes and closely monitored the risk factors associated with retinal detachment. Also, we analyzed possible interventions, their associated factors, and efficacies for timely preventions to protect the retina from damage in professional divers.

METHODSBetween 2009 and 2012, a total of 39 professional divers enrolled in follow-up management. The conducted examinations included ocular examination, record screening on retinal lesion, monitoring best-corrected visual acuity, and checking intraocular pressure (IOP) and the scope of retinal lesion. The management included optimizing training methods, taking customized follow-up based on different retinal lesions, laser treatments for definite cases of retinal tear, retinal degeneration caused by retinal layer thinning or vitreous traction, and observing the changes in the scope of retinopathy.

RESULTSEvery year, the percentage of divers who have various degrees of retinal lesions is between 43.3% and 56.2%. During the 4 years, there were no statistically significant differences in divers' best-corrected visual acuity and retinal lesions. There were also no statistically significant differences between male and female athletes. However, there were statistically significant differences in IOP during these years. Moreover there were statistically significant differences in IOP and the scope of retinal lesions between platform divers and springboard divers.

CONCLUSIONSOur management of retinal lesions could be effective to prevent severe retinopathy in professional divers. At the same time, platform divers are more likely to have retinal lesions than springboard divers.

Adolescent ; Diving ; injuries ; Female ; Humans ; Male ; Retina ; pathology ; Retinal Detachment ; etiology ; Retinal Diseases ; therapy

Interference with the circulation of the blood and diseases of the blood vessels are of special importance in ocular disorders. Various conditions of the vascular disorders, namely inflammations, hypertension, sclerosis, occlusion, and prematurity, etc are briefly reviewed. Some additional findings in the retinal vessels after the fluorescence angiography are described on several important entities of the retinal vascular diseases.
Blood Vessels ; Fluorescein Angiography ; Hypertension ; Inflammation ; Retina* ; Retinal Vessels ; Retinaldehyde ; Sclerosis ; Vascular Diseases

Diseases caused by arteriosclerosis now occupy the first rank of the causes of death; they tend to increase further, and the countermeasure for adults' diseases is now noticed as one of big social problems. This study was devised to observe the effect of riboflavin tetrabutyrate on themetabolic changes in arteriosclerotic retinopathy, diabetic retinopathy, cataract and external eye diseases. After each case was treated three times daily for up to 13 weeks with riboflavin terabutyrate 120mg, we examined the visual acuity, retina changes, and cholesterol level at each visit. The results were as follows: 1. In arteriosclerotic retinopathy, visual improvement is noted in 44% of 18 cases and serum cholesterol level is decreased by 30.9mg/dl in average. 2. In diabetic retinopathy, visual improvement is noted in 37.5% of 16 cases and serum cholesterol level is decreased by 21.9mg/dl in average. 3. In cataract, visual improvement is noted in 8% of 12 cases and serum cholesterol level is reduced by 12.1mg/dl in average. 4. In external eye diseases, the symptoms and signs are much relieved.
Arteriosclerosis ; Cataract ; Cause of Death ; Cholesterol ; Diabetic Retinopathy ; Eye Diseases ; Retina ; Riboflavin* ; Social Problems ; Visual Acuity