PURPOSE: To compare the choroidal thickness in central serous chorioretiopathy (CSC) patients and normal controls using spectral domain optical coherence tomography (SD-OCT). METHODS: The authors compared the choroidal thickness in eyes with CSC, fellow eyes and in normal eyes. In addition, the authors attempted to determine any correlation between choroidal thickness and other factors such as age, height of serous retinal detachment, and spherical equivalent. Choroidal thickness was measured using a perpendicular line from the outer margin of the subfoveal retinal pigment epithelium to the inner surface of the sclera. RESULTS: Twenty-five eyes of 25 CSC patients, 17 fellow eyes and 29 age-matched normal eyes were examined and categorized as group 1, group 2 and group 3, respectively. Subfoveal choroidal thickness was 370.64 +/- 58.06 microm in group 1, 301.85 +/- 47.83 microm in group 2, and 261.84 +/- 48.22 microm in group 3. The choroidal thickness in group 1 was significantly greater than those in group 2 and group 3, and the choroidal thickness in group 2 was significantly greater than that in group 3 (p = 0.001, p < 0.001, p = 0.004, respectively), where the choroidal thickness showed a negative correlation with age (p = 0.015). CONCLUSIONS: The choroidal thickness was greater in eyes with CSC and in their fellow eyes compared to that in normal eyes. The results suggest that CSC may be caused by choroidal vascular hyperpermeability and increased hydrostatic pressure in the choroid.
Central Serous Chorioretinopathy ; Choroid ; Eye ; Humans ; Hydrostatic Pressure ; Retinal Detachment ; Retinal Pigment Epithelium ; Tomography, Optical Coherence

proliferative vitreoretinopathy (PVR) is the most common cause of failure in retinal reattachment surgery. Three different procedures were performed in 20 pigmented rabbits to devise a simple model to induce experimental PVR. Rabbits were assigned randomly to three groups (I, II, and III). Group I rabbits (5 rabbits, 10 eyes) rereived normal saline into the vitreous cavity, after an iatrogenic retinal tear was made. In group II rabits (8 rabbits, 8 eyes), a suspension of retinal pigment epithelium (RPE) and choroid from the left eye was transferred into the vitreous cavity of the right eye. In group III rabbits (7 rabbits, 7 eyes), a suspension of RPE and choroid from the left eye was transferred into the vitreous cavity of the right eye after an iatrogenic retinal tear was made. The fundus was observed for 2 months with an indirect ophthalmoscope. The incidence of retinal detachment in group I was zero (O/IO), that of group II was 37.5% (3/8), and that of group III was 85.7% (6/7). Electron microscopic findings of the vitreous strand of one eye of group II showed a central melanocytic core, peripheral fibroblasts, and intercellular collasen fibril. Electron microscopic findings in one eye of group III revealed a subretinal membrane composed of suspected RPE and glial cells.
Animals ; *Disease Models, Animal ; Pigment Epithelium of Eye/pathology ; Rabbits ; Retinal Diseases/*etiology ; Vitreous Body/pathology

PURPOSE: We evaluated the relationship between the delayed visual acuity (VA) improvement and retinal features, including in the photoreceptor layer, after a successful macular hole surgery using optical coherence tomography (OCT) images during long-term post-operative observation. The goal was to find the mechanism in delayed VA improvement. METHODS: Postoperative OCT scans were analyzed in nine eyes of eight patients who underwent idiopathic macular hole surgery between June 2003 to June 2005. Horizontal and vertical OCT scans taken of the operated eyes immediately after absorption of intraocular gas and after VA improvement were exported to Adobe Photoshop 7.0. We measured changes in parameters of the central foveal thickness (central 1 mm area), photoreceptor layer thickness, relative reflectivity of photoreceptor to retinal pigment epithelium, and the defective area of photoreceptor layer. RESULTS: The median visual acuity was determined to be 0.2 (range: 0.15~0.3) at the VA unimproved period and 0.5 (range: 0.3~1.0) at VA improved period. The mean central foveal thickness decreased from 221.3 micrometer (range: 155~265 micrometer) to 191.2 micrometer (range: 150~231 micrometer), as VA improved (p=0.007). The mean photoreceptor layer thickness increased from 15.2 micrometer (range: 4.2~27.6 micrometer) to 22.6 micrometer (range: 4.2~35.8 micrometer) as VA improved (p=0.032), and mean relative reflectivity of photoreceptor layer increased from 0.43 (range: 0.08~0.67) to 0.48 (range: 0.10~0.70), as VA improved (p=0.415). The defective area of photoreceptor layer decreased from 70% (range: 90~45%) to 27% (range: 8~5), as VA improved (p=0.001). CONCLUSIONS: A decrease of the central foveal thickness and of photoreceptor layer defective signal, and an increase of photoreceptor layer thickness were observed on OCT during delayed vision improvement after a successful macular hole surgery. Improvement of macular edema and photoreceptor reorganization are suggested as important parts of the mechanism toward vision recovery.
Absorption ; Eye ; Humans ; Macular Edema ; Retinal Perforations ; Retinal Pigment Epithelium ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity

