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The Pan African Medical Journal 2017
PubMed: 29881517
DOI: 10.11604/pamj.2017.28.279.13717 -
International Journal of Ophthalmology 2022Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that... (Review)
Review
Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that is most frequently caused by severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion, and ocular ischemic syndrome. Uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and likely predominant agent involved in the pathogenesis of intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis and neovascular glaucoma is divided into four stages: prerubeosis, preglaucoma, open angle glaucoma, and angle-closure glaucoma.
PubMed: 35814894
DOI: 10.18240/ijo.2022.06.20 -
Indian Journal of Ophthalmology Dec 2018Twenty-five percent of diabetes-related vision loss stems from complications of proliferative diabetic retinopathy (PDR). Panretinal photocoagulation has been the... (Review)
Review
Twenty-five percent of diabetes-related vision loss stems from complications of proliferative diabetic retinopathy (PDR). Panretinal photocoagulation has been the preferred treatment of high-risk PDR for decades and more recently intravitreal injections of drugs that inhibit the actions of vascular endothelial growth factor have become popular. But despite these treatments PDR may progress uncontrollably to advanced pathologies such as traction retinal detachments (TRDs), combined traction/rhegmatogenous retinal detachments (TRD/RRDs), vitreous hemorrhages, rubeosis iridis, and traction maculopathies, which produce mild-to-severe loss of vision. TDR have long been the most common indication for PDR-related vitreoretinal surgery. Vitrectomy surgery is indicated for recent (<6 months duration) TRD involving the macula, progressive TRD that threatens the macula, and recent data suggest that chronic macula-involving TRDs (>6 months duration) may also benefit. Combined TRD/RRD represents a particularly challenging surgical condition but advances in surgical instrumentation, dissection techniques, and post-operative tamponade have produced excellent success rates. The recent development of small-gauge vitrectomy systems has persuaded most surgeons to switch platforms since these appear to produce shorter surgical times and quicker post-operative recoveries. Pre-operative injections of bevacizumab are frequently administered for persistent neovascularization to facilitate surgical dissection of pre-retinal fibrosis and reduce the incidence of post-operative hemorrhages. Recent trends toward earlier surgical intervention and expanded indications are likely to continue as surgical instrumentation and techniques are further developed.
Topics: Angiogenesis Inhibitors; Diabetic Retinopathy; Disease Management; Fluorescein Angiography; Fundus Oculi; Humans; Intravitreal Injections; Retinal Detachment; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A; Visual Acuity; Vitrectomy
PubMed: 30451175
DOI: 10.4103/ijo.IJO_1217_18 -
PloS One 2016To estimate the etiology and features of the eyes with rubeosis iridis among Korean patients.
PURPOSE
To estimate the etiology and features of the eyes with rubeosis iridis among Korean patients.
MATERIALS AND METHODS
This study is a retrospective review of 533 Korean patients with rubeosis iridis who visited an eye hospital in Seoul, Korea. We defined rubeosis iridis as visible blood vessels on the iris surface detected during a slit-lamp examination. All cases were reviewed for age at the time of diagnosis, medical history, the most likely cause of rubeosis iridis, visual acuity, and intraocular pressure.
RESULTS
The most commonly observed cause of rubeosis iridis was diabetic retinopathy (DR; n = 337, 63.2%), followed by retinal vein occlusion (RVO; n = 101, 18.9%), ocular ischemic syndrome (OIS; n = 24, 4.5%), retinal detachment (n = 17, 3.2%), and uveitis (n = 15, 2.8%). The cause was classified as miscellaneous in 18 cases (3.4%); in 21 eyes (3.9%), the cause was not clear. Age at the time of rubeosis iridis diagnosis was lower in patients with DR (56.5 years) than in those with RVO (61.0 years) and OIS (64.8 years; P < 0.01). Intraocular pressure of the eyes with DR (37.3 mmHg) and RVO (39.5 mmHg) was higher than that of the eyes with OIS (25.8 mmHg; P < 0.01).
