摘要:

The vast majority of patients with rhegmatogenous retinal detachments present with either acute or chronic symptoms. In these cases repair of the retinal detachment is almost always recommended to either improve vision or prevent further visual loss. In a small subgroup, rhegmatogenous retinal detachments were detected as incidental findings in asymptomatic patients. Such asymptomatic detachments are often caused by atrophic holes in lattice degeneration and are more commonly located in the inferior quadrants. Demarcation lines are often present. Asymptomatic retinal detachments also occur in a younger age group of patients when compared with symptomatic rhegmatogenous retinal detachments. The management of eyes with an asymptomatic retinal detachment is controversial. The risk of complications during surgical repair must be weighed against the chance that the retinal detachment will progress. Recently published clinical data suggest that the risk of progression of asymptomatic rhegmatogenous retinal detachments is small. Consequently, observation can be considered as a reasonable management option in reliable patients until progression is documented or symptoms occur. Patient education geared toward instruction on self-monitoring of the visual field and a review of the risks and benefits of retinal detachment repair versus observation are important in patients with asymptomatic retinal detachment.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Ocular manifestations in Lyme disease have been considered rare. In surveys and epidemiologic studies the possibility of ocular Lyme disease has usually not been taken into account. Patients with late ocular Lyme disease may be seronegative by routine enzyme-linked immunosorbent assays, but immunoblot or detection ofBorreliaDNA by polymerase chain reaction may help in diagnosing those cases. An ophthalmologist may suspect the diagnosis of Lyme disease in inflammatory ocular syndromes with unusual biomicroscopic or angiographic findings. Intraocular Lyme disease is usually treated with intravenous ceftriaxone or cefotaxime. Jarisch-Herxheimer reaction may occasionally complicate the antibiotic treatment of ocular manifestations. Overtreatment with ceftriaxone should be avoided because of a possibility of biliary complications.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

It is often a challenge for the ophthalmologist to find the underlying cause of a vitreous hemorrhage. Unless clinical signs clearly point in another direction, the first suspicion should always be a posterior vitreous detachment causing a retinal tear. The other two major causes, diabetic retinopathy and retinal vein occlusion, remain common complications in spite of recent years' improvement in retinal treatment. Macroaneurysm is one of the most often overlooked causes of vitreous hemorrhage. An ocular tumor sometimes presents with a vitreous hemorrhage. In all cases of dense vitreous hemorrhages, the use of diagnostic ultrasonography is mandatory.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The management of retinoblastoma has evolved tremendously for the past century, and recently there is a trend toward focal conservative treatments. This trend is due primarily to the earlier detection of the disease when the tumors are in a smaller stage of development as well as to advanced, more focused treatment modalities. Enucleation is still used for advanced retinoblastoma, especially when there is a concern that there may be invasion of the optic nerve, choroid, or orbit. The hydroxyapatite implant has provided improved cosmetic rehabilitation of the socket after enucleation. External-beam radiotherapy continues to be an important method of treating advanced retinoblastoma, especially when there is diffuse vitreous seeding. Plaque radiotherapy is a useful tool for controlling medium or small retinoblastomas, especially tumors with focal vitreous seeding or those that recur after other methods have failed. Cryotherapy and photocoagulation provide excellent control of small tumors, and advanced laser delivery systems have improved the visualization and ease of treatment of retinoblastoma. Thermotherapy and chemothermotherapy are the newest focal methods that are showing promising results for small to medium-sized retinoblastoma. Recent developments with chemotherapy regimens have allowed dramatic control of intraocular retinoblastoma, and they play an important role in the initial management of many cases.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The management of uveal melanoma has evolved tremendously for the past century, and more recently there is a trend toward more focal conservative treatment. Enucleation is still performed for large uveal melanoma when there is no hope for useful vision with conservative treatment. Plaque radiotherapy is particularly recommended for medium- or small-sized uveal melanoma. Special custom-designed plaque radiotherapy can be used for iris, ciliary body, or juxtapapillary choroidal melanoma. Charged-particle irradiation constitutes an alternative treatment modality for posterior uveal melanoma. However, charged-particle therapy is limited by the availability of appropriate therapeutic facilities. Local tumor resection using lamellar sclerouvectomy is mainly suitable for selected iris, ciliary body, or anterior choroidal tumors with smaller basal dimension and greater thickness. Ablative laser photocoagulation is indicated for very selected cases of small posterior choroidal uveal melanoma. Combined plaque radiotherapy with indirect ophthalmoscope laser therapy appears to be a more effective local tumor treatment plan than plaque radiotherapy alone. Transpupillary thermotherapy is the newest modality used as primary treatment or as complementary method to brachytherapy for treatment of selected choroidal melanomas. Hyperthermia with infrared irradiation below photocoagulation level produces tumor necrosis with few ocular complications. Based on the published ophthalmic literature, it seems that enucleation carries the same survival prognosis as each of the conservative treatment modalities.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Optical coherence tomography (OCT) is a new diagnostic tool for high-resolution cross-sectional imaging of the retina. By measuring the “echo” delay time of light as it reflects from tissue at different ranges and by performing multiple axial scans in the transverse direction, OCT generates two-dimensional images detailing retinal architecture. OCT is a powerful new modality because it has a longitudinal resolution of 10jxm in the retina, which is superior to other currently available imaging techniques. Examinations are exceptionally tolerable for patients because OCT is noninvasive, the probe beam is near infrared and thus not very bright, and scan acquisition time is only 2.5 seconds. OCT appears to be a useful device for evaluating a variety of retinal diseases, including macular holes, macular edema, and central serous chorioretinopathy.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Sympathetic ophthalmia is probably the ocular disorder best known to practitioners outside of ophthalmology. It is characterized by a bilateral, nonnecrotizing granulomatous panuveitis that occurs after intentional or unintentional trauma to the exciting eye. So far, the identity of the inciting antigen has not been delineated with certainty. The sequelae from sympathetic ophthalmia have declined markedly in this century as a result of earlier diagnosis, use of corticosteroids, and better management of ocular injuries, in large part due to improved surgical techniques. Cases of sympathetic ophthalmia, however, still occur with their severe sight-threatening complications, which impose on ophthalmologists the importance of prompt diagnosis and aggressive treatment in order to achieve good visual outcome.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

For the past year, indocyanine green angiography has been applied to evaluation of choroidal neovascularization, pigment epithelial detachment, retinal vascular disorders, and choroidal diseases and tumors. These applications have expanded the potential use of this technique. The relative safety of indocyanine green angiography has contributed to its continued widespread application.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Retinopathy of prematurity is a disease that manifests soon after birth in the premature infant and may lead to a lifelong disability. More infants at risk for developing the retinopathy are surviving, and the ophthalmologist must be aware of possible vision abnormalities, such as decreased acuity, strabismus, nystagmus, retinal scarring, and retinal detachment, that occur during childhood and in adult life. These abnormalities may occur in children who developed only mild forms of retinopathy of prematurity during early life.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Over the past decade, a better understanding of the pathogenesis and evolution of idiopathic macular holes has developed. Theories implicating the role of the vitreous in hole formation have led to surgical interventions that have met with surprising success. Recent advances in identifying early lesions, coupled with variations in surgical results based on the hole's preoperative stage, have led some authors to suggest earlier intervention. This report reviews current concepts of macular hole development, focusing on the pathoanatomy, natural history, surgical approach, and surgical outcomes of stage 2 macular holes.

ISSN:1040-8738    

出版商:OVID    

年代:1996

数据来源: OVID