In ultrasound/computed tomography (CT) fusion images, ultrasound allows visualization of the target in real time. CT provides a navigation for ultrasound scanning and improves the overview in areas of limited visualization with ultrasound. This study was performed to investigate the feasibility of ultrasound/CT fusion based on an electromagnetic tracking technique using external fiducial markers for canine ocular and periocular regions. In 7 Beagle dogs, contrast-enhanced CT images of the head were obtained with placing external fiducial markers over the frontal region and both sides of the forepaws of the dog. Ultrasonography was performed under a magnetic field by installing a position sensor in the linear probe, without changing the dog's position. The positions of the external fiducial markers were adjusted and matched, based on the CT images. The execution time of co-registration and the distance between the regions of interest and the co-registration points, the frontal bone, cornea, retina, and optic nerve, were estimated. Approximately 60% of external fiducial markers were properly recognized in all dogs. After adjustment, all external fiducial markers were precisely matched. The co-registration execution time was less than 1 min. The distances between the regions of interest and co-registration points were less than 3 mm in all dogs. The electromagnetic tracking technique using external fiducial markers was a simple and applicable method for fusion imaging of a canine head using real-time ultrasonography and CT. This technique can be useful for interventional procedures of retrobulbar and periorbital lesions.
Animals ; Cornea ; Dogs ; Fiducial Markers ; Frontal Bone ; Head ; Magnetic Fields ; Magnets ; Methods ; Optic Nerve ; Retina ; Tomography, X-Ray Computed ; Ultrasonography

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder caused by mutation of one of two genes, TSC1 (encoding hamartin, 9q34) and TSC2 (encoding tuberin, 16p13). It invades the central nervous system and various parts of the body, causing various symptoms. Crohn's disease (CD) is a chronic immune-mediated disease that has not been clearly elucidated. It is thought to be caused by an excessive immune response of the body to bacteria that normally exist in the digestive tract with genetic factors. No cases have been reported in which both of the above-mentioned diseases occurred simultaneously. We report a case of CD in a patient with TSC. A 12-year-old boy was brought to our hospital because of abdominal pain. Skin lesions were observed in the TSC. Fundus examination revealed a hamartoma in the right retina. Brain magnetic resonance imaging revealed a subendothelial giant cell astrocytoma (SEGA). On the basis of these findings, he was diagnosed as having TSC. Blood test results showed increased levels of inflammatory markers. On abdominal ultrasonography, his colon walls were observed to be thickened with increased vascularity of the proximal ascending colon, ileocecal valve, and terminal ileum. Colonoscopy revealed discontinuous ulcerations and inflammations of the ileum, IC valve, and cecum, similar to those found in CD. Everolimus was administered orally for the SEGA but was discontinued frequently owing to the exacerbation of CD. The possibility of CD should be kept in mind in patients with TSC considering to undergo treatment for SEGA.
Abdominal Pain ; Astrocytoma ; Bacteria ; Brain ; Cecum ; Central Nervous System ; Child ; Colon ; Colon, Ascending ; Colonoscopy ; Crohn Disease* ; Everolimus ; Gastrointestinal Tract ; Giant Cells ; Hamartoma ; Hematologic Tests ; Humans ; Ileocecal Valve ; Ileum ; Inflammation ; Magnetic Resonance Imaging ; Male ; Retina ; Skin ; Tuberous Sclerosis* ; Ulcer ; Ultrasonography