CONCLUSION
In our population-based single center study, DR was the leading cause of rubeosis iridis followed by RVO and OIS among Korean patients. The clinical characteristics of the eyes with rubeosis iridis differed according to etiology. This finding may be useful when assessing eyes with rubeosis iridis.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Child; Diabetic Retinopathy; Female; Humans; Intraocular Pressure; Iris Diseases; Male; Middle Aged; Republic of Korea; Retinal Detachment; Retinal Vein Occlusion; Retrospective Studies; Sex Factors; Young Adult
PubMed: 27490797
DOI: 10.1371/journal.pone.0160662 -
Current Oncology (Toronto, Ont.) Jul 2023Uveal melanoma represents the most prevalent form of primary malignant intraocular tumor in adults. Historically, enucleation was considered the gold-standard approach... (Review)
Review
Uveal melanoma represents the most prevalent form of primary malignant intraocular tumor in adults. Historically, enucleation was considered the gold-standard approach in the treatment of uveal melanoma. Currently, radiotherapy is the most commonly used therapy, aiming at a better quality of life. However, radiotherapy can result in several ocular complications, some of which may be vision-threatening. Radiation-induced dry eye, scleral necrosis, cataract, rubeosis iridis, neovascular glaucoma, radiation retinopathy, maculopathy, and optic neuropathy are the most common complications. This article aims to summarize the current literature regarding the ocular complications after radiotherapy, as well as their clinical features, risk factors, and management strategies. A thorough understanding of these issues is crucial for ophthalmologists and oncologists to provide optimal patient care, improve visual outcomes, and minimize long-term complications.
Topics: Adult; Humans; Quality of Life; Uveal Neoplasms; Melanoma; Risk Factors
PubMed: 37504330
DOI: 10.3390/curroncol30070470 -
Cells Aug 2019Dysregulation of vascular networks is characteristic of eye diseases associated with retinal cell degeneration and visual loss. Visual impairment is also the consequence... (Review)
Review
Dysregulation of vascular networks is characteristic of eye diseases associated with retinal cell degeneration and visual loss. Visual impairment is also the consequence of photoreceptor degeneration in inherited eye diseases with a major inflammatory component, but without angiogenic profile. Among the pathways with high impact on vascular/degenerative diseases of the eye, a central role is played by a system formed by the ligand urokinase-type plasminogen activator (uPA) and its receptor uPAR. The uPAR system, although extensively investigated in tumors, still remains a key issue in vascular diseases of the eye and even less studied in inherited retinal pathologies such as retinitis pigmantosa (RP). Its spectrum of action has been extended far beyond a classical pro-angiogenic function and has emerged as a central actor in inflammation. Preclinical studies in more prevalent eye diseases characterized by neovascular formation, as in retinopathy of prematurity, wet macular degeneration and rubeosis iridis or vasopermeability excess as in diabetic retinopathy, suggest a critical role of increased uPAR signaling indicating the potentiality of its modulation to counteract neovessel formation and microvascular dysfunction. The additional observation that the uPAR system plays a major role in RP by limiting the inflammatory cascade triggered by rod degeneration rises further questions about its role in the diseased eye.
Topics: Animals; Disease Models, Animal; Humans; Inflammation; Mice; Mice, Inbred BALB C; Neovascularization, Pathologic; Rats; Rats, Sprague-Dawley; Receptors, Urokinase Plasminogen Activator; Retinal Diseases; Urokinase-Type Plasminogen Activator
PubMed: 31426601
DOI: 10.3390/cells8080925 -
Case Reports in Ophthalmology 2021A 72-year-old Japanese woman presented to our hospital with decreased vision. At the initial visit, her best-corrected visual acuity (BCVA) and intraocular pressure...
