No abstract available.
Hepatitis A Antibodies* ; Hepatitis* ; Immunoglobulin M*

PURPOSE: To assess whether a 4 mg/0.05 ml intravitreal triamcinolone acetonide injection can reduce the IOP elevation compared to conventional 4 mg/0.1 ml injection. METHODS: A retrospective case study was performed in 48 patients (48 eyes) who received intravitreal triamcinolone acetonide injection and who had a minimum follow-up time of six months. Patients were randomly assigned to receive 4 mg/0.1 ml or 4 mg/0.05 ml (24 patients in each group). RESULTS: Before injection, mean IOP was 13.8+/-2.2 mmHg and 13.9+/-2.4 mmHg in the 0.1 ml and 0.05 ml group. The difference in IOP elevation between the two groups was statistically significant immediately after injection (P=0.000), one hour after injection (P=0.001), and one day after injection (P=0.000). After injection, the central macular thickness decreased significantly the of two groups. The difference of the central macular thickness decrease between both groups was not statistically significant. CONCLUSIONS: An intravitreal triamcinolone acetonide 4 mg/0.05 ml injection will more quickly reduce the IOP elevation in the early phase compared to 4 mg/0.1 ml injection, while providing a similar effect on the change of central macular thickness.
Follow-Up Studies ; Humans ; Intraocular Pressure ; Retrospective Studies ; Triamcinolone ; Triamcinolone Acetonide

PURPOSE: To evaluate long-term effects and usefulness of combined intravitreal injection of bevacizumab and panretinal photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy. METHODS: The authors retrospectively reviewed the records of 40 patients (40 eyes) with high-risk proliferative diabetic retinopathy who had been treated with PRP alone (laser treatment group, n=20) or intravitreal bevacizumab before PRP (combined treatment group, n=20). Changes in best corrected visual acuity (BCVA), central macular thickness (CMT) and the total area of leakage from active new vessels (NVs) were compared between the groups at one, three, and six months and at one year post-treatment. RESULTS: In the combined treatment group, CMT decreased significantly at one month (p=0.021), and the areas of active NVs decreased significantly at one month (p=0.001) and three months (p=0.014) compared to those of the laser treatment group. However, there were no differences between the two groups after three months. In the combined treatment group, elevated intraocular pressures were found in three cases after one month, and there were vitreous hemorrhages in two cases after three months. CONCLUSIONS: The combined treatment showed significant early improvements in BCVA, CMT, and NVs regression for up to three months. However, long-term follow-up and additional treatment was necessary in the patients with persistent or recurred NVs and macular edema after three months.
Antibodies, Monoclonal, Humanized ; Diabetic Retinopathy ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Light Coagulation ; Macular Edema ; Retrospective Studies ; Visual Acuity ; Vitreous Hemorrhage ; Bevacizumab

PURPOSE: To report a rare case of choroidal metastasis from renal cell carcinoma. CASE SUMMARY: A 61-year-old man visited our clinic with the chief complaint of decreased vision in the right eye. Three years earlier, he underwent right nephrectomy due to renal cell carcinoma. Best corrected visual acuity was 0.2 in the right eye and 1.0 in the left eye. Fundoscopic examination of the right eye revealed a yellowish, dome-shaped elevated choroidal mass with serous retinal detachment, measuring 5.0 x 4.0 disc diameter and located lateral to the macular area. Systemic evaluations showed multiple lung and brain metastases. A diagnosis of choroidal metastasis from renal cell carcinoma was made for the right eye, and the patient received local treatments with oral sorafenib therapy, composed of subtenon triamcinolone injection and intravitreal ranibizumab injection. Tumor progression continued, and visual acuity declined to hand motion. Enucleation was recommended, but the patient refused and is on a regular follow-up after transpupillary thermotherapy. CONCLUSIONS: Ocular manifestation may be the initial presenting sign of a recurrent tumor, and an extensive systemic evaluation for metastatic malignancy should be performed. The present example showed a rare case of choroidal metastasis from renal cell carcinoma.
Antibodies, Monoclonal, Humanized ; Brain ; Carcinoma, Renal Cell ; Choroid ; Eye ; Follow-Up Studies ; Hand ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Niacinamide ; Phenylurea Compounds ; Retinal Detachment ; Triamcinolone ; Vision, Ocular ; Visual Acuity ; Ranibizumab

