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Background and Aim: degenerative retinal diseases are among the common causes of blindness in the world. The purpose of this study was to investigate transplantation of neurosphere derived from bone marrow tissue into subretinal space in age related macular degeneration induced by injection of sodium iodate in animal model
Materials and Methods: 40 mg/kg of sodium iodate was injected into retro-orbital sinus of albino rats. Then histological investigation by flat-mount and hematoxylin and eosin staining was performed after 30 days. Bone marrow stromal stem cells isolated from albino rats femur, were cultured in the differentiation medium and induced into floating neurosphere. Differentiated cells were labeled with nuclear anti-BrdU and were transplanted into subretinal space. Seven days after injection, sections were prepared, and survival, migration and also arrangement of transplanted cells were investigated by immunohistochemistry
Results: three days after sodium iodate injection, the pathological changes such as increased autofluorescence, hypertrophy and multinuclearity in retinal pigmented epithelium were observed. Histological investigation showed disorganization of outer segment of photoreceptors and also changes in the retinal pigmented epithelium. Immunohistochemsitry findings, seven days after injection, showed that transplanted cells survived in subretinal space and could migrate into both retinal pigmented epithelium and the retinal layer and finally integrated with host tissue
Conclusion: due to accessibility, mesenchymal stem cells are regarded as a good source for transplantation. Potential of differentiation to neural linage and also survival ability and migration of these cells after transplantation could be regarded as a new way for the treatment of retinal degenerative diseases
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To estimate the magnitude and causes of visual impairment [VI] in subjects aged >/= 50 years in Varamin district in 2009 using the proposed method by the World Health Organization [WHO]. This cross sectional population based survey was performed in Varamin targeting people over the age of 50 years using the proportional probabilities to size and cluster compact segment sampling method. Blindness was defind by WHO definition as best corrected visual acuity [VA] in the better eye less than 3/60. Severe visual impairment [SVI] and visual impairment [VI] were defined as 3/60
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Fungi are among the most important biological agents in air pollution. Textile factories are known as high risk places for contamination with fungal spores and metabolites. Since Yazd is one of the most important textile industry centers, this study was conducted to determine the concentration and types of airborne fungi in Yazd textile factories. A total of 235 indoor air samples from 30 randomly selected Yazd textile factories in 2007 were collected using air sampler pumps with appropriate filters. The concentration and types of isolated fungi were determined according to NIOSH standard technique for isolation of biologic agents. Data were analyzed based on the survey objectives, using statistical tests. Overall, 958 colonies from 16 different genera of fungi were isolated and among them Penicillium, Aspergillus and Cladosporium were known as the most prevalent isolated fungi. The fungal contamination rates were higher in the small factories than bigger factories and also in few factories, which usually used natural based fiber compared to those used synthetic fiber [P=0.0001]. The finishing areas had more contamination than the other parts and working areas with the topical air conditioner had lower contamination [P= 0.034]. There was a direct relationship between the amount of moisture and air fungal contamination [P=0.046], but there was no significant correlation between the whole fungal contamination rates and temperature. The results showed a high rate of contamination to fungal viable cultivable spores in Yazd textile factories. The presence of opportunistic fungi in these places, especially in summer is hazardous for immunosuppresed workers or those with malignancies or diabetes
