PURPOSE: Recently diffuse diabetic macular edema has been morphologically classified by optical coherence tomography. This study was conducted to examine the difference of risk factors of the classified types of diffuse macular edema. METHODS: The subjects included 93 people who were diagnosed with non-insulin dependent diabetes. We diagnosed the presence of diabetic macular edema with slit lamp fundus examination and used OCT for the classification of diffuse macular edema. We examined the differences in epidemiological risk factors in non-diabetic macular edema patients after diabetic macular edema patients were examined with fluorescein angiography to confirm diffuse macular edema. RESULTS: Diabetic macular edema was classified into 4 types using OCT. Compared with patients without macular edema, sponge-like macular edema - related epidemiological risk factors included diabetic nephropathy, cystoid macular edema was related to HbA1c, serous macular detachment was related to treatment of diabetes by insulin, and posterior hyaloid raction was related to diastolic blood hypertension. CONCLUSIONS: In the present study, differences in epidemiological risk factors were related to the occurrence of a type of diffuse macular edema.
Classification ; Diabetic Nephropathies ; Fluorescein Angiography ; Humans ; Hypertension ; Insulin ; Macular Edema* ; Risk Factors* ; Tomography, Optical Coherence*

Background: and Purpose This study aimed to describe the clinical, electrophysiological, and ultrasonographic findings of patients with nerve injury after vessel puncture. Methods: Data on ten patients (three males and seven females) with nerve injury after vessel puncture were reviewed. Demographic and clinical data were analyzed retrospectively. Bilateral electrophysiological studies were performed based on clinical findings. Ultrasonographic examinations were performed on both the affected and unaffected sides of the injured nerve. Results: The nerves of nine patients were injured following vein puncture, and injury occurred following arterial sampling in one patient. Seven patients had superficial radial sensory nerve injury: five medial, one lateral, and one at both branches. One patient had injury to the dorsal ulnar cutaneous nerve, one to the lateral antebrachial cutaneous nerve, and one to the median nerve. Nerve conduction studies produced abnormal findings in 80% of patients, whereas ultrasonographic examinations produced abnormal findings in all of the patients. Spearman’s coefficient for the correlation between the amplitude ratio and nerve cross-sectional area ratio was not significant, at -0.127 (95% confidence interval=-0.701 to 0.546, p=0.721). Conclusions Ultrasonography supported by electrodiagnosis was found to be a useful method for identifying the lesion location and structural abnormalities of vessel-puncture-related neuropathy.

PURPOSE: We report a case of intravitreal bevacizumab injection for the treatment of choroidal neovascularization in morning glory syndrome. CASE SUMMARY: A 51-year-old male visited our hospital for a 1.5-year visual disturbance in his right eye. The patient's best-corrected visual acuity was 0.1 in the right eye. After fundus examination, we found characteristic findings of morning glory syndrome with submacular hemorrhage and serous retinal detachment in the right eye. Optical coherence tomography, fluorescein angiography and indocyanine green angiography were performed for evaluation. Retinoschisis, subretinal fluid, and choroidal neovascularization were detected, and thus bevacizumab was injected in the right eye. After intravitreal bevacizumab injection, retinoschisis was improved, and subretinal fluid was decreased. However, retinal pigment epithelial detachment was newly detected, and serous retinal detachment persisted. After 2 months, a second bevacizumab injection was performed. After these intravitreal bevacizumab injections at 1 and 2 months, visual acuity was 0.4 and 0.6, respectively. Visual acuity improved to 1.0 after 3 months. Visual acuity was maintained for at least 6 months with no relapse of choroidal neovascularization. CONCLUSIONS: The choroidal neovascularization in morning glory syndrome was effectively treated with intravitreal bevacizumab injections.
Angiography ; Choroidal Neovascularization* ; Fluorescein Angiography ; Hemorrhage ; Humans ; Indocyanine Green ; Male ; Middle Aged ; Recurrence ; Retinal Detachment ; Retinoschisis ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity ; Bevacizumab

PURPOSE: To assess the clinical outcomes in idiopathic epiretinal membrane (ERM) patients after vitrectomy and ERM removal with or without additional indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling. METHODS: The medical records of 43 patients with an idiopathic ERM that underwent vitrectomy and ERM removal between July 2007 and April 2010 were reviewed. The patients were divided into two groups: triamcinolone-assisted simple ERM peeling only (group A, n = 23) and triamcinolone-assisted ERM peeling followed by ICG staining and peeling of the remaining internal ILM (group B, n = 20). RESULTS: No difference was found between the two groups in terms of visual acuity, macular thickness, P1 amplitude or implicit time on multifocal-electroretinogram (mfERG) at six and 12 months postoperatively. In group B, ICG staining after ERM peeling demonstrated that the ILM had been removed together with the ERM in 12 eyes (60%), and all 12 eyes showed punctate retinal hemorrhages during ERM peeling. There was no recurrence of an ERM in either group. CONCLUSIONS: Additional procedures involving ICG staining and ILM peeling during ERM surgery do not appear to have an additive effect on the clinical outcomes in terms of visual acuity, retinal function based on mfERG, or recurrence rate.
Aged ; Coloring Agents/diagnostic use ; Epiretinal Membrane/*surgery ; Female ; Follow-Up Studies ; Humans ; Indocyanine Green/*diagnostic use ; Male ; Middle Aged ; Postoperative Complications/*diagnosis ; Retinal Hemorrhage/diagnosis ; Retrospective Studies ; Treatment Outcome ; Visual Acuity ; *Vitrectomy

