Solar retinopathy is an injury of the retinal photoreceptors due to excessive exposure to the solar radiation. Diagnosis of the disease is challenging and requires combination of a detailed history and imaging modalities. This case report focuses on a 55-year-old fruit picker with an irreversible central scotoma of the right eye. A diagnosis of solar retinopathy was made based on history but mainly by several imaging modalities, such as optical coherence tomography (OCT), infrared (IF) imaging of the fundus and fundus autofluorescence (FAF). Electroretinogram (ERG)showed flattened and reduced waves in both scotopic and photopic response. Fundus angiography (FA) revealed no obvious telangectatic vessels. In conclusion, solar retinopathy is a disease where multimodal imaging may play an important role in the diagnosis. The condition may be irreversible thus advocating protective eyewear is mandatory in patients who are chronically exposed to the sun.
Photoreceptor Cells, Vertebrate

Animals ; Embryo, Mammalian ; Humans ; Photoreceptor Cells, Vertebrate ; metabolism ; physiology ; Retinal Ganglion Cells ; metabolism ; physiology ; Retinal Pigments ; metabolism

PURPOSE: Sildenafil citrate (Viagra(R)) acts as a relatively specific inhibitor of the type 5 phosphodiesterase isoenzyme (PDE5) in the corpus cavernosum. But, it also has a mild inhibitory effect on PDE6 in the retinal photoreceptor. Therefore, we studied the ocular side effects of sildenafil. METHODS: We tested the visual acuity, intraocular pressure, color vision, visual evoked potential (VEP), electroretinogram (ERG), anterior segment and fundus appearance. All tests were done before and after medication of 50 mg and 100 mg sildenafil, respectively. RESULTS: There was no significant effect of sildenafil on visual acuity, intraocular pressure, color vision, VEP, anterior segment and fundus appearance. ERG changes after 50 mg sildenafil were not significant. The a-wave amplitude of the maximal combined response after 100 mg sildenafil showed significant changes (p=0.021). The b-wave amplitude of the maximal combined response after 100 mg sildenafil showed changes with borderline significance (p=0.059). CONCLUSIONS: In considering the fact that even single dose of 100 mg sildenafil showed changes on ERG, it seems that retinal function in patients receiving sildenafil for a longer period, especially in patients with underlying vascular abnormalities should be monitored by clinical and electrophysiologic tests.
Citric Acid ; Color Vision ; Eating* ; Evoked Potentials, Visual ; Humans ; Intraocular Pressure ; Photoreceptor Cells, Vertebrate ; Retinaldehyde ; Visual Acuity ; Sildenafil Citrate

It already has been known that various ions were participated in phototransduction mechanism of the vertebrate photoreceptor during the visual adaptation. The vitreous humor(VH)contains certain amount of Na+, K+ and Ca++ as well. However, the roles of these ions are unknown except functioning of metabolic process. Our preliminary electroretinogram(ERG) experiments suggested that the permeability of these ions has light dependent activity during the light illumination. We have supported this suggestion more tangibly by trying out various experiments with bullfrog eyes as a reference of visual adaptation. The results are summarized as follows: 1)According to our atomic absorption spectroscopic measurements, the concentration of Na+, K+ and Ca++ in light adapted VH was higher than that of dark adapted VH. This result indicated that the light-dependention transport systems which affect the ionic movements might be in internal limiting membrane(ILM). 2)The amplitude of ERG b-wave was reduced by concentration decrement of Na+ and concentration increment of K+ respectively. On the other hand, the elimination of Ca++ within ringer solution resulted in b-wave amplitude increment. 3)Treatment of Na+ hannel blockers(TTX, STX)and K+ channel blockers(Ba++, Cd++, Cs+, 4-AP and TEA)in the vitreous humor side induced the increment and the decrement of b-wave response respectively. Taken together, these results suggest that the light dependent Na+ K+ channels exist in the ILM of vertebrate retina which participates visual adaptation.
Absorption ; Hand ; Ions ; Light Signal Transduction ; Lighting ; Membranes* ; Metabolism ; Permeability ; Photoreceptor Cells, Vertebrate ; Rana catesbeiana ; Retina ; Vertebrates* ; Vitreous Body

