During cerebral vasospasm (CVS) due to ruptured aneurysm the retinal arteries were photographed and evaluated with angiographic studies at various stages to study any correlation between them. Among 60 cases with angiographic CVS, ophthalmoscopic retinal artery spasm (RAS) was detected in 29 cases. Photographic demonstration of the RAS was possible in 7 cases. In general, in a series of cases, the degree of RAS seems to correspond to the severity of CVS.
Carotid Artery Diseases/complications ; Human ; Intracranial Aneurysm/complications ; Ischemic Attack, Transient/complications* ; Ophthalmoscopy* ; Retinal Artery* ; Retinal Diseases/diagnosis

A 5-year-old girl was diagnosed with neurofibromatosis type 2 (NF-2) due to multiple neurofibromas, cafe-au-lait spots, and schwannomas of the brain. During ophthalmologic evaluation, a posterior subcapsular cataract and a gray-green colored subretinal lesion were found in right eye. Fluorescein angiography (FA) revealed a combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). At age 9, she underwent cataract surgery. At this time FA and spectral-domain optical coherence tomography (SD-OCT) were taken. The SD-OCT showed an elevated hyperreflective mass in the retina with prominent attenuation of the inner and outer retina, but minimal attenuation in the photoreceptor layers. The underlying retina appeared to be disorganized and thick (791 microm). This is the first case report of SD-OCT imaging of a CHRRPE associated with NF-2 in a pediatric patient. By using SD-OCT in this patient, we could obtain detailed tumor characteristics, and SD-OCT may be helpful in the diagnosis and management of CHRRPE.
Child, Preschool ; Diagnosis, Differential ; Female ; Hamartoma/complications/*diagnosis ; Humans ; Neurofibromatosis 2/*complications/diagnosis ; Retinal Diseases/complications/*diagnosis ; Retinal Pigment Epithelium/*pathology ; Tomography, Optical Coherence/*methods ; Visual Acuity

The variability of cardiovascular abnormalities is one of the characteristics of systemic lupus erythematosus (SLE). Among the cardiovascular manifestations, hypertension is reported in 14% to 58.1% of patients in diverse ethnic populations, and remains a clinically important issue due to its close relationship with early mortality in patients with SLE. The development of hypertension in patients with SLE has been associated with advanced lupus-related renal disease and the medications used for the treatment of lupus. Malignant hypertension is a serious complication of hypertension; it rarely occurs in patients with SLE. However, it can occur in patients with other complicated medical conditions such as the antiphospholipid antibody syndrome (APS) or cardiac tamponade. Here, we report the case of a patient with SLE and malignant hypertension with hypertensive retinopathy that initially presented without clinical evidence of APS or hypertensive nephropathy.
Adult ; Female ; Humans ; Hypertension, Malignant/*diagnosis/*etiology ; Lupus Erythematosus, Systemic/*complications/*diagnosis ; Lupus Nephritis/complications/diagnosis ; Retinal Diseases/*diagnosis/*etiology

The aim of this study is to elucidate the association of neovascularization in branch retinal vein occlusion (BRVO) combined with major arterial insufficiency (MAI), compared with BRVO alone. The authors retrospectively reviewed the charts, color photographs, and fluorescein angiograms of 304 patients (308 eyes) who had BRVO from 1990 to 2002 at Hanyang University hospital. Patients with BRVO combined with MAI and patients with BRVO alone were differentiated by angiographic appearance. Of the 308 eyes, 12 (3.9%) had neovascularization, all of which were in the 56 eyes of the MAI group for which the neovascularization rate was 21.4%. Neovascularization in BRVO was more strongly associated with the non-perfusion caused by MAI, rather than with the extent of the non-perfusion area that originated from retinal capillary obstruction. MAI is considered as a risk factor for neovascularization and hence could be a prognostic factor.
Adult ; Aged ; Comparative Study ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Artery/*physiopathology ; Retinal Diseases/*complications/physiopathology ; Retinal Neovascularization/diagnosis/*etiology/physiopathology ; Retinal Vein Occlusion/*complications/diagnosis/physiopathology ; Retrospective Studies

