The comparison of retinal findings in end stage of CKD and in diabetic renal failure / Шинэ санаа Шинэ нээлт

Background@#Retinal pathologic features are associated with inflammatory processes and endothelial dysfunction, leading to circulatory abnormalities and reduced vascular reactivity. Both retinopathy and nephropathy involve thickening of basement membrane and muscular layers and increased leakage. These pathologic and hemodynamic abnormalities may occur throughout the body and their effects on the retinal vasculature may be useful indicators of cumulative microvascular damage from hypertension, inflammation, diabetes mellitus, and other processes. Type 2 MPGN is an uncommon renal condition associated with electron dense deposits in the lamina densa of the glomerular basement membrane with C3 found in the capillary loops and mesangium. The deposits in the basement membrane can lead to a breakdown of the blood-retinal barrier by interfering with the RPE layer, and type 2 MPGN has been described in association with central serous retinopathy.@*Purpose@#To assess the retinal findings in end stage of Chronic kidney disease (CKD) and diabetic renal failure@*Methods@#Data of diabetic renal failure (n=20, mean age 56.8±11.6), and end stage of CKD(n=83, mean age 48.2± 11.6) were cross-sectional analyzed. Nonmydriatic fundus photographs of the disc and macula in both eyes were obtained in all the subjects. The photographs were assessed by ophthalmologist using the standard protocols. The following parameters were recorded: BCVA, IOP, BP GFR, serum Creatinine, ophthalmic and fundus examination.@*Results@#Greater severity of retinopathy was associated with DM. The presence of vascular abnormalities usually associated with Diabetes Mellitus ( DM) and was not associated with lower estimated glomerular filtration rate. All of patients with DM (n=20, 100%) ,they have Diabetic retinopathy. We found sight direct relationship between retinal posterior pole deposit with CKD patients. Some of patients who have end stage of CKD, (n=18, 11%) they have retinal deposit on their posterior pole.@*Conclusion@#Our findings show ,In participants with end stage of CKD, there was no significant severe retinopathy. In summary, our study demonstrates that DM, is one of the leading cause of irreversible vision loss. Every patients with DM need the ophthalmic follow up examination in every six months.

Posterior pole retinal thickness and retinal nerve fiber layer thickness in children with refractive error by SD-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To measure the posterior pole retinal thickness and retinal nerve fiber layer(RNFL)thickness using the Heidelberg spectral domain optical coherence(SD-OCT), and explore the correlation between age, refraction diopter and retinal thickness. <p>METHODS: A total of 192 eyes of 96 healthy children with the age from 5 to 15 years old were examined by routine ophthalmic examinations. The SD-OCT of Spectralis Heidelberg was used to examine the thickness of the posterior retina and optic nerve fibers of the subjects within 20° and this district was divided to superior and inferior by the line collecting optic disc and macula. The detection was taken within the area of 1mm away the macular fovea. The correlation between age, refraction diopter and change of retinal morphology were analyzed. <p>RESULTS: The average thickness of the retina around 1mm area from the fovea was 252.72±13.87μm, the mean posterior pole retinal thickness(PPRT)was 294.02±8.70μm, the superior PPRT was 294.53±9.11μm, the inferior PPRT was 293.53±9.50μm, and the average RNFL thickness was 105.75±10.60μm. There were positive correlation between age and PPRT, and positive correlation between diopter, PPRT and RNFL thickness. <p>CONCLUSION: SD-OCT can accurately measure the thickness of children's retina, and there is a correlation between age, refractive diopter and retinal thickness.

Diagnostic accuracy of posterior pole asymmetry analysis parameters of spectralis optical coherence tomography in detecting early unilateral glaucoma.

Purpose: To report the diagnostic ability of posterior pole asymmetry analysis (PPAA) parameters of spectralis optical coherence tomography (OCT) in detecting early unilateral glaucoma. Methods: A prospective, cross‑sectional study which included 80 eyes of 80 normal subjects and 76 eyes of 76 patients with unilateral early primary open‑angle glaucoma by Hodapp‑Anderson‑Parrish classification. All subjects were of age more than 18 years, best‑corrected visual acuity 20/40 or better, and a refractive error within ± 5 diopter (D) sphere and ± 3 D cylinder. Control subjects had a normal ocular examination, intraocular pressure (IOP) <22 mmHg, no past history of high IOP, no family history of glaucoma, normal optic disc morphology, and visual field in both eyes. One eye of the control subject was randomly included. All eyes underwent OCT for retinal nerve fiber layer (RNFL) analysis and PPAA. The number of continuous black squares was noted in the asymmetry analysis (right‑left + hemisphere asymmetry). The area under curve (AUC) was calculated for all OCT parameters. Results: The best value for AUC for RNFL analysis was 0.858 for the inferotemporal quadrant thickness. This was similar to the best value for AUC for PPAA which was 0.833 for the inferior macular thickness parameter (P = 0.5). The AUC for the right‑left and the hemisphere asymmetry part of PPAA was 0.427 and 0.499, respectively. Conclusion: The macular thickness PPAA parameters were equally good as the RNFL parameters. However, the asymmetry analysis parameters performed poorly and need further refinement before its use in early unilateral glaucoma diagnosis.

