PURPOSE: To report the clinical features, clinical course, and treatment outcomes after laser photocoagulation in infants with aggressive posterior retinopathy of prematurity (APROP) and capillary-free zones in vascularized retina. METHODS: Six patients (12 eyes) with APROP and capillary-free zones in vascularized retina were retrospectively reviewed. Twelve eyes of six infants were included and were treated with laser photocoagulation for avascular retina and for capillary-free zones in vascularized retina, except for the posterior pole, and fundus findings were photographically-documented in sequence. In addition, anatomic and visual outcomes were evaluated with complications of APROP. RESULTS: Among all of the consecutive infants with APROP, capillary-free zones in vascularized retina were demonstrated in 24% of the infants. All of the infants were >27 weeks of gestation age and had birth weights >1,000 g. After laser treatment, 7 eyes (58.3%) had favorable outcomes, and late capillary filling in capillary-free zones of vascularized retina were noted, however 4 eyes (33.3%) progressed to retinal detachment and 1 eye (8.3%) was complicated by a retinal fold-distorting posterior pole. The visual outcomes were associated with anatomic outcomes. CONCLUSIONS: The anatomic outcomes in infants with APROP who had capillary-free zones were comparable to previously reported infants with APROP. The late capillary filling of capillary-free zones in vascularized retina was noted, and angiogenesis was considered to be involved. This process toward normal capillary formation or neovascularization in APROP, might determine its outcome.
Capillaries/*pathology ; Female ; Humans ; Infant ; Laser Coagulation/*methods ; Male ; Retina/*pathology/surgery ; Retinal Vessels/*pathology/surgery ; Retinopathy of Prematurity/*pathology/*surgery ; Retrospective Studies ; Treatment Outcome

PURPOSE: To report the clinical features, clinical course, and treatment outcomes after laser photocoagulation in infants with aggressive posterior retinopathy of prematurity (APROP) and capillary-free zones in vascularized retina. METHODS: Six patients (12 eyes) with APROP and capillary-free zones in vascularized retina were retrospectively reviewed. Twelve eyes of six infants were included and were treated with laser photocoagulation for avascular retina and for capillary-free zones in vascularized retina, except for the posterior pole, and fundus findings were photographically-documented in sequence. In addition, anatomic and visual outcomes were evaluated with complications of APROP. RESULTS: Among all of the consecutive infants with APROP, capillary-free zones in vascularized retina were demonstrated in 24% of the infants. All of the infants were >27 weeks of gestation age and had birth weights >1,000 g. After laser treatment, 7 eyes (58.3%) had favorable outcomes, and late capillary filling in capillary-free zones of vascularized retina were noted, however 4 eyes (33.3%) progressed to retinal detachment and 1 eye (8.3%) was complicated by a retinal fold-distorting posterior pole. The visual outcomes were associated with anatomic outcomes. CONCLUSIONS: The anatomic outcomes in infants with APROP who had capillary-free zones were comparable to previously reported infants with APROP. The late capillary filling of capillary-free zones in vascularized retina was noted, and angiogenesis was considered to be involved. This process toward normal capillary formation or neovascularization in APROP, might determine its outcome.
Capillaries/*pathology ; Female ; Humans ; Infant ; Laser Coagulation/*methods ; Male ; Retina/*pathology/surgery ; Retinal Vessels/*pathology/surgery ; Retinopathy of Prematurity/*pathology/*surgery ; Retrospective Studies ; Treatment Outcome

No abstract available.
Choroid/pathology ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic/*etiology/pathology ; Retina/pathology ; Retinal Detachment/surgery ; Vitrectomy/*adverse effects

No abstract available.
Choroid/pathology ; Humans ; Male ; Middle Aged ; Ophthalmia, Sympathetic/*etiology/pathology ; Retina/pathology ; Retinal Detachment/surgery ; Vitrectomy/*adverse effects