PURPOSE: We report the case of a patient diagnosed with central retinal artery occlusion caused by cardiac myxoma who underwent surgery to remove the myxoma. CASE SUMMARY: A 47-year-old woman came to our clinic presenting with a sudden decrease of visual acuity in the left eye. At the first visit, left eye visual acuity was hand motion, and intraocular pressure was 15.4 mmHg. A relative afferent pupillary defect was observed in the left eye. On fundus examination, a pale retina and cherry-red spot were observed at the posterior pole. On optical coherence tomography, macular edema was found. On fluorescein angiography and indocyanine green angiography, delayed blood circulation of the retina and choroid was found at early and late stages. Cerebral angiography was performed in the neurosurgery department and showed no occlusion of the ophthalmic artery. Cardiac ultrasonography and brain magnetic resonance imaging were performed. On cardiac ultrasonography, 4.46 × 2.09 cm cardiac myxoma was found. Resection of the cardiac myxoma was conducted in the thoracic and cardiovascular surgery department. Multiple cerebral infarcts were detected by brain imaging, and antithrombotic treatment was administered. After one month, blood circulation in the retina and choroid was observed in fluorescence angiography, but there was no improvement of visual acuity. At the 3-month follow-up visit, macular edema was decreased, but retinal atrophy and epiretinal membrane were observed on optical coherence tomography. CONCLUSIONS: Central retinal artery occlusion is a disease related to one's general condition. We experienced this case of central retinal artery occlusion caused by cardiac myxoma.
Angiography ; Atrophy ; Blood Circulation ; Brain ; Cerebral Angiography ; Choroid ; Epiretinal Membrane ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Hand ; Humans ; Indocyanine Green ; Intraocular Pressure ; Macular Edema ; Magnetic Resonance Imaging ; Middle Aged ; Myxoma* ; Neuroimaging ; Neurosurgery ; Ophthalmic Artery ; Pupil Disorders ; Retina ; Retinal Artery Occlusion* ; Retinal Artery* ; Retinaldehyde ; Tomography, Optical Coherence ; Ultrasonography ; Visual Acuity

PURPOSE: To report a case of retinal blot hemorrhage localized to 1 eye accompanied by Raynaud's phenomenon. CASE SUMMARY: A 65-year-old female was referred for vision disorder in the right eye. She had been taking an antihypertensive drug since diagnosed with systemic hypertension 2 years previously. On initial examination, her best corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye and intraocular pressure was 15 mm Hg in the right eye and 21 mm Hg in the left eye. Fundus examination showed retinal blot hemorrhage across the entire retina and increased retinal vascular tortuosity. No specific finding was found on visual field examination, transthoracic ultrasonography and carotid Doppler ultrasound. The blood test was positive for antinuclear and anticentromere antibodies, thus she was referred to the rheumatologic department. The patient was diagnosed with primary Raynaud's phenomenon because no correlation with other rheumatologic diseases was found. Subsequently, she was scheduled for regular follow-ups with a prescription of circulatory stimulant. Five months later, her best corrected visual acuity was 20/20 in the both eyes and retinal blot hemorrhage in the right eye was significantly decreased based on fundus examination. CONCLUSIONS: In the case of atypical retinal blot hemorrhage without other ophthalmic causes except Raynaud's phenomenon, the change in retinal circulatory autoregulation associated with the mechanism of retinal blot hemorrhage can be presumed. Therefore, a close examination and history taking should be conducted so that Raynaud's phenomenon as a pathological factor is not overlooked.
Aged ; Antibodies ; Female ; Fibrinogen ; Follow-Up Studies ; Hematologic Tests ; Hemorrhage* ; Homeostasis ; Humans ; Hypertension ; Intraocular Pressure ; Prescriptions ; Retina ; Retinaldehyde* ; Ultrasonography ; Vision Disorders ; Visual Acuity ; Visual Fields