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To report the efficacy of a single intravitreal injection of bevacizumab [IVB] alone or in combination with intravitreal triamcinolone acetonide [IVT] versus macular laser photocoagulation [MPC] as primary treatment for diabetic macular edema [DME]. This randomized three-arm clinical trial included 103 eyes of 97 patients with clinically significant DME and no previous treatment. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB [37 eyes], the IVB/IVT group received 1.25 mg IVB together with 2 mg IVT [33 eyes], and the MPC group underwent focal or modified grid laser photocoagulation [33 eyes]. Primary outcome measure was change in best-corrected visual acuity [BCVA]. Changes in BCVA [logMAR] at 12 weeks were -0.22 +/- 0.23, -0.13 +/- 0.31 and +0.08 +/- 0.31 in the IVB, IVB/IVT and MPC groups, respectively. The marginal regression model based on generalized estimating equation analysis demonstrated that changes in visual acuity was statistically significant in the IVB group at both 6 [P<0.001] and 12 [P=0.024] weeks but only at 6 weeks in the IVB/IVT group. Significant decrease in central macular thickness [CMT] was observed in the IVB and IVB/IVT groups at 6 weeks. Up to 12 weeks, IVB treatment in eyes with DME yielded better visual outcome than laser photocoagulation, although it was not associated with a significant decrease in CMT. IVT seemed to have no further beneficial effect in combination with IVB
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To evaluate the visual and anatomical outcomes of pars plana vitrectomy and indocyanine green [ICG] assisted internal limiting membrane [ILM] peeling in fresh central retinal vein occlusion [CRVO] with primary low vision. In a prospective interventional case series, 15 eyes of 15 patients with fresh CRVO [less than 3 months' duration] and presenting best-corrected visual acuity [BCVA] less than 20/200, underwent standard 3-port pars plana vitrectomy and ICG assisted ILM peeling. BCVA and central macular thickness [CMT] by optical coherence tomography [OCT] were evaluated 2 weeks and 1, 2, 4 and 6 months postoperatively and when needed thereafter. The patients included 8 male and 7 female subjects with mean age of 54.7 +/- 11.9 [range 29-75] years. Mean duration of symptoms at the time of surgery was 51.7 +/- 17.8 [range 26-85] days. CRVO was ischemic in 12 eyes [80%] and non-ischemic in 3 eyes [20%]. Patients were followed for 9.5 +/- 4.8 [range 6-23] months. Mean BCVA [logMAR] was 1.86 +/- 0.37 at presentation which improved to 1.65 +/- 0.40 at 2 weeks [P=0.23], 1.68 +/- 0.39 at one month [P=0.095], 1.60 +/- 0.46 at 2 months [P=0.069], 1.72 +/- 0.72 at 4 months [P=0.423], 1.58 +/- 0.69 at 6 months [P=0.140] and 1.42 +/- 0.37 at last visit [P=0.006]. Mean CMT was 605.5 +/- 279.2 +/- m preoperatively which was decreased to 527.4 +/- 274.3 microm at 2 weeks [P=0.371], 624.4 +/- 336.7 microm at one month [P=0.773], 546.4 +/- 344.9 microm at 2 months [P= 0.491], 343.3 +/- 256.9 microm at 4 months [P=0.250], 369.3 +/- 207.5 microm at 6 months [P=0.078] and 368.9 +/- 199.0 microm at final visit [P=0.03]. Pars plana vitrectomy with ILM peeling in patients with fresh CRVO and low presenting visual acuity [<20/200] may improve visual acuity and decrease in CMT in long-term follow-up, but does not seem to have any significant effect in comparison to the natural course of CRVO. Certain postoperative complications such as vitreous hemorrhage are relatively common requiring repeat vitreoretinal surgery. Therefore, we do not recommend this procedure for such patients
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The most important progress in the field of retinal diseases during recent years might be the introduction of pharmacotherapy. Age-related macular degeneration for instance was an irreversible disease leading to permanent anatomical and functional changes in the macula up to the previous decade; however, the use of anti-vascular endothelial growth factor agents [anti-VEGFs] not only stops the progression of the disease but also improves vision in a significant proportion of patients. Ophthalmologists now deal with numerous questions about anti-VEGF agents. This review indicates how VEGFs act in normal and pathological conditions in the eye and introduces the most important agents in this category of ocular drugs
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To evaluate the complications of scleral perforation during strabismus surgery and the role of cryopexy, laser therapy, and conservative management in an animal model. In this experimental study, 42 pigmented-eye rabbits were included. An S-24 needle attached to a 6-0 polyglactin suture was passed through the sclera and into the vitreous cavity in both eyes of the animals. One eye of the rabbits received either laser therapy [n=20] or cryopexy [n=22] and the fellow eyes were left untreated [n=42]. The incidence of complications was compared between the three groups. Cataracts developed in 7 [8.3%] eyes. Corneal opacity and transient localized sub-retinal fluid around the break were observed in one [1.2%] eye each. Other complications such as endophthalmitis and retinal detachment were not seen. There was no significant difference between the study groups in terms of complications. Vision-threatening complications following scleral perforation during strabismus surgery are uncommon and long-term follow-up is sufficient for management of this complication
