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Optic disk edema associated with peripapillary serous retinal detachment:: An early sign of systemic Bartonella henselae infection

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第3期130卷 327-334页

作者： Wade, NK Levi, L Jones, MR Bhisitkul, R Fine, L Cunningham, ET Univ Calif San Francisco Francis I Proctor Fdn Pearl & Samuel J Kimura Ocular Imunol Lab Med Ctr San Francisco CA 94143 USA Univ Calif San Francisco Med Ctr Dept Ophthalmol San Francisco CA 94143 USA Univ Calif San Diego Dept Ophthalmol La Jolla CA 92093 USA Univ Calif San Diego Dept Neurosci La Jolla CA 92093 USA

PURPOSE: To describe optic disk edema associated with peripapillary serous retinal detachment as an early sign of systemic Bartonella henselae infection. METHODS: Multicentered, retrospective case series. RESULTS: Five women and two men presented with optic disk edema producing peripapillary serous retinal detachment, Each patient had a markedly elevated serum anti-B, henselae antibody titer. Patient age ranged from 11 to 44 years, with a mean and median of 26.6 and 28 years, respectively. The time from the onset of systemic symptoms to the onset of visual symptoms varied from 3 days to 1 month. The peripapillary serous retinal detachment resolved within 1 to 3 weeks in each case, producing a macular star in four of seven patients, Initial vision was 20/200 or worse in five of seven patients and improved in four of these five patients to 20/30 or better, CONCLUSIONS: Systemic B, henselae infection should be considered in patients who develop optic disk edema associated with a peripapillary serous retinal detachment, even in the absence of classic neuroretinitis with a macular star. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：抗菌药/治疗应用抗体细菌/分析菌血症/诊断菌血症/药物疗法菌血症/微生物学巴尔通体汉赛/免疫学巴尔通体汉赛/分离和提纯猫抓病/诊断猫抓病/药物疗法猫抓病/微生物学多西环素/治疗应用眼感染细菌性/诊断眼感染细菌性/药物疗法眼感染细菌性/微生物学荧光素血管造影术眼底免疫球蛋白G/分析免疫球蛋白M/分析视乳头水肿/诊断视乳头水肿/药物疗法视乳头水肿/微生物学视网膜脱离/诊断视网膜脱离/药物疗法视网膜脱离/微生物学回顾性研究视敏度青少年成年人儿童女(雌)性人类男(雄)性

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Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative diabetic retinopathy

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第4期131卷 468-471页

作者： Jonas, JB Hayler, JK Söfker, A Panda-Jonas, S Univ Heidelberg Fac Clin Med Mannheim Dept Ophthalmol Heidelberg Germany Univ Heidelberg Fac Clin Med Mannheim Hosp Eye Heidelberg Germany Univ Erlangen Nurnberg Dept Ophthalmol D-8520 Erlangen Germany Univ Erlangen Nurnberg Hosp Eye D-8520 Erlangen Germany

PURPOSE: To report the clinical outcome and complications of intravitreal injections of crystalline cortisone in patients undergoing pars plana vitrectomy for treatment of proliferative diabetic retinopathy. METHODS: The prospective, interventional case series study included 29 consecutive patients (29 eyes) who underwent pars plana vitrectomy for treatment of complicated proliferative diabetic retinopathy associated with central retinal traction detachment. All patients received an intravitreal injection of 15 to 20 mg of crystalline triamcinolone acetonide at the end of surgery, and were operated on by the same surgeon. Mean follow-up time was 1.4 +/- 1.1 months (median, 1 month;range, 0.30 to 4.9 months). RESULTS: At the end of the follow-up period, the retina was attached in 26 of the 29 patients (89.7%). In three of the 29 patients (10.3%), a retinal redetachment had occurred. None of the patients developed iris neovascularization, and the iris neovascularization, present preoperatively in 12 patients, slightly to markedly regressed in all 12 patients, Preoperative and postoperative intraocular pressure values (P = .72) and blood glucose measurements did not vary significantly. A pseudohypopyon consisting of cortisone crystals in the inferior anterior chamber angle was detected in one patient and resolved spontaneously within 4 days. CONCLUSIONS: The present clinical study suggests that intravitreal injection of crystalline cortisone with most of the vehicle removed seems to be well tolerated by eyes undergoing pars plana vitrectomy for treatment of complicated diabetic proliferative retinopathy, In view of the antiphlogistic and antiproliferative effect of cortisone, future randomized clinical trials may be indicated to investigate further the role of intravitreal injection of crystalline cortisone in the treatment of proliferative diabetic retinopathy. (Am J Ophthalmol 2001;131:468-471. (C) 2001 by Elsevier Science Inc. All rights reserved).

