We performed this study to identify the biomicroscopic variations of posterior vitreous detachment(PVD)and to evaluate the clinical relationship of the vitreoretinal pathology and variations of PVD. Three hundred eyes with PVD were examined with biomicroscope using a 3CCD camera and a personal computer developed by us. The biomicroscopic variations were classifed as complete PVD with collapse, complete PVD without collapse, partial PVD with TPVC(thickened posterior vitreous cortex), or partial PVD without TPVC. In each type, the following pathologies were frequently observed :in complete PVD with collapse(150 eyes), age related changes without vitreoretinal diseases(72 eyes, 48%)and high myopia(41 eyes, 27.3%), in complete PVD without collapse(96 eyes), age related changes without vitreoretinal diseases(33 eyes, 34.3%), nonproliferative diabetic retinopathy(20 eyes, 20.8%), high myopia(15 eyes, 15.6%), branch retinal vein occlusion(14 eyes, 14.5%), in partial PVD with TPVC(36 eyes), proliferative diabetic retinopathy(18 eyes, 50%)and uveitis(10 eyes, 27.7%)and in partial PVD without TPVC(18 eyes), age related changes without vitreoretinal diseases(9 eyes, 50%). The type of PVD was significantly associated with the prevalence of each vitreoretinal disease(P<0.001). Biomicroscopic variations of PVD can be classified into four types, which was useful to evaluate the certain vitreoretinal disorders.
Microcomputers ; Pathology ; Prevalence ; Retinal Vein ; Vitreous Detachment*

32 eyes with vitroretinal pathologies caused by branch retinal vein occlusion (BRVO) under went pars plana vitrectomy. Visual acuity was restored postoperatively in 28 of 32 eyes (87.5%). Visual acuity was restored in 19 of 19 eyes (100%) with vitreous opacity only, in 5 of 6 eyes (83.3%) with fibrous proliferation and in 4 of 7 eyes (57.1%) with retinal detachment. Regarding final visual acuity. 78.1% showed 0.1 or better, and 43.8% showed 0.5 or better Among the complications. surgically induced retinal detachment showed the worst prognosis.
Pathology* ; Prognosis ; Retinal Detachment ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Visual Acuity ; Vitrectomy*

This study investigated the baseline predictors of best corrected visual acuity (BCVA) and central retinal thickness (CRT) at 6 months in patients with treatment-naive branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). This multicenter, interventional case series included 208 BRVO and 123 CRVO patients with follow-up period of 6 months or more. Outcome measures of BCVA (logMAR) included absolute change from baseline and a gain or loss of > or = 0.3 from baseline. Outcome measures of CRT included absolute change from baseline and a measurement of < or = 250 microm or > or = 400 microm at 6 months. Univariate and multiple regression analyses were done to find baseline predictors. For BRVO, younger age, worse baseline BCVA, and shorter duration of symptom were associated with more gain in BCVA. For CRVO, worse baseline BCVA was associated with more gain in BCVA. For CRT outcomes, higher baseline CRT predicted greater decrease at 6 months in both BRVO and CRVO. Younger age and better baseline BCVA were associated with an increased likelihood of measurement of a < or = 250 microm outcome for BRVO and CRVO, respectively. For CRVO, smoking was associated with greater decrease from baseline and decreased likelihood of measurement of a CRT > or = 400 microm at 6 months. In conclusion, several baseline factors including age, symptom duration, and baseline BCVA and CRT are associated with BCVA and CRT outcomes at 6 months, which may help to predict disease course for RVO patients.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retina/*pathology ; Retinal Vein Occlusion/pathology/*physiopathology ; *Visual Acuity

BACKGROUNDObstructive sleep apnea syndrome (OSAS) has been shown to generate hypertension and endothelial dysfunction. Retinal vessel is the only vessel that can be observed directly and noninvasively; retinal vascular abnormalities can serve as a predictive marker for the occurrence, clinical course, and prognosis of cardiovascular and cerebrovascular diseases. The objective of this study was to identify the effect of OSAS severity on the morphological changes of retinal vessels.

METHODSAdult patients complained of snoring were included in this study. The patients' general information, polysomnography, and fundus photography parameters including central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and arteriole-to-venule ratio (AVR) were collected. Patients were divided into four groups according to their apnea-hypopnea index (AHI) results: Group I, AHI ≤5/h; Group II, 5/h < AHI ≤30/h; Group III, 30/h < AHI ≤60/h; and Group IV, AHI> 60/h.

