Incidence of Retinal Lesions before and after Refractive Surgery and Preoperative Prophylactic Laser Treatment

PURPOSE: We investigated the incidence of retinal lesions before and after surgery and the percentage of preoperative prophylactic laser treatment in patients who underwent corneal refractive surgery or phakic intraocular lens implantation (pIOLi). METHODS: The medical records of patients who underwent refractive surgery from January 2005 to June 2013 were reviewed retrospectively. We investigated the incidence and type of retinal lesions identified during the preoperative examination. Additionally, the percentage of preoperative prophylactic laser treatment and the incidence of postoperative newly developed retinal lesions were analyzed. RESULTS: A total of 894 eyes of 466 subjects (laser in situ keratomileusis [LASIK] 225 eyes, 117 subjects; laser-assisted subepithelial keratectomy [LASEK] or photorefractive keratectomy [PRK] 450 eyes, 231 subjects; pIOLi 219 eyes, 121 subjects) were enrolled in the present study. Retinal lesions were found in 268 eyes (29.98%) and of those, 144 eyes (16.11%) received prophylactic laser treatment. Postoperative newly developed retinal lesions were detected in 8 cases (LASEK or PRK, 5 cases; pIOLi, 3 cases) during the follow-up period. There was a significant correlation between preoperative spherical equivalent and the presence of retinal lesions. CONCLUSIONS: The patient population of refractive surgery is largely myopic and thus particularly vulnerable to retinal lesions. Additionally, a considerable number of patients required preoperative prophylactic laser treatment. Therefore, both surgeons and patients should be aware of the risks of developing postoperative retinal lesions.

The Characteristics of Non-Retinal Lesions in the Ultra-Wide Field Scanning Laser Ophthalmoscope Image

PURPOSE: To evaluate various types and; characteristics of non-retinal lesions associated with ultra-wide field scanning laser ophthalmoscope images. METHODS: This retrospective study included 139 eyes of 139 patients with non-retinal lesions observed on color images obtained using Optomap 200Tx (Optos PLC, Dunfermline, Scotland, UK). The non-retinal lesion is a hyperreflective or hyporeflective shadow due to anterior segment of the eye or vitreous except the retina. Types and characteristics of red laser separation, green laser separation and autofluorescence images of non-retinal lesions were evaluated. RESULTS: All non-retinal lesions in images were categorized into 2 groups according to the location of non-retinal lesions. The anterior non-retinal lesions group included corneal opacity, cataract and posterior capsular opacity. The posterior non-retinal lesions group included asteroid hyalosis, posterior vitreous detachment, vitreous opacity and vitreous hemorrhage. Anterior non-retinal lesions were more often hyporeflective in red and green laser separation images (p < 0.001). Posterior non-retinal lesions were more often hyperreflective in green laser separation images and hyporeflective in red laser separation images (p < 0.001). CONCLUSIONS: Ultra-wide field scanning laser ophthalmoscope images can frequently have various shadows from anterior or posterior lesions of the eye. These shadows show a difference in reflectivity depending on their origins. To understand the difference helps in the interpretation of the fundus images.

Clinical Analysis of Sensory Strabismus with Fundus Abnormalities in Children and the Effectiveness of Occlusion Therapy

Fifty-nine children (75 eyes) with organic amblyopia were investigated to know the distribution and incidence of the optic nerve or retinal lesion, the type of sensory strabismus, and the effect of occlusion therapy in organicamblyopia. Optic nerve lesion was found more frequently than retinal lesion as causes of organic amblyopia. Among these optic nerve lesions, optic nerve hypoplasia and tilted disc were most frequently found, and in the retinal lesion, ROP (retinopathy of prematurity: macular dragging), foveal dysplasia, and myopic degeneration were frequent.Thirty-nine of 59 children with organic amblyopia (66%)showed strabismus and 74.4% of them had horizontal deviation; 17 eyes had esotropia, and 12 eyes exotropia. No vertical eyeball deviation was found. Myopic anisometropia was accompanied in 19 cases. Better visual outcome was obtained after occlusion therapy in cases with tilted disc and ROP according to the degree of these lesions. However, there was no improvement in other cases. Authors suggest that fundus examination should be included in the routine ophthalmologic examination in chlidren with strabismus.

Clinical Investigation of Fundus Fluoroangiography for 30 Cases of Leukemia / 昆明医科大学学报

The results of fundus fluoroangiography for 30 cases with leukemia showed that the incidence of leukemic ophtalmopathy in these patients was 86.7%.It was mainly caused by the infiltration of diseased leukoeytes and was parallel to the incidence of central-nervous-system leukemia.The lesions of leukemic ophthalmopathy were as follows:fundus capillarcetasia seen in 20 cases,making up 66%;veinletectasia in 11 cases,36.6%;fluorotranslucence(absence of chromoepithelia)in 11 cases, 36.6%;fluorocover-up from bleeding in 8 cases,26.6%;optic papilla edema in 3 cases,10%.