Objectives: The aim of this review was to examine the effects of PDT in the treatment of neovascular ARMD.
PHOTOCHEMOTHERAPY ; RETINAL NEOVASCULARIZATION ; MACULAR DEGENERATION

To investigate the relationship between peripheral retinal degeneration and axial length, we conducted a clinical study on 254 subjectives (508 eyes) whose age lie between 19-25 years and who had no other ocular disease nor any previous eye surgery. Axial length was measured with A-scan ultrasonography and retinal periphery was inspected by 360 degrees biomicroscopic examination with Goldmann three-mirror lens. The recorded degenerative peripheral retinal lesions were; lattice degeneration, pigmentary degeneration, cystoid degeneration, white without pressure, retinal hole or tears, retinal detachment, posterior vitreous detachment. The statistical analysis was done by using the chi-square test. The mean axial length was 24.01 +/- 1.08mm with a range of 21.8 to 27.9mm. The overall prevalence of the peripheral retinal degenerations increased as axial length did. Specially, that of pigmentary, cystoid, lattice degeneration was significantly related with long axial length individually for each lesion(p<0.01). However, there was a significantly greater percentage(53.37%) of all lesions in 23.0 - 24.9mm axial length group. These results suggest that the frequency of peripheral retinal degeneration increased with axial length but there was a posibility that the peripheral retinal degenerative lesions can be found in eyes of the mean and the shorter axial length.
Prevalence ; Retinal Degeneration* ; Retinal Perforations ; Retinaldehyde* ; Ultrasonography ; Vitreous Detachment

Description histopathologic pictures of rhegmatogenous retinal dctachment in its early stase to late stage is reviewed. Histology on the results of experimental retinal detachment and reattachment is introduced with short comment. Formatlon of subretinal fluid in retinal detachment is a complex and dynamic processes involving alterations in retinal and choroidal structures and metabolism of vitreal components. Peripheral retinal degenerations as predispoing features of retinal detachment are listed. Some pathologic findings following retinal detachment surgeries of clinical importances are noted briefly.
Choroid ; Metabolism ; Pathology* ; Retinal Degeneration ; Retinal Detachment* ; Retinaldehyde* ; Subretinal Fluid

PURPOSE: In this study we evaluated and analyzed the causes and prognosis of spontaneous vitreous hemorrhage except direct ocular trauma and diabetic retinopathy-induced vitreous hemorrhage confirmed after therapeutic vitrectomy. METHODS: The present study included Non-traumatic, non-diabetic vitreous hemorrhage patients who underwent vitrectomy in our hospital from March 2010 to December 2013 and were followed up for more than 1 year. Past history, preoperative visual acuity and intraocular pressure were evaluated postoperatively at 1, 3, 6 and 12 months. RESULTS: A total of 157 patients (157 eyes) were included in the study. Common causes of vitreous hemorrhage were branch retinal vein occlusion, retinal tear and age-related macular degeneration. Age-related macular degeneration and central retinal vein occlusion patients showed a poor visual prognosis. Lattice retinal degeneration or retinal tear in the opposite eye was observed in 27 patients and therefore, barrier laser was performed. CONCLUSIONS: The most common cause of spontaneous vitreous hemorrhage was retinal vein occlusion. Visual prognosis varied depending on the cause of disease, but significant vision improvement can be expected if the macula is not involved. Additionally, in some patients without evidence of retinal detachment on ultrasound, a possible retinal tear accompanied by localized retinal detachment should be considered.
Humans ; Intraocular Pressure ; Macular Degeneration ; Prognosis ; Retinal Degeneration ; Retinal Detachment ; Retinal Perforations ; Retinal Vein ; Retinal Vein Occlusion ; Ultrasonography ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage*