Congenital renal arteriovenous malformation is a rare lesion. Nephrectomy or partial nephrectomy is a well-known treatment and as alternative method, transcatheter embolization therapy has been developed. We report a case of congenital arteriovenous malformation manifested by intermittent right flank pain and gross hematuria with blood clots, cured by means of transcatheter embolization therapy during angiographic study with polyvinyl alcohol foam (IVALON).
Arteriovenous Malformations* ; Flank Pain ; Hematuria ; Kidney ; Nephrectomy ; Polyvinyl Alcohol

PURPOSE: Bacillus cereus is an important cause of post-traumatic endophthalmitis. Several different anti-biotics have been used to prevent permanent visual loss. The authors compared the efficacy of intravitreal vancomycin and ciprofloxacin in the treatment of experimental Bacillus cereus endophthalmitis. METHODS: Forty eyes of 20 white rabbits were inoculated with B. cereus organisms. Ten eyes were randomized to receive intravitreal vancomycin (group 1) and 10 eyes ciprofloxacin (group 2) after 12 or 24 hours. Fellow eyes were injected with normal saline as control group. After 48 hours, the eyes were examined and graded for clinical signs of infection and enucleated for histologic examination. RESULTS: There was a statistically significant difference in clinical features between treated groups and control group (p<0.05). There was no significant difference between vancomycin-treated group and ciprofloxacin-treated group. Compared to eyes treated 12 hours after inoculation, eyes treated 24 hours after inoculation showed worse clinical gradings (p<0.05). Histologic examination showed vancomycin or ciprofloxacin-treated groups had significant less inflammation and tissue destruction than control group (p<0.05). There was a statistically significant difference in vitreous and retinal structure between ciprofloxacin-treated after 12 hours inoculation and 24 hours inoculation group (p<0.05). CONCLUSIONS: Ciprofloxacin appeared to be limiting inflammation and tissue destruction in experimental Bacillus endophthalmitis and might effective in substitute vancomycin when necessary.
Bacillus cereus ; Bacillus* ; Ciprofloxacin* ; Endophthalmitis* ; Inflammation ; Rabbits ; Retinaldehyde ; Vancomycin

Systemic candidiasis is a life-threatening disease in premature infants and may result in several complications. Early recognition is essential, but it is delayed and treatment is difficult. Candida endophthalmitis develop with systemic infection and intraocular involvement is detected by fundus examination with an indirect ophthalmoscope. Improvement of intraocular lesion and therapeutic effect of systemic candidiasis are detected with careful retinal examination. Twenty five premature infants received indirect ophthalmoscopic examination and we investigated the prevalence of intraocular involvements and related factors for eye involvement. The ocular findings were classified chorioretinitis, endophthalmitis and nonspecific lesion, except premature vitreous haziness. Chorioretinitis in 4 infants and nonspecific lesion in 3 infants were detected but endophthalmitis was not found. There was slight difference in each group for gestational age, birth weight and ventilator etc, but no signifficant statistical difference was noted. Systemic candidiasis was treated with systemic antifungal agent, and the chorioretinitis is resolved with systemic antifungal agents. We propose that retinal examination be performed on all infants suspected of having systemic candidiasis for the diagnosis and early treatment. Funduscopy may be a helpful as an early diagnostic tool, and to monitor appropriate therapy of systemic candidiasis.
Antifungal Agents ; Birth Weight ; Candida* ; Candidiasis* ; Chorioretinitis ; Diagnosis ; Endophthalmitis ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Ophthalmoscopes ; Prevalence ; Retinaldehyde ; Sepsis* ; Ventilators, Mechanical

