A new case of the recently experienced intraocular cysticercosis associated with multiple skin lesions (subcutaneous nodules) is presented. Clinical picture of this case was characteristic with bizarre shape retinal hemorrhage, and clinical diagnosis was possible by the fluorescein angiography of fundus. Trans-scleral extraction of the subretinal cysticercus was performed successfully without rupture of a cyst-capsule through the infero-temporal quadrant of sclera near to the equator of right eye. Diagnosis of ocular cysticercosis was confirmed by histo-parasitological examination on the extracted cyst of 5 x 7 mm in size. Oral medication is generally not amenable treatment for the intraocular cysticercosis, and less traumatic surgical removal is the only effective method for the improvement of visual function or preservation of the eye itself. The immense review of literatures on the ocular cysticercosis including the subretinal invas ion was attempted.
Cysticercosis* ; Cysticercus ; Diagnosis ; Fluorescein Angiography ; Retinal Hemorrhage ; Rupture ; Sclera ; Skin

PURPOSE: To evaluate the efficacy of intravitreal aflibercept monotherapy in submacular hemorrhage (SMH) secondary to wet age-related macular degeneration (AMD). METHODS: This study included 25 eyes in 25 patients with SMH involving the fovea secondary to wet-AMD. All patients were treated with three consecutive monthly intravitreal aflibercept (2.0 mg/0.05 mL) injections, followed by as-needed reinjection. They were followed for at least 6 months. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), and area of SMH were measured at diagnosis, as well as at 3 and 6 months after treatment initiation. RESULTS: The BCVA significantly improved from 0.79 ± 0.41 logarithm of the minimum angle of resolution (logMAR) at baseline to 0.54 ± 0.41 logMAR at 6 months (p < 0.001). BCVA ≥3 lines and stable vision were observed in 96% of the eyes. The CFT significantly decreased from 560.8 ± 215.3 µm at baseline to 299.8 ± 160.2 µm at 6 months (p < 0.001). The area of SMH significantly decreased from 10.5 ± 7.1 mm² at baseline to 1.8 ± 6.5 mm² at 6 months (p < 0.001). The BCVA, CFT, and area of SMH at baseline, as well as duration of symptoms, all correlated with BCVA at the 6-month follow-up. CONCLUSIONS: Intravitreal injection of aflibercept is an effective treatment option for patients with SMH secondary to wet-AMD; however, there may be limited efficacy in eyes with large SMH area and cases in which treatment is delayed.
Choroid Hemorrhage ; Diagnosis ; Follow-Up Studies ; Hemorrhage* ; Humans ; Intravitreal Injections ; Macular Degeneration* ; Retinal Hemorrhage ; Visual Acuity

PURPOSE: To analyze retinal tears and to compare the clinical outcomes between retinal tear and rhegmatogenous retinal detachment (RRD) as the cause of dense non-diabetic vitreous hemorrhage in patients who underwent vitreoretinal surgery. METHODS: In a retrospective case series, the medical records of patients who presented dense non-diabetic vitreous hemorrhage and who underwent vitreoretinal surgery between January 2005 and June 2009 were reviewed. Among the 134 patients, 27 patients had dense vitreous hemorrhage caused by retinal tears. The first group had retinal tears only and the second group had accompanying RRD. A comparison of clinical features and postoperative prognoses between the two groups was performed. RESULTS: Among the 27 eyes with non-traumatic retinal tear and RRD, 18 were categorized into the retinal tear group and 9 to the RRD group. The demographic findings between the two studied groups exhibited no significant differences except for time between onset of symptoms and diagnosis. However, the time to diagnosis was significantly delayed in the group with RRD (22.67 +/- 37.47 days) compared to the retinal tear group (5.00 +/- 3.41 days) (p = 0.035). The amount of visual improvement was also greater in the retinal tear group than the RRD group (p = 0.002). CONCLUSIONS: Retinal tears are a major cause of non-diabetic vitreous hemorrhage. Vitreous hemorrhage caused by retinal detachment may result in delayed diagnosis and poor visual recovery. Therefore, early examinations in suspicion of RRD and appropriate treatments are needed in non-diabetic vitreous hemorrhage.
Delayed Diagnosis ; Eye ; Humans ; Medical Records ; Prognosis ; Retinal Detachment ; Retinal Perforations ; Retinaldehyde ; Retrospective Studies ; Vitreoretinal Surgery ; Vitreous Hemorrhage