The vitreous and fundus changes in the fellow eyes of 121 patients with unilateral retinal detachment were evaluated ophthalmoscopically. Fourteen cases with traumatic retinald etachment were included in this study. We studied the relationship between the posterior vitreous detachment, lattice degeneration, retinal holes, myopia and retinal detachment to be of any help in prevention of progression of retinal detachment. Retinal breaks were found in 11.6% and lattice degeneration in 21.5% of fellow eyes. The frequency of retinal breaks and lattice degeneration in fellow eyes were greater than that of retinal breaks and lattice degeneration in normal eyes. Retinal breaks and lattice degeneration were found most frequently in the superior temporal quadrant followed by the inferior temporal quadrant. Posterior vitreous detachment(PVD) was found in 33.9% of fellow eyes. Of the 41 eyes with PVD, 22 eyes had retinal breaks and lattice degeneration and 19 eyes had no retinal breaks and lattice degeneration. The proportion of myopia was 54.5% and that of high myopia over -8.0D was 16.5%. The proportion of myopia and high myopia were higher in the fellow eye of patients with unilateral retinal detachment than in general population. In myopic eyes, the incidence of retinal holes, lattice degeneration, and PVD were greater than that of retinal tear.
Humans ; Incidence ; Myopia ; Retinal Degeneration ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde* ; Vitreous Detachment

PURPOSE: To investigate postoperative visual acuities of patients who underwent vitrectomy for their dense nondiabetic vitreous hemorrhage, and in addition to assess postoperative visual results of the group who underwent early vitrectomy. METHODS: Included in the study were 52 patients (52 eyes) who had undergone vitrectomy and been followed up for longer than 4 months after surgeries. Authors investigated the underlying diseases of vitreous hemorrhage, surgical outcomes, and the rate of complications. In addition, we evaluated the results of the group who had undergone vitrectomy between 4 weeks and 6 weeks after development of hemorrhage. RESULTS: The most common cause of vitreous hemorrhage was branch retinal vein occlusion followed by macular hole, ocular trauma, central retinal vein occlusion, age related macular degeneration, Terson`s syndrome, and unknown cases. Visual acuity before operation is less than light perception to 0.3 and improved in 44 eyes (84.6%) after operation. The rate of more than 5 lines' improvement is 63.4% (33 eyes) and 51.9% (27 eyes) obtained their visual acuity of 0.5 or better. In the group which had been operated 4 to 6 weeks after the development, visual acuity improved in 100% (16 eyes). Thirteen eyes (81.2%) showed more than 5 lines' improvement of their visual acuity and 12 eyes had 0.5 or better (75.5%). The most common complication after surgeries is cataract in 5 eyes (10.8%), others were macular hole in 3 eyes (5.7%), retinal detachment in 2 eyes (3.8%), macular hole in 1 eye (6.2%). CONCLUSIONS: Pars plana vitrectomy is a good procedure to improve visual acuity for the patients who have suffered persistent visual disturbances due to non-diabetic vitreous hemorrhage. Also, early vitrectomy should be considered for early visual rehabilitation.
Cataract ; Hemorrhage ; Humans ; Macular Degeneration ; Rehabilitation ; Retinal Detachment ; Retinal Perforations ; Retinal Vein ; Retinal Vein Occlusion ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage*

Stargardt-like macular dystrophy 4 (STGD4) is a rare macular dystrophy characterized by bull's eye atrophy of the macula and the underlying retinal pigment epithelium. Patients with STGD4 show decreased central vision, which often progresses to severe vision loss. The PROM1 gene encodes prominin-1, which is a 5-transmembrane glycoprotein also known as CD133 and is involved in photoreceptor disk morphogenesis. PROM1 mutations have been identified as genetic causes for STGD4 and other retinal degenerations such as retinitis pigmentosa. We report a case of STGD4 with a PROM1 p.R373C mutation in a Korean patient. Ophthalmic examinations of a 38-yr old man complaining of decreased visual acuity revealed bilateral atrophic macular lesions consistent with STGD4. Targeted exome sequencing of known inherited retinal degeneration genes revealed a heterozygous missense mutation c.1117C>T (p.R373C) of PROM1, which was confirmed by Sanger sequencing. To the best of our knowledge, this is the first case of a PROM1 mutation causing STGD4 in Koreans.
Atrophy ; Exome ; Glycoproteins ; Humans ; Macular Degeneration* ; Morphogenesis ; Mutation, Missense ; Retinal Degeneration ; Retinal Pigment Epithelium ; Retinitis Pigmentosa ; Visual Acuity

