Ophthalmology: Current and Future Developments: Volume 2: Diagnostic Atlas of Retinal Diseases E-Book
81,78 €
Mehr erfahren.
- Herausgeber: Bentham Science Publishers
- Kategorie: Fachliteratur
- Serie: Ophthalmology: Current and Future Developments
- Sprache: Englisch
This 3 volume set offers a comprehensive compilation which presents detailed information about ophthalmic (retinal, vitreous and macular) diseases. Key features of this set include:
Emphasis on practical features of clinical diagnosis
Concise and didactic presentation of key manifestations of diseases designed for rapid reference and target recall
A vast selection of illustrations to sharpen clinical problem-solving skills
Step by step treatment approaches to enhance the reader’s ability to handle medical cases
Citations or relevant research articles in each chapter for further reading
The second volume of this set covers several choroid and retinal disorders including, commotio retinae, choroidal rupture and macular trauma, retinal breaks and detachment, and a variety of congenital / genetic eye diseases such as Best’s disease and Stargardt disease. Written by a group of retina specialists, this book is an excellent resource for knowledge about retinal disorders. The streamlined format and evidence based medicine presented in the volume make this book the perfect reference for medical students, residents, general ophthalmologists and retina specialists.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 216
Veröffentlichungsjahr: 2017
Ähnliche
Ophthalmology:
Current and Future Developments
Diagnostic Atlas of Retinal
Diseases
(Volume 2)
Edited by
Mitzy E. Torres Soriano
&
Gerardo García Aguirre
Co-Edited by
Maximiliano Gordon
&
Veronica Kon Graversen
BENTHAM SCIENCE PUBLISHERS LTD.
End User License Agreement (for non-institutional, personal use)
This is an agreement between you and Bentham Science Publishers Ltd. Please read this License Agreement carefully before using the ebook/echapter/ejournal (“Work”). Your use of the Work constitutes your agreement to the terms and conditions set forth in this License Agreement. If you do not agree to these terms and conditions then you should not use the Work.
Bentham Science Publishers agrees to grant you a non-exclusive, non-transferable limited license to use the Work subject to and in accordance with the following terms and conditions. This License Agreement is for non-library, personal use only. For a library / institutional / multi user license in respect of the Work, please contact: [email protected].
Usage Rules:
All rights reserved: The Work is the subject of copyright and Bentham Science Publishers either owns the Work (and the copyright in it) or is licensed to distribute the Work. You shall not copy, reproduce, modify, remove, delete, augment, add to, publish, transmit, sell, resell, create derivative works from, or in any way exploit the Work or make the Work available for others to do any of the same, in any form or by any means, in whole or in part, in each case without the prior written permission of Bentham Science Publishers, unless stated otherwise in this License Agreement.You may download a copy of the Work on one occasion to one personal computer (including tablet, laptop, desktop, or other such devices). You may make one back-up copy of the Work to avoid losing it. The following DRM (Digital Rights Management) policy may also be applicable to the Work at Bentham Science Publishers’ election, acting in its sole discretion:25 ‘copy’ commands can be executed every 7 days in respect of the Work. The text selected for copying cannot extend to more than a single page. Each time a text ‘copy’ command is executed, irrespective of whether the text selection is made from within one page or from separate pages, it will be considered as a separate / individual ‘copy’ command.25 pages only from the Work can be printed every 7 days.3. The unauthorised use or distribution of copyrighted or other proprietary content is illegal and could subject you to liability for substantial money damages. You will be liable for any damage resulting from your misuse of the Work or any violation of this License Agreement, including any infringement by you of copyrights or proprietary rights.
Disclaimer:
Bentham Science Publishers does not guarantee that the information in the Work is error-free, or warrant that it will meet your requirements or that access to the Work will be uninterrupted or error-free. The Work is provided "as is" without warranty of any kind, either express or implied or statutory, including, without limitation, implied warranties of merchantability and fitness for a particular purpose. The entire risk as to the results and performance of the Work is assumed by you. No responsibility is assumed by Bentham Science Publishers, its staff, editors and/or authors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products instruction, advertisements or ideas contained in the Work.