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One of the important factors in orthodontic treatment planning is prediction of growth potential which is applied by stages of skeletal age and or another criteria such as the chronological age, sexual maturity, dental development stages, and height and weight. Another importance in determining the patient's age is in legal medicine to determine the guiltiness' age, more or less than 18 years. The aim of this study is to assess the correlation between skeletal, dental and chronological age. This diagnostic study was performed as a cross sectional method in dental faculty of Yazd Shaheed Sadoughi University from 2004 to 2005. 58 Patients of 15-25 years old who referred to private dental office were selected. The samples were chosen with continues method until it reached to the desired total numbers. Each patient completed 4 questionnaires consisting of chronological age, determined age from panoramic radiography, measured age from surgical teeth and determined age according to h and wrist radiography. Panoramic radiographs were read by two oral and maxillofacial radiologists and h and wrist radiographs were read by two radiologists. Statistical analysis was performed by Paired T, Correlation coefficient, Wilcoxon, Smirnov - Kolmogorov. The least fault obtained from determined age and real patient age was related to the right m and ibular surgical wisdom teeth [1.6 months difference]. H and wrist radiographs had the most fault in age determination and both of the two radiologists determined the ages less than real ages [P=0.000]. In the statistical analysis, it seemed that the age determination from wisdom teeth by panoramic radiographs is just a suitable method. When age determination is considered to special case, the maxillary right wisdom teeth showed more proximity to real age [39.4%] and m and ibular left third molars [24.5%] and m and ibular right third molars [23.9%] were in the next steps. Age prediction by wisdom teeth on panoramic views is a proper way to report for legal medicine. Since the h and wrist radiographs had the most faults in age prediction, its advantage is not proposed, in individuals more than 18 years old
Subject(s)
Humans , Male , Female , Age Determination by Teeth , Age Determination by Skeleton , Dental Clinics , Forensic Medicine , Cross-Sectional StudiesABSTRACT
To determine the visual and anatomical outcomes and complications of vitrectomy for non-traumatic non-diabetic vitreous hemorrhage [NDVH] and to report the causes of the condition among patients at Labbafinejad Medical Center, Tehran-Iran, from 1993 to 2003. Records of patients who underwent vitrectomy for non-traumatic NDVH with 6 months follow up were reviewed for demographic characteristics, causes of NDVH and results of surgery. Fifty eyes [54.2% right eyes] of 49 patients [51% male] with mean age of 62.7 +/- 10.3 years were enrolled in the study. Mean visual acuity [VA] was 2.36 +/- 0.52 LogMAR and relative afferent pupillary defect [RAPD] was positive in 91.7% of the eyes, preoperatively. Causes of non-traumatic NDVH detected intraoperatively were: branch retinal vein occlusion [56%], central retinal vein occlusion [16%], choroidal neovascularization [12%], and posterior vitreous detachment with break, Eales disease, familial exudative vitreoretinopathy, and Terson syndrome [each in 4%]. Mean VA increased significantly at 6th month [1.38 +/- 0.72 IogMAR] compared to preoperative value. [P<0.0001] The most common causes of decreased VA were: macular pigmentary derangement [26%], optic atrophy [16%], severe lens opacity [12%], and epiretinal membrane [8%]. Despite the statistically significant increase in mean VA following vitrectomy, underlying macular pathology limits significant improvement of central VA in most cases of non-traumatic NDVH
Subject(s)
Humans , Male , Female , Vitreous Hemorrhage/etiology , Vitrectomy/adverse effects , Visual AcuityABSTRACT
