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BMC Ophthalmology Sep 2023To evaluate the clinical patterns of retinopathy in patients who received cardiopulmonary resuscitation (CPR) using wide-field fundus photography and slit-lamp fundus...
PURPOSE
To evaluate the clinical patterns of retinopathy in patients who received cardiopulmonary resuscitation (CPR) using wide-field fundus photography and slit-lamp fundus examination.
METHODS
The medical records of patients aged ≥ 18 years who survived after receiving CPR and underwent wide-field fundus photography and slit-lamp fundus examination within 3 months were retrospectively analyzed. Fundus findings, including retinal hemorrhage and cotton wool spots, were investigated. The subjects were categorized into the retinopathy and non-retinopathy groups based on the presence of fundus findings. Systemic and CPR-related factors were analyzed to compare the two groups.
RESULTS
Twenty eyes (10 patients) and 28 eyes (14 patients) were included in the retinopathy and non-retinopathy groups, respectively. The retinopathy group had longer CPR time than the non-retinopathy group (15 ± 11 min vs. 6 ± 5 min, p = 0.027). In the retinopathy group, retinal nerve fiber layer hemorrhage was observed in all eyes, and intraretinal hemorrhage was observed in 55% of the eyes. 80% of hemorrhages were located in the peripapillary or posterior pole. There were no interval changes in visual acuity, intraocular pressure, and central retinal thickness for 6 months. The average remission periods of retinal hemorrhage and cotton wool spots were 6.8 ± 2.6 month and 5.6 ± 2.1 months, respectively. No retinopathy progression was observed.
CONCLUSION
The signs of retinopathy, such as retinal hemorrhages and cotton wool spots, which are found after CPR, mainly occur in patients who receive longer time of CPR and improve over time.
Topics: Humans; Retinal Hemorrhage; Retrospective Studies; Retinal Diseases; Retina; Cardiopulmonary Resuscitation
PubMed: 37735637
DOI: 10.1186/s12886-023-03137-3 -
PloS One 2022Polypoidal choroidal vasculopathy (PCV) with hemorrhagic complications is at higher risk for breakthrough vitreous hemorrhage (VH). This study aimed to evaluate the...
Polypoidal choroidal vasculopathy (PCV) with hemorrhagic complications is at higher risk for breakthrough vitreous hemorrhage (VH). This study aimed to evaluate the clinical features and outcomes of breakthrough VH secondary to PCV. Data of patients receiving pars plana vitrectomy for breakthrough VH secondary to PCV (VH group) were evaluated retrospectively and compared statistically to data of age and sex-matched PCV patients without breakthrough VH (control group). Among PCV patients, 36 eyes with breakthrough VH and 62 eyes without VH were included. Compared with baseline, best corrected visual acuity (BCVA) was worse in the VH group (P < 0.001), and improved postoperatively (P < 0.001). Percentages of pigmented epithelial detachment (PED), hemorrhagic PED, massive subretinal hemorrhage, hemorrhagic retinal detachment (RD), and hemorrhagic choroidal detachment (CD) (P = 0.007) were higher in the VH group (P < 0.001). Incidence of choroidal vascular hyperpermeability (P < 0.001), massive subretinal hemorrhage (P = 0.001), hemorrhagic retinal detachment (P = 0.001) and hemorrhagic type PCV (P = 0.001) was higher in patients with pachychoroid PCV, while fibrovascular type had lower incidence (P < 0.001). Better initial BCVA (P < 0.001), higher frequency of anti-VEGF treatment (P = 0.009), and previous photodynamic therapy (P = 0.017) showed better visual outcomes. Breakthrough VH risk is higher in PCV patients with massive subretinal hemorrhage, hemorrhagic PED and hemorrhagic RD. BCVA and hemorrhagic complications improve significantly postoperatively. Higher frequency of anti-VEGF treatment and previous photodynamic therapy are associated with better visual prognosis in PCV patients with breakthrough VH.
Topics: Humans; Vitreous Hemorrhage; Polypoidal Choroidal Vasculopathy; Angiogenesis Inhibitors; Retinal Detachment; Retrospective Studies; Retinal Hemorrhage; Choroid; Fluorescein Angiography; Tomography, Optical Coherence
PubMed: 36584198
DOI: 10.1371/journal.pone.0279778 -
The Neuroradiology Journal Feb 2022For infants presenting with subdural hemorrhage, retinal hemorrhage, and neurological decline the "consensus" opinion is that this constellation represents child abuse...
