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Comparative Medicine Feb 2014To study spontaneous intraocular hemorrhage in rats during postnatal ocular development and to elucidate the underlying mechanism, postnatal ocular development in the... (Comparative Study)
Comparative Study
To study spontaneous intraocular hemorrhage in rats during postnatal ocular development and to elucidate the underlying mechanism, postnatal ocular development in the albino Wistar Hannover (WH) and Sprague-Dawley (SpD) and pigmented Long-Evans (LE) strains was analyzed. Pups (n = 2 to 5) from each strain were euthanized daily on postnatal days (PND) 0 through 21 and their eyes examined macroscopically and histologically; similar analyses were performed in 26 to 39 additional WH pups daily from PND 7 to 14. At necropsy, ring-shaped red regions and red spots were present in the eyes of WH and SpD rats. These lesions were attributed histologically to hemorrhage of the tunica vasculosa lentis or of the retina, choroid, and hyaloid artery, respectively. Similar intraocular hemorrhages occurred in LE rats, although the macroscopic alterations found in WH and SpD rats were not present in this strain. Among the 3 strains evaluated, the incidence of the intraocular hemorrhage was highest in WH rats. We here showed that intraocular hemorrhage occurs spontaneously during normal ocular development in rats regardless of the strain; however, the region, degree, and incidence of intraocular hemorrhage differ among strains. Hemorrhage in the tunica vasculosa lentis and hyaloid artery may result from the leakage of erythrocytes from the temporary vasculature of these tissues during regression. The mechanisms underlying hemorrhage in the retina and choroid remain unclear. To our knowledge, this report is the first to describe the spontaneous intraocular hemorrhage that occurs during postnatal ocular development in rats.
Topics: Age Factors; Animals; Animals, Newborn; Choroid Hemorrhage; Eye; Rats; Rats, Long-Evans; Rats, Sprague-Dawley; Rats, Wistar; Retinal Hemorrhage; Rodent Diseases; Severity of Illness Index; Species Specificity
PubMed: 24512959
DOI: No ID Found -
PloS One 2016To identify prognostic factors, including optical coherence tomographic features, of visual outcome in exudative age-related macular degeneration with submacular...
PURPOSE
To identify prognostic factors, including optical coherence tomographic features, of visual outcome in exudative age-related macular degeneration with submacular hemorrhage treated with pneumatic displacement.
METHODS
This retrospective interventional case series included 37 eyes with exudative age-related macular degeneration and submacular hemorrhage, all of which underwent pneumatic displacement. The best-corrected visual acuity (BCVA) was measured at diagnosis and at 3 and 6 months after treatment. In addition to demographic and funduscopic parameters, tomographic features such as reflectance of the submacular hemorrhage were analyzed with regard to BCVA at 6 months.
RESULTS
After pneumatic displacement and a subsequent treatment such as laser or anti-vascular endothelial growth factor therapy, the BCVA at 3 and 6 months improved significantly (P < 0.001, respectively). Higher baseline BCVA (P < 0.001), shorter symptom duration (P = 0.007), and younger age (P = 0.014) were significant positive prognostic factors on regression analysis. Among optical coherence tomography characteristics, reflectance of the submacular hemorrhage, the shortest radius of the submacular hemorrhage centered on the fovea, and defects in the ellipsoid zone, and external limiting membrane affected the BCVA at 6 months (P < 0.05).
CONCLUSION
A favorable visual outcome was demonstrated after initial pneumatic displacement and subsequent treatment for submacular hemorrhage. The submacular hemorrhages exhibiting lower reflectance on optical coherence tomography and a smaller shortest radius from the foveal center were found to be good candidates for pneumatic displacement.
Topics: Aged; Aged, 80 and over; Female; Follow-Up Studies; Humans; Male; Prognosis; Retinal Hemorrhage; Retrospective Studies; Tomography, Optical Coherence
PubMed: 27992524
DOI: 10.1371/journal.pone.0168474 -
JAMA Ophthalmology Oct 2018Radial hemorrhage in the outer plexiform layer of Henle may be a complication of macular telangiectasia type 2 (MacTel 2) and may occur because of microvascular...
IMPORTANCE
Radial hemorrhage in the outer plexiform layer of Henle may be a complication of macular telangiectasia type 2 (MacTel 2) and may occur because of microvascular abnormalities of the deep retinal capillary plexus in the absence of subretinal neovascularization.
OBJECTIVE
To describe the multimodal imaging findings, including cross-sectional and en face optical coherence tomography (OCT), of radial hemorrhage in the outer plexiform layer of Henle, which may be a complication of MacTel 2.