Limitation of Liability:
In no event will Bentham Science Publishers, its staff, editors and/or authors, be liable for any damages, including, without limitation, special, incidental and/or consequential damages and/or damages for lost data and/or profits arising out of (whether directly or indirectly) the use or inability to use the Work. The entire liability of Bentham Science Publishers shall be limited to the amount actually paid by you for the Work.
General:
Any dispute or claim arising out of or in connection with this License Agreement or the Work (including non-contractual disputes or claims) will be governed by and construed in accordance with the laws of the U.A.E. as applied in the Emirate of Dubai. Each party agrees that the courts of the Emirate of Dubai shall have exclusive jurisdiction to settle any dispute or claim arising out of or in connection with this License Agreement or the Work (including non-contractual disputes or claims).Your rights under this License Agreement will automatically terminate without notice and without the need for a court order if at any point you breach any terms of this License Agreement. In no event will any delay or failure by Bentham Science Publishers in enforcing your compliance with this License Agreement constitute a waiver of any of its rights.You acknowledge that you have read this License Agreement, and agree to be bound by its terms and conditions. To the extent that any other terms and conditions presented on any website of Bentham Science Publishers conflict with, or are inconsistent with, the terms and conditions set out in this License Agreement, you acknowledge that the terms and conditions set out in this License Agreement shall prevail.Bentham Science Publishers Ltd. Executive Suite Y - 2 PO Box 7917, Saif Zone Sharjah, U.A.E. Email: [email protected]
PREFACE
We are honored to contribute to the information and education of ophthalmology students around the world. We have attempted to distill the current knowledge of medical practice and basic science retina research into a diagnostic atlas of retinal diseases. This is a quick-reference atlas eBook of the retina, edited by specialists in the field, essential to any practicing ophthalmologist or resident who has more than a passing interest in diseases and treatment of the retina.
This e-book includes contributors from Mexico, Venezuela, Argentina, Brazil, United States, Denmark, Spain, Italy, Costa Rica and Peru. It is divided into three volumes: Volume I, retinal vascular diseases, choroidal neovascularization related diseases, vitreomacular interface, and other macular disorders; Volume II, traumatic retinopathies, diseases of vitreous, peripheral degenerations, retinal detachment, pediatric retinal diseases, and retinal dystrophies; and Volume III, posterior uveitis, tumors of the retina and choroid.
This diagnostic atlas eBook of retinal diseases contains full-color, high quality images of the most frequent retinal pathologies with a brief and comprehensive review of retinal diseases. Each chapter includes essentials of diagnosis, differential diagnosis and treatment. The format is concise, well organized, and didactic, without being exhaustive.
We hope and expect that our atlas of retina will facilitate in providing patients with the best pos-sible care.
ACKNOWLEDGEMENTS
We would like to express our gratitude to Judy Soriano, who provided support with english composition and edition.
To our friends and colleagues without whose contribution would not have been possible to realize this project.
We also want to thank the staff of Bentham Science for their help and support and give us the opportunity to publish this eBook.
DEDICATION
This e-book is specially dedicated to Guillermo Manuel Gordon, MD. He inspired us to always work hard and try our best. He was a friend and a recognized ophthalmologist of Rosario-Argentina, who died on May 2nd, 2015.
List of Contributors
Commotio Retinae
Matteo Forlini*The term commotio retinae describes a whitish or yellowish discoloration of the retina after blunt trauma. It is caused by shock waves that traverse the eye from the site of impact. The mechanism by which the retina acquires this appearance is uncertain, but extracellular edema, glial swelling or disruption of the photoreceptor outer segments have been proposed as potential causes. There is little to no intercellular edema [1, 5, 7].