关键词：消炎药/投药和剂量消炎药/治疗应用化学疗法辅助结晶糖尿病视网膜病变/药物疗法注射眼内压前瞻性研究视网膜脱离/药物疗法治疗结果曲安奈德/投药和剂量曲安奈德/治疗应用视敏度玻璃体切除术玻璃体成年人老年人女(雌)性人类男(雄)性中年人

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EXUDATIVE RETINAL-DETACHMENT AND SCLERITIS IN POLYARTERITIS

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1976年第5期82卷 694-698页

作者： KIELAR, RA UNIV KENTUCKY MED CTR DEPT OPHTALMOL LEXINGTON KY 40506 USA

A 64 yr old white man, treated with systemic corticosteroids for 5 yr, developed polyarteritis. He then developed a severe scleritis with an exudative retinal detachment in the right eye, which became blind and painful and was enucleated 23 mo. after onset of the scleritis. Histopathologic examination of the enucleated eye revealed granulomatous scleritis, chronic nongranulomatous uveitis, exudative retinal detachment and perivasculitis of intrascleral, iris, ciliary body and retinal blood vessels. Systemic findings were minimal and limited to elevated sedimentation rate, weight loss, mild anemia and microscopic hematuria. Respiratory disease, severe kidney disease, hypertension and arthritis were notably absent. A muscle biopsy established the diagnosis.

关键词：肾上腺皮质激素类/投药和剂量盲/病理学肉芽肿巨细胞/病理学炎症肌/病理学坏死多动脉炎结节性/并发症多动脉炎结节性/药物疗法多动脉炎结节性/病理学泼尼松/投药和剂量泼尼松/治疗应用视网膜/病理学视网膜脱离/药物疗法视网膜脱离/病理学巩膜/病理学人类男(雄)性中年人

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Progressive outer retinal necrosis and acute retinal necrosis in fellow eyes of a patient with acquired immunodeficiency syndrome

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第3期132卷 421-423页

作者： Gariano, RF Berreen, JP Cooney, EL Yale Univ Sch Med Ctr Eye Dept Ophthalmol & Visual Sci New Haven CT 06520 USA Yale Univ Sch Med Dept Med New Haven CT 06510 USA

PURPOSE: To describe an unusual concurrence of acute retinal necrosis and progressive outer retinal necrosis in fellow eyes of a patient with acquired immunodeficiency syndrome (AIDS). METHODS: Interventional case report. In a 37-year-old man with AIDS and herpes zoster keratitis in the right eye, progressive outer retinal necrosis developed in the right eye and acute retinal necrosis developed in the left eye. RESULTS: Disparate presentations of retinitis persisted in each eye, and retinal detachment and vision loss ensued in both eyes despite antiviral therapy. CONCLUSION: Distinct features of acute retinal necrosis and progressive outer retinal necrosis do not necessarily reflect systemic factors, and they may be variant manifestations of the same underlying infection. (Am J Ophthalmol 2001;132:421-423. (C) 2001 by Elsevier Science Inc. All rights reserved.).

关键词：获得性免疫缺陷综合征/并发症获得性免疫缺陷综合征/病毒学抗病毒药/治疗应用疱疹带状眼部/并发症视网膜脱离/药物疗法视网膜脱离/病因学视网膜脱离/病毒学视网膜坏死综合征急性/并发症视网膜坏死综合征急性/药物疗法视网膜坏死综合征急性/病毒学视网膜炎/并发症视网膜炎/药物疗法视网膜炎/病毒学成年人人类男(雄)性

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Outcomes and complications associated with perfluoro-n-octane and perfluoroperhydrophenanthrene in complex retinal detachment repair

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OPHTHALMOLOGY 2000年第5期107卷 860-865页

作者： Scott, IU Murray, TG Flynn, HW Smiddy, WE Feuer, WJ Schiffman, JC Univ Miami Sch Med Bascom Palmer Eye Inst Dept Ophthalmol Miami FL 33136 USA

