Computerised visual field deficits in tears of the retinal pigment epithelium.

Retinal Pigment epithelial tears have been well documented as a complication of pigment epithelial detachment in patients with age related macular degeneration. Spontaneous and iatrogenic separation of detached retinal pigment epithelium, with subsequent retraction and exposure of the underlying choriocapillaris and Bruch's membrane, usually results in poor visual function in the affected areas. However, exact characterisation of the resultant scotomas has not been previously described. We present two patients with spontaneous pigment epithelial tears who underwent Octopus computerised visual field analysis. The density and characteristics of their associated field loss is compared with their clinical and fluorescein angiographic appearance.

Krypton red laser photocoagulation of peripapillary subretinal neovascular membranes.

The visual outcome of 20 eyes of 20 patients with peripapillary subretinal neovascular membranes (SRNVM) treated with krypton red laser photocoagulation (KRLP) was studied. Complete obliteration of the SRNVM was achieved in all eyes in the study. In 18 of 20 patients, the visual acuity improved or remained the same during an average follow-up of 9.9 months. There were no treatment-related complications. The efficacy of KRLP in the management of patients with peripapillary SRNVM is discussed.

Krypton red laser photocoagulation of subretinal neovascular membranes located within the foveal avascular zone.

Fifty-one eyes with senile macular degeneration and a well-defined subretinal neovascular membrane located within 250 microns from the center of the foveal avascular zone were treated with krypton red laser photocoagulation. Follow-up ranged from 8 to 18 months (mean, 10 months). The eyes were divided into two groups based upon the location of the neovascular membrane. Group I (juxtafoveal membrane 1 to 250 microns from the center of the foveal avascular zone) contained 26 eyes. Following treatment the visual acuity in 16 of the 26 eyes (62%) improved by two or more lines on the Snellen chart or stabilized. Group II (subfoveal membrane present under the center of the foveal avascular zone) contained 25 eyes. Following treatment only 7 of 25 eyes (28%) improved by two or more Snellen lines or maintained their pretreatment visual acuity. Of 16 eyes that had a pretreatment visual acuity of 20/100 or better, only 2 eyes (12%) remained in this group following treatment.

Complications of krypton red laser photocoagulation to subretinal neovascular membranes.

The use of krypton red laser photocoagulation (KRLPC) to treat subretinal neovascular membranes (SRNVM) is increasing. The complications of this treatment in a large series of patients have not been reported. Over a 15-month period, 195 patients had KRLPC to SRNVM of the following etiologies: senile macular degeneration (151), presumed ocular histoplasmosis (33), miscellaneous (11). Fourteen patients had the following complications attributable to KRLPC: choroidal hemorrhage (9), retinal pigment epithelial tears (3), choroidal ischemia (1) and choroidal folds (1). The visually significant complication rate was 3.6%. Proper patient selection and treatment technique may decrease the risk of complications.

Presumed acquired retinal hemangiomas.

This paper presents the clinical findings in 12 patients with a peculiar vascular mass of the sensory retina. On the basis of ophthalmoscopy, fluorescein angiography, ultrasonography and other studies, the authors presume that the described lesion is a primary acquired benign vascular tumor, most likely a variant of capillary hemangioma. The features that seem to differentiate clinically this lesion from von Hippel's retinal angiomatosis, other ocular tumors, and pseudotumors are discussed and therapeutic recommendations are presented.

Retinal pigment epithelial tears.

Retinal pigment epithelial tears have been recognized recently as a complication of retinal pigment epithelial detachments. They are characterized by sudden separation of detached from attached pigment epithelium at the margin of the detachment. Retraction of the overlying pigment epithelium occurs and exposes Bruch's membrane and choroid. Most pigment epithelial tears appear to arise spontaneously, but they also may occur following krypton red laser photocoagulation. The visual prognosis is poor in eyes in which the tear involves the subfoveolar pigment epithelium.