ESSENTIALS OF DIAGNOSIS
Decreased vision or asymptomatic.History of recent ocular trauma.A sheenlike retinal whitening is observed, appearing several hours after injury (confluent area of retinal whitening, gray opacification of the retina) (Fig. 1).Commotio can occur to peripheral retina (most frequently it affects the temporal fundus) or the central macular region; commotio retinae in the posterior pole is also called Berlin edema [1-9] (Fig. 1).If the macula is involved, a “cherry-red spot” may be seen at the fovea, because the cells involved in the whitening are not present in the fovea (Fig. 1).Retinal blood vessels are unaffected. However, other signs of ocular trauma may be seen, such as intraretinal or vitreous hemorrhage.Visual acuity does not always correlate with the degree of commotio retinae [1-9].Sequelae to more severe commotio may include progressive pigmentary degeneration, choroidal rupture, or macular hole formation [2, 5-9].Fig. (1)) Color fundus photograph. Commotio retinae.DIFFERENTIAL DIAGNOSIS
The patient should also be evaluated for serous retinal detachment, which also diminishes the prognosis for vision recovery.Branch retinal artery occlusion (whitening of the retina along the distribution of an artery) should be excluded, even though it rarely follows trauma.“White without pressure” (a common peripheral retinal finding) could also present with retinal whitening; it may be associated with a prominent vitreous base.Considerable damage to the retinal pigment epithelium can occur, eventually leading to granular pigmentation and bone corpuscular appearance of the affected retina resembling retinitis pigmentosa.MANAGEMENT
Complete ophthalmic evaluation, including dilated fundus examination with scleral depression should be performed (or without scleral depression if a ruptured globe, hyphema, or iritis is present).Commotio retinae may decrease visual acuity to as low as 20/200, or even less. Fortunately the prognosis in mild cases, with no associated complications, is good with spontaneous resolution within 3-4 weeks. No treatment is required. Rarely, some patients with foveal involvement may be left with chronic visual impairment secondary to photoreceptor damage.Dilated fundus examination is repeated in 1 to 2 weeks. Patients should be educated about the symptoms of retinal detachment and instructed to return sooner if present [1-9].CONFLICT OF INTEREST
The author confirms that author has no conflict of interest to declare for this publication.
ACKNOWLEDGEMENTS
Declared none.
REFERENCES
[1]Kitchens JW, Rubsamen PE. Yanoff M, Duker JS. Posterior Segment Ocular Trauma. In: Yanoff M, Duker JS, eds. Ophthalmology. (4th ed.) Mosby Elsevier 2014. pp. 670-1.[2]Ahn SJ, Woo SJ, Kim KE, Jo DH, Ahn J, Park KH. Optical coherence tomography morphologic grading of macular commotio retinae and its association with anatomic and visual outcomes. Am J Ophthalmol 2013; 156(5): 994-1001.e1. [http://dx.doi.org/10.1016/j.ajo.2013.06.023] [PMID: 23972302][3]Cavallini GM, Martini A, Campi L, Forlini M. Bottle cork and cap injury to the eye: a review of 34 cases. Graefes Arch Clin Exp Ophthalmol 2009; 247(4): 445-50. [http://dx.doi.org/10.1007/s00417-008-0912-6] [PMID: 18696096][4]Brumitt J, Erickson GB. Erickson GB. Ocular injuries in sports: assessment and management. In: Erickson GB, eds. Sports vision: vision care for the enhancement of sports performance. St. Louis: Butterworth Heinemann Elsevier 2007. p. 170. [http://dx.doi.org/10.1016/B978-0-7506-7577-2.50012-5][5]Trattler WB, Kaiser PK, Friedman NJ. Chapter 11: Posterior Segment–Commotio Retinae. In: Trattler WB, Kaiser PK, Friedman NJ, Eds. Review of Ophthalmology. 2nd ed. Elsevier Saunders 2012; pp 302-303.[6]Liem AT, Keunen JE, van Norren D. Reversible cone photoreceptor injury in commotio retinae of the macula. Retina 1995; 15(1): 58-61. [http://dx.doi.org/10.1097/00006982-199515010-00011] [PMID: 7754249][7]Gerstenblith AT, Rabinowitz MP. Gerstenblith AT, Rabinowitz MP. Trauma – Commotio Retinae. In: Gerstenblith AT, Rabinowitz MP, eds. The Wills Eye Manual: Office and emergency room diagnosis and treatment of eye disease. (6th ed.) Philadelphia: Lippincott Williams & Wilkins 2012. pp. 49-50.[8]Cavallini GM, Masini C, Volante V, Pupino A, Campi L, Pelloni S. Visual recovery after scleral buckling for macula-off retinal detachments: an optical coherence tomography study. Eur J Ophthalmol 2007; 17(5): 790-6. [PMID: 17932857][9]Oladiwura D, Lim LT, Ah-Kee EY, Scott JA. Macular optical coherence tomography findings following blunt ocular trauma. Clin Ophthalmol 2014; 8(8): 989-92. [PMID: 24899795]Choroidal Rupture
Francys J. Torres Méndez1,2,Mitzy E. Torres Soriano3,*The choroid is the external vascular layer lying between the retina and the sclera [1]. Its thickest part is in the posterior pole (0.22 mm) and it narrows towards the ora serrata to 0.1 mm. The choroid’s main function is the vascular supply to the retinal pigment epithelium (RPE) that comes from the internal carotid artery and the ophthalmic artery, and drains into the vortex veins, determining the color of the ocular fundus [2, 3].