We studied the ultrastructural features of four consecutive subfoveal neovascularmembranes (SFNM) associated with age-related macular degeneration. Cellular components of the membranes included retinal pigment epithelial (RPE) cells, endothelium-lined vascular channels, macrophages, myofibroblasts, fibrocytes, glial cells, erythrocytes, and lymphocytes. Extracellular interstitial constituents included collagen fibrils, basal laminar deposits, fibrin and young elastic fibrils. These findings show that SFNMs consist of various cells originating from surrounding tissues and vessels. Among these RPE cells and macrophages are the main cellular components and in conjunction with various extracellular matrix, especially collagen, may play an important role in the formation and maintenance of the membranes.
Basement Membrane/surgery/ultrastructure ; Humans ; Macular Degeneration/complications ; Microscopy, Electron ; Retina/*ultrastructure ; Retinal Neovascularization/etiology/*pathology/surgery

A 42-year-old man was admitted to our clinic complaining of visual distortion in his left eye two months after bilateral myopic photorefractive keratectomy (PRK). Macular optical coherence tomography (OCT) showed a stage II macular hole in the left eye. Simultaneous OCT in the right eye showed vitreous traction and distortion of the outer retina. One month later, the patient underwent vitrectomy for the left eye, and the macular hole was closed. Two months after that, the patient complained of visual distortion in the right eye, and OCT revealed increased traction and accentuated outer retinal distortion indicating a stage IB macular hole. Traction attenuated later without any intervention. The short interval between PRK and hole formation, bilateral involvement, and the moderate refractive error in this case highlight the possible role of PRK in aggravating vitreoretinal interface abnormalities. We recommend the addition of PRK to the list of procedures that may be associated with the formation of a macular hole.
Adult ; Humans ; Male ; Myopia/*surgery ; Photorefractive Keratectomy/*adverse effects ; Retina/*pathology ; Retinal Perforations/diagnosis/*etiology ; Tomography, Optical Coherence ; *Visual Acuity

Extraocular muscle imbalance and diplopia after retina surgery have been previously reported, but the etiology is still controversial. In order to better understand the cause of strabismus after retinal surgery, the authors retrospectively studied 30 patients with persistent strabismus following retinal surgery and combined the result about seven patients of strabismus after retinal surgery in the previous report. Results showed multiple etiologies for the strabismus. Causes of strabismus included fat adherence syndrome (14 patients), non-specific restrictive adhesion (11), displacement of superior oblique tendon (2), scleral explant interfering with ocular motility (1), lost or slipped muscle with adhesion (2), sensory strabismus (2), macular pucker causing ectopic fovea (2), and previous strabismus before the retinal surgery (3). Knowledge of the varieties of abnormalities that can cause strabismus and diplopia will help both the retina and strabismus surgeon prevent and treat strabismus after retinal surgery.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Diplopia/etiology ; Humans ; Middle Aged ; Oculomotor Muscles/pathology ; *Postoperative Complications ; Retina/*surgery ; Retinal Diseases/*surgery ; Retrospective Studies ; Strabismus/*etiology

PURPOSE: To describe the results of lens-sparing vitrectomy for the correction of retinal detachment associated with retinopathy of prematurity (ROP) and its associated complications. METHODS: Seventeen patients who underwent a lens-sparing vitrectomy for stage 4 and stage 5 ROP with plus disease at Seoul National University Children's Hospital between 1999 and 2003 were enrolled in this study. The patients who had bilateral retinal detachment of ROP underwent a lens-sparing vitrectomy in one eye and a scleral buckling surgery or lensectomy-vitrectomy in the other eye. The patients who had a retinal detachment in one eye and a regressed ROP in the other eye underwent unilateral lens-sparing vitrectomies. A review of their preoperative clinical findings (including the status of retinal detachment and plus disease), post-operative results, and any complications encountered was performed. RESULTS: In 17 patients, the postoperative success rate of lens-sparing vitrectomy was 58.8%. However, lens-sparing vitrectomy as a treatment for stage 5 ROP (25.0%) produced more negative post-operative results than it did when used to treat either those for stage 4a (75,0%) or 4b (66.7%) ROP. Among the 10 eyes in which the retina was attached, form vision was shown in six eyes, light could be followed by three eyes, and no light perception was present in one eye. Intra- and post-operative complications included retinal break formation, cataracts, vitreous hemorrhages, and glaucoma in patients with stages 4b and stage 5 ROP. CONCLUSIONS: Lens-sparing vitrectomy resulted in encouraging surgical outcomes in the correction of retinal detachment of ROP, especially in stage 4 patients. Therefore, a lens-sparing vitrectomy for stage 4 ROP patient may be beneficial, although it is still associated with some intra- and post-operative complications.
Vitrectomy/*methods ; Treatment Outcome ; Severity of Illness Index ; Scleral Buckling/methods ; Retrospective Studies ; Retinopathy of Prematurity/complications/pathology/*surgery ; Retinal Detachment/etiology/pathology/surgery ; Retina/*pathology ; Male ; Lens, Crystalline/*surgery ; Infant, Newborn ; Infant ; Humans ; Follow-Up Studies ; Female ; Child, Preschool