For infants presenting with subdural hemorrhage, retinal hemorrhage, and neurological decline the "consensus" opinion is that this constellation represents child abuse and that cerebral venous sinus thrombosis and cortical vein thrombosis is a false mimic. This article contends that this conclusion is false for a subset of infants with no evidence of spinal, external head, or body injury and is the result of a poor radiologic evidence base and misinterpreted data. Underdiagnosis of thrombosis is the result of rapid clot dissolution and radiologic under recognition. A pre-existing/chronic subdural hemorrhage predisposes to development of venous sinus thrombosis/cortical vein thrombosis, triggered by minor trauma or an acute life-threatening event such as dysphagic choking, variably leading to retinal and subdural hemorrhages and neurologic decline. These conclusions are based on analysis of the neuroradiologic imaging findings in 11 infants, all featuring undiagnosed cortical vein or venous sinus thrombosis. Subtle neuroradiologic signs of and the mechanisms of thrombosis are discussed. Subarachnoid hemorrhage from leaking thrombosed cortical veins may be confused with acute subdural hemorrhage and probably contributes to the development of retinal hemorrhage ala Terson's syndrome. Chronic subdural hemorrhage rebleeding from minor trauma likely occurs more readily than bleeding from traumatic bridging vein rupture. Radiologists must meet the challenge of stringent evaluation of neuro imaging studies; any infant with a pre-existing subdural hemorrhage presenting with neurologic decline must be assumed to have venous sinus or cortical vein thrombosis until proven otherwise.
Topics: Child Abuse; Hematoma, Subdural; Humans; Infant; Intracranial Thrombosis; Retinal Hemorrhage; Venous Thrombosis
PubMed: 34167377
DOI: 10.1177/19714009211026904 -
Arquivos Brasileiros de Oftalmologia 2022To assess the anterior and posterior segments of full-term neonates over a 1.5-year period.
PURPOSE
To assess the anterior and posterior segments of full-term neonates over a 1.5-year period.
METHODS
The findings of full-term neonates who underwent ophthalmological examinations between June 2019 and December 2020 were analyzed, and the results were retrospectively recorded.
RESULTS
The study comprised 2972 neonates with a mean birth week of 38.7 ± 1.2 weeks and a mean birth weight of 3235 ± 464 g. The neonates were examined on an average of 49.3 ± 18.9 postnatal days. Of the examined neonates, 185 (6.2%) showed abnormal ophthalmological findings, the most prevalent of which were retinal hemorrhage in 2.3% (n=68) and white changes in the peripheral retina in 1.9% (n=55) of the neonates. Cases of optic disc pathologies (n=20), choroidal nevus (n=10), iris-choroidal coloboma (n=5), subconjunctival hemorrhage (n=6), non-specific retinal pigmentary change (n=4), congenital cataract (n=3), posterior synechia (n=3), iris nevus (n=3), corneal opacity (n=1), choroidal coloboma (n=1), iris coloboma (n=1), buphthalmos (n=1), anophthalmos (n=1), microphthalmia (n=1), lid hemangioma (n=1), and vitreous hemorrhage (n=1) collectively accounted for approximately 2% of all neonates. Pathologies that could potentially impair vision, which were detected by ophthalmological examination, accounted for 1.2% of all neonates (n=37).
CONCLUSION
The most prevalent finding of the ophthalmological examinations of neonates in the present study was retinal hemorrhage. Ophthalmological examinations of neonates can help in identifying diseases that may affect their vision and are curable or may lead to amblyopia in the long term.
Topics: Humans; Infant, Newborn; Coloboma; Retinal Hemorrhage; Retrospective Studies; Eye Abnormalities; Nevus
PubMed: 35857993
DOI: 10.5935/0004-2749.2021-0536 -
BMJ Case Reports Mar 2013Purtscher's retinopathy is a haemorrhagic and vaso-occlusive retinal vasculopathy, caused by microembolisation occluding retinal and choroidal arterioles. This leads to...