PURPOSE: To identify the factors related to repeatability of intravitreal bevacizumab injections in patients with macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: The present study included 26 patients with macular edema secondary to BRVO occurring within 1 month of diagnosis. Initial best corrected visual acuity, type of BRVO according to the involved vein branch, distance between fovea and occlusion vein, central macular thickness, type of macular edema, presence of macula hemorrhage, and presence of capillary nonperfusion were evaluated at the time of diagnosis. The patients received an intravitreal bevacizumab injection at the time of diagnosis and reinjections when macular edema and visual acuity were aggravated. According to the factors considered, the reinjection-free rate which was considered a survival rate was evaluated for 1 year after the first injection. RESULTS: The patients with initial visual acuity lower than log MAR 0.5 showed 52.6% survival rate within 1 year compared with 14.3% of the patients with visual acuity higher than log MAR 0.5 (p < 0.01). The patients with occluded vein closer than a distance of 2.5 disc diameters (DD) from the foveal center had a 57.1% survival rate and the patients with occluded vein farther than a distance of 2.5 DD from the foveal center had a 25.0% survival rate (p = 0.04). Macular BRVO and major BRVO patients had 64.3% and 16.7% survival rates, respectively (p = 0.01). CONCLUSIONS: The patients with BRVO may have less chance of repetitive intravitreal bevacizumab injections due to macular edema when initial visual acuity is lower than log MAR 0.5, occluded vein is closer than 2.5 DD from the foveal center, and macular branch is involved at the initial diagnosis. These factors can be utilized to predict the prognosis of BRVO patients and the probability of repetitive intravitreal bevacizumab injections.
Capillaries ; Diagnosis ; Edema* ; Hemorrhage ; Humans ; Macular Edema ; Prognosis ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Survival Rate ; Veins ; Visual Acuity ; Bevacizumab

PURPOSE: To investigate the characteristics of fluorescein angiograms (FAG) of the optic nerve head and retina according to the presence of optic nerve head swelling (ONHS) in central retinal vein occlusion (CRVO). METHODS: The records of 69 eyes were reviewed, confirmed with the diagnosis of CRVO, and compared for several features according to the presence of ONHS. The best-corrected visual acuities and intraocular pressures were recorded and patterns of retinal hemorrhage were described. The presence of fluorescein filling defects of the optic disc, time till fluorescein started to fill at the optic disc, arteriovenous transit time, and nonperfused areas were assessed using FAG. RESULTS: Forty-one patients without ONHS (group 1) and 28 patients with ONHS (group 2) were included. The mean ages for groups 1 and 2 were 61.4 and 56.9 years, respectively, and there was no significant difference the mean ages between the groups. The fluorescein filling defect of the optic disc was seen more often in group 1 (n=13) than in group 2 (n=2). Marginal irregularity of the foveal avascular zone due to perifoveal capillary drop out was seen significantly more often in group 1 (n=12) than in group 2 (n=2). CONCLUSIONS: Fluorescein filling defects of the optic disc and perifoveal capillary drop out were more frequently seen in CRVO patients without ONHS. However, longitudinal studies are needed to confirm the prognostic value of ONHS and the correlation of filling defects with progressive optic neuropathy in CRVO.
Capillaries ; Diagnosis ; Fluorescein* ; Humans ; Intraocular Pressure ; Optic Disk* ; Optic Nerve Diseases ; Optic Nerve* ; Retina ; Retinal Hemorrhage ; Retinal Vein* ; Visual Acuity

PURPOSE: To report a case of lipemia retinalis in a patient with diabetes. CASE SUMMARY: A 27-year-old female with type 2 diabetes visited our clinic with visual disturbance in her left eye while being followed up from a pars plana vitrectomy in her right eye for proliferative diabetic retinopathy. On fundus examination of both eyes, the retinal vessels were creamy white and the retinal veins were undistinguishable from the retinal arteries. The serum triglyceride level was 2,676 mg/dL. The patient was asymptomatic except for visual impairment due to vitreous hemorrhage in her left eye. The patient was diagnosed with lipemia retinalis and chylomicronemia syndrome. After controlling the triglyceride level, funduscopic findings in the both eyes were improved. However, the visual acuity in her right eye remained unchanged. CONCLUSIONS: Lipemia retinalis can be a sign of a systemic condition although it may not affect visual acuity. Fundus examination may be a useful tool in the early diagnosis of hyperlipidemia.
Adult ; Diabetic Retinopathy* ; Early Diagnosis ; Female ; Humans ; Hyperlipidemias* ; Retinal Artery ; Retinal Vein ; Retinal Vessels ; Triglycerides ; Vision Disorders ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

