Objective: To evaluate the additional value of funduscopy in the routine management of patients with hypertension. Design: Systematic review. Participants: Adults aged 19 or more with hypertensive retinopathy. Data so...Objective: To evaluate the additional value of funduscopy in the routine management of patients with hypertension. Design: Systematic review. Participants: Adults aged 19 or more with hypertensive retinopathy. Data sources: Medline, Embase, and the Cochrane Library from 1990. Review methods: Studies were included that assessed hypertensive retinopathy with blinding for blood pressure and cardiovascular risk factors. Studies on observer agreement had to be assessed by two or more observers and expressed as a κstatistic. Studies on the association between hypertensive retinopathy and hypertensive organ damage were carried out in patients with hypertension. The association between hypertensive retinopathy and cardiovascular risk was carried out in unselected normotensive and hypertensive people without diabetes mellitus. Results: The assessment of microvascular changes in the retina is limited by large variation between observers. The positive and negative predictive values for the association between hypertensive retinopathy and blood pressure were low(47%to 72%and 32%to 67%, respectively). Associations between retinal microvascular changes and cardiovascular risk were inconsistent, except for retinopathy and stroke. The increased risk of stroke, however, was also present in normotensive people with retinopathy. These studies did not adjust for other indicators of hypertensive organ damage. Conclusion: Evidence is lacking that routine funduscopy is of additional value in the management of hypertensive patients.展开更多
Case report of a 44-year old man who presented to the Long Island College Hospital in Brooklyn with complaints of a central scotoma and blurred vision in the right eye, which occurred while he was having a routine col...Case report of a 44-year old man who presented to the Long Island College Hospital in Brooklyn with complaints of a central scotoma and blurred vision in the right eye, which occurred while he was having a routine colonoscopy. The patient reported experiencing pain during the procedure. The funduscopic examination revealed a dumb bell shaped hemorrhage in the fovea of the right eye. A diagnosis of Valsalva retinopathy was made based on history and funduscopic examination. The hemorrhage resolved within a month without any sequelae. To our knowledge, this is the first report of the occurrence of Valsalva retinopathy following a routine colonoscopy.展开更多
Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF)-in patients with multiple soft drusen in corr...Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF)-in patients with multiple soft drusen in correlation to visual fu nction. Methods: Inclusion criteria were age > 50 years, the presence of soft dr usen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination includ ing ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Auto- fluorescence Classification Group (IFAG) for the description of the AF patterns. Results: One hundred and twenty-five patients (81 women, 44 men) aged from 55 to 86 years (mean 70±7 years) were included in this prospective study. During f ollow-up (mean 18±6 months), 6 of 35 eyes with patchy AF pattern developed exu dative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque-like pattern at baseline. A to tal of 11 eyes presented with severe visual loss (6 ETDRS lines). Ten (91%) o f these had patchy AF pattern. Conclusion: Imaging of fundus AF in patients with age-related maculopathy allows identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relativ ely high risk of progression to age-related macular degenerationwith visual los s.展开更多
Purpose: To report the presence and disappearance of subretinal fibrinous exud ate in pregnancy-induced central serous chorioretinopathy studied with optical coherence tomography (OCT). Methods: Case report. A 32-year...Purpose: To report the presence and disappearance of subretinal fibrinous exud ate in pregnancy-induced central serous chorioretinopathy studied with optical coherence tomography (OCT). Methods: Case report. A 32-year-old woman was refe rred for ophthalmoscopic evaluation in her 32nd week of pregnancy, complaining o f reduced vision in her right eye. Results: The funduscopic examination revealed a serous detachment of the macula with subretinal exudative deposits in the rig ht eye and a peripapillary serous detachment in the left eye. OCT sections throu gh the right macula demonstrated serous elevation of the retina and the presence of highly reflective material in the subretinal space. Two weeks after delivery , OCT showed resolution of subretinal fluid and the disappearance of submacular exudate in the right eye. Conclusion: During pregnancy and immediately after del ivery, OCT may provide information reflecting the relationship between the retin a, subretinal space, and retinal pigment epithelium without any known adverse ef fects to the infant. In a patient with pregnancy-associated central serous chor ioretinopathy, a highly reflective material, presumably fibrin, was detected spa nning the subretinal space that was subsequently shown to disappear. This inform ation may help us better understand the pathological retinal changes that may oc cur during pregnancy.展开更多