Purtscher's retinopathy is a haemorrhagic and vaso-occlusive retinal vasculopathy, caused by microembolisation occluding retinal and choroidal arterioles. This leads to retinal haemorrhages and ischaemia. The usual cause is severe trauma. 1 However, a variety of conditions including acute pancreatitis, childbirth, long bone fracture, chest trauma and systemic inflammatory vasculitides may cause similar retinal presentations. 1-4 This highlights Purtscher's retinopathy as a clinically important differential diagnosis of visual loss. We present a case report of a 43-year-old man who was diagnosed with acute pancreatitis. While in hospital he developed sudden onset unilateral loss of vision. This case highlights the need to ensure prompt diagnosis and initiation of appropriate multidisciplinary management.
Topics: Adult; Alcoholism; Diagnosis, Differential; Diagnostic Imaging; Humans; Male; Pancreatitis; Retinal Hemorrhage
PubMed: 23470674
DOI: 10.1136/bcr-2013-008607 -
PloS One 2020The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after... (Observational Study)
Observational Study
The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after symptoms onset. This was a case series observed during May 2020 in two referral centers for COVID-19 treatment in Rio de Janeiro, Brazil. 47 eyes from 25 hospitalized patients with severe or critical confirmed illness were evaluated. A handheld retinal camera was used to acquire bilateral fundus images at several time points after symptoms onset. Electronic health records were retrospectively analyzed and clinical data collected. Severe and critical diseases were noticed in 52% (13/25) and 48% (12/25) of enrolled patients, respectively. Retinal changes were present in 12% (3/25) of patients: a 35 year-old male demonstrated bilateral nerve fiber layer infarcts and microhemorrhages in the papillomacular bundle, but required mechanical ventilation and developed severe anemia and systemic hypotension, acute kidney injury and neurologic symptoms during the course of the disease (critical illness); a 56 year-old male, who required full enoxaparin anticoagulation due to particularly elevated D-dimer (>5.0 mcg/mL), demonstrated unilateral and isolated flame-shaped hemorrhages; and a 49 year-old hypertensive male showed bilateral and discrete retinal dot and blot microhemorrhages. The other 22 patients evaluated did not demonstrate convincing retinal changes upon examination. There was no correlation between disease severity and admission serum levels of CRP, D-dimer and ferritin. This was the first study to show that vascular retinal changes may be present in not insignificant numbers of severe or critical COVID-19 inpatients. These retinal changes, only seen after morbid developments, were likely secondary to clinical intercurrences or comorbidities instead of a direct damage by SARS-CoV-2, and may be important and easily accessible outcome measures of therapeutic interventions and sentinels of neurologic and systemic diseases during COVID-19 pandemic.
Topics: Adult; Aged; COVID-19; Female; Fundus Oculi; Humans; Inpatients; Male; Middle Aged; Retinal Hemorrhage; Retinal Vessels
PubMed: 33270751
DOI: 10.1371/journal.pone.0243346 -
The British Journal of Ophthalmology Nov 1968
Topics: Adolescent; Adult; Aged; Animals; Aqueous Humor; Bilirubin; Cattle; Child; Child, Preschool; Chromatography, Paper; Electroretinography; Gangliosides; Humans; In Vitro Techniques; Lipids; Middle Aged; Rabbits; Retina; Retinal Hemorrhage; Vision Disorders; Vitreous Body
PubMed: 5696908
DOI: 10.1136/bjo.52.11.808 -
The Pan African Medical Journal 2015
Topics: Humans; Male; Retinal Hemorrhage; Retinal Telangiectasis; Vision Disorders; Young Adult
PubMed: 26113936
DOI: 10.11604/pamj.2015.20.205.6390 -
Asia-Pacific Journal of Ophthalmology...
Topics: Fluorescein Angiography; Humans; Retinal Arterial Macroaneurysm; Retinal Hemorrhage; Retinal Perforations
PubMed: 33512835
DOI: 10.1097/APO.0000000000000356 -
Neurology India 2017
Topics: Adult; Brain; Female; Humans; Hyperemesis Gravidarum; Magnetic Resonance Imaging; Pregnancy; Pregnancy Complications; Retinal Hemorrhage; Wernicke Encephalopathy
PubMed: 28879936
DOI: 10.4103/neuroindia.NI_35_17