PURPOSE: To investigate which spectral domain optical coherence tomography (SD-OCT) findings predict visual outcome after anti-vascular endothelial growth factor (VEGF) treatment in neovascular age-related macular degeneration (NV-AMD). METHODS: We reviewed the medical records of patients with treatment-naive NV-AMD who underwent three or more consecutive anti-VEGF injections. The patients were divided into three groups according to their changes of visual acuity (VA); improved (group I), static (group S), or worsened (group W). We assessed the incidences and values of all available SD-OCT findings of these groups, compared these findings between the three groups and compared the initial values with the post-treatment values. RESULTS: Better initial VA and longer external limiting membrane (ELM) length were associated with less change in VA after anti-VEGF treatment. The initial VA was mildly correlated with initial photoreceptor inner and outer segment junction (IS/OS) length and initial ELM length. The final VA was also mildly correlated with the final IS/OS length and the final ELM length. VA was significantly changed after anti-VEGF treatment in groups W and I. With regard to incidence, disruption of the IS/OS (IS/OS-D), disruption of the ELM (ELM-D) and ELM length differed significantly between the three groups, particularly ELM-D. The incidences of IS/OS-D and ELM-D in group I were significantly lower than those in groups S and W, and those in group S were also lower than those in group W. The ELM length in group I was significantly longer than it was in groups S and W, and the ELM length in group S was longer than that for group W. However, these three findings did not change after the anti-VEGF treatment. CONCLUSIONS: Initial IS/OS-D, ELM length and particularly ELM-D can be useful predictors of the visual outcome after anti-VEGF treatment in NV-AMD patients.
Aged ; Aged, 80 and over ; Angiogenesis Inhibitors/*therapeutic use ; Choroidal Neovascularization/*drug therapy/physiopathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Ranibizumab/*therapeutic use ; Retinal Photoreceptor Cell Inner Segment/pathology ; Retinal Photoreceptor Cell Outer Segment/pathology ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity/*physiology ; Wet Macular Degeneration/*drug therapy/physiopathology

PURPOSE: To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) compared with observation for treating acute central serous chorioretinopathy (CSC). METHODS: A retrospective study of 36 patients with acute CSC, including 21 patients treated with anti-VEGF (anti-VEGF group) and 15 patients with observation (observation group). Patients in the anti-VEGF group received a single dose of bevacizumab or ranibizumab at baseline. Best-corrected visual acuity (BCVA), central foveal thickness (CFT) and resolution of subretinal fluid (SRF) on optical coherence tomography (OCT) were assessed. The integrity of the foveal inner segment/outer segment (IS/OS) line at 12 months was also analyzed. RESULTS: Resolution of SRF was achieved in 20 of 21 eyes in the anti-VEGF group and in 12 of 15 eyes in the observation group (p = 0.151). Mean BCVA and CFT were not different between the two groups at 12 months (p > 0.05). The amount of change in BCVA, however, differed significantly between the groups (p = 0.044). Final OCT more frequently detected the foveal IS/OS line in the anti-VEGF group than in the observation group (p = 0.012). CONCLUSIONS: In terms of BCVA, anti-VEGF and observation only had similar therapeutic effects in acute CSC patients. In some patients, however, the rapid resolution of SRF by anti-VEGF might reduce the risk of photoreceptor degeneration and improve long-term visual acuity.
Acute Disease ; Adult ; Angiogenesis Inhibitors/*therapeutic use ; Bevacizumab/therapeutic use ; Central Serous Chorioretinopathy/*drug therapy/physiopathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Observation ; Ranibizumab/therapeutic use ; Retinal Photoreceptor Cell Inner Segment/pathology ; Retinal Photoreceptor Cell Outer Segment/pathology ; Retrospective Studies ; Subretinal Fluid/drug effects ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity

To report three cases in which reorganization of the photoreceptor layer on optical coherence tomography (OCT) was concurrent with long-term visual recovery after macular hole surgery. Serial OCT scans of three eyes in which visual acuity continued to improve for 1 or more years after successful macular hole surgery were reviewed. Case 1. At postoperative four weeks, visual acuity was 20/100 with disorganized photoreceptor layer on OCT. The photoreceptor layer had been reorganized and visual acuity had improved to 20/25 by 1 year. Case 2. Two weeks after the operation, visual acuity was 20/125 and disorganization of the photoreceptor layer was noted. Visual acuity improved to 20/50 by four months. The photoreceptor layer had been partly reorganized and had appearance of a broken line. Visual acuity had improved to 20/40 and the photoreceptor layer had been reorganized further with a residual defect on OCT by 15 months. Case 3. Visual acuity at two weeks was 20/100. OCT revealed disorganization of the photoreceptor layer. Six months after the operation, the partly reorganized photoreceptor layer appeared as a broken line and visual acuity had reached 20/80. Visual acuity had improved further to 20/40 by 1 year, concurrent with improved organization of the photoreceptor layer. The reorganization of the photoreceptor layer plays a part in long-term improvement of visual acuity after macular hole surgery.
Adult ; Aged ; Basement Membrane/surgery ; Female ; Humans ; Middle Aged ; Photoreceptor Cells, Vertebrate/*physiology ; Regeneration/*physiology ; Retinal Perforations/*surgery ; Tomography, Optical Coherence ; Visual Acuity/*physiology ; Vitrectomy

