ABSTRACT
Vitreomacular traction syndrome is a complication of partial posterior vitreous detachment: vitreous is separated from the retina throughout the peripheral fundus but remains adherent posteriorly with anteroposterior traction on the macular area and the optic nerve. The functional and anatomical examinations of this condition are based on the following triad: clinical examination, angiography, and OCT.
Subject(s)
Retina/pathology , Retinal Detachment/diagnosis , Vitreous Body/pathology , Vitreous Detachment/diagnosis , Humans , Retina/anatomy & histology , Syndrome , Vitreous Body/anatomy & histologyABSTRACT
Macular edema typically occurs as the final ocular manifestation of many intraocular or systemic diseases with fluid collection within the macular layers due to the breakdown of the blood-retinal barrier. This could be chemically mediated by VEGF, because increased VEGF has been shown to increase blood-retinal barrier permeability, or mechanically induced by vitreomacular traction causing hemodynamic or retinal pigment epithelium pump disturbances. This article reviews the different clinical entities of macular edema, focusing on their physiopathological concepts and on the current therapeutic strategies for their management.
Subject(s)
Eye Diseases/complications , Macular Edema/etiology , Blood-Retinal Barrier/physiology , Humans , Macula Lutea/pathology , Macular Edema/physiopathology , Vascular Endothelial Growth Factor A/physiology , Vitreous Body/pathologyABSTRACT
PURPOSE: To analyze the retinal and choroidal side-effects of radiotherapy given for age-related macular degeneration (ARMD) and to describe the risk factors of these complications and their treatment. MATERIAL: and methods: Two hundred and ninety five eyes in 270 patients with ARMD were treated using radiotherapy. Nineteen patients had diabetes. The doses were as follows: 15 Gy or less (4 eyes); 16 Gy/4 fractions (113 eyes); 18 Gy/5 fractions (35 eyes); 20 Gy/5 fractions (123 eyes); 24 Gy/6 fractions (2 eyes); 28.8 Gy/8 fractions (17 eyes); more than 28.8 Gy (1 eye). Patients had a regular follow-up visit with visual acuity, contrast sensitivity evaluation, biomicroscopic fundus examination, fluorescein and ICG angiographies every six months over a mean period of 15 months. RESULTS: Radiation retinopathy was noted in 15 eyes, a bilateral neovascular glaucoma in one patient, ischemic optic neuropathy in 5 eyes, choroidal telangiectasiae in 19 eyes, venous occlusion in 2 eyes, oedematous retinopathy with major exudation (ORME) in 31 eyes, and choroidal hematoma in 8 eyes. Radiation retinopathy, choroidal telangiectasiae and ORME were related to radiation dose. Radiation retinopathy was more severe and more frequent in patients with diabetes. Choroidal telangiectasiae were diagnosed with ICG angiography and were treated early with laser. CONCLUSION: Radiotherapy for ARMD should not be done in patients with diabetes. Hypofractionation is not recommended. ICG angiography should be considered essential in the follow-up of patients treated with radiotherapy.
Subject(s)
Choroid/radiation effects , Macular Degeneration/radiotherapy , Optic Nerve/radiation effects , Radiation Injuries/etiology , Retina/radiation effects , Aged , Female , Fluorescein Angiography , Follow-Up Studies , Humans , Male , Radiation Injuries/therapy , Radiotherapy Dosage , Risk Factors , Treatment OutcomeABSTRACT
We report the case of a patient with a dural carotid-cavernous fistula. The examination showed a proptosis, a chemosis, an increased intraocular pressure and a choroidal detachment. The diagnosis was confirmed by arteriography. The treatment consisted of the embolisation of the feeders originating from the external carotid artery. The ocular improvement was only partial, but choroidal detachment regressed.
