CyberKnife Stereotactic Radiotherapy in Secondary Vasoproliferative Tumor of the Retina

A 16-year-old boy with X-linked retinoschisis was examined for the visual decline on his left eye. Upon examination, a vasopermeable elevated mass lesion was determined at the lower temporal retinal periphery associated with surrounding arc-like hard exudates which is consistent with a vasoactive proliferative tumor of the retina. After discussing the therapeutic options with the patient and his parents, 3 successive dexamethasone implants 6 months apart were administered. As no satisfactory regression was noticed, CyberKnife stereotactic radiosurgery (SRS) was performed. Regression of the exudative tumor was obtained in follow-up examinations at 12 and 24 months after the SRS session and the thickness of the lesion was markedly reduced.

Retinal Periphery Is Insensitive to Sudden Transient Motion

Peripherally viewed targets moved around against a background of random dynamic noise. Slow movements were visible, fast movements were not. Thus, a target that repetitively drifted to the right and snapped back appeared to drift endlessly to the right with no visible snapbacks.

Modern optical methods of peripheral defocus correction

Experimental animal studies proved that by manipulating with the defocus one can slow down or speed up the eye growth. The leading mechanism among modern optical strategies of myopia progression treatment is to induce myopic defocus to retinal periphery or decrease the hyperopic defocus. This review sums up the data on peripheral refraction in orthokeratological, multifocal contact, and multifocal spectacle correction. The effectiveness of these methods in myopia control in children and teenagers is shown.

Fluorescein Angiography, Wide Field Angiography, and Indocyanine Green Angiography in Behcet Uveitis

In Behcet's disease, the anterior and posterior segments of the eye may be affected separately or together. Fundus fluorescein angiography should be performed in addition to ophthalmoscopic examination for early diagnosis and treatment of ocular involvement. Fundus fluorescein angiography (FFA) is the gold standard for the evaluation of the retinal vascular system and pathologies. Fundus fluorescein angiography is more sensitive than fundus examination in the detection of vasculitis, and angiographic involvement is always more common than clinical involvement. Fluorescein angiography may reveal leakage from retinal veins in eyes whose visual impression is not affected and the fundus examination is normal. The absence of vascular leakage with fluorescein angiography indicates that the disease is in a completely inactive period. Because of the development of blindness due to posterior segment involvement, early detection of the disease with fundus angiography and the initiation of the treatment is successful in terms of visual prognosis. It has an important place in terms of early activation of patients with FFA in the early diagnosis of eye involvement and follow-up of the disease and treatment. Wide-field imaging angiography imaging of the retinal periphery revealed the importance of lesions in retinal periphery and peripheral areas invisible by standard angiography. The use of indocyanine green angiography in Behcet uveitis is limited.

Wide Field Imaging and Angiography

The recently developed wide-field imaging systems (WIS) enable 200 degrees imaging of retina by just one shot and angiographic and autofluorescence imaging of retinal periphery. In addition to facilitating the detection of retinal pathologies, WIS revealed the importance of lesions in retinal periphery and peripheral nonperfusion areas invisible by standard angiography. The novel finding of utmost importance for diabetic retinopathy (DR) patients was the 3 fold increased risk of progression assessed for peripheral DR lesions compared to that in the posterior pole. Detection of peripheral nonperfusion areas in DR or retinal vein occlusion cases with refractory macular edema altered the management approach. On the other hand by means of WIS new terms have been brought into the era like peripheral vascular leakage whose relevance and importance are unknown for retinal vascular diseases. In age-related macular degeneration, a disease known to affect the macula, WIS proved the effect on peripheral retina documented by both angiographies and also peripheral autofluorescence. In diseases known to affect peripheral retina like uveitis, degenerative myopia, etc. WIS further contributes to the detection of additional pathologies. WIS enabled documentation of retinal periphery and thus seems to change the treatment modality and probably clinical classification of unknown or treatment-refractory pathologies in retinal diseases where we mainly focused on macula always.