A 72-year-old Japanese woman presented to our hospital with decreased vision. At the initial visit, her best-corrected visual acuity (BCVA) and intraocular pressure (IOP) in her right eye (OD) were 0.02 and 36 mm Hg, respectively. By slit lamp examination, rubeosis iridis was observed on the iris surface. With higher magnification observation, movement of clustered RBCs were clearly observed; the blood drained into episcleral vessels that were connected with the main trunk of rubeosis iridis. She was diagnosed with the neovascular glaucoma secondary to central retinal vein occlusion OD. She underwent panretinal photocoagulation, intravitreal injection of aflibercept, and Ahmed Glaucoma Valve implantation. At 2 weeks postoperatively, the BCVA and IOP OD were 0.2 and 7 mm Hg, respectively; rubeosis iridis was partially regressed and movement of RBCs was not observed. Acquisition of directional flow by the connection of the main trunk of neovessels with the episcleral vessels and reduction of flow speed by the high IOP could explain the reason for visible blood flow in our case.
PubMed: 35111032
DOI: 10.1159/000513795 -
Transactions of the American... 1978The high incidence of rubeosis iridis accompanying retinoblastoma has been reaffired. Factor common to ocular tumors in general and retinoblastoma, as well as reactions... (Comparative Study)
Comparative Study
The high incidence of rubeosis iridis accompanying retinoblastoma has been reaffired. Factor common to ocular tumors in general and retinoblastoma, as well as reactions to retioblastoma that have some contributory effect upon vascularization of the iris have been studied and complied. No single causative factor emerged, although tumor necrosis obviously played an important role. To a lesser extent, the site, location, and intraocular extension bore some relationship to neovascularization. That iris neovascularization carries a more grave prognosis, until now only a clinical impression, was definitely confirmed. Clinicians, therefore, studying patients with retinoblastoma would be well advised to pay more attention to the iris and anterior segment since recognition of changes leads to more timely and knowledgeable management. It was hoped that increased recognition of rubeosis would differentiate between eyes with retinoblastoma and those with pseudoglioma; however, an equally high incidence of neovascularization accompanied certain pseudogliomas. In both studies, as is often the case, numerous interesting observations were made; several with clinical implications. Finally, a frequently associated glaucoma, suggested by the anterior segment histologic features, went urecognized and unrecorded in these patients.
Topics: Diagnosis, Differential; Eye Neoplasms; Glaucoma; Humans; Iris; Retina; Retinal Diseases; Retinoblastoma; Uveal Diseases
PubMed: 754383
DOI: No ID Found -
Survey of Ophthalmology 1992Vitrectomy techniques including endolaser photocoagulation allow visual rehabilitation in many eyes that are otherwise untreatable. Discerning the indications and timing... (Review)
Review
Vitrectomy techniques including endolaser photocoagulation allow visual rehabilitation in many eyes that are otherwise untreatable. Discerning the indications and timing for diabetic vitrectomy is increasingly important as the treatment of complications of diabetic retinopathy continues to undergo modification and redefinition. The most common indications for diabetic vitrectomy include: 1) severe nonclearing vitreous hemorrhage; 2) traction retinal detachment recently involving the macula; 3) combined traction and rhegmatogenous detachment; 4) progressive fibrovascular proliferation; and 5) rubeosis iridis and vitreous hemorrhage for eyes in which the media opacity has prevented adequate laser photocoagulation. Other less common indications in selected cases include dense premacular hemorrhage, ghost cell glaucoma, macular edema with premacular traction, cataract preventing treatment of severe, proliferative diabetic retinopathy, anterior hyaloidal fibrovascular proliferation, and fibrinoid syndrome with retinal detachment. The rationale and surgical objectives are discussed and results are summarized.
Topics: Diabetic Retinopathy; Eye Diseases; Fundus Oculi; Humans; Laser Coagulation; Retinal Detachment; Vitrectomy
PubMed: 1475753
DOI: 10.1016/0039-6257(92)90137-i