scholarly journals A Case of Idiopathic Dense Vitreous Hemorrhage: Suspected Rupture of a Large Retinal Arterial Macroaneurysm on the Optic Disc

2021 ◽  
pp. 634-639
Author(s):  
Shizuka Takahashi ◽  
Kentaro Nishida ◽  
Hirokazu Sakaguchi ◽  
Kohji Nishida
Keyword(s):  
Macular Hole ◽  
Optic Disc ◽  
Vitreous Hemorrhage ◽  
Unknown Origin ◽  
Internal Limiting Membrane ◽  
Sudden Onset ◽  
Acute Onset ◽  
Blurred Vision ◽  
Disc Diameter ◽  
Retinal Arterial Macroaneurysm

We report a novel case of vitreous hemorrhage associated with suspected rupture of 2-disc-diameter retinal arterial macroaneurysm on the optic disc. A 90-year-old woman presented with blurred vision (sudden onset) in her left eye. Examination of the fundus revealed acute onset vitreous hemorrhage of unknown origin without retinal detachment. She underwent vitrectomy, but after excision of the dense vitreous hemorrhage, a 2-disc-diameter hematoma appeared on the optic disc and was removed promptly. Because the bleeding at the base of the hematoma was of arterial origin and pulsating, the first vitrectomy could not achieve hemostasis. Five days after the first surgery, we performed a second vitrectomy. This revealed a subretinal hemorrhage along the superior and inferior arcade vessels and a macular hole, which was almost completely closed with an inverted internal limiting membrane flap. Unfortunately, the macular hole reopened 41 days after the second surgery. In patients presenting with only a large hematoma on the optic disc, it might be prudent to leave the hematoma. However, this large retinal arterial macroaneurysm was on a rare location on the optic disc, making it doubly difficult for the surgeons to diagnose and choose the best option intraoperatively. The differential diagnosis for dense vitreous hemorrhage of unknown origin should include a large retinal arterial macroaneurysm on the optic disc.

Internal retinal layer thickness and macular migration after internal limiting membrane peeling in macular hole surgery

2017 ◽  
Vol 28 (3) ◽  
pp. 311-316 ◽  
Author(s):  
Mun Y. Faria ◽  
Nuno P. Ferreira ◽  
Sofia Mano ◽  
Diana M. Cristóvao ◽  
David C. Sousa ◽  
...  
Keyword(s):  
Macular Hole ◽  
Layer Thickness ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Retinal Layer ◽  
Ilm Peeling ◽  
Macular Hole Surgery ◽  
Internal Limiting Membrane Peeling ◽  
Retinal Layers ◽  
Sd Oct

Purpose: To provide a spectral-domain optical coherence tomography (SD-OCT)-based analysis of retinal layers thickness and nasal displacement of closed macular hole after internal limiting membrane peeling in macular hole surgery. Methods: In this nonrandomized prospective interventional study, 36 eyes of 32 patients were subjected to pars plana vitrectomy and 3.5 mm diameter internal limiting membrane (ILM) peeling for idiopathic macular hole (IMH). Nasal and temporal internal retinal layer thickness were assessed with SD-OCT. Each scan included optic disc border so that distance between optic disc border and fovea were measured. Results: Thirty-six eyes had a successful surgery with macular hole closure. Total nasal retinal thickening (p<0.001) and total temporal retinal thinning (p<0.0001) were observed. Outer retinal layers increased thickness after surgery (nasal p<0.05 and temporal p<0.01). Middle part of inner retinal layers (mIRL) had nasal thickening (p<0.001) and temporal thinning (p<0.05). The mIRL was obtained by deducting ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness from overall thickness of the inner retinal layer. Papillofoveal distance was shorter after ILM peeling in macular hole surgery (3,651 ± 323 μm preoperatively and 3,361 ± 279 μm at 6 months; p<0.0001). Conclusions: Internal limiting membrane peel is associated with important alteration in inner retinal layer architecture, with thickening of mIRL and shortening of papillofoveal distance. These factors may contribute to recovery of disrupted foveal photoreceptor and vision improvement after IMH closure.