Stargardt's disease, first described in detail by Stargardt in 1909, is a recessively inherited macular dystrophy which evidences itself by reduced visual acuity, bilaterality, slowly progressive lesion, occurring familially, starting in youth (8 to 15 years). We have recently seen macular dystrophies occurring in siblings, three out of six. All developed this disease between 9 to 15 years and vision deteriorate progressively to the adult hood. Ophthalmoscopic examination revealed slight pale dise, narrowing of retinal vessels, definite alterations in the macular region associated with the development of red-yellow flecks in the center surrounded by yellow-white flecks in the paracentral region. Angiogram showed the evidence of marked alteration in the retinal pigment epithelium on the macula bilaterally. All cases were noted by ring shaped area of mottled hyperfluorescene but central flecks were nonfluorescent. Field examination showed the central scotoma to a small targets and ERG the subnormal in photopic and scotopic responces. The Ishihara test disclosed a mild to moderate red-green dyschromatopsia.
Adolescent ; Adult ; Humans ; Macular Degeneration ; Retinal Pigment Epithelium ; Retinal Vessels ; Scotoma ; Siblings ; Visual Acuity

Circumferential orientation of the buckle in desirable length may be preferable for closing the retinal breaks and the neighboring retinal degenerations. In contrast to radial buckling, according to Lincoff et al, the circumferential one is likely to lead to fishmouthing and radial folds; and the greater the buckle length, the more radial folds are anticipated. In this paper I summarized my opinions on these two problems pertaining to circumferential buckling; the method for preventing fishmouthing and diminishing radial folds on which the hole would impinge and leak posteriorly. A lamellar scleral undermining is performed on both sides of a single scleral incision which is parallel to the limbus and lccated on the equator. The undermining extends from the ora serrata to the region near the scleral entrance of the vortex veins (Fig. 2). The vortex veins are left intact. Surface diathermies are applied in the area undermined. Multiple penetrating diathermies are then applied in the undermined area near the retinal breaks to release subretinal fluid so that the detached retina of the breaks' area may sink on to the pigment epitheHum at first. Preserved sclera is used as an implant. The surface of the implant remains irregulary contoured. The width and the height of the implant depend upon the buckle desired (Fig. 1). After the implant is in place, the sutures are first tied in an area near the retinal breaks so that the radial folds move laterally from the retinal breaks. The surface of the buckles is somewhat irregular, which may compensate for redundant limbal parallel circumference of the detached retina (Fig. 3). The operation may be segmental or encircling. The circling band follows the globe's equator. 17 cases of ratinal detachments were treated with this technique; and in none of the above cases did the posterior edge of the break fishmouth or impinge upon a radial fold. The 100 percent final success in the small series of 17 cases in which an equatorial buckling was used at the initial surgery is also attributable to the relative lack of compiexity (excluding dialysis, giant tears, fixed retinal folds etc.) of cases. In my opinion, circumferential buckling on the equator utilizing a preserved sclera as an implant is convenient, sufficiently promising and carries less risk of reoperation.
Dialysis ; Diathermy ; Reoperation ; Retina ; Retinal Degeneration ; Retinal Perforations ; Retinaldehyde ; Sclera ; Subretinal Fluid ; Sutures ; Veins

Total vitrectomy and removal of the posterior hyaloid membrane were done in 7 patients who were diagnosed as macular hole with specific causative factors. The causative factor of 2 patients is high myopia and of remainers is trauma. Of the 7 patients treated by removal of the posterior hyaloid membrane during total vitrectomy, 3 patients showed anatomical and functional success, 2 patients only the anatomical success, and 2 patients failure. The postoperative complications included phthisis bulbi, proliferative vitreoreinopathy, optic atrophy, and macular degeneration, and iatrogenic rhegmatogenous retinal detachment. Two patients of the 3 success cases complained of mild diplopia after operation.
Diplopia ; Humans ; Macular Degeneration ; Membranes* ; Myopia ; Optic Atrophy ; Postoperative Complications ; Retinal Detachment ; Retinal Perforations* ; Vitrectomy*