DESIGN, SETTING, AND PARTICIPANTS
This retrospective case series from 2 tertiary referral centers (Stein Eye Institute, Los Angeles, California; New England Eye Center, Boston, Massachusetts) between January 1, 2012, and December 31, 2017, describes 3 patients with MacTel 2 complicated by characteristic radial hemorrhage in the outer plexiform layer of Henle.
MAIN OUTCOMES AND MEASURES
Color fundus photography, cross-sectional and en face OCT, OCT angiography (OCTA), fundus autofluorescence, and fluorescein angiography.
RESULTS
Three male patients presented with sudden vision loss in the right eye. A characteristic radial pattern of hemorrhage was noted with color fundus photography. Cross-sectional and en face OCT and OCTA localized the hemorrhage to the outer plexiform layer of Henle in the absence of subretinal neovascularization. Optical coherence tomography findings consistent with MacTel 2 were identified in the fellow eye in each patient. At the follow-up visit 1 to 2 months after presentation, spontaneous resolution of the hemorrhage was noted in all 3 patients, and OCTA illustrated underlying microvascular abnormalities in the deep retinal capillary plexus in 2 patients.
CONCLUSIONS AND RELEVANCE
This report describes 3 patients with MacTel 2 complicated by characteristic radial hemorrhage in the outer plexiform layer of Henle, which may represent a characteristic finding in MacTel 2 that may develop as a result of microvascular abnormalities of the deep retinal capillary plexus in the absence of subretinal neovascularization.
Topics: Aged; Cross-Sectional Studies; Fluorescein Angiography; Humans; Male; Middle Aged; Multimodal Imaging; Retinal Hemorrhage; Retinal Telangiectasis; Retinal Vessels; Retrospective Studies; Tertiary Care Centers; Tomography, Optical Coherence; Visual Acuity
PubMed: 30054619
DOI: 10.1001/jamaophthalmol.2018.2979 -
BMC Ophthalmology Apr 2023Premacular hemorrhage is among the causes of sudden deterioration of visual acuity. This study aimed to investigate the therapeutic outcomes of a new Q-switched Nd:YAG...
BACKGROUND
Premacular hemorrhage is among the causes of sudden deterioration of visual acuity. This study aimed to investigate the therapeutic outcomes of a new Q-switched Nd:YAG laser on premacular hemorrhage.
METHODS
Retrospective, case series study of 16 eyes from 16 patients diagnosed with premacular hemorrhage, including 3 cases of Valsalva retinopathy, 8 cases of retinal macroaneurysm, 3 cases of diabetic retinopathy, 1 case of trauma-related hemorrhage and 1 case with leukemia. A 1064nm Q-switched Nd:YAG laser was performed to puncture the posterior hyaloid and inner limiting membrane to drain the hemorrhage.
RESULTS
The success rate of 16 patients with premacular hemorrhage drainage was 100% in this study. Improved visual acuity was observed in each patient.
CONCLUSIONS
In this case series of 16 patients, the new Q-switched Nd:YAG laser was successful in draining premacular hemorrhage with no serious complications.
Topics: Humans; Treatment Outcome; Lasers, Solid-State; Retrospective Studies; Laser Therapy; Retinal Hemorrhage; Vitreous Body
PubMed: 37029355
DOI: 10.1186/s12886-023-02876-7 -
Emerging Infectious Diseases Feb 2007
Topics: Dengue; Humans; Retinal Hemorrhage
PubMed: 17479914
DOI: 10.3201/eid1302.061105 -
Indian Journal of Ophthalmology Jun 2017The purpose of this study was to evaluate the treatment efficacy of vitrectomy combined with subretinal recombinant tissue plasminogen activator (r-tPA) and factors...
PURPOSE
The purpose of this study was to evaluate the treatment efficacy of vitrectomy combined with subretinal recombinant tissue plasminogen activator (r-tPA) and factors affecting visual improvement in patients with submacular hemorrhage (SMH) due to neovascular age-related macular degeneration (nAMD).
MATERIALS AND METHODS
Medical records of 17 consecutive patients diagnosed with SMH secondary to nAMD were retrospectively reviewed. The initial surgical procedure involved a 23-gauge transconjunctival vitrectomy, subretinal r-tPA application through a self-sealing inferior retinotomy, and sulfur hexafluoride gas for tamponade in all patients. The duration, size, and thickness of the hemorrhage and the pre- and post-operative visual acuity (VA) using a Snellen chart were recorded. VA was converted to logMAR for statistical analysis.