No abstract available.
Aged ; Diagnosis, Differential ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; *Intraocular Pressure ; Regional Blood Flow/*physiology ; Retina/*diagnostic imaging ; Retinal Hemorrhage/*diagnosis/physiopathology ; Retinal Vein Occlusion/*diagnosis

PURPOSE: This study aimed to determine the accuracy of ultrasonography (US) in detecting retinal detachment in vitreous hemorrhage (V-HEMO). METHODS: A chart review of 81 patients (86 eyes) who have undergone pars plana vitrectomy in the treatment of V-HEMO between June 1996 and June 2004 was done. RESULTS: The most common cause of vitreous hemorrhaging was proliferative diabetic retinopathy (PDR) (39 eyes, 45.3%), followed by ocular trauma (22 eyes, 25.6%). the correct anatomic position of the retina was identified with US in 72 of 86 eyes (83.7%), with eight false positives (9.3%) and six false negatives(7.9%). The sensitivity of US was calculated as 73% and specificity was 88%. US within the PDR group correctly identified 29 of 39 eyes (74.4%), and had a sensitivity of 62% and a specificity of 81%. US within the non-PDR group correctly identified 43 of 47 eyes (91.5%), and had a sensitivity of 89% and a specificity of 92%. CONCLUSIONS: It has been reported that US is an effective diagnostic tool in patients with media opacity, however physicians should bear in mind that US can be unreliable in some patients with PDR. Thus, caution is warranted in making diagnoses and determining the appropriated surgical procedure.
Diabetic Retinopathy ; Diagnosis ; Humans ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Sensitivity and Specificity ; Ultrasonography* ; Vitrectomy ; Vitreous Hemorrhage*

PURPOSE: To evaluate the efficacy and safety of fine-needle aspiration biopsy in the diagnosis of suspected intraocular malignancy and simulating conditions. METHODS: We performed a retrospective study of the medical records of patients who underwent diagnostic pars plana transvitreal biopsy. RESULTS: A total of 12 biopsies were performed in 11 eyes of 11 patients with intraocular tumor and the final diagnosis was confirmed by cytologic examination in 10 eyes. There was insufficient amount of material for cytologic examination in one case. In another case, biopsy was repeated to obtain the final result due to false negative result of the first biopsy. Localized intraocular hemorrhage was found to be the most common complication, but resolved spontaneously in most cases. Retinal detachment and tumor recurrence were not observed. CONCLUSIONS: Transvitreal fine-needle aspiration biopsy is an accurate diagnostic procedure in the evaluation of intraocular tumors difficult to diagnose with other non-invasive diagnostic technique and it can be performed safely with minimal complication.
Biopsy ; Biopsy, Fine-Needle* ; Diagnosis ; Hemorrhage ; Humans ; Medical Records ; Melanoma ; Recurrence ; Retinal Detachment ; Retrospective Studies

Retinal arterial macroaneurysm may be presented with diverse clinical manifestations, such as various types of hemorrhage, exudate, edema or serous detachment especially in the elderly patients. Correct diagnosis can sometimes be difficult. A high index of suspicion is always required, and the characteristic findings of fluorescein angiography are useful for the correct diagnosis. Especially it is inevitably revealed as extrafoveal round hyperfluorescence on indocyanine green angiography(ICGA) which has recently become a useful tool in hemorrhagic and exudative disease, and can be misinterpreted as hot spot in choroidal neovascularization(CNV). So it may be misdiagnosed and treated as CNV associated with age-related macular degeneration(AMD), and the risk of branch retinal artery occlusion will be increased. We experienced four cases of retinal arterial macroaneurysms that showed various types of hemorrhagic and exudative change, and one case with serous retinal detachment. Two of these cases were misdiagnosed and treated as CNV associated with AMD, and branch retinal artery occlusion was developed in one of them. In the case presented with serous retinal detachment, it revealed as mass like lesion adjacent to the optic disc, and differential diagnosis with vascualr tumors was necessary. Our purpose is calling attention to the possibility of retinal arterial macroaneurysm in the diagnosis of various hemorrhagic and exudative lesions, especially in the elderly patients with hypertension.
Aged ; Choroid ; Diagnosis ; Diagnosis, Differential ; Edema ; Exudates and Transudates ; Fluorescein Angiography ; Hemorrhage ; Humans ; Hypertension ; Indocyanine Green ; Retinal Artery Occlusion ; Retinal Detachment ; Retinaldehyde*