PURPOSE: Using a temporary keratoprosthesis(TKP), earlier surgical treatment became amenable in eyes with coexisting vitreoretinal and corneal disease. We analysed our experience with this type of surgery. METHOD: Medical records of patients who had undergone pars plana vitrectomy(PPV) using Eckardt TKP from 1994 to 2000 were reviewed. Analysis was focused on preoperative conditions, surgical outcome and complications. RESULT: Of 34 eyes of consecutive 34 patients, 25(73.5%) showed trauma-related indications and 4 had IOFB. Retinal detachments were present in 24(70.6%) eyes, proliferative vitreoretinopathy in 8(23.5%) and vitreous hemorrhage in 10(29.4%) eyes. Penetrating keratoplasty(PKP) with donor corneas were performed in only 3 patients at the time of surgery and patient's excised corneas were sutured to 31 patients, 9 of whom underwent PKP later. After mean follow up period of 14 months, retinas remained attached in 27(79.4%) eyes and 3 eyes were phthisical. Visual acuity improved in 18(53%) eyes and worsened in 5 eyes. CONCLUSIONS: In cases with coexisting corneal and vitreoretinal pathology, PPV using TKP was effective for preserving vision and globe. Timing of grafting clear cornea might be delayed when donor cornea was not available.
Cornea ; Corneal Diseases ; Follow-Up Studies ; Humans ; Keratoplasty, Penetrating* ; Medical Records ; Pathology ; Retina ; Retinal Detachment ; Tissue Donors ; Transplants ; Visual Acuity ; Vitreoretinal Surgery* ; Vitreoretinopathy, Proliferative ; Vitreous Hemorrhage

PURPOSE: To evaluate whether systemically injected bone marrow-derived mesenchymal stem cells (MSCs) can be incorporated into neuroretinal tissues and play an important role in retinal wound healing in the laser-induced retinal trauma model. METHODS: Retinotomies were made by applying an Nd:YAG laser to rat retina. On the first day after the injuries, cell suspensions that were obtained from the same line of rat (containing 1 x 10(6) green fluorescence protein [GFP]-marked bone marrow-derived MSCs) were injected through a tail vein in the experimental group and phosphate buffer solution (PBS) was injected in the same way in the control group. Fundus photographs were taken serially for fundus examination and eyeballs were enucleated for histological studies that were conducted at five and seven weeks after MSC and PBS injection. After the tissues were prepared, the retinotomy sites were observed with routine histological staining and confocal microscopy. RESULTS: Retinal detachment resolved in the experimental group, whereas it progressed in the control group. The retinotomy sites closed partially with identifiable GFP positive cells 5 weeks after MSC injection. At 7 weeks after MSC injection, complete healing without retinal detachment and plentiful GFP positive cells were observed at the transitional zone between damaged and normal retina. CONCLUSIONS: Systemically administered GFP-marked MSCs may be incorporated into the neuroretinal tissues and play an important role in the wound modulation of physically damaged retinal tissues.
Animals ; *Bone Marrow Transplantation ; Disease Models, Animal ; Eye Injuries/pathology/*surgery ; Mesenchymal Stem Cell Transplantation/*methods ; Microscopy, Confocal ; Prognosis ; Rats ; Rats, Sprague-Dawley ; Retina/injuries/pathology/*surgery ; *Wound Healing