RESULTS
The average duration and size of the SMH were 12.8 ± 18.2 days and 8.6 ± 5.3 disc areas, respectively. The mean follow-up time was 16.9 ± 4.7 months. A statistically significant visual improvement was found when comparing initial VA with postoperative best-corrected VA (BCVA) and final BCVA (Wilcoxon rank test, P ≤ 0.01). There was no significant correlation between the size of the hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). There was no statistically significant correlation between the initial VA and postoperative BCVA and final BCVA (Spearman's rho test). There was no significant correlation between the duration of hemorrhage and postoperative BCVA and final BCVA (Spearman's rho test). The preoperative thickness of hemorrhage (747.5 ± 30 μm) was not correlated with postoperative BCVA or final BCVA (Pearson's test).
CONCLUSIONS
Vitrectomy combined with subretinal r-tPA injection and gas tamponade is an effective surgical intervention to preserve VA in selected patients with apparent SMH.
Topics: Aged; Aged, 80 and over; Endotamponade; Female; Fibrinolytic Agents; Fluorescein Angiography; Follow-Up Studies; Fundus Oculi; Humans; Injections; Intraoperative Period; Macular Degeneration; Male; Middle Aged; Retina; Retinal Hemorrhage; Retrospective Studies; Time Factors; Tissue Plasminogen Activator; Treatment Outcome; Visual Acuity; Vitrectomy
PubMed: 28643713
DOI: 10.4103/ijo.IJO_129_16 -
American Journal of Ophthalmology Feb 2021To investigate the relationship between intraretinal macular hemorrhage and visual acuity outcomes in eyes with central retinal vein occlusion or hemiretinal vein... (Randomized Controlled Trial)
Randomized Controlled Trial
SCORE2 Report 13: Intraretinal Hemorrhage Changes in Eyes With Central or Hemiretinal Vein Occlusion Managed With Aflibercept, Bevacizumab or Observation. Secondary Analysis of the SCORE and SCORE2 Clinical Trials.
PURPOSE
To investigate the relationship between intraretinal macular hemorrhage and visual acuity outcomes in eyes with central retinal vein occlusion or hemiretinal vein occlusion managed with aflibercept, bevacizumab, or observation.
DESIGN
Retrospective analysis of data from 2 randomized clinical trials.
METHODS
A total of 362 participants were randomized in the Study of Comparative Treatments for Retinal Vein Occlusion 2, and 88 participants randomized to observation in the Standard Care vs Corticosteroid in Retinal Vein Occlusion Study. Participants received monthly intravitreal aflibercept or bevacizumab through month 6 or observation through month 8. The main outcome was visual acuity letter score (VALS).
RESULTS
Reduced area of hemorrhage by month 6 was observed in 70.7% (116 of 164) of aflibercept-treated eyes, 63.8% (104 of 163) of bevacizumab-treated eyes, and 42.2% (27 of 64) of observation eyes by month 8 (P < .01). Relative to eyes with hemorrhage during follow-up, aflibercept-treated eyes without hemorrhage at month 6 had a mean VALS improvement of 8.0 (99% confidence interval [CI]: 1.9, 14.2); bevacizumab-treated eyes without hemorrhage at month 6 had a mean VALS improvement of 3.2 (99% CI: -4.6, 11.0); and observation eyes without hemorrhage at month 8 had a mean VALS improvement of 13.5 (99% CI: 0.4, 26.5). At month 6, the presence of hemorrhage and the change in central subfield thickness (CST) were significantly associated with the change in VALS; however, CST was a more important predictor.
CONCLUSION
Improvement in hemorrhage during follow-up was associated with visual acuity improvements and predicted visual acuity changes beyond what was explained by CST. These findings suggest that intraretinal macular hemorrhage is an important indicator of disease severity in retinal vein occlusion.
Topics: Angiogenesis Inhibitors; Bevacizumab; Female; Humans; Intravitreal Injections; Male; Middle Aged; Receptors, Vascular Endothelial Growth Factor; Recombinant Fusion Proteins; Retina; Retinal Hemorrhage; Retinal Vein Occlusion; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome
PubMed: 32828880
DOI: 10.1016/j.ajo.2020.08.030 -
Transactions of the American... 2014To assess the performance of a refined Web-based tool for documenting retinal hemorrhage characteristics in suspected abusive head trauma.
PURPOSE
To assess the performance of a refined Web-based tool for documenting retinal hemorrhage characteristics in suspected abusive head trauma.