Retinal Displacement Toward Optic Disc After Internal Limiting Membrane Peeling for Idiopathic Macular Hole

2014 ◽  
Vol 157 (5) ◽  
pp. 971-977 ◽  
Author(s):  
Masahiro Ishida ◽  
Yoshikazu Ichikawa ◽  
Rieko Higashida ◽  
Yorihisa Tsutsumi ◽  
Atsushi Ishikawa ◽  
...  
Keyword(s):  
Macular Hole ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Idiopathic Macular Hole ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling

scholarly journals Unusual eye injury related to abusive head trauma

Rechtsmedizin ◽  
2021 ◽  
Author(s):  
Cordula Eddahabi ◽  
Yassin Djalali-Talab ◽  
Sibylle Banaschak ◽  
Katharina Feld
Keyword(s):  
Optic Disc ◽  
Head Trauma ◽  
Vitreous Hemorrhage ◽  
Abusive Head Trauma ◽  
Internal Limiting Membrane ◽  
Posterior Pole ◽  
Ophthalmological Examination ◽  
Eye Injuries ◽  
Two Phase ◽  
The Right

AbstractOphthalmological examination is an essential component in clinically diagnosing abusive head trauma (AHT). Typical of AHT injuries is retinal bleeding, with other parts of the eye sometimes also being affected. Visual impairment and blindness are long-term complications in this context. We present a case with unusual eye injuries after a diagnostically confirmed AHT.The ophthalmological findings on admission day showed a massive subhyaloid hemorrhage at the posterior pole and extensive flame-shaped intraretinal hemorrhages accented on the right side., A centrally localized vitreous hemorrhage appeared on both sides 3 weeks later, obscuring the optic disc and macula most probably due to a breakthrough of a sub-internal limiting membrane (ILM) hemorrhage into the vitreous cavity. Follow-up 4 weeks later revealed a dense and organized vitreous hemorrhage occupying the optic disc and macula so that a pars plana vitrectomy was performed on both eyes.The bilateral bleeding in different retinal layers, the vitreous hemorrhage and the proliferative vitreoretinal reaction (PVR) indicated massive damage caused by a significant acceleration-deceleration trauma. A two-phase vitreous hemorrhage in a child with AHT does not yet appear to have been described in the literature.

scholarly journals Sub internal limiting membrane hemorrhage followed by bilateral optic disc hemorrhage in Kikuchi-Fujimoto disease: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tomohito Sato ◽  
Koji Kanda ◽  
Yusuke Kawamura ◽  
Masaru Takeuchi
Keyword(s):  
Optic Disc ◽  
Cervical Lymphadenopathy ◽  
Unknown Origin ◽  
Internal Limiting Membrane ◽  
Lymph Node Biopsy ◽  
Disc Hemorrhage ◽  
Old Japanese ◽  
Cervical Lymph Node Biopsy ◽  
Neodymium:Yttrium Aluminum Garnet Laser ◽  
Sudden Decrease

Abstract Background Kikuchi-Fujimoto disease (KFD) is a necrotizing lymphadenitis, and presents fever of unknown origin and cervical lymphadenopathy. Ocular complications are unusual in KFD. Here we report a case of sub internal limiting membrane (ILM) hemorrhage followed by bilateral optic disc hemorrhage in KFD. Case presentation A 16-year-old Japanese man perceived a sudden decrease of right vision 3 days after onset of fever with unknown origin and left cervical lymphadenopathy. At presentation, visual acuity (VA) of right eye was 0.05 in decimal chart (1.30: converted to logarithm of minimum angle of resolution: logMAR). Fundus photograph showed extensive sub-ILM hemorrhage in right eye, and optic disc hemorrhages in both eyes. Fluorescein angiography presented hypo- and hyperfluorescences in optic disc of right eye, and hyperfluorescence in the disc of left eye. To make a definitive diagnosis, cervical lymph node biopsy was performed, and KFD was diagnosed pathologically. Thereafter, fever, headache and the cervical lymphadenopathy disappeared spontaneously. The sub-ILM hemorrhage was drained into the vitreous cavity by neodymium:yttrium-aluminum-garnet laser (Nd: YAG) hyaloidotomy. VA recovered to 1.5 (− 0.18: logMAR VA) in right eye. Conclusion Sub-ILM hemorrhage and optic disc hemorrhage are a KFD-related ocular complication.

scholarly journals Choroidal and retinal displacements after vitrectomy with internal limiting membrane peeling in eyes with idiopathic macular hole

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kensuke Goto ◽  
Takeshi Iwase ◽  
Tomohiko Akahori ◽  
Kentaro Yamamoto ◽  
Eimei Ra ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Hole ◽  
Optic Disc ◽  
Internal Limiting Membrane ◽  
Oct Angiography ◽  
Optical Coherence ◽  
Idiopathic Macular Hole ◽  
Ilm Peeling ◽  
Internal Limiting Membrane Peeling ◽  
En Face

