Humans ; Panuveitis/etiology* ; Retinal Detachment/etiology* ; Typhoid Fever/diagnosis* ; Visual Acuity

PURPOSE: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) is the first choice of treatment for age-related macular degeneration. However, quite a few eyes treated using conventional dose anti-VEGF (CDAV) have persistent pigment epithelial detachment (PED) on optical coherence tomography. This study investigated the efficacy and safety of high dose anti-VEGF (HDAV) for refractory PED. METHODS: In this retrospective study, 31 eyes of neovascular age-related macular degeneration patients with persistent PED findings despite six or more intravitreal injections of CDAV (bevacizumab 1.25 mg or ranibizumab 2.5 mg) were analyzed. Changes in visual outcome, central foveal thickness, and PED height were compared before and after HDAV (bevacizumab 5.0 mg) for these refractory PED cases. RESULTS: The mean age of patients was 67.7 years. The number of CDAV injections was 12.1. The number of HDAV injections was 3.39. Best-corrected visual acuity in logarithm of the minimum angle of resolution before and after HDAV was 0.49 and 0.41 (p < 0.001), respectively. Central foveal thickness before and after HDAV was 330.06 and 311.10 µm (p = 0.125), respectively. PED height before and after HDAV was 230.28 and 204.07 µm (p = 0.014), respectively. There were no serious adverse reactions in all the eyes. CONCLUSIONS: Increasing the dose of bevacizumab in refractory PED may be a possible treatment option.
Aged ; Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/*administration & dosage ; Dose-Response Relationship, Drug ; Female ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Intravitreal Injections ; Macular Degeneration/*complications/diagnosis/drug therapy ; Male ; Middle Aged ; Retinal Detachment/diagnosis/*drug therapy/etiology ; Retinal Pigment Epithelium/*diagnostic imaging/drug effects ; Retrospective Studies ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors

PURPOSE: To describe early macular hole (MH) development in rhegmatogenous retinal detachment (RRD) after scleral buckling (SB) based on optical coherence tomography (OCT) findings. METHODS: The medical records and spectral domain OCT images of patients in whom MH developed after RRD repair were evaluated retrospectively. RESULTS: A postoperative MH was detected in five eyes that underwent SB during a 6-year period. All had fovea-off RRD without MH at the time of surgery. OCT showed partial loss of the inner retina with a preserved photoreceptor layer in early postoperative days. On average, 7 days (range,5 to 8 days) after surgery, outer retinal tissues disappeared, resulting in the full-thickness MH. CONCLUSIONS: Serial OCT findings revealed that partial-thickness lamellar holes progressed to full-thickness MHs, which were formed by the degeneration of the outer retina in eyes with preceding loss of the glial cone in the fovea.
Aged ; Humans ; Male ; Middle Aged ; *Postoperative Complications ; Retinal Detachment/*surgery ; Retinal Perforations/diagnosis/*etiology ; Retrospective Studies ; *Scleral Buckling ; Tomography, Optical Coherence

Uveitis was a rare adverse event of vaccination. We met two cases of acute uveitis with exudative retinal detachment following vaccination of H1N1 influenza. Case 1 was a 10-year-old boy who was admitted for bilateral blurred vision at 10 days after vaccination of H1N1 influenza. Vitreous opacity was obvious in both eyes. Broad exudative retinal detachment was observed in the right eye. Case 2 was a 47-year-old female who suffered from an acute high fever at 2 days after the vaccination of H1N1 influenza. Later, she encountered bilateral headache and decreasing vision. In both eyes, mutton fat keratic precipitates, positive Tyndall phenomenon, congestion of optic disc and exudative retinal detachment were observed.
Child ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; pathogenicity ; Influenza Vaccines ; adverse effects ; therapeutic use ; Influenza, Human ; immunology ; prevention & control ; Male ; Middle Aged ; Retinal Detachment ; diagnosis ; etiology ; Uveitis ; diagnosis ; etiology