METHODS
Using a comprehensive tabular secure platform, with access to digital images in color, black and white, and 4-zone system schematic overlay, four pediatric ophthalmologists performed pilot testing with 80 images for tool refinement. In a second phase, retinal hemorrhages were documented by number, zone, and type. Interobserver agreement was calculated using the Fleiss kappa coefficient. Intraobserver agreement was calculated using Cohen's kappa statistic. We used surface area mapping software for further analysis.
RESULTS
Interobserver agreement was good (kappa 0.4-0.6) and very good (kappa 0.6-0.8) for all questions in Zone A (peripapillary). For zones C (midperiphery) and D (peripheral retina), agreement was very good for all questions except number of hemorrhages, for which agreement was good. Zone B (macula) showed good and fair agreement except for superficial hemorrhage, for which agreement was poor. There was very good intraobserver agreement for number (kappa 0.68, 0.65, 0.67) and type of hemorrhages in zones A, B, and C. Surface area mapping results revealed no significant differences between zones A and B. Zones C and D had significantly less hemorrhage than A and B.
CONCLUSIONS
Our tool performed with good or very good interobserver and intraobserver agreement in almost all domains. We attribute zone B underperformance to the significant increased area covered by hemorrhages compared to zones C and D and the lack of contrast with normal anatomical structures in zone A.
Topics: Analysis of Variance; Child; Child Abuse; Child, Preschool; Craniocerebral Trauma; Humans; Internet; Observer Variation; Photography; Pilot Projects; Retinal Hemorrhage
PubMed: 25075150
DOI: No ID Found -
Clinical & Experimental Optometry Jan 2002The Valsalva manoeuvre comprises forcible exhalation against the closed glottis, thereby creating a sudden increase in the intrathoracic or intra-abdominal pressure. A...
The Valsalva manoeuvre comprises forcible exhalation against the closed glottis, thereby creating a sudden increase in the intrathoracic or intra-abdominal pressure. A simultaneous rapid rise in intraocular venous pressure may result in the spontaneous rupture of perifoveal capillaries, leading to a characteristic clinical picture of a preretinal haemorrhage in an otherwise healthy eye. The haemorrhage typically occurs at the macula and in the vast majority of cases resolves without compromising visual acuity. Valsalva maculopathy is an isolated and self-limited event. A case of Valsalva maculopathy in a young healthy male attributable to an incontrovertible Valsalva stress associated with weightlifting is presented.
Topics: Adult; Humans; Male; Retinal Hemorrhage; Scotoma; Valsalva Maneuver; Weight Lifting
PubMed: 11952395
DOI: 10.1111/j.1444-0938.2002.tb03071.x -
Investigative Ophthalmology & Visual... Mar 2020In this experimental study, we quantify retinal microvasculature morphological features with depth, region, and age in immature and mature ovine eyes. These data...
PURPOSE
In this experimental study, we quantify retinal microvasculature morphological features with depth, region, and age in immature and mature ovine eyes. These data identify morphological vulnerabilities in young eyes to inform the mechanics of retinal hemorrhage in children.
METHODS
Retinal specimens from the equator and posterior pole of preterm (n = 4) and adult (n = 9) sheep were imaged using confocal microscopy. Vessel segment length, diameter, angular asymmetry, tortuosity, and branch points were quantified using a custom image segmentation code. Significant differences were identified through two-way ANOVAs and correlation analyses.
RESULTS
Vessel segment lengths were significantly shorter in immature eyes compared to adults (P < 0.003) and were significantly shorter at increasing depths in the immature retina (P < 0.04). Tortuosity significantly increased with depth, regardless of age (P < 0.05). These data suggest a potential vulnerability of vasculature in the deeper retinal layers, particularly in immature eyes. Preterm retina had significantly more branch points than adult retina in both the posterior pole and equator, and the number increased significantly with depth (P < 0.001).
CONCLUSIONS
The increased branch points and decreased segment lengths in immature microvasculature suggest that infants will experience greater stress and strain during traumatic loading compared to adults. The increased morphological vulnerability of the immature microvasculature in the deeper layers of the retina suggest that intraretinal hemorrhages have a greater likelihood of occurring from trauma compared to preretinal hemorrhages. The morphological features captured in this study lay the foundation to explore the mechanics of retinal hemorrhage in infants and identify vulnerabilities that explain patterns of retinal hemorrhage in infants.
Topics: Aging; Animals; Animals, Newborn; Arteries; Biomechanical Phenomena; Female; Humans; Joint Instability; Microscopy, Confocal; Microvessels; Observer Variation; Retinal Hemorrhage; Retinal Vessels; Sheep; Skin Diseases, Genetic; Vascular Malformations
PubMed: 32176264
DOI: 10.1167/iovs.61.3.16