PURPOSE: To report a case of oxaliplatin (Eloxatin(R))-related ocular toxicity in a patient with advanced stomach cancer. CASE SUMMARY: A 43-year-old female with advanced stomach cancer experienced visual symptoms during the treatment with oxaliplatin on a XELOX schedule (a combination of oxaliplatin and capecitabine). After 1 cycle of chemotherapy, she complained of blurred vision and visual field defects in both eyes. Visual field tests showed a bilateral concentric field defect and the electroretinogram revealed a marked reduction of responses in both eyes. On the second cycle of chemotherapy, oxaliplatin was discontinued due to suspicious ocular toxicity. Her visual symptoms improved and visual field test showed normal results 1 month after oxaliplatin discontinuation. However, 3 months after oxaliplatin discontinuation, electroretinogram remained abnormal despite the progressive improvement. CONCLUSIONS: Platinum-based antineoplastic agents such as oxaliplatin should be administered with caution because oxaliplatin can cause damage to the retinal photoreceptors and the optic nerve. Early detection of ocular toxicity and discontinuation of oxaliplatin therapy could prevent severe and irreversible visual loss.
Adult ; Antineoplastic Agents ; Appointments and Schedules ; Drug Therapy ; Female ; Humans ; Optic Nerve ; Photoreceptor Cells, Vertebrate ; Stomach Neoplasms ; Visual Field Tests ; Visual Fields

PURPOSE: To examine the effects of retinal vein occlusion (RVO) on VEGF expression and the ultrastructural change of the various ocular tissues in the rat. METHODS: Sprauge Dawley rats were grouped into RVO group induced with argon laser (n=30) and control (n=10). The ocular tissues of the rats were collected on the first, third and seventh day after RVO. VEGF expression was evaluated with immunohistochemical stain, and the ultrastructural changes were observed with electron microscopy. RESULTS: In control group, VEGF stain was positive in various ocular tissues except outer nuclear cells. In RVO group, VEGF expression had gradual increase in the inner nuclear layer, the retinal pigment epithelia and the ciliary body epithelia after RVO. Especially, in the retinal pigment epithelia, VEGF was significantly increased on the seventh day. In electron microscopic examination, degenerative changes had gradual increase in the inner and middle retinal layers after RVO. The degenerative changes in the retinal pigment epithelia were noted on the third day, and in the retinal photoreceptor cells on the seventh day. CONCLUSIONS: These results showed that VEGF expressions in the inner nuclear layer, retinal pigment epithelia and ciliary body epithelia had a gradual increase, and the ischemic damages of the retina and the optic nerve progressed from the inner layer to the outer layer after RVO.
Animals ; Argon ; Ciliary Body ; Microscopy, Electron ; Optic Nerve ; Photoreceptor Cells, Vertebrate ; Rats* ; Retina ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Vascular Endothelial Growth Factor A*

The aim of this study was to observe and compare the endogenous circadian rhythm and photoresponse of Clock gene transcription in the suprachiasmatic nucleus (SCN) and pineal gland (PG) of rats. With free access to food and water in special darkrooms, Sprague-Dawley rats were housed under the light regime of constant darkness (DD) for 8 weeks (n=36) or 12 hour-light: 12 hour-dark cycle (LD) for 4 weeks (n=36), respectively. Then, their SCN and PG were dissected out every 4 h in a circadian day, 6 rats at each time (n=6). All animal treatments and sampling during the dark phases were conducted under red dim light (<0.1 lux). The total RNA was extracted from each sample and the semi-quantitative RT-PCR was used to determine the temporal mRNA changes of Clock gene in the SCN and PG at different circadian times (CT) or zeitgeber times (ZT). The grayness ratio of Clock/H3.3 bands was served as the relative estimation of Clock gene expression. The experimental data were analyzed by the Cosine method and the Clock Lab software to fit original results measured at 6 time points and to simulate a circadian rhythmic curve which was then examined for statistical difference by the amplitude F test. The main results are as follows: (1) The mRNA levels of Clock gene in the SCN under DD regime displayed the circadian oscillation (P<0.05). The endogenous rhythmic profiles of Clock gene transcription in the PG were similar to those in the SCN (P>0.05) throughout the day with the peak at the subjective night (CT15 in the SCN or CT18 in the PG) and the trough during the subjective day (CT3 in the SCN or CT6 in the PG). (2) Clock gene transcription in the SCN under LD cycle also showed the circadian oscillation (P<0.05), and the rhythmic profile was anti-phasic to that under DD condition (P<0.05). The amplitude and the mRNA level at the peak of Clock gene transcription in the SCN under LD were significantly increased compared with that under DD (P<0.05), while the value of corresponding rhythmic parameters in the PG under LD were remarkably decreased (P<0.05). (3) Under LD cycle, the circadian profiles of Clock gene transcription induced by light in the PG were quite different from those in the SCN (P<0.05). Their Clock transcription rhythms were anti-phasic, i.e., showing peaks at the light phase ZT10 in the SCN or at the dark time ZT17 in the PG and troughs during the dark time ZT22 in the SCN or during the light phase ZT5 in the PG. The findings of the present study indicate a synchronous endogenous nature of the Clock gene circadian transcriptions in the SCN and PG, and different roles of light regime in modulating the circadian transcriptions of Clock gene in these two central nuclei.
Animals ; CLOCK Proteins ; genetics ; Circadian Rhythm ; physiology ; Male ; Photoreceptor Cells, Vertebrate ; physiology ; Pineal Gland ; physiology ; Rats ; Rats, Sprague-Dawley ; Suprachiasmatic Nucleus ; physiology ; Transcription, Genetic