PURPOSE: To report a case of a rapidly progressive endogenous endophthalmitis with subretinal abscess that involved the macula and was treated with early vitrectomy. CASE SUMMARY: A 42-year-old man with liver cirrhosis, hepatic cellular carcinoma and diabetes, who underwent regular fundus checkup for diabetic retinopathy presented with reduced vision, ocular pain in the left eye and headache. Indirect ophthalmoscopy showed subretinal abscess approximately five times the optic disc size and surrounding retinal hemorrhage in the nasal upper quadrant. A provisional diagnosis of bacterial endophthalmitis was made based on systemic disease and funduscopic findings. Treatment with topical and systemic empirical antibiotics was initiated along with intravitreal vancomycin and ceftazidime injection. Despite the treatment, after 24 hours the abscess size increased to approximately 10 times the optic disc size and began to involve the macula. The patient underwent diagnostic and therapeutic pars plana vitrectomy as well as vitreous and abscess content cultures. MRSA was found in a blood culture test. Five days postoperatively, the patient's vision and symptoms improved significantly and the residual lesion was cleared, with retinal scars. CONCLUSIONS: In a patient with endogenous endophthalmitis with subretinal abscess, presence of macular invasion and rate of progression is important in determining the time and method of operation. In this case, early vitrectomy was a good choice to preserve macular structure and the patient's visual acuity.
Abscess* ; Adult ; Anti-Bacterial Agents ; Blood ; Ceftazidime ; Diabetic Retinopathy ; Diagnosis ; Endophthalmitis* ; Headache ; Humans ; Liver Cirrhosis ; Methicillin-Resistant Staphylococcus aureus ; Ophthalmoscopy ; Retinal Hemorrhage ; Retinaldehyde ; Vancomycin ; Vision, Low ; Vision, Ocular ; Visual Acuity ; Vitrectomy

The medial prefrontal cortex (mPFC) has been implicated in the processing of emotionally significant stimuli, particularly the inhibition of inappropriate responses. We examined the role of the mPFC in regulation of fear responses using a differential fear conditioning procedure in which the excitatory conditioned stimulus (CS+) was paired with an aversive footshock and intermixed with the inhibitory conditioned stimulus (CS-). In the first experiment, using rats as subjects, muscimol, a gamma-amino-butyric acid type A (GABAA) receptor agonist, or artificial cerebrospinal fluid (aCSF) was infused intracranially into the mPFC across three conditioning sessions. Twenty-four hours after the last conditioning session, freezing response of the rats was tested in a drug-free state. Neither the muscimol nor the aCSF infusion had any effect on differential responding. In the second experiment, the same experimental procedure was used except that the infusion was made before the testing session rather than the conditioning sessions. The results showed that muscimol infusion impaired differential responding: the level of freezing to CS- was indiscriminable from that to CS+. Taken together, these results suggest that the mPFC is responsible for the regulation of fear response by inhibiting inappropriate fear expressions.
Animals ; Freezing ; Muscimol ; Prefrontal Cortex ; Rats

PURPOSE: To investigate the clinical features of patients with macular edema persisting for three months after a successful vitrectomy and removal of the epiretinal membrane. METHODS: The authors retrospectively reviewed the records of 32 patients (32 eyes) with epiretinal membranes who underwent pars plana vitrectomies and membranectomies from January 2005 to September 2008. The patients selected for the study underwent optical coherence tomography (OCT) which revealed macular edema. Macular edema is defined as central macular thickness measuring over 300 m. Several factors including age, presence of systemic disorders, preoperative visual acuity, surgical technique, preoperative state of the macula, and the response to treatment for macular edema were reviewed. RESULTS: Eight out of 32 eyes (25%) had no improvement of visual acuity after surgery of the epiretinal membrane. Six out of 32 eyes (18.75%) persisted in their macular edema. No common features were detected. All patients showed no improvement of visual acuity after their vitrectomies. Two of the eyes were treated with intravitreal or subtenon triamcinolone injection or non-steroidal anti-inflammatory eye drops. Only one eye (16.7%) achieved visual improvement as of the last follow-up. CONCLUSIONS: Despite a successful vitrectomy and membranectomy, macular edema can remain without any specific cause. Persistantmacular edema appears to be a main cause of poor visual outcome and tends to resist conventional treatment.
Edema ; Epiretinal Membrane ; Eye ; Humans ; Macular Edema ; Ophthalmic Solutions ; Retrospective Studies ; Tomography, Optical Coherence ; Triamcinolone ; Visual Acuity ; Vitrectomy