RESULTSA total of 133 patients were included in this study with 111 males (83.5%) and 22 females (16.5%). Mean age was 41.6 ± 9.9 years, and the mean body mass index was 28.1 ± 4.0 kg/m2. AHI ranged between 0 and 130.8/h with a mean of 39.1 ± 30.7/h. There were 24, 34, 35, and 40 patients in Group I, Group II, Group III, and Group IV, respectively. Significant differences were found for AHI (F = 388.368, P< 0.001), minimal pulse oxygen saturation (F = 91.902, P< 0.001), and arousal index (F = 31.014, P< 0.001) among four groups; no significant differences were found for CRAE (F = 0.460, P = 0.599) and CRVE (F = 0.404, P = 0.586) among groups; there were significant differences for AVR between Group I and Group IV (63.6 ± 5.1% vs. 67.2 ± 5.5%, P = 0.010) Group II and Group IV (64.5 ± 6.0% vs. 67.2 ± 5.5%, P = 0.030), and Group III and Group IV (64.7 ± 4.1% vs. 67.2 ± 5.5%, P = 0.043). A main group-by-AHI effect was found on the AVR: patients with higher AHI showed higher AVR results (r = 0.225, P = 0.009). Multivariate logistic regression analysis was used for multi-variable factors. A group-by-age effect was found on the AVR: younger patients showed higher AVR results (β = -0.001, P = 0.020).

CONCLUSIONSThis study indicated that increased AVR of retinal vessel can be observed in extremely severe OSAS patients. For patients with OSAS, retinal vascular abnormalities may become an early indication for further cardiovascular abnormalities.

Adult ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Retina ; pathology ; physiopathology ; Retinal Artery ; pathology ; physiopathology ; Retinal Vein ; pathology ; physiopathology ; Sleep Apnea, Obstructive ; pathology ; physiopathology ; Young Adult

PURPOSE: To develop a novel, simplified method for correcting the ischemic index of nonperfused areas in diabetic retinopathy (DR). METHODS: We performed a retrospective review of 103 eyes with naive DR that underwent ultra-widefield angiography (UWFA) over a year. UWFAs were graded according to the quantity of retinal non-perfusion, and uncorrected ischemic index (UII) and corrected ischemic index (CII) were calculated using a simplified, novel method. RESULTS: The average differences between UII and CII in the non-proliferative DR group and the proliferative DR group were 0.7 +/- 0.9% in the <25% CII group, 3.0 +/- 0.9% in the 25% to 49.9% CII group, and 3.6 +/- 0.6% in the >50% CII group, respectively. A CII >25% was critical for determining DR progression (p < 0.001). CONCLUSIONS: Distortion created by UWFA needs to be corrected because the difference between UII and CII in DR increases with the ischemic index.
Adult ; Aged ; Aged, 80 and over ; Diabetic Retinopathy/*diagnosis/pathology ; Female ; Fluorescein Angiography/*methods ; Humans ; Ischemia/pathology ; Male ; Middle Aged ; Retinal Vein/pathology ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: To develop a novel, simplified method for correcting the ischemic index of nonperfused areas in diabetic retinopathy (DR). METHODS: We performed a retrospective review of 103 eyes with naive DR that underwent ultra-widefield angiography (UWFA) over a year. UWFAs were graded according to the quantity of retinal non-perfusion, and uncorrected ischemic index (UII) and corrected ischemic index (CII) were calculated using a simplified, novel method. RESULTS: The average differences between UII and CII in the non-proliferative DR group and the proliferative DR group were 0.7 +/- 0.9% in the <25% CII group, 3.0 +/- 0.9% in the 25% to 49.9% CII group, and 3.6 +/- 0.6% in the >50% CII group, respectively. A CII >25% was critical for determining DR progression (p < 0.001). CONCLUSIONS: Distortion created by UWFA needs to be corrected because the difference between UII and CII in DR increases with the ischemic index.
Adult ; Aged ; Aged, 80 and over ; Diabetic Retinopathy/*diagnosis/pathology ; Female ; Fluorescein Angiography/*methods ; Humans ; Ischemia/pathology ; Male ; Middle Aged ; Retinal Vein/pathology ; Retrospective Studies ; Sensitivity and Specificity

PURPOSE: We report two young patients who developed central retinal vein occlusion (CRVO) without any systemic disease, and various thrombophilia tests were performed to determine the etiology. CASE SUMMARY: Two young patients, a 22-year-old female and a 23-year-old male, who had acute vision loss were diagnosed with nonischemic CRVO via fluorescein angiography. They had no other disease and no common risk factors for CRVO. We performed various tests to determine the thrombophilic risk factors and discovered a transient decrease in protein S antigen and protein C antigen in the female and male patients, respectively. CONCLUSIONS: CRVO in young patients without systemic disorders may have different mechanisms in the pathology and thus additional laboratory tests to determine thrombophilic disorders are necessary.
Female ; Fluorescein Angiography ; Humans ; Male ; Pathology ; Protein C ; Protein C Deficiency ; Protein S ; Protein S Deficiency ; Retinal Vein* ; Risk Factors ; Thrombophilia* ; Young Adult

