Frank S Siringo

Enhanced High-Density Line Spectral-Domain Optical Coherence Tomography Imaging of the Vitreoretinal Interface: Description of Selected Cases.

Abstract Purpose: We introduce a new method to observe the morphologic features of the vitreous with spectral-domain optical coherence tomography (SD-OCT) by evaluating and describing the posterior vitreous structure of various selected cases using enhanced high-density (HD) line mode. Methods: This is a descriptive case series of SD-OCT images with enhanced HD line at Denver Health Medical Center, University of Colorado School of Medicine, in 2014. The medical records with ocular images for these patients were analyzed. Results: Enhanced HD line in vitreoretinal mode with SD-OCT offered wide images with well-visible vitreoretinal interface. The posterior precortical vitreous pocket (PPVP), often mistaken as a posterior vitreous detachment on standard retina-based cross line mode, was easily identified. Vitreomacular adhesion and traction, absence or presence of connecting channels between PPVP and Cloquet’s canal, liquefied vitreous lacuna, and emulsified silicone oil droplet-layer could be observed. Conclusions: SD-OCT using enhanced HD line in vitreoretinal mode enables clear visualization of the posterior vitreous structure and often reclassifies patients previously thought to have a posterior vitreous detachment.

Assessment of posterior vitreous detachment on enhanced high density line optical coherence tomography

Department of Ophthalmology, University of Colorado School of Medicine, Rocky Mountains Lions Eye Institute, Aurora 80045, USA Department of Ophthalmology, University of Colorado School of Medicine, Denver Health Medical Center, Denver 80204, USA Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, Daegu 41931, Korea Correspondence to: Yu Cheol Kim. Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, #56, Dalseong-ro, Jung-gu, Daegu 41931, Korea. eyedr@dsmc.or.kr Received: 2015-12-23 Accepted: 2016-05-20

Spectral Domain Optical Coherence Tomographic Analysis Of Healthy Retina In Branch Retinal Vein Occlusion And Its Response To Antiangiogenic Therapy

Purpose: To propose a model that measures the effect of intravitreal bevacizumab (IVB) on relatively healthy retina. The purpose is to analyze the remote effect of a branch retinal vein occlusion in the healthy retina, to determine the response it may have to IVB, and to determine if IVB has an atrophic effect on the healthy retina. Methods: Retrospective, longitudinal comparative analysis of patients with branch retinal vein occlusion treated with IVB. Eyes were divided into experimental (branch retinal vein occlusion eye) and control (contralateral eye) groups. Each eye was analyzed for thickness and area. Thickness measurements were performed for total retinal thickness, inner retina thickness, and outer retina thickness. Area was measured for photoreceptors, choroid, and total retina. Results: Eighteen eyes of 9 patients. For thickness analysis, 1,050 scans were studied, and 126 measurements were performed on 42 scans for area analysis. No difference was observed for thickness, except for inner retina thickness. No difference was observed for area. No difference was observed when analyzing a cumulative exposure to IVB. Conclusion: There is no evidence to suggest an atrophic effect caused by IVB when analyzing thickness or area in this experiment. This model could be used to analyze the long-term safety of IVB in larger studies.

CONCURRENT ENDOPHTHALMITIS AND ANTERIOR SEGMENT ISCHEMIA AFTER STRABISMUS SURGERY.

Background/Purpose: To report a case of simultaneous endophthalmitis and anterior segment ischemia (ASI) that occurred in a patient after strabismus surgery. This is the first known case of both complications occurring at the same time. Methods: Case report. Results: A 60-year-old woman presented with eye pain and loss of vision 6 days after uncomplicated strabismus surgery for thyroid eye disease. On examination, she had corneal edema, anterior segment fibrin, an atonic iris, and no view to the posterior segment. On fluorescein angiography of the anterior segment, a large portion of the iris was nonperfused. Posterior segment ultrasound showed dense vitritis and a choroidal abscess. Intraoperative cultures grew methicillin-resistant Staphylococcus aureus. Conclusions: Endophthalmitis and anterior segment ischemia are both exceedingly rare complications of strabismus surgery. It is possible that each one occurred independently, but more likely one process potentiated the other. One possible mechanism is inflammation-induced thrombosis.

Polypoidal Choroidal Vasculopathy

PCV was first described in 1990 by Yannuzzi and colleagues, as a diagnosis distinct from exudative age-related macular degeneration (AMD) characterized as a bilateral exudative age-related macular disease characterized by orange-red subretinal nodules, with associated subretinal pigment epithelium (RPE) and/or subretinal serous fluid or hemorrhage.

Intraretinal Silicone Oil Infiltration following Traumatic Macular Hole Repair

Purpose: To present a case study describing incorporation of silicone oil into a traumatic macular hole following surgical correction. Methods: Case report Results: A nine-year-old male presented with a traumatic macular hole. After waiting for spontaneous closure, pars plana vitrectomy with standard 1000 centistroke silicone oil tamponade was performed. Postoperatively, spectral-domain optical coherence tomography, demonstrated closure of the macular hole, but with infiltration of silicone oil into the foveal architecture. A second surgical approach with different attempts to remove the retained silicone oils bubble was successfully performed using a soft-tip cannula. However, the macular hole reopened intraoperatively. Therefore silicone oil was replaced with no infiltration and adequate closure of the macular hole. Conclusion: Previous reports have demonstrated small droplets of retained silicone oil within the retinal layers, but to our knowledge, this is the first report of a large globule of oil becoming incorporated into a healing macular hole.