To evaluate the clinical manifestations and results of lensectomy in patients with hereditary lens subluxation at Labbafinejad Medical Center, Tehran-Iran from 1996 to 2003. In an interventional case series, records of patients with hereditary lens subluxation who had undergone lensectomy were reviewed. Patients with at least 6 months of follow up were included. Background disease, best corrected visual acuity [BCVA] before and after surgery, intraocular pressure [IOP], and post-operative refraction and complications were evaluated. The study was performed on 87 eyes of 49 patients including 27 male and 22 female subjects. Mean follow up was 20 +/- 18 months. Marfan syndrome [79.5%], Weill-Marchesani syndrome [8.2%], simple ectopia lentis [8.2%], and homocystinuria [4.1%]. The most common indication for surgery was non-correctable refractive error [92.1%]. Mean BCVA was 1.13 LogMAR preoperatively which improved to 0.26 Log MAR post-operatively [P< 0.001]. BCVA better than 20/40 was achieved in 82.8% of cases after surgery. Angle-supported anterior chamber intraocular lens [AC IOL] was implanted in 85.1% of the eyes. Prophylactic band was applied in 63 eyes [72.4%]. Retinal detachment developed in four eyes, which was successfully treated. Lensectomy with implantation of angle-supported AC IOL in patients with hereditary subluxated lens will improve vision significantly without significant complications
Subject(s)
Humans , Male , Female , Genetic Diseases, Inborn , Visual Acuity , Intraocular Pressure , Refraction, OcularABSTRACT
To evaluate the effect of age, sex, type of surgery, extent of retinal detachment [RD] vitreous incarceration in wound, and myopic degeneration on the rate of retinal redetachment following RD surgery using eternal Weibull regression analysis. We performed a survival analysis on a multi-center randomized controlled trial conducted on patients with pseudophakic or aphakic RD to compare the anatomic outcome of scleral buckling vs primary vitrectomy alone. Patients were examined one week and then 1, 2, 4 and 6 months after the operations. We applied modification to the survival, density and hazard function and considered the two-parameter Weibull distribution for survival times. Herein we evaluated the appropriateness of the modified model vs unmodified model with and without the effects of covariates. The mean survival time for the unmodified model was 2920 days confirming the eternal nature of the survivor function whereas the mean survival time for the modified model was 43.06 days. In the absence of covariates, the eternal proportion in the modified model was estimated to be 0.73. Taking the effects of covariates into account, the modified model revealed that the risk of redetachment is 76% higher among males than females and is almost 4 times greater in eyes with myopic degeneration, while this risk was 2.6 times for males and 2.7 times for those with myopia in the unmodified model. Moreover, vitreous incarceration in the wound played a significant role in the unmodified model whereas it had been set aside in the modified model. Comparing the two final models showed the superiority of modified model: -2 log L[m]- [-2 log L[um]] = 46.274 [P<0.001]. This study strongly suggests the benefit of using the modified over the unmodified model of eternal Weibull regression analysis in situations such as the present study in which some cases will have the event of interest whereas others will never have the event, given enough time
Subject(s)
Humans , Male , Female , Recurrence , Regression Analysis , Myopia, Degenerative , Randomized Controlled Trials as Topic , Multicenter Studies as Topic , Vitreous BodyABSTRACT
Grave's disease is an autoimmune process manifested by three hallmarks: hyper-thyroidism with diffuse goiter, ophthalmopathy and dermopathy. This disease usually occurs with hyper thyroidism; although the may be euthyroidism. To evaluate the ophthalmic lesion in patients with grave's disease according to sex, age, and the duration of the illness as well as the treatment. Ninety five patients [62% females and 38% males] with grave's disease were included in this study. The subjects underwent a complete ophthalmic examination and the results were recorded. The elevation of IOP and chemosis were significantly higher in males than in females. The prevalence of ophthalmopathy was 60%, and most common ophthalmic signs were proptosis and lid retraction. Eyes lesions were more frequent among 50-70 years old patients. In addition, chemosis, periorbital edema, corneal sensitivity secondary to dry eye, convergence insufficiency, diplopia and proptosis were positively correlated with age. Initially, ophthalmic complains were only given by 15% of the subjects. Lid retraction was decreased with prolonged duration of disease whereas chemosis, conjunctival congestion, and extra-ocular muscle enlargements were increased. Grave's ophthalmopathy was found mostly in males and proptosis with lid retractions were the most important signs of the disease.