Visual Prognosis of Retinoblastoma in the Posterior Pole Treated with Primary Chemotherapy Plus Local Treatments

PURPOSE: To evaluate the visual outcomes of retinoblastoma in the posterior pole (RBPP) treated with chemotherapy plus local treatments and to address the prognostic factors that influence such outcomes. METHODS: The medical records of patients with RBPP diagnosed at the Department of Pediatric Ophthalmology, Seoul National University Children's Hospital between August 1987 and September 2007 were reviewed retrospectively. Only those patients treated via primary chemotherapy plus local treatments were included. The presence of foveal involvement and tumors in the posterior pole before and after treatment, the type of regression pattern and the best corrected visual acuity (BCVA) of each patient were evaluated. RESULTS: A total of 13 eyes in 12 patients were included. The mean final BCVA for treated RBPP was 20/210 (range, hand motion to 20/16). However, eight eyes (61.5%) had an acuity of 20/200 or better and seven eyes (53.8%) had an acuity of 20/50 or better. The mean final BCVA was significantly better in cases with negative foveal involvement; however, four eyes (37.5%) with positive foveal involvement had an acuity of 20/200 or better. Tumors area in the posterior pole and the type of regression pattern were not significantly related to final BCVA. CONCLUSIONS: Over one half of the studied RBPP patients had working vision. Although the eyes had RBPP with positive foveal involvement, about one-third of the patients had working vision. Vision preservation should be considered when deciding on RBPP treatment.

Isolated Posterior Pole-Penetrating Ocular Injury Treated by Nonsurgical METHODS: A Case Report

PURPOSE: To report a case of isolated posterior pole-penetrating ocular injury treated by nonsurgical methods such as argon laser photocoagulation and administration of antibiotics. CASE SUMMARY: A 46-year-old male visited the hospital complaining of floaters in his left eye which had occurred when his cheek was penetrated by scissors from the inferior posterior part to the superior anterior part while working earlier that day. Upon initial examination, his best corrected visual acuity (BCVA) in the left eye was 0.8, and his intraocular pressure (IOP) was 10 mmHg. No cells or aqueous flares were observed in the anterior chamber. Fundus examination was performed, and three disc diameter-large breaks of the retina and choroid, scleral rupture and vitreous hemorrhage were observed at the posterior pole three disc diameters away from the fovea. It was difficult to make a surgical approach as the lesion was situated on the posterior pole, and there was the risk of prolapse of the eye contents. Therefore, we first performed argon laser photocoagulation around the lesion and administered topical as well as and systemic antibiotics. After admission the patient was observed carefully as the tractional retinal fold was located at the posterior pole. Additional argon laser photocoagulation was performed. After six months of treatment, BCVA in the left eye was 1.0, IOP was 16 mmHg, and no pathologic change was observed on fundus examination.

Choroidal Osteoma

Choridal osteomas are benign, ossified peripapillary lesions occurring predominantly in healthy young women, They appear as yellow-white to yellow-red lesions with well-defined geographics borders. On radiologic examination, bony lesion is shown. We report herein a case of choroidal osteoma located at the posterior pole of the left eye in a 27-years-old woman the chief complaint of decreased visual acuity.

Change of refraction in premature infants after cryotherapy for retinopathy of prematurity between the age of six months and three years

To investigate the chronological change of refraction in premature infants after cryotherapy for retinopathy of prematurity (ROP), cycloplegic refractions had been performed at 6 months and 3 years after term in premature infants who underwent cryotherapy for ROP. The changes of refractions between the two study ages were evaluated not only in the total cryo-treated eyes, but also in the subdivided groups according to the posterior pole appearances. In the total 61 eyes of 32 premature infants, mean spherical equivalents were -4.05D vs. -5.94D (6 months vs. 3 years) (p = 0.0001). In the normal posterior pole group (48 eyes), mean spherical equivalents were -3.45D vs. -5.68D (6 months vs. 3 years) (p = 0.0000), and in the abnormal posterior pole group (13 eyes), -6.28D vs. -6.86D (6 months vs. 3 years) (p = 0.6496). These results mean that there is a myopic progressive change between 6 months and 3 years after term in the cryo-treated eyes for acute ROP and it is more evident in the eyes with normal posterior pole.

Clinical Evaluation Of Surgical Treatments For Displaced Lens: Tranafixation And Para Plana Technique

We experienced 20 patient's 21 eyes of lens displacement including subluxation(16 eyes) and luxation(5 eyes) which were surgically treated by two methods; trans-scleral fixation(14 eyes) and pars plana approach(7 eyes). The causes of lens displacement were trauma(10 eyes), unknown or spontaneous(6 eyes), congenital(2 eyes) and iatrogenic(3 eyes). All patients were male, except 2 female and aging from 11 to 75 years(mean 48.4 years). Post-operative vision showed varying degrees of improvement although 3 showed no change and 1 eye was enucleated for accompanying disorders. Increased intraocular pressures were noticed in 13/21(61.9%) eyes preoperatively, but 3/12(25%) eyes excluding 1 enucleated eye remained high postoperatively, meaning that the intraocular pressure can be normalized by the removal of lens itself. We concluded that these two methods would be adequate modalities for the management of displaced lens, and these two methods share some benifit/drawback over each other. In case of hard nucleus, the pars plana technique must be done very carefully because the fallen, whirling nuclear debris might damage the posterior pole. It may be necessary to switch to the transfixation mehtod.