PURPOSE: To investigate the clinical characteristics of polypoidal choroidal vasculopathy (PCV) associated with chronic central serous chorioretinopathy (CSC). METHODS: We retrospectively reviewed the medical records of 246 PCV patients (283 eyes) between July 2004 and August 2009 and investigated the clinical characteristics of the PCV patients who had specific fundus findings of chronic CSC. RESULTS: Among PCV patients, 13 eyes (4.6%) of 13 PCV patients (5.3%) had fundus findings of chronic CSC. All of the PCV lesions had a solitary polyp located outside the atrophic retina, predominantly in the macular area (84.6%), most showed an exudative pattern (69.2%) and there were a few that showed a hemorrhagic pattern (30.8%). All of the lesions were smaller than 1 disc diameter. Most of the PCV lesions (76.9%) were cured with less than two treatments in a short period of 6.4 +/- 1.9 months; however, visual acuity deteriorated (61.5%) or was not changed (30.8%) in most of the cases. CONCLUSIONS: The PCV associated with chronic CSC had several clinical features such as a small exudative retinal lesion with a solitary polyp and frequent involvement of the macular area. Even though there was poor visual outcome due to the atrophic change, all of the PCV lesions were easily resolved in a short period with a simple treatment course and no recurrence.
Aged ; Choroid/*blood supply ; Choroid Diseases/*complications/diagnosis/therapy ; Female ; Fluorescein Angiography ; Humans ; Indocyanine Green/diagnostic use ; Male ; Middle Aged ; Retinal Detachment/complications/diagnosis/therapy ; Retinal Diseases/*complications/diagnosis/therapy ; Retrospective Studies ; Risk Factors ; Visual Acuity

Retinoblastoma, the most common primary intraocular malignancy of childhood, usually presents in the first three years of life. Atypical presentation of retinoblastoma can masquerade as virtually any ocular or orbital pathology, which may lead to diagnostic dilemmas especially in the presence of other systemic diseases. We report a 20-month-old boy who was diagnosed with coronary aneurysm as a complication of Kawasaki disease, and presented with sudden left eye redness. His mother noticed the presence of white pupillary reflex three months earlier. Atypical acute ocular presentation secondary to Kawasaki disease was initially suspected, but the presence of multiple calcification and mild proptosis on imaging suggested characteristics of advanced retinoblastoma. Histopathological examination of the enucleated eye, which revealed a classical rosette pattern appearance, confirmed the diagnosis. Atypical presentations of retinoblastoma are usually associated with advanced disease. The presence of other systemic conditions further complicates the diagnosis. Early diagnosis is important to reduce the mortality and morbidity.
Coronary Aneurysm ; complications ; diagnosis ; Diagnosis, Differential ; Eye ; diagnostic imaging ; physiopathology ; Eye Diseases ; diagnosis ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; Retinal Neoplasms ; complications ; diagnosis ; diagnostic imaging ; Retinoblastoma ; complications ; diagnosis ; diagnostic imaging ; Treatment Outcome ; Ultrasonography

A 44-year-old woman who showed recurrent vitreous hemorrhages with vascular tortuosity received CT angiography which revealed an internal carotid artery aneurysm. A case of internal carotid aneurysm was associated with a pattern of retinal arteriolar tortuosity pathognomic for familial retinal arterial tortuosity (fRAT), suggesting possible involvement of the cerebral circulation. We present a case of internal carotid aneurysm associated with a pattern of retinal arteriolar tortuosity pathognomic for fRAT.
Adult ; Aneurysm/*complications/radiography ; Angiography ; Carotid Artery Diseases/*complications/radiography ; *Carotid Artery, Internal ; Diagnosis, Differential ; Eye Abnormalities/complications/diagnosis/*genetics ; Female ; Follow-Up Studies ; Humans ; Retinal Artery/*abnormalities ; Tomography, X-Ray Computed ; Torsion Abnormality/complications/diagnosis/*genetics ; Visual Acuity