Subject(s)
Humans , Male , Female , Eye/physiopathology , Graves OphthalmopathyABSTRACT
To evaluate the effect of intravitreal triamcinolone acetonide [IVT] on clinical, angiographic, and optical coherence tomographic parameters in refractory diabetic macular edema [DME]. In a double-masked placebo-controlled randomized clinical trial, 88 eyes of 61 patients with DME refractory to previous laser therapy or not suitable for such treatment were included in the study. Eligible eyes were randomly assigned into two groups. The treatment group [45 eyes] received 4 mg IVT and the placebo group [43 eyes] received subconjunctival injection of placebo. Complete ophthalmologic examination, fluorescein angiography, and optical coherence tomography [OCT] were performed before intervention and repeated after 2 and 4 months. Quantitative measurement of variables on angiograms including hard exudates [HE], size of foveal avascular zone, and leakage severity was performed using Photoshop software. Two months after intervention, visual acuity [VA] improved in the treatment group [-0.13 Log MAR, P=0.01] but slightly deteriorated in the placebo group [0.02 Log MAR, P=0.63]. The difference of the above changes [0.15 Log MAR] was statistically significant at 2 months [P=0.02] but reduced to 0.11 Log MAR [P=0.08] after 4 months. Mean [standard deviation] of central macular thickness [CMT] by OCT before and 2 and 4 months after injection was 393 [15 I], 293 [109], and 362 [119] microns in the treatment group and 393 [166], 404 [134], and 405 [160] microns in the placebo group, respectively. The second month difference was statistically significant [P=0.01]. Reduction of the amount of HE [51%, P=0.004] and petaloid pattern [P=0.012] was significant in the treatment group as compared with the placebo group. There were no significant IVT-related side effects except for transient ocular hypertension in 32.6% of patients after 2 months. The greatest therapeutic effect of IVT on DME according to CMT and VA occurs at 2 months and decreases up to the fourth month. However, concerning cyctoid macular edema and hard exudates, the effect is maintained up to 4 months
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To evaluate the agreement between a new method for quantitative analysis of fundus or angiographic images using Photoshop software and clinical judgment. Four hundred evaluated by three retina variables were selected for eighteen fundus and angiographic images of diabetic patients were specialists and then by computer using Photoshop 7.0 software. Four amount of hard exudates [HE] on color pictures, amount of HE on red-free pictures, severity of leakage, and size of foveal avascular zone. Available programs in the software such as color selection, luminosity channel, and histogram and tools such as magnetic lasso and magic wand were used for measurement. Coefficients of agreement and kappa measurements were calculated. Agreement [kappa] between the two methods in the amount of HE on color and red-free photographs were 85% [0.69] and 79% [0.59], respectively. This agreement for severity of leakage was 72% [0.46]. In the evaluation of the foveal avascular zone size with two methods of quantification using the magic and lasso software tools the agreement was 54% [0.09] and 89% [0.77], respectively. Quantitative measurement of fundus and angiographic image variables such as HE, leakage, and foveal avascular zone can be performed precisely using Photoshop software
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To evaluate the effect of intravitreal triamcinolone acetonide [IVT] reinjection on clinical and optical coherence tomographic [OCT] features in refractory diabetic macular edema [DME]. In an interventional case series, all IVT-treated patients enrolled in a previous clinical trial [45 subjects], were recalled for performing a new ophthalmologic examination and OCT. Suitable eyes for reinjection received 4 mg IVT. Complete ophthalmologic examination and OCT were performed after two and four months.From 45 recalled patients, 23 were included for the new study [51.1% response rate]. Of these, only 12 cases were considered as candidates for reinjection. Visual acuity [VA] changes were not significant in the reinjected eyes after both the first and the second interventions, although there was a relative improvement [0.14 logMAR] at two months after the first injection. Central macular thickness [CMT] was reduced by 27 and 49 pt two and four months after the reinjection and 43 and 40.t at two and four months after the first injection. None of the mentioned changes was significant. I013 elevation was significant two and four months after the second injection [3.6 and 2.4 mmHg, respectively, P<0.05]. However, it was significant [5.58 mmHg, P=0.001] only two months after the first injection. The transient beneficial effects of IVT on refractory DME are not repeated with second injections. However, IVT-related ocular hypertension is more persistent after reinjection
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To report complications involving the posterior segment after laser assisted in situ keratomileusis [LASIK] in 5 myopic patients ranging in age from 26 to 38 years. Case on developed bilateral cilioretinal artery obstruction in association with ischemic optic neuropathy. Case two presented with nonsimultaneous bilateral delayed-onset optic neuropathy. In case three, aggravation of the symptoms and signs of Stargardt's maculopathy was noticed. Case four showed rapid progression and worsening of diabetic retinopathy in both her eyes. In case five, early onset unilateral macular hemorrhage was observed. The increased intraocular pressure LASIK surgery may disturb blood flow in posterior ciliary arteries and choroid. The deleterious effect of LASIK on ocular circulation may result in sight threatening complications in predisposed patients
