Resolution Of Retinopathy Research Articles

Hypertensive retinopathy in the end-stage renal failure – study case.

The case of 26-year-old woman with a transient deterioration of binocular vision secondary to chronic renal failure due to glomerulonephritis is presented. The patient reported the onset of the disease at the age of 2. As her kidney disease was poorly controlled, she developed renal hypertension followed by bilateral hypertensive retinopathy. The patient was hospitalized intheDepartment of Nephrology, where she received dialyses and her blood pressure was normalised. The follow up intheOphthalmology Clinic was continued for 9 months. The treatment of her primary disease resulted in a significant resolution of retinopathy and improved her visual acuity.

RETINAL VEIN OCCLUSION AND THE OPTIC DISK

To investigate the effect of cup to disk (C/D) ratio in various types of retinal vein occlusion (RVO) on the severity of retinopathy, visual outcome, and resolution of retinopathy and validity of the concept of the "compartment syndrome" in RVO. The study comprised 1,222 consecutive eyes (768 central retinal vein occlusion [CRVO], 183 hemi-CRVO, and 271 branch retinal vein occlusion). Ophthalmic evaluation at initial and follow-up visits included recording visual acuity, visual fields, and detailed anterior segment and fundus examinations and fluorescein fundus angiography. Compared to sex-matched and age-matched normal eyes, C/D ratio ≥0.5 was significantly more common in all CRVOs and hemi-CRVO eyes but not in branch retinal vein occlusion. Retinal hemorrhages were significantly more severe in nonischemic CRVO with C/D ratio ≥0.5 compared to those with no or small cup, but no difference was found in hemi-CRVO and branch RVO. In ischemic CRVO, moderate hemorrhages were more with C/D ≥0.5 but severe hemorrhages were more with no cup. In various types of RVO, there was no significant association of C/D ratio with macular edema, retinopathy resolution, visual acuity, and visual field defect. The findings of our study contradict the concept that the "compartment syndrome" plays any role in the prevalence of various types of RVO or in their severity, the resolution of retinopathy, or the visual outcome. This indicates that the advocated procedure of radial optic neurotomy, based on the compartment syndrome, is not a logical treatment for CRVO.

Bevacizumab for Coats' disease with exudative retinal detachment and risk of vitreoretinal traction

AimTo evaluate the effect of supplemental intravitreal bevacizumab for management of Coats' disease.MethodsRetrospective analysis of eight patients with Coats' disease manifesting total or partial exudative retinal detachment where the retinal...

Malignant hypertension: cardiac structure and function at presentation and during therapy.

We have studied electrocardiograms, chest radiographs, and digitised apex echocardiograms in 16 patients with malignant hypertension before and after up to six months of antihypertensive treatment and compared them with those of eight patients with severe benign hypertension. Adequate blood pressure reduction was obtained in 14 with resolution of retinopathy, but one patient died and another had poor blood pressure control. Nine had electrocardiographic criteria of left ventricular hypertrophy which did not change with treatment and 10 had lateral ischaemia which resolved in seven. The malignant hypertensives were divided into seven with and nine without a previous hypertensive history. Both groups had normal echocardiographic cavity dimensions, but the former group tended to have hypertrophy (similar to that in benign hypertensives) and the latter did not. After adequate reduction of blood pressure, no change in wall and septal thickness occurred (except in one patient with poor blood pressure control). At entry, malignant hypertensives showed delayed mitral valve opening with significant cavity dimension increase during prolonged isovolumic relaxation, reduced peak rate, and prolonged duration of cavity dimension increase and cavity shape change (inward wall motion) during the upstroke of the apexcardiogram which showed a tall "a" wave. After reduction of blood pressure, though the delay in mitral valve opening persisted, the timing of A2 returned towards normal and the dimension change during the upstroke of the apexcardiogram and the relative height of the "a" wave were reduced but remained significantly different from normal. Some patients without a previous hypertensive history may develop a malignant phase without left ventricular hypertrophy on the electrocardiogram or echocardiogram. They maintain their pump function even with radiological pulmonary oedema, have incoordinate relaxation and contraction, and have abnormal filling. Similar functional abnormalities were found in malignant hypertensives with hypertrophy. Treatment to reduce blood pressure reduces incoordinate contraction, but impaired diastolic function persists as in benign hypertension, suggesting that these abnormalities are the result of altered myocardial properties that may occur without hypertrophy.