ABSTRACT
BACKGROUND: The course of Purtscher's retinopathy (PR) or Purtscher-like retinopathy (P-lR) is dependent on time, length, and expression of confluent cotton-wool spots. To correlate the course of the disease with findings of optical coherence tomography (OCT), we present two extreme courses of PR and P-lR. METHODS: Complete ophthalmological examination plus electroretinography (ERG) and OCT were performed. In the first case the follow-up was carried out until complete resorption of the edema and in the second case 8 years after the occurrence of P-lR. RESULTS: An increase of the central retinal thickness (308-430 microm was observed during the acute phase of PR. Normalization of visual acuity and central retinal thickness to 210-273 microm with an ERG within normal limits (35 ms) was achieved after 8 weeks. In the course of P-lR the marked edema was visible even after 6 months and a markedly reduced neuroretina (112-120 microm) was measured after 8 years. CONCLUSIONS: Retinal thickness analysis correlates well with organic functions in the cases of PR or P-lR. Fast reduction of the edema was associated with a good prognosis for visual acuity.
Subject(s)
Retinal Diseases/pathology , Tomography, Optical Coherence/methods , Adult , Female , Humans , Male , Statistics as TopicABSTRACT
Purtscher's retinopathy is a traumatic angiopathy, most commonly caused by head and chest trauma. Retinal signs include white ischemic infarcts (cotton-wool spots or Purtscher flecken) and hemorrhages (dot and blot, preretinal, or flame). The prognosis for patients with decreased vision is unpredictable. We report one case of this disease developing 3 days after a motorcycle accident.
Subject(s)
Ischemia/diagnosis , Ischemia/etiology , Retinal Hemorrhage/diagnosis , Retinal Hemorrhage/etiology , Retinal Vessels , Thoracic Injuries/complications , Thoracic Injuries/diagnosis , Accidents, Traffic , Adult , Humans , Male , Rare Diseases/diagnosis , Rare Diseases/etiology , Syndrome , Vision Disorders/diagnosis , Vision Disorders/etiologyABSTRACT
BACKGROUND: Protein S deficiency, which exists in 0.7% of the population, is a risk factor for retinal vein branch occlusions and is inherited in an autosomal dominant manner. METHODS: A genealogical study was carried out on three generations of one family who exhibited different venous occlusions and subsequent complications. RESULTS: Four members of the family, spanning three generations, suffered from complications of venous thrombosis. In the first generation a great uncle died of complications from a deep leg venous thrombosis. In the second generation, the mother underwent a venous branch thrombosis at the age of 41 with a protein S activity of 18%. Subsequently, a palsy of the N. abducens developed with multiple cerebral lesions (presumably post-thrombotic) in the MRI. Fluorescein angiography showed a typical picture of a venous branch occlusion which had been treated by laser. In the third generation, the 16-year-old daughter developed iliac venous thrombosis and a pulmonary embolism with a protein S activity of 0%. The fluorescein angiography showed distinctively engorged veins. A 28-year-old daughter, with a protein S activity of 16%, remained asymptomatic, although fluorescein angiography demonstrated engorged veins. Protein C activity and APC resistance of all family members were normal. The chromosomal analysis of the family members revealed no morphological aberrations. CONCLUSION: Protein S deficiency increases the risk of congenital thrombosis in young and middle-aged heterozygous individuals.
Subject(s)
Abducens Nerve Diseases/genetics , Protein S Deficiency/genetics , Retinal Vein Occlusion/genetics , Abducens Nerve Diseases/diagnosis , Adolescent , Adult , Chromosomes, Human, Pair 3 , DNA Mutational Analysis , Female , Fluorescein Angiography , Genetic Predisposition to Disease/genetics , Genotype , Humans , Intracranial Embolism/diagnosis , Intracranial Embolism/genetics , Male , Middle Aged , Pedigree , Phenotype , Point Mutation/genetics , Protein S/genetics , Protein S Deficiency/diagnosis , Pulmonary Embolism/diagnosis , Pulmonary Embolism/genetics , Retinal Vein Occlusion/diagnosis , Thrombophilia/diagnosis , Thrombophilia/genetics , Venous Thrombosis/diagnosis , Venous Thrombosis/geneticsABSTRACT
PURPOSE: To define the physicochemical parameters of viscoelastics that are most important for visual acuity after phacoemulsification. MATERIAL AND METHODS: Eleven commercially available viscoelastics (ophthalmic viscosurgical device, OVD) were used in consecutive cataract operations. In addition to clinical findings, we assessed visual acuity, intraocular pressure, endothelial cell density, and pachymetric data preoperatively and on the first postoperative day. RESULTS: On the first postoperative day the loss of endothelial cells in all phacoemulsifications was 0.661%, corrected for 1 s phacotime, while corneal thickness increased by 0.2384% and visual acuity by 5.206%, and intraocular pressure decreased by 0.306%. The most important parameters for visual acuity were the concentration of sodium hyaluronate and viscosity (100/s.) of the OVD. Pachymetric data were more relevant for postoperative visual acuity than endothelial cell counts. CONCLUSION: Early visual rehabilitation after phacoemulsification depends on stable pachymetric data. OVD with a high content of sodium hyaluronate and high viscosity significantly reduces corneal swelling and improves visual acuity after phacoemulsifications on the first postoperative day.