A closed eyeball model was designed to estimate the chorioretinal adhesion of the laser-photocoagulated region. We used it to measure the duration of development of retinal detachment during vitrectomy before and after killing the test rabbits. During testing, negative pressure was applied into the vitreous cavity of the pigmented rabbits. Laser burns were produced in the posterior retina by exposure to an argon blue-green laser beam with a focus diameter of 200 microns of 0.1 to 0.2 second duration and 150 to 250 mW intensity. One hour and one, two, five, seven and fourteen days following laser photocoagulation, vitrectomy was done with a cutting rate of 500 per minute, aspiration pressure of 50 mmHg and infusion pressure of 55.2 mmHg. After core vitrectomy, the rabbit was killed with an intravenous bolus of 100 mg sodium pentobarbital solution. After killing the rabbit, the vitreous cavity was continuously aspirated under the pressure of 25 mmHg while the infusion was stopped. The changes of the fundus, especially development of retinal detachment, were observed in the laser-treated and untreated regions before and after killing the rabbit. When retinal detachment was noted anywhere before killing the rabbit, this postmortem change was not observed. One hour following laser photocoagulation, the laser-treated retina was detached during core vitrectomy before killing the rabbit, and the untreated area was not detached. One day following photocoagulation, the retina was intact before killing the rabbit. After killing the rabbit, the laser-treated retina was detached in four minutes and the untreated retina in 18 minutes postmortem.
Adhesiveness ; Animal ; *Laser Coagulation ; Pigment Epithelium of Eye/*physiology ; Rabbits ; Retina/*physiology ; Retinal Detachment/prevention & control ; Time Factors

PURPOSE: To report a patient with Leber's idiopathic stellate neuroretinitis accompanying peripapillary sensory retinal detachment detected with optical coherence tomography. CASE SUMMARY: A 26-year-old woman complained of visual disturbance in her right eye for several months. Her best corrected visual acuity was 0.5 in the right eye and 0.9 in the left eye. A relative afferent papillary defect was present in the right eye. Severe disc swelling with retinal hemorrhage and stellate macular exudates were observed in the right eye. Fluorescein angiography revealed optic disc leakage. There appeared to be no leakage from the other retinal vessels or from the retinal pigment epithelium. OCT revealed outer nuclear-plexiform layer fluid accumulation in the papillomacular region. Eight weeks after steroid treatment, the best corrected visual acuity in the right eye had improved to 0.7, and the optic disc edema had improved. The OCT showed that the fluid in the outer nuclear-plexiform layer space had largely been absorbed.
Adult ; Edema ; Exudates and Transudates ; Eye ; Female ; Fluorescein Angiography ; Humans ; Retinal Detachment ; Retinal Hemorrhage ; Retinal Pigment Epithelium ; Retinal Vessels ; Retinaldehyde ; Retinitis ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To investigate morphologic changes in the asymptomatic fellow eye of central serous chorioretinopathy (CSC) using spectral domain optical coherence tomography (SD OCT). METHODS: The present retrospective study included 55 asymptomatic fellow eyes of 55 patients with acute CSC. All patients underwent SD OCT, fluorescein angiography (FA), and indocyanine green angiography (ICGA), and the results were analyzed. RESULTS: Sixteen eyes (29.1 %) with normal FA also showed normal SD OCT; however, 70% of the eyes showed choroidal hyperpermeability or punctate hyperfluorescent spots on ICGA. Window defects on FA were observed in 25 eyes (45.5%), and they were represented as a corrugation or bump in the retinal pigment epithelium (RPE) on SD OCT. Retinal pigment epithelial detachments (PEDs) were observed in six eyes (10.9 %) on FA and were represented as PEDs on SD OCT. Leakages on FA were observed in ten eyes (18.2%) and were represented as normal, serous retinal detachment, and a corrugation or bump of RPE on SD OCT. CONCLUSIONS: Greater information regarding morphologic changes and pathophysiology of CSC can be obtained by investigating SD OCT findings in the asymptomatic fellow eyes of acute CSC.
Angiography ; Central Serous Chorioretinopathy ; Choroid ; Eye ; Fluorescein Angiography ; Humans ; Indocyanine Green ; Retinal Detachment ; Retinal Pigment Epithelium ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence

A 46-year-old man presented with visual disturbances in both eyes. His best corrected visual acuity was 0.7 (both eyes). Ptosis and limitation of ocular movement in every direction were observed. Slit lamp examination showed a bilateral iridescent cataract. Fundus examination showed peripheral depigmentation of the retinal pigment epithelium and pigmentary clumping in both eyes that agreed with blocked fluorescence and widow defects on fluorescein angiography. The amplitude of b-wave was decreased on electroretinography. Fourteen months later, the patient's best corrected visual acuity decreased to 0.3 due to increased lens opacity. Phacoemulsification and intraocular lens implantation were performed on both eyes. At the patient's final visit, retinal findings were stable with a best corrected visual acuity of 0.7 in both eyes. In conclusion, the visual disturbance could have been caused by both cataracts and retinal degeneration, meaning the fundus should be examined carefully in patients with myotonic dystrophy.
Diagnosis, Differential ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Myotonic Dystrophy/*complications/diagnosis ; Pigment Epithelium of Eye/*pathology ; Retinal Degeneration/diagnosis/*etiology