The suprachoroidal space is a virtual space. Pathologically, the choroidal rupture is a break in the Bruch membrane and the RPE. Unlike the retina and the sclera, which can resist several impacts thanks to their strength and elasticity, choroidal ruptures occur in 8% of patients who suffer blunt trauma and they are caused by an anteroposterior compression of the globe with expansion in the horizontal plane [3].
ESSENTIALS OF DIAGNOSIS
Initially, a choroidal rupture may be difficult to diagnose because it may be obscured by associated vitreous, intra- or subretinal hemorrhages. Hemorrhages caused by choroidal rupture are characterized by regular, sharply-defined edges, which indicates they are located in the sub retina or the choroid [2].
Choroidal ruptures can develop in two ways: Indirect ruptures are evidenced at an early stage with choroidal or retinal hemorrhages. After hemorrhages are resolved, the typical crescent-shaped lesions become visible (Fig. 1), similar to a fundoscopic image of angioid streaks, (Fig. 2) concentric and concave to the optic disc and, most frequently, in the inter papillo-macular region [4]. In other cases, lesions are located around the optic disc, corresponding to traumatic peripapillary choroidopathy, which can lead to optic atrophy [6]. Direct ruptures are located at the site of trauma, involve hemorrhage and oedema, and, only after hemorrhage is resolved, the atrophic site becomes visible surrounded by pigmentation [4].
Fig. (1)) Colour fundus photograph. Choroidal rupture (Courtesy of Ophthalmology Department, Hospital Central de Maracay, Venezuela). Fig. (2)) Angioid streaks, a mixture of brownish streaks, pale atrophic areas, mainly around the margin of the optic disc, curved streaks concentric with the disc that are reminiscent of traumatic choroidal rupture lines (Courtesy of Michael Larsen, MD, Copenhagen, Denmark).The visual prognosis depends mainly on the location of the injury. The histo- pathological process of choroidal rupture repair is completed 3 weeks after trauma and is accompanied by the formation of a well-established scar. This tissue process includes fibroblastic activity and RPE hyperplasia at the edges of the lesion. Choroidal neovascularization can develop from choroidal rupture in approximately 10-20% of cases during the scarring process [5].
Diagnosis is made based on clinical findings: clinical record, clinical interview, routine eye examination, visual acuity (VA) testing. VA may be affected depending on the location and size of the lesion [6]. Vision loss is imminent when the macular area is affected [7]. It is necessary to carry out a timely examination of the ocular fundus, followed by additional tests, such as: an eye ultrasound; an OCT, which will detect a retinal pigment epithelium tear; a fluorescein angiography, which will show hyperfluorescence early and consistently throughout the test, and will also rule out neovascular membrane [8]; and ICG will evidence hypofluorescence in early and late phases [3, 9]. Patients should be recommended to use the Amsler grid for self-assessment [2].
DIFFERENTIAL DIAGNOSIS
Macular degeneration, neovascular membranes, Fuchs’ spots, lacquer cracks in myopic eye, angioid streaks (Fig. 2) and pathological alterations of the RPE are in the differential diagnosis of choroidal rupture.
MANAGEMENT
There is no immediate treatment available. However, the condition is currently being assessed and managed by means of tissue plasminogen activator (tPA) and intravitreal injection of pure C3F8 (0.4 cc) for pneumatic displacement of hemorrhage [10]; vitreous surgery, if clinically necessary [11]; intravitreal administration of anti-angiogenic agents, such as vascular endothelial growth factor (VEGF) inhibitors, for the treatment of post-traumatic choroidal neovascular membrane [12].
CONFLICT OF INTEREST
The author confirms that author has no conflict of interest to declare for this publication.
ACKNOWLEDGEMENTS
Declared none.