Objective: To compare rates of perfluorocarbon liquid (PFCL) intraocular retention, anatomic and visual acuity outcomes, and complications associated with intraoperative perfluoro-n-octane (Perfluoron) versus perfluoroperhydrophenanthrene (Vitreon) in retinal detachment repair. Design: Retrospective noncomparative consecutive case series. Participants and Methods: Records of consecutive patients who underwent retinal detachment repair with intraoperative Perfluoron (n = 78) or Vitreon (n = 84) at the Bascom Palmer Eye Institute between November 1, 1991, and October 31, 1994, were retrospectively reviewed. Main Outcome Measures: Comparison of PFCL intraocular retention rates, retinal reattachment rates, visual acuity outcomes, and postoperative complication rates between the Perfluoron and Vitreon groups at postoperative day 1, week 1, month 1, month 3, and month 6. To assess the study's generalizability, the Perfluoron data obtained in the current study were compared with results of the Perfluoron Multicenter Clinical Study. Results: Retained Perfluoron was noted less frequently (P < 0.03) than retained Vitreon at each postoperative visit assessed. At 6 months postoperatively, the cumulative rate of retained PFCL (noted at any of the study postoperative visits) was 7.8% of patients in the Perfluoron group and 38.3% in the Vitreon group (P < 0.001). No significant difference was found between the groups in retinal reattachment rates;at 6 months postoperatively, the retina was attached in 45 of 61 (74%) patients in the Perfluoron group and 36 of 57 (63%) patients in the Vitreon group (P = 0.2). There was a trend (P = 0.055) toward better 6-month visual acuity in the Perfluoron group compared with the Vitreon group. The incidence of corneal abnormality at any study visit was 46.7% in the Perfluoron group and 77.4% in the Vitreon group (P < 0.001). At 6 months postoperatively, the cumulative rate of elevated intraocular pressure (>25 mmHg) was 13 +/- 4% and 37 +/- 5%, r

关键词：角膜/药物作用氟碳化合物/副作用氟碳化合物/治疗应用眼内压结果评价(卫生保健) 手术后并发症视网膜脱离/药物疗法视网膜脱离/外科学回顾性研究视敏度玻璃体切除术青少年成年人老年人老年人 80以上儿童儿童学龄前女(雌)性人类男(雄)性中年人

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Perfluoroperhydrophenanthrene versus perfluoro-n-octane in vitreoretinal surgery

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OPHTHALMOLOGY 2000年第6期107卷 1078-1082页

作者： Loewenstein, A Humayun, MS de Juan, E Campochiaro, PA Haller, JA Tel Aviv Univ Sackler Fac Med IL-69978 Tel Aviv Israel Tel Aviv Univ Tel Aviv Sourasky Med Ctr IL-69978 Tel Aviv Israel

Purpose: To compare two perfluorocarbon liquids, perfluoroperhydrophenanthrene (Vitreon) and perfluoro-n-octane (PFO), regarding (1) ease of removal at the time of surgery and (2) efficacy and safety. Design: Retrospective, nonrandomized, comparative trial. Participants: Two hundred sixty-four patients, Methods: All medical records of patients who participated in either the Vitreon (n = 142) or the PFO (n = 122) multicenter trials at the Wilmer Eye Institute were reviewed, Patients in the two groups were compared with respect to presence and amount of postoperative perfluorocarbon, Safety and efficacy of the two perfluorocarbon liquids were evaluated in the subset of patients undergoing surgery for retinal detachment with PVR grade C or more, who had at least 6 months of postoperative follow-up (n = 46 in the Vitreon group and n = 55 in the PFO group), Best-corrected visual acuity, intraocular pressure, and status of the cornea, lens, and retina after 3, 6, and 12 months of follow-up were compared in the two groups, Main Outcome Measures: Percentage of eyes with retained perfluorocarbon, final visual acuity, final retinal attachment rate, Results: At the 6-month postoperative visit, retained Vitreon or PFO was detected in 8.4% and 4% of the eyes, respectively (P < 0.05), No statistically significant difference was found between the two perfluorocarbons in attachment rate or visual acuity after 6 and 12 months, After 6 months, the retina was attached in 71.7% of the eyes in which Vitreon was used and in 78.3% of the eyes in which PFO was used (P = 0.81), Visual acuity improved or remained stable in 80% of the Vitreon group eyes and in 74.5% of the PFO group eyes (P = 0.75), No statistically significant difference was found in final visual acuity or intraocular pressure between the two groups after 6 or 12 months. There was a tendency at the 12-month follow-up examination for the cornea to remain clearer in the Vitreon group (P = 0.01), Conclusions: Although PFO was e

关键词：氟碳化合物/治疗应用眼内压视网膜脱离/药物疗法视网膜脱离/外科学回顾性研究安全治疗结果视敏度玻璃体视网膜病增生性/药物疗法玻璃体视网膜病增生性/外科学青少年成年人老年人老年人 80以上儿童儿童学龄前女(雌)性人类男(雄)性中年人

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