AbstractIt has been reported that the macular region of the retina is displaced after vitrectomy with internal limiting membrane (ILM) peeling in eyes with macular hole (MH), but the displacements of the deeper layers of the eye, e.g. RPE and choroid are unclear following the surgery. We used optical coherence tomography (OCT) and OCT angiography (OCTA) to obtain 3 mm × 3 mm en face images before, and 2, 4, and 8 weeks following the vitrectomy with internal limiting membrane (ILM) peeling from 22 eyes of 22 patients with a MH. The OCT and OCTA images showed displacements of the fovea and choroidal intermediate vessels postoperatively. The degree of displacement of the choroid was significantly less than that of the retina (P < 0.001). The displacements of the choroidal bifurcations were significantly correlated to their preoperative distance from the optic disc (r = −0.467, P < 0.001) and they were significantly correlated with the retinal displacements (r = 0.535, P < 0.001). The retina was displaced inferiorly and centripetally, but these localized displacements were not observed in the choroid. In conclusion, clinicians need to be aware of these displacements when evaluating the subfoveal choroid following the surgery because the displacement is different between the retina and the choroid.

scholarly journals Terson syndrome with macular hole: A case report

2019 ◽  
Author(s):  
Hui Qi ◽  
tao hong Yan ◽  
Yan Cheng ◽  
Ling Zuo
Keyword(s):  
Macular Hole ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Vitreous Hemorrhage ◽  
Blurred Vision ◽  
Case Presentation ◽  
Terson Syndrome ◽  
Inner Limiting Membrane ◽  
Temporal Side ◽  
The Right

Abstract Background Terson’s syndrome with macular hole (MH) is rarely seen, and the mechanism of which is not clear. Here we report a case of Terson Syndrome with the inner limiting membrane (ILM) peeled off spontaneously associated with a rare finding: MH. Case presentation This report presents the case of a 36-year-old female patient with aneurysmal subarachnoid hemorrhage (SAH) and Terson syndrome in the right eye was admitted to our hospital with blurred vision in August 2018. Pas plana vitrectomy (PPV) was performed in the right eye, a hyaloid detachment and dyeing of the ILM with indocyanine green (ICG) was assisted. After removal of the vitreous hemorrhage (VH), a full-thickness MH was noted and we also noticed a particular aspect: the ILM was already peeled spontaneously. So we conducted gas tamponade, and face-down positioning after PPV. At two weeks follow-up, spectral domain optical coherence tomography (SD-OCT) confirmed that the MH had closed, while the thickness of nasal retina was 0.137 nm thicker than that in the temporal side. Her best corrected visual acuity (BCVA) was 0.15 in the right eye and 1.0 in the left eye. Conclusions MH is a rarely seen complication of Terson Syndrome. We conferred that the pathogenic mechanisms of this unusual MH may include stretching forces at the ILM-macular interface.

scholarly journals A surgical cause of pseudopapilledema

2019 ◽  
Vol 1 (3) ◽  
pp. 222-229
Author(s):  
Chua Shee Wen ◽  
Teo Shee Kiang ◽  
Malisa Ami ◽  
Mushawiahti Mustapha ◽  
Tang Seng Fai
Keyword(s):  
Macular Hole ◽  
Optic Disc ◽  
Anterior Segment ◽  
Lamellar Macular Hole ◽  
Blurred Vision ◽  
Insidious Onset ◽  
Vitreoretinal Traction ◽  
Optic Disc Swelling ◽  
Eye Examination ◽  
Retinal Pathologies

We report a case of vitreopapillary traction mimicking optic disc swelling in a 73-year-old female with pseudophakia in the left eye and satisfactory postoperative vision of 6/6 and N5 two years prior. She presented with insidious onset of blurred vision in her left eye for two months. She was referred to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for further investigations of apparent optic disc swelling in the left eye by a general ophthalmologist. Her left eye vision was 6/18, pinhole 6/12, with near vision at N6. There was no relative afferent pupillary defect and anterior segment examination was normal. Examination of the posterior segment revealed a pink optic disc with blurred and elevated margins without hyperaemia. Vessels of the optic nerve head appeared normal and a lamellar macular hole was present with dull foveal reflex clinically. Right eye examination was normal. Optical coherence tomography (OCT) of the left eye using the raster line scan showed vitreopapillary traction surrounding the optic disc and vitreomacular traction (VMT) with lamellar macular hole. The patient was counselled for surgical release of VMT, however, she opted for conservative management. Peripapillary vitreoretinal traction is a rare cause of pseudo-optic disc swelling. Thorough fundus examination with the help of OCT is crucial in making a prompt diagnosis, preventing unnecessary investigations, and evaluating other retinal pathologies which may benefit from treatment.  

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