文摘Objective: To evaluate the additional value of funduscopy in the routine management of patients with hypertension. Design: Systematic review. Participants: Adults aged 19 or more with hypertensive retinopathy. Data sources: Medline, Embase, and the Cochrane Library from 1990. Review methods: Studies were included that assessed hypertensive retinopathy with blinding for blood pressure and cardiovascular risk factors. Studies on observer agreement had to be assessed by two or more observers and expressed as a κstatistic. Studies on the association between hypertensive retinopathy and hypertensive organ damage were carried out in patients with hypertension. The association between hypertensive retinopathy and cardiovascular risk was carried out in unselected normotensive and hypertensive people without diabetes mellitus. Results: The assessment of microvascular changes in the retina is limited by large variation between observers. The positive and negative predictive values for the association between hypertensive retinopathy and blood pressure were low(47%to 72%and 32%to 67%, respectively). Associations between retinal microvascular changes and cardiovascular risk were inconsistent, except for retinopathy and stroke. The increased risk of stroke, however, was also present in normotensive people with retinopathy. These studies did not adjust for other indicators of hypertensive organ damage. Conclusion: Evidence is lacking that routine funduscopy is of additional value in the management of hypertensive patients.
文摘Case report of a 44-year old man who presented to the Long Island College Hospital in Brooklyn with complaints of a central scotoma and blurred vision in the right eye, which occurred while he was having a routine colonoscopy. The patient reported experiencing pain during the procedure. The funduscopic examination revealed a dumb bell shaped hemorrhage in the fovea of the right eye. A diagnosis of Valsalva retinopathy was made based on history and funduscopic examination. The hemorrhage resolved within a month without any sequelae. To our knowledge, this is the first report of the occurrence of Valsalva retinopathy following a routine colonoscopy.
文摘Background: As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluo rescence (AF)-in patients with multiple soft drusen in correlation to visual fu nction. Methods: Inclusion criteria were age > 50 years, the presence of soft dr usen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination includ ing ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Auto- fluorescence Classification Group (IFAG) for the description of the AF patterns. Results: One hundred and twenty-five patients (81 women, 44 men) aged from 55 to 86 years (mean 70±7 years) were included in this prospective study. During f ollow-up (mean 18±6 months), 6 of 35 eyes with patchy AF pattern developed exu dative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque-like pattern at baseline. A to tal of 11 eyes presented with severe visual loss (6 ETDRS lines). Ten (91%) o f these had patchy AF pattern. Conclusion: Imaging of fundus AF in patients with age-related maculopathy allows identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relativ ely high risk of progression to age-related macular degenerationwith visual los s.
文摘Purpose: To report the presence and disappearance of subretinal fibrinous exud ate in pregnancy-induced central serous chorioretinopathy studied with optical coherence tomography (OCT). Methods: Case report. A 32-year-old woman was refe rred for ophthalmoscopic evaluation in her 32nd week of pregnancy, complaining o f reduced vision in her right eye. Results: The funduscopic examination revealed a serous detachment of the macula with subretinal exudative deposits in the rig ht eye and a peripapillary serous detachment in the left eye. OCT sections throu gh the right macula demonstrated serous elevation of the retina and the presence of highly reflective material in the subretinal space. Two weeks after delivery , OCT showed resolution of subretinal fluid and the disappearance of submacular exudate in the right eye. Conclusion: During pregnancy and immediately after del ivery, OCT may provide information reflecting the relationship between the retin a, subretinal space, and retinal pigment epithelium without any known adverse ef fects to the infant. In a patient with pregnancy-associated central serous chor ioretinopathy, a highly reflective material, presumably fibrin, was detected spa nning the subretinal space that was subsequently shown to disappear. This inform ation may help us better understand the pathological retinal changes that may oc cur during pregnancy.