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To evaluate the success rate of vitrectomy in giant retinal tears [GTR] and factors influencing it. In an interventional case series, hospital records of 68 eyes of 63 patients operated for GRT were reviewed. Standard three port vitrectomy plus placement of an encircling band, retinopexy, and internal tamponade was performed for all eyes. Possible influencing factors including age, sex, visual acuity, afferent pupillary defect, grade of PVR, size and location of GRT, macular status, extent of RD, interval from onset of symptoms to operation, co-existing eye diseases, surgical technique, post-operative complications, and results after silicone oil removal were evaluated. Anatomic success was classified as complete success, relative success, and failure. Mean age of the patients was 31.2+]-17.2 and 50 patients [79.3%] were male. Underlying ocular disease existed in 39 eyes, of which high myopia was the most prevalent [33.8%]. The eyes were operated after a mean of 30 days from beginning of symptoms. Silicone oil was used for internal tamponase in 64 eyes and was removed from 36 eyes. Patients were followed from 1 to 54.5 months [median 10 months]. Anatomic success rate was 73.7%. Preoperative stage of PVR was the only factor found to be associated with worse anatomic results. Anatomic success rate was comparable to that of other centers and significantly better than results of a previous from our center. Early operation of eyes with GRT before development of PVR results in better anatomic success
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To evaluate the influence of different confounding factors on the effect of intravitreal triamcinolone acetonide injection for refractory diabetic macular edema. In a prospective placebo-controlled randomized clinical trial, 88 eyes with refractory diabetic macular edema were randomly assigned into two groups including 45 in the treatment group [4 mg intravitreal triamcinolone acetonide] and 43 in the placebo group. Multivariate analysis was performed for three main outcomes, including visual acuity, central macular thickness, and the amount of hard exudates. Confounding factors that showed some effect on the main outcomes were used for building multivariate models. It was revealed that blood urea nitrogen, fasting blood sugar, serum cholesterol, initial visual acuity, presence of cystoid macular edema, amount of hard exudates, and size of foveal avascular zone had some influence on visual acuity outcome; previous macular photocoagulation, serum cholesterol, baseline central macular thickness, initial intraocular pressure, amount of hard exudates, and size of foveal avascular zone had some influence on visual acuity outcome; previous macular photocoagulation, serum cholesterol, baseline central macular thickness, initial intraocular pressure, amount of hard exudates, and size of foveal avascular zone had some influence on central macular thickness changes; and serum cholesterol, baseline central macular thickness, and amount of hard exudates had some influence on hard exudates in both groups. Size of foveal avascular zone, initial intraocular pressure, amount of hard exudates, and baseline central macular thickness also had an additive effect on the outcomes in the treatment group. Many confounding factors may influence the effect of intravitreal triamcinolone. These factors should be considered when adopting intravitreal triamcinolone. These factors should be considered when adopting intravitreal triamcinolone as a treatment strategy for refractory diabetic macular edema
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To evaluate the effect of oral prednisolone on visual outcome and complications of scleral buckling [SB] in patients with rhegmatogenous retinal detachment [RRD]. In a randomized double-blind placebo-controlled trial, patients with acute RRD who underwent SB were randomly divided into two groups. Oral prednisolone was administered for the treatment group and placebo for the control group. The two groups were compared for visual acuity [VA] , retinal detachment [RD], cystoid macular edema [CME], and proliferative vitreoretinopathy [PVR]. The trial was performed on 25 patients in the treatment group and 27 patients in the placebo group. Mean preoperative VA [LogMAR] was 1.46 +/- 0.81 overall, including 0.85 +/- 0.62 in location were equal in both group. [P=0.45] Significant PVR was seen in one eye in the treatment group and 3 eyes in the placebo group. [P=0.39]. Postoperative oral prednisolone does not seem to affect visual outcomes and complications of scleral buckling in phakic patients
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Purpose: to report a case of exudative retinal detachment [ERD] secondary to bilateral choroidal metastasis of bilateral adenocarcinoma the breast
Patient and findings: a 50-year-old woman with history of decreased visual acuity [OD] since for 3 months had multiple visits and history of subtenon Depomedrol injection. Visual acuity was counting fingers at 2 meters and 6/10 in the right and left eyes, respectively. Relative afferent pupillary defect was 3+ [OD]. On slit lamp, 2+ anterior chamber and vitreous reaction was detected. On funduscopy, advanced ERD of the right eye and multiple subretinal masses in the left eye were noted. On systemic work up, bilateral multiple breast masses were found on mammography. Her breast biopsy showed advanced invasive intraductal adenocarcinoma
Conclusion: any patient with exudative retinal detachment of undetermined cause should undergo a thorough systemic work up. Prompt intervention is imperative and may be life saving