PURPOSE: Vasoproliferative tumor of the retina (VPTR) is a histologically benign lesion that can lead to visual loss due to associated complications. Herein, the authors report the clinical presentation, treatment, and prognosis of 3 VPTR cases. CASE SUMMARY: Three eyes of 3 patients with VPTR were enrolled in the present study. The patients' fundoscopic feature showed characteristic elevated lesions of the peripheral retina without previous history of ocular disease. The patients included 2 males and 1 female, with an average age of 44.7 years. Fluorescein angiography (FAG) and indocyanine green angiography (ICGA) were helpful in establishing the diagnosis of VPTR. Additionally, 1 patient underwent ultrasonography and 2 patients underwent magnetic resonance imaging (MRI). During the follow-up period, subtenon triamcinolone acetonide injection was performed for 1 patient with macular edema, and cryotherapy was performed for 1 patient with increased peripheral exudation. CONCLUSIONS: For an adequate diagnosis of VPTR, careful examination of the peripheral retina is important. In addition, FAG/ICGA and ultrasonography can be helpful in VPTR diagnosis. Furthermore, proper treatment according to each subset of complication during the follow-up period is recommended.
Angiography ; Cryotherapy ; Diagnosis ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Indocyanine Green ; Macular Edema ; Magnetic Resonance Imaging ; Male ; Prognosis ; Retina* ; Triamcinolone Acetonide ; Ultrasonography

OBJECTIVETo evaluate the hazardous effects of fried potato chips upon the retina of two developmental stages of the albino rats aged 7 and 14 days from parturition.

METHODSPREGNANT RATS WERE ARRANGED INTO TWO GROUPS: control pregnant rats and consequently their delivered newborns until reaching 7 and 14 days old from parturition and fried potato chips group in which pregnant rats at the 6th day of gestation maintained on diet formed of fried potato chips supplied from the market mixed with standard diet at a concentration of 50% per each till 7 and 14 post-partum. Three fold integrated approaches were adopted, namely, histological, ultrastructural and proteomic analysis.

RESULTSHistological examination of the retina of the experimental offsprings revealed many histopathological changes, including massive degeneration, vacuolization and cell loss in the ganglion cell layer, as well as general reduction in retinal size. At the ultrastructural level, the retina of experimental offsprings exhibited number of deformities, including ill differentiated and degenerated nuclear layer, malformed and vacuolated pigment epithelium with vesiculated and fragmented rough endoplasmic reticulum, degenerated outer segment of photoreceptors, as well as swollen choriocapillaris and loss of neuronal cells. Proteomic analysis of retina of the two experimental developmental stages showed variations in the expressed proteins as a result of intoxication which illustrated the adverse toxic effects of fried potato chips upon the retina.

CONCLUSIONSIt can be concluded that the effect of fried potato chips on the development of retina in rats may be due to the presence of acrylamide or its metabolite.

Acrylamide ; toxicity ; Animals ; Animals, Newborn ; Cooking ; methods ; Diet ; methods ; Female ; Histocytochemistry ; Male ; Pigments, Biological ; Pregnancy ; Proteome ; analysis ; Rats ; Retina ; pathology ; Solanum tuberosum ; chemistry ; Ultrasonography

PURPOSE: To determine the proper time frame in which to assess retinal attachment status and to evaluate the superior retinal attachment status by performing B-scan ultrasonography in different positions on patients who have undergone pars plana vitrectomy and gas tamoponade. METHODS: In this prospective study, 23 patients (23 eyes) who had undergone pars plana vitrectomy and gas tamponade were investigated between June 2005 and February 2006. SF6 (18%) was injected into the vitreous cavity of 15 eyes, and C3F8 (14%) was injected into the vitreous cavity of 8 eyes. At postoperative day 1, day 3, week 1, week 2, and week 4, B-scan ultrasonography was performed in the supine, sitting, prone, right decubitus, and left decubitus positions. RESULTS: The proper time to evaluate the retinal attachment status was three days post-operatively in 10 eyes (66.7%) with SF6 (18%) injections and two weeks post-operatively in six eyes (75%) that had C3F8 (14%) injections. The superior retinal attachment status can be evaluated from the summation of B-scan ultrasonography results performed in the right decubitus and left ducubitus positions. CONCLUSIONS: The proper time to evaluate the retinal attachment status was related to the degree of the gas absorption when performing B-scan ultrasonography after pars plana vitrectomy and gas tamponade. To evaluate the entire retina, it is useful to perform B-scan ultrasonograhy in the prone, right decubitus and left decubitus positions.
Adult ; Aged ; Aged, 80 and over ; Air ; Female ; Follow-Up Studies ; Humans ; Injections ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Retina/*ultrasonography ; Retinal Diseases/*surgery/ultrasonography ; Time Factors ; Treatment Outcome ; Vitrectomy/*methods ; Vitreous Body