PURPOSE: To evaluate and compare the clinical and angiographic characteristics of retinal vein occlusion (RVO) in glaucomatous and non-glaucomatous eyes with unilateral RVO in the fellow eye. METHODS: Twenty-one glaucomatous eyes (GL group) and 25 age-matched non-glaucomatous eyes (non-GL group) with unilateral RVO in the fellow eye were included in this study. Fluorescein angiographic images were assessed in both groups by 3 retina specialists in order to determine the RVO occlusion site. The occlusion site was divided into 2 types: arteriovenous (AV)-crossing and non-AV-crossing (optic cup or optic nerve sited). The clinical characteristics and prevalence of AV-crossing and non-AV-crossing RVO were compared between the 2 groups. RESULTS: The mean baseline intraocular pressures of the RVO eye and the fellow eye did not differ between the 2 groups (RVO eye: 14.3 +/- 2.5 mmHg [non-GL group], 15.5 +/- 3.9 mmHg [GL group], p = 0.217; fellow eye: 14.4 +/- 2.5 mmHg [non-GL group], 15.7 +/- 3.7 mmHg [GL group], p = 0.148). The prevalence of systemic disease did not differ between the 2 groups (e.g., diabetes mellitus and hypertension, p = 0.802 and 0.873, respectively). AV-crossing RVO was significantly more frequent in the non-GL group (19 eyes; 76%) than in the GL group (4 eyes, 19%, p < 0.001). CONCLUSIONS: Non-AV-crossing RVO, i.e., optic cup- or optic nerve-sited RVO, is more frequently associated with glaucomatous changes in the fellow eye. Therefore, this type of RVO should be monitored more carefully for indications of glaucoma in the fellow eye.
Female ; Fluorescein Angiography/*methods ; Follow-Up Studies ; Fundus Oculi ; Glaucoma, Open-Angle/*diagnosis ; Humans ; Male ; Middle Aged ; Retinal Vein Occlusion/*diagnosis ; Retinal Vessels/*pathology ; Retrospective Studies ; Severity of Illness Index

INTRODUCTIONMacular oedema is the main cause of visual impairment following retinal vein occlusion. The purpose of this study was to evaluate the anatomical and functional outcome of pars plana vitrectomy and internal limited membrane (ILM) peeling for macular oedema secondary to retinal vein occlusion.

CLINICAL PICTUREThis pilot study is a prospective nonrandomised series of 11 eyes of 11 patients with macular oedema secondary to retinal vein occlusion. The best-corrected visual acuity (BCVA), foveal thickness on optical coherence tomography, fundus fluorescein angiography (FFA) and multifocal electroretinography were evaluated.

TREATMENT AND OUTCOMEAll 11 patients underwent pars plana vitrectomy with ILM peeling. The mean postoperative follow-up was 13.5 months (range, 1.5 to 24). The mean thickness at the foveal centre decreased from 794 +/- 276 microm preoperatively to 373 +/- 150 microm, 302 +/- 119 microm, 249 +/- 203 microm and 185 +/- 66 microm at 1 week, 1 month, 3 months and the final visit postoperatively, respectively (all P <0.001, paired t- test, compared to preoperative thickness). Postoperative FFA demonstrated markedly reduced leakage in the macular region. At the final visit, BCVA improved 2 lines or more in 72.7% (8/11) of patients and was unchanged in 27.3% (3/11) patients. Complications included cataract in 7 patients and vitreous haemorrhage, recurrence of macular oedema and visual field defect in 1 case each.

CONCLUSIONPars plana vitrectomy and ILM peeling rapidly reduced the macular oedema caused by retinal vein occlusion, with improvement in BCVA.

Adult ; Aged ; Epiretinal Membrane ; pathology ; surgery ; Female ; Humans ; Macular Edema ; etiology ; surgery ; Male ; Middle Aged ; Pars Planitis ; pathology ; surgery ; Pilot Projects ; Prospective Studies ; Retinal Vein Occlusion ; complications ; Visual Acuity ; Vitrectomy

PURPOSE: There is currently no treatment proven effective for central retinal vein occlusion (CRVO). Radial optic neurotomy (RON) has recently surfaced as a new treatment for the disorder, however, and we compare here the visual acuity (VA) and arteriovenous transit time (AVTT) following RON and panretinal photocoagulation (PRP). METHODS: We conducted a retrospective, uncontrolled study of 27 patients. Of 27 eyes diagnosed with CRVO, 16 were treated with panretinal photocoagulation (PRP) and 11 with RON. VA and fluorescein angiography were used to monitor the evolution of CRVO, and for follow-up. RESULTS: All patients underwent PRP or RON with no major complications. The difference between pre- and post-operative VA was not statistically significant for either group (p=0.092 on PRP; p=.0081 on RON). The change in AVTT was also not statistically significant for either group (p=0.024 on PRP; p=0.027 on RON). Ultimately, we found no statistically-significant difference in comparing VA and AVTT for the two groups (p=0.074 on VA; p=0.510 on AVTT). CONCLUSIONS: No evidence supporting the effectiveness of RON could be found in this study, suggesting that surgical decompression by RON may not be effective for treating CRVO. Further studies regarding the efficacy of RON should be made.
Visual Acuity ; Treatment Outcome ; Retrospective Studies ; Retinal Vein Occlusion/pathology/physiopathology/*surgery ; Retina/*surgery ; Optic Nerve/*surgery ; Middle Aged ; Male ; Laser Coagulation/*methods ; Humans ; Follow-Up Studies ; Female ; Decompression, Surgical/*methods ; Aged ; Adult