PURPOSE: The butterfly-shaped pigment dystrophy is an extremely rare autosomal dominant retinal disorder. The authors present a case of butterfly-shaped pigment dsytrophy not reported previously in Korea. CASE SUMMARY: A 45-year-old man had bilateral blurred vision for 2 years. His visual acuity was 0.2 in the right eye, and 0.3 in the left and was uncorrected. Funduscopically, yellow pigment deposits were present at the level of retinal pigment epithelium (RPE) in the central macula of both eyes. Fluorescein angiography (FA) revealed a central, dark, butterfly-shaped lesion surrounded by a region of hyperfluorescence, Spectral domain optical coherence tomography (OCT) showed thick elevation of the RPE with hyperreflectivity and disruption of the inner and outer segment (IS/OS) interface of the photoreceptors. The patient had normal color vision, visual field and electroretinograms and reduced electrooculograms. CONCLUSIONS: In general, butterfly-shaped pigment dystrophy is known to have good visual prognosis. However, in some cases the disease can be a chronic progressive disorder with secondary involvement of the photoreceptors, as exemplified this patient. The authors anticipate more detail regarding the natural course of this disease will be obtained through spectral domain OCT.
Butterflies ; Color Vision ; Eye ; Fluorescein Angiography ; Humans ; Middle Aged ; Prognosis ; Retinal Pigment Epithelium ; Retinaldehyde ; Tomography, Optical Coherence ; Vision, Ocular ; Visual Acuity ; Visual Fields

We report the clinical course of photodynamic therapy (PDT) in a patient with drusenoid pigment epithelium detachment (PED). A patient with drusenoid PED underwent PDT follow-up was carried out at one week, one month, three months, six months and one year after treatment. Fundus exam, optical coherence tomography (OCT) and fluorescein angiography were performed. After the PDT, drusen and PED were gradually diminished over one year. However, pure serous PED eventually developed at the same location of the drusenoid PED. The results of the PDT, on drusenoid PED, were initially effective, but not completely successful. Therefore, PDT may be considered as an alternative treatment option for drusenoid PED.
Aged ; Fluorescein Angiography ; Humans ; Male ; *Photochemotherapy ; Photosensitizing Agents/*therapeutic use ; Pigment Epithelium of Eye/*drug effects/pathology ; Porphyrins/*therapeutic use ; Retinal Detachment/diagnosis/*drug therapy ; Retinal Drusen/diagnosis/*drug therapy ; Tomography, Optical Coherence

PURPOSE: Intravitreal anti-vascular endothelial growth factor (VEGF) treatment has become an important part in the treatment of neovascular age-related macular degeneration (AMD). In the present study we describe the clinical feature of retinal pigment epithelium (RPE) tears after intravitreal injection of anti-VEGF agent and compared the tear group to the control group. METHODS: In this retrospective case series, data of 11 patients with eyes that developed RPE tears after intravitreal anti-VEGF injection (8 ranibizumab and 3 bevacizumab) were collected and analyzed. The tear group included 11 patients with eyes that developed RPE tears and the control group included 22 patients with no RPE tears after treatment. We investigated age, gender, bilaterality, duration from injection to tear, pigment epithelial detachment (PED) height and diameter, along with central retinal thickness (CMT) using optical coherence tomography (OCT), fluorescein angiography (FAG), and visual acuities before and after treatment. RESULTS: The mean age of the tear group was 81.36 +/- 5.55 years which was significantly different from the control group's mean age of 74.82 +/- 5.28 years (p = 0.003). OCT findings showed PED greatest linear dimension (GLD) was 2978.45 +/- 947.69 microm in the tear group and 2250.23 +/- 988.49 microm in the control group (p = 0.027). PED height was 507.09 +/- 153.97 microm in the tear group and 353.23 +/- 199.42 microm in the control group (p = 0.010). CMT was 431.64 +/- 200.33 microm in the tear group and 289.95 +/- 61.27 microm in the control group (p = 0.005). There was no significant difference between groups according to gender, bilaterality, visual acuities, and subretinal fluid based on OCT and FAG findings. In the tear group, visual acuities before and after the tear were not significantly different. CONCLUSIONS: Old age and eyes with high and wide PED appear to be more vulnerable to RPE tear. Further investigation with a larger number of patients is needed to further confirm these results.
Antibodies, Monoclonal, Humanized ; Endothelial Growth Factors ; Eye ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Macular Degeneration* ; Retinal Pigment Epithelium* ; Retinaldehyde* ; Retrospective Studies ; Risk Factors* ; Subretinal Fluid ; Tomography, Optical Coherence ; Visual Acuity ; Bevacizumab ; Ranibizumab