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 postoperative surgical outcome of vitreous surgery with removal of the internal limiting membrane assisted by indocyanine green (ICG) and the epiretinal membrane assisted by triamcinolone acetonide (TA.) METHODS: We examined the posterior vitreous state with ultrasound and OCT. The procedures performed included pars plana vitrectomy with internal limiting membrane removal assisted by ICG and epiretinal membrane peeling assisted by TA. We prospectively examined 9 eyes with retinal detachment resulting from a macular hole and with follow-up periods longer than 12 months. The main outcome was evaluated by the anatomical success rate, functional success rate, and postoperative complications. RESULTS: In the 7 of 9 eyes, the retina was reattached with closure of the macular hole and without closure of the macular hole in 1 of 9 eyes. Successful retinal reattachment was achieved in 8 eyes (88%) after the initial surgery and in one eye after an additional operation. Visual acuity was improved in 7 eyes, was unchanged in one eye, and decreased in one eye. The functional success rate was 78%. CONCLUSIONS: In retinal detachment resulting from a macular hole, removal of the internal limiting membrane by ICG, and the posterior hyaloid membrane and epiretinal membrane by TA typically results in anatomical and functional success.
Epiretinal Membrane* ; Follow-Up Studies ; Indocyanine Green ; Membranes* ; Postoperative Complications ; Prospective Studies ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Triamcinolone Acetonide ; Ultrasonography ; Visual Acuity ; Vitrectomy

Optical coherence tomography is a new imaging technique analogous to ultrasound B scan that can provide cross sectional images of retina with approximately 10micrometer resolution. This study was designed to evaluate the quantification of nerve fiber layer [NFL] thickness in normal eyes using OCT. We studied 66 eyes of 66 subjects by conventional ophthalmoscopic physical examination, Humphrey central 30-2 visual fields, stereoscopic optic nerve head photography, retinal nerve fiber layer photography, HRT and OCT. Imaging with OCT was performed circumferentially around the optic nerve head with a circle diameter of 2.3mm & 3.4mm using an internal fixation technique. At a scan diameter of 2.3mm and 3.4mm, average, superior, inferior, nasal and temporal NFL thicknesses were 125.45 +/-19.05 micrometer, 150.33 +/-25.53micrometer, 154.55 +/-25.72 micrometer, 102.89 +/-29.13micrometer, and 92.65 +/-27.04micrometer and 109.02 +/-15.68 micrometer,135.53 +/-22.65 micrometer, 132.98 +/-20.19micrometer, 73.11 +/-26.85 micrometer and 89.70 +/-14.65 micrometer each. The NFL was thickest in the superior and inferior quadrants,thinnest in the nasal quadrant at a scan diameter of 2.3mm, and thinnest in the temporal quadrant at a scan diameter of 3.4 mm. In general the thickness for the 2.3 mm scans was greater than that for the 3.4mm scans.NFL thickness decreased significantly with age in the temporal quadrants [P<0.05]. At a scan diameter of 3.4 mm, NRA decreased significantly with decreased average NFL thickness and average NFL thickness decreased significantly with decreased disc area [P<0.05]. By direct investigation of the NFL with OCT, earlier diagnosis of glaucoma and earlier detection of glaucomatous progression can be made, before conventional signs such as visual field loss, cupping of the optic nerve head, and NFL defects are evident, thus allowing earlier treatment and reducing the damage.
Diagnosis ; Glaucoma ; Nerve Fibers* ; Optic Disk ; Photography ; Physical Examination ; Retina ; Retinaldehyde* ; Tomography, Optical Coherence* ; Ultrasonography ; Visual Fields