PURPOSE: To determine the lowest limit of signal strength that is still effective for accurate analysis of optic coherence tomography (OCT) values, we investigated the reproducibility of OCT scans by signal strength (SS). METHODS: A total of 668 subjects were scanned for measurements of retinal nerve fiber layer (RNFL) thickness using the Stratus OCT twice on the same day. The variability of overall RNFL thickness parameters obtained at different SS was analyzed and compared by repeated-measures of ANOVA and Spearman's correlation coefficient. Values of the intraclass correlation coefficient (ICC) and variability (standard deviation) of RNFL thickness were obtained. The false positive ratio was analyzed. RESULTS: When SS was 3, the variability of RNFL thickness was significantly different (low ICC, high variability) in comparison to when SS was 4 or greater. Significant negative correlations were observed between variability in RNFL thickness and signal strength. The difference of variability of average RNFL thickness between SS 4 (4.94 microm) and SS 6 (4.41 microm) was 0.53 microm. CONCLUSIONS: Clinically, the difference of variability of average RNFL thickness between SS 4 and SS 6 was quite small. High SS is important, however, when signal strength is low due to uncorrectable factors in patients in need of OCT for glaucoma and retinal disease. Our results suggest that SS 4 is the lowest acceptable limit of signal strength for obtaining reproducible scanning images.
Adolescent ; Cross-Sectional Studies ; Diagnosis, Differential ; Disease Progression ; False Positive Reactions ; Female ; Glaucoma/complications/*diagnosis ; Humans ; Male ; Prospective Studies ; Reproducibility of Results ; Retinal Diseases/*diagnosis/etiology ; Retinal Ganglion Cells/*pathology

PURPOSE: To report a case of bilateral bullous exudative retinal detachment in central serous chorioretinopathy (CSC) which was attached by vitrectomy and internal drainage of the subretinal fluid. METHODS: A 47-year-old man affected by bilateral atypical CSC with a bullous retinal detachment with subretinal exudate. A fluorescein angiogram (FAG) showed multiple points of leakage and staining of subretinal fibrosis. A tentative diagnosis of Vogt-Koyanagi-Harada (VKH) syndrome was made and the patient was treated with systemic corticosteroids and immunosuppressive agents. However, the subretinal fluid was not absorbed. He was then treated with vitrectomy and internal drainage of subretinal fluid. RESULTS: The retina was attached successfully in both eyes. Visual acuity improved to 20/50 in his left eye but did not improve in the right eye due to subretinal fibrotic scarring and atropic changes on the macula. CONCLUSIONS: Our case suggests that the surgical management of bullous exudative retinal detachment is safe and necessary.
*Vitrectomy ; Retinal Detachment/etiology/pathology/*surgery ; Middle Aged ; Male ; Humans ; Fundus Oculi ; Follow-Up Studies ; Fluorescein Angiography ; Exudates and Transudates ; Drainage/*methods ; Diagnosis, Differential ; Choroid Diseases/*complications/diagnosis

PURPOSE: To report a case of uveal effusion syndrome associated with hypotony and a case of uveal effusion syndrome in nanophthalmos. METHODS: The first case was a 25-year-old man who presented with decreased visual acuity in the left eye and hypotony. Fundus examination revealed choroidal effusion and retinal detachment with a thickened eyeball. Partial thickness sclerotomy and sclerectomy were performed. The second case was a 13-year-old boy who had uveal effusion syndrome with a nanophthalmic eye. RESULTS: In the patient with hypotony, intraocular pressure was well maintained following partial thickness sclerotomy and sclerectomy, and choroidal effusion and retinal detachment were reduced. The visual acuity of the nanophthalmic patient was well maintained during a 3-year follow-up period without treatment. CONCLUSIONS: appropriate treatment modalities should be considered depending on the ophthalmic condition of the individual patient.
Syndrome ; Sclera/surgery ; Retinal Detachment/diagnosis/*etiology ; Ophthalmologic Surgical Procedures/methods ; Microphthalmos/*complications/diagnosis ; Male ; Humans ; Follow-Up Studies ; Exudates and Transudates ; Diagnosis, Differential ; Choroid Diseases/*complications/diagnosis ; Adult ; Adolescent