PURPOSE: To determine predictive factors associated with visual outcome after treatment for myopic choroidal neovascularization (mCNV). METHODS: Medical records of the patients who underwent photodynamic therapy (PDT), intravitreal anti-vascular endothelial growth factor (Anti-VEGF) injection, or combination therapy of PDT and Anti-VEGF for myopic CNV, and followed up for more than a year, were reviewed retrospectively. Multiple linear regression analyses were performed to evaluate the predictive factors significantly associated with the visual outcome at 1 year after the treatment. RESULTS: Mean best-corrected visual acuity (BCVA) of 45 eyes of 45 patients showed statistically significant improvement 1 year after the treatment with a mean of 3.5 line improvement (p < 0.01, Wilcoxon signed rank test). Age, 1-month BCVA after treatment and treatment type appeared to be associated with the 1-year visual outcome after treatment for mCNV (p = 0.033, p < 0.001, and p = 0.044, respectively, multivariate linear regression analysis). CONCLUSIONS: Younger age (less than 40 years), better 1-month BCVA after treatment, intravitreal Anti-VEGF monotherapy were associated with improved visual outcome after treatment for mCNV. In particular, 1-month BCVA after treatment is a useful indicator to predict therapeutic response after treatment for mCNV.
Antibodies, Monoclonal, Humanized ; Choroid ; Choroidal Neovascularization ; Endothelial Growth Factors ; Eye ; Humans ; Linear Models ; Medical Records ; Photochemotherapy ; Retrospective Studies ; Triazenes ; Visual Acuity ; Bevacizumab ; Ranibizumab

PURPOSE: To evaluate the correlation between lesional variation and visual outcome and natural course of idiopathic choroidal neovascularization (CNV) in the patient who had been treated with conservative treatment only. METHODS: Best corrected visual acuity (BCVA), fluorescein and indocyanine angiographic examination (FAG and ICGA) and comparative analyses were performed for twenty eyes diagnosed with subfoveal and juxtafoveal idiopathic CNV and the long-term (mean, 24.7 months) natural course was followed. RESULTS: Juxtafoveal CNV occurred in 12 eyes (60%) and final BCVA in 17 eyes (85%) improved over 1 line or remained unchanged. Minimal or no leakage of final FAG was shown in 12 eyes (60%). In final ICGA, dark rim was found in 16 eyes (80%), hyperfluorescent area in 12 (60%) and focal choroidal venous dilatation in 3 (15%). Juxtafoveal CNV had more favorable visual outcome than subfoveal CNV and the increased dark rim and decreased hyperfluorescent area in ICGA were significantly correlated with favorable visual outcome. CONCLUSIONS: Idiopathic CNV had a favorable visual outcome during long-term follow-up period with conservative treatment only.
Choroid* ; Choroidal Neovascularization* ; Dilatation ; Fluorescein ; Follow-Up Studies ; Humans ; Visual Acuity

PURPOSE: To investigate the incidence and predisposing factors of macular pucker formation after pars plana vitrectomy in patients who developed primary rhegmatogenous retinal detachment. METHODS: We retrospectively reviewed a consecutive series of 284 eyes in 284 patients who underwent primary retinal detachment repair by pars plana vitrectomy alone between January 1, 2009 and December 31, 2010. Patients with a history of retinal surgery or another visually significant ocular problem were excluded. RESULTS: Postoperatively, of the 264 eyes that completed at least six months of follow-up, 16 (6.1%) eyes developed obvious macular pucker at clinical examination. Of these 16 eyes, ten (70.0%) underwent repeat vitrectomy with membrane peeling for macular pucker removal during the follow-up period. The mean time from primary vitrectomy for the retinal reattachment to the secondary vitrectomy with membrane peeling for macular pucker was 7.9 months. The mean improvement in vision after membrane peeling surgery was 0.37 (logarithm of the minimum angle of resolution). Using an independent t-test, chi-square test, and Mann-Whitney U-test, we found that the number or size of retinal break and vitreous hemorrhage could be significant risk factors of macular pucker. CONCLUSIONS: In our study, 6.1% of eyes which underwent pars plana vitrectomy alone for primary retinal detachment developed a postoperative macular epiretinal membrane. Multiple or large retinal breaks and postoperative vitreous hemorrhage were related to macular pucker formation. Overall, the 70.0% of eyes which underwent secondary vitrectomy with membrane peeling for removal of macular pucker showed a favorable visual outcome.
Adolescent ; Adult ; Aged ; Chi-Square Distribution ; Epiretinal Membrane/*pathology/surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Reoperation ; Retinal Detachment/*surgery ; Retrospective Studies ; Risk Factors ; Statistics, Nonparametric ; Visual Acuity ; Vitrectomy/*methods

PURPOSE: The authors used the instrument, OCT3, to evaluate the reproducibility and map the macular thickness rapidly in normal subjects METHODS: Macular thickness was measured in 120 eyes of 62 normal subjects, aged 18 to 79 years, with the macular OCT3 map. There was no history of ocular disease in any of the subjects, and routine ophthalmoscopic examination results were normal. RESULTS: The coefficient value for macular thickness was lower than 2%, indicating that OCT3 provides reliable measurements. Macular thickness of normal subjects was 193.4 +/- 14.6 micro meter in the central ring, 273.0 +/- 14.8 micro meter in the inner ring and 238.2 +/- 15.6 micro meter in the outer ring. The nasal and superior quadrants of the inner ring and the nasal quadrant of the outer ring had higher thickness measurements than another. A decrease of retinal thickness was observed in the old group. However, gender did not have a significant effect on the values. CONCLUSIONS: Macular thickness analysis with OCT3 provided a detailed map of the macular thickness. This indicates that the method may provide a sensitive detection of pathologic thickening or thinning of the retina and suggests that the macular thickness decreases with age.
Retina ; Retinaldehyde