PURPOSE: The goal of the present research was to study post-treatment changes in polypoidal choroidal vasculopathy (PCV) shown by optical coherence tomography (OCT). METHODS: The study included 12 patients with naive PCV. Photodynamic therapy and 3 consecutive intravitreal bevacizumab injections at 6-week intervals were given. Best corrected visual acuity, subretinal fluid (SRF), pigment epithelium detachment (PED), central macular thickness (CMT), and total macular volume (TMV) were measured before and after treatment as assessed by Stratus OCT3. RESULTS: After treatment, the SRF height decreased earlier than the PED height. The SRF diameter decreased with statistical significance. However, the PED diameter did not show a statistically significant improvement, persisting at pre-treatment levels. Both CMT and TMV decreased significantly after treatment. CONCLUSIONS: After PCV treatment, SRF and PED stabilized, as shown by OCT. However, the PED treatment response was both delayed and refractory compared to the SRF response. The small change in post-treatment PED diameter may suggest the possibility of PCV recurrence.
Aged ; Choroid/*pathology ; Choroid Diseases ; Choroidal Neovascularization/diagnosis/*drug therapy ; Disease Progression ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Male ; Photochemotherapy/*adverse effects ; Prognosis ; Retinal Detachment/diagnosis/*etiology ; Retinal Pigment Epithelium/*pathology ; Retrospective Studies ; *Subretinal Fluid ; Time Factors ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: To investigate correlated factors on final visual acuity in conjunction with fluorescein angiography (FA) and optical coherence tomography (OCT) findings of chronic central serous chorioretinopathy (CSCR). METHODS: Twenty-four patients (36 eyes) with typical findings of chronic CSCR based on medical records, FA and OCT results were enrolled in this study. We investigated demographic findings, initial and final visual acuity (VA), and some typical findings of FA including the type of leakage pattern, the existence of a gravitational tract and an abnormal hyperfluorescent area centered on the fovea. We also investigated OCT findings to examine serous retinal detachment, outer photoreceptor layer (OPRL) preservation, continuity of the inner segment (IS) and the outer segment (OS) of the photoreceptor layer in case of macular attachment, and other typical findings. The converted logarithm of the minimum angle of resolution VA was used to investigate the statistical correlation with these FA and OCT findings. RESULTS: An abnormal hyperfluorescent area within 1 macular photocoagulation study disc area on FA and cystoid degeneration on OCT were correlated with poor final VA of less than 20 / 40. However, the preserved OPRL and the continuity of IS / OS junction were correlated with a good final VA of 0.5 or more. CONCLUSIONS: These specific findings could be associated with recurrent or persistent subretinal fluid and could be important parameters of decision for treatment.
Adult ; Aged ; Central Serous Chorioretinopathy/complications/diagnosis/*physiopathology ; Chronic Disease ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Male ; Middle Aged ; Retina/*pathology ; Retinal Detachment/diagnosis/etiology/physiopathology ; Retrospective Studies ; Severity of Illness Index ; Tomography, Optical Coherence ; *Visual Acuity

We present a case of bilateral serous retinal detachment (SRD) as a presenting sign of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). A 45-year-old woman presented with decreased vision and was found to have bilateral serous retinal detachment. Peripheral blood smears revealed leukocytosis of 53.9x10(3)/microliter with 64.6% lymphoblasts. A bone marrow aspirate revealed the presence of lymphoblasts. Cytogenetic and molecular genetic analysis detected a reciprocal translocation between chromosome 9 and 22, t(9;22) (q34;q11). A diagnosis of Ph+ ALL was made. Following systemic chemotherapy, the bilateral SRD resolved completely with full recovery of vision. The sudden appearance of SRD should raise suspicion for leukemia. Prompt recognition of this disease is important for early systemic treatment and restoration of visual function.
Antineoplastic Agents/therapeutic use ; Female ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/*complications/diagnosis/drug therapy ; Recovery of Function ; Retinal Detachment/diagnosis/*etiology/physiopathology ; Tomography, Optical Coherence ; Visual Acuity/physiology

