ABSTRACT
BACKGROUND AND OBJECTIVE: To study the morphological features of the macula of patients with retinitis pigmentosa and visual acuities of 20/200 or less as examined by optical coherence tomography. PATIENTS AND METHODS: In an observational case series study, 42 eyes (21 patients) with retinitis pigmentosa and visual acuities of 20/200 or less were evaluated by optical coherence tomography. RESULTS: Thirty-four (81%) eyes had atrophic retina (group 1) and 8 (19%) eyes had cystoid macular edema (group 2). The mean visual acuity was 20/1000 in group 1 and 20/300 in group 2. Epiretinal membrane was identified in 27 (64.3%) eyes. CONCLUSION: Optical coherence tomography is a more sensitive method in detecting macular pathology and can help in selecting cases where treatment may be applied.
Subject(s)
Retina/pathology , Retinitis Pigmentosa/diagnosis , Tomography, Optical Coherence/methods , Vision, Low/diagnosis , Visual Acuity , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of Results , Retrospective Studies , Young AdultABSTRACT
PURPOSE: To report a case of full-thickness macular hole (FTMH) after intravitreal injection of ranibizumab in a patient with retinal pigment epithelium detachment (PED) and tear. METHODS: A 67-year-old woman with PED and retinal pigment epithelium (RPE) tear due to age-related macular degeneration was studied by biomicroscopy, fluorescein and indocyanine green angiography, and optical coherence tomography and was treated with intravitreal ranibizumab. RESULTS: The patient developed a FTMH that was observed 1 month after the ranibizumab injection. CONCLUSIONS: Intravitreal ranibizumab may create focal sites of tractional forces on the retinal surface while contraction of the choroidal neovascular membrane may also place forces on the RPE and outer retina. Both actions may have as a result contraction and tearing of the retina leading to the formation of a FTMH.
Subject(s)
Antibodies, Monoclonal/adverse effects , Retinal Detachment/drug therapy , Retinal Perforations/chemically induced , Retinal Perforations/drug therapy , Retinal Pigment Epithelium/pathology , Aged , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Humanized , Diagnosis, Differential , Female , Fluorescein Angiography , Follow-Up Studies , Fundus Oculi , Humans , Injections , Microscopy, Acoustic , Ranibizumab , Retinal Detachment/complications , Retinal Detachment/diagnosis , Retinal Perforations/complications , Retinal Perforations/diagnosis , Retinal Pigment Epithelium/drug effects , Tomography, Optical Coherence , Vitreous BodyABSTRACT
BACKGROUND: To assess vitreous findings in optic disc pit maculopathy using Optical Coherence Tomography (OCT). METHODS: Thirty-eight eyes of 38 patients (14-51 years of age) with macular detachment associated with optic disc pit maculopathy were included in the study. The patients were divided into two groups. In group 1, 16 eyes were studied by OCT at presentation and after surgical treatment. In group 2, 22 eyes were examined by OCT only after treatment. In both groups thorough vitreous examination was performed over the macula and the optic disc. All patients were operated by the macular buckling procedure. RESULTS: Vitreous abnormalities were found in 28 out of 38 eyes (74%) of both groups. In group 1, 10 of the 16 eyes had vitreous traction on the macula at presentation. The traction started from the optic disc and terminated to the macula. The posterior hyaloid that exerted the traction between the points of adhesion at the optic disc and the macula had a course parallel to the retinal surface in 9 of the 10 cases. Postoperatively, vitreous traction on the macula was not found. Of the remaining 6 eyes 4 had complete or partial posterior vitreous detachment. In group 2, 8 eyes had vitreous strands over the optic disc and 5 eyes posterior vitreous detachment. In the remaining 9 cases no vitreous involvement was noticed. CONCLUSIONS: OCT was able to detect vitreous abnormalities such as vitreomacular traction, vitreous strands over the optic disc and complete or partial posterior vitreous detachment associated with optic disc pit maculopathy. Our observations support the view that the abnormal vitreous over the macula and optic disc is likely to play a role in the development of macular elevation in cases with optic disc pit. Prospective OCT studies could further assist to better understand the role of vitreous in this disease.
Subject(s)
Eye Abnormalities/complications , Eye Diseases/diagnosis , Optic Disk/abnormalities , Tomography, Optical Coherence , Vitreous Body/pathology , Adolescent , Adult , Eye Abnormalities/diagnosis , Female , Humans , Male , Middle Aged , Optic Disk/pathology , Retinal Detachment/etiologyABSTRACT
PURPOSE: To describe the macular findings by optical coherence tomography in both eyes of a patient with tilted optic disk and visual decrease. METHODS: A 35-year-old woman with bilateral tilted optic disk and serous macular detachment was examined by slit-lamp biomicroscopy, fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT). RESULTS: Fluorescein angiography demonstrated staining of the temporal rim of the staphyloma adjacent to the optic disk and hyperfluorescence of the diffuse pigmentary changes in the papillomacular area. Leakage points and serous macular detachment were not observed. The existing neurosensory detachment at the fovea became evident only by OCT. CONCLUSIONS: The existence of subretinal fluid, which became evident only by OCT, supports the view that OCT could further contribute to the study of the asymptomatic pigmentary lesions of the macula that are present in 11% of eyes with tilted optic disk. The reason for the localized macular detachment remains unclear. Dysfunction of the retinal pigment epithelium (RPE) or leakage of the optic disk staphyloma rim could possibly explain the cause of fluid accumulation in the macula.
Subject(s)
Diagnostic Techniques, Ophthalmological , Optic Disk/abnormalities , Optic Nerve Diseases/diagnosis , Retinal Detachment/diagnosis , Tomography, Optical Coherence/methods , Adult , Capillary Permeability , Exudates and Transudates , Female , Fluorescein Angiography , Humans , Indocyanine Green , Optic Nerve Diseases/congenital , Retinal Detachment/etiologyABSTRACT
PURPOSE: To present the postoperative optical coherence tomography (OCT) findings of the macula in rhegmatogenous retinal detachment with spared macula preoperatively. METHODS: Eleven of 46 patients who underwent surgery for rhegmatogenous retinal detachment had an uninvolved macula preoperatively. Scleral buckling without intravitreous gas injection was the operation used in all eyes. All 11 patients were examined before and after treatment with slit-lamp biomicroscopy, indirect ophthalmoscopy, fundus photography, fluorescein angiography, and OCT. RESULTS: In 3 of the 11 patients with rhegmatogenous retinal detachment and uninvolved macula preoperatively, fluid was identified with OCT in the macula after successful treatment. OCT showed that the fluid gradually diminished and finally disappeared 5 to 7 months after the scleral buckling procedure. The fluid in the macula became visible with slit-lamp biomicroscopy in only one of the three patients. CONCLUSION: Subretinal fluid in a preoperatively uninvolved macula can be found after successful treatment of rhegmatogenous retinal detachment. If the fluid is located in the fovea, the visual acuity decreases and does not reach the preoperative levels. OCT identifies the presence of fluid and contributes to the study of the fluid's evolution.