PURPOSE: This study was designed to evaluate the efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment. METHODS: We retrospectively reviewed the records of 33 consecutive patients (35 eyes) who underwent fluid-gas exchange treatment for postvitrectomy retinal detachment using the two-needle pars plana approach technique. RESULTS: The retinal reattachment rate was 80.0% after complete intravitreal gas disappearance following the fluid-gas exchange; the overall success rate was 65.7%. Visual acuity was improved or stable in 80.0% of cases; a two-line or greater vision improvement or a best-corrected visual acuity of 0.4 or better occurred in 62.9% of cases. The success rates for superior retinal detachments and posterior pole retinal detachments were 76.5% and 85.7%, respectively. CONCLUSIONS: Fluid-gas exchange represents a simple and cost-effective alternative outpatient procedure for retinal reattachment without reoperation for the treatment of superior and posterior pole retinal detachments.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Humans ; Injections ; Laser Coagulation/methods ; Male ; Middle Aged ; Ophthalmoscopy ; Postoperative Care/*methods ; Retinal Detachment/diagnosis/etiology/*therapy ; Retrospective Studies ; Sulfur Hexafluoride/*administration & dosage ; Time Factors ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*adverse effects ; Vitreous Body ; Young Adult

We describe a case of bilateral exudative retinal detachment associated with prodromal symptoms simulating the presentation of acute Vogt-Koyanagi-Harada disease that was eventually diagnosed as acute lymphoblastic leukemia. A 42-year-old man presented with sudden visual loss in both eyes for two weeks. He complained of intermittent headache, neck stiffness and tinnitus for a month. His best-corrected visual acuities were 20/200 in both eyes. Fluorescein angiography, optical coherence topography and indocyanine green angiography featured bilateral serous retinal detachments. A clinical diagnosis of incomplete type Vogt-Koyanagi-Harada disease was considered. However, complete blood cell count showed a marked increase in the number of white blood cells and bone marrow examination revealed precursor B cell lymphoblastic leukemia. The patient started on induction chemotherapy. A week later, his best-corrected visual acuities were 20/25 and the serous retinal detachments were nearly absorbed in both eyes. Bilateral exudative retinal detachment associated with neurologic and auditory abnormalities may be a presenting sign of acute lymphoblastic leukemia. Clinicians should be aware of the possibility of leukemia in such patients.
Adult ; Diagnosis, Differential ; Fluorescein Angiography ; Follow-Up Studies ; Fundus Oculi ; Humans ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications/*diagnosis ; Retinal Detachment/diagnosis/*etiology ; Tomography, Optical Coherence ; Uveomeningoencephalitic Syndrome/*diagnosis ; Visual Acuity

We report a rare case of retinal detachment in colobomatous macrophthalmos with microcornea syndrome. A 25-year-old female who had suffered from poor vision in her left eye since early childhood and high myopia in her right eye (-11 D) visited our clinic because of a sudden deterioration of vision. Examination of the anterior segment showed microcornea with coloboma of the inferior pupil margin in the left iris. Fundus examination of the left eye revealed an inferior choroidal coloboma extending from the optic disc and macula. The patient also had total bullous retinal detachment. Pars plana vitrectomy with silicone oil tamponade was performed, and the retina was reattached. In the very rare condition of colobomatous macropthalmos with microcornea, retinal detachment may develop. Pars plana vitrectomy with additional silicone oil tamponade may be performed to treat this condition.
Adult ; Choroid/*abnormalities ; Coloboma/*complications/diagnosis ; Cornea/*abnormalities ; Female ; Follow-Up Studies ; Humans ; Retinal Detachment/diagnosis/*etiology/surgery ; Syndrome ; Vitrectomy/methods