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Peripheral Vasoproliferative Retinopathy

Peripheral Retinal Neovascularization


Presentation

  • RESULTS: Of 275 patients with VPT, 41% (n 113) were male and 59% (n 162) were female, with a mean age of 44 years at presentation. Primary VPT occurred in 80% (n 219) and secondary VPT, in 20% (n 56) of patients.[ncbi.nlm.nih.gov]
  • Retinal vasoproliferative tumours may be present at any age, although the majority are present in the third and fourth decades of life. 8 These tumours, in contrast to those observed in von Hippel Lindau disease, are sporadic in nature.[nature.com]
  • Posted June 30, 2016 INITIAL PRESENTATION Chief Complaint "Floaters and a shadow in my vision" History of Present Illness A 19-year-old male presented to his local optometrist with a 4-week history of floaters and a shadow in the superotemporal visual[webeye.ophth.uiowa.edu]
  • However, CT may miss nearly 50 percent of retinoblastomas that present without calcification,9 and conversely, Coats’ disease can present with intraocular bone formation.[reviewofophthalmology.com]
  • Diabetic retinopathy has been and probably remains one of the four major causes of blindness in the United States. 1 , 2 The risk of retinopathy is directly related to the degree and duration of hyperglycemia. 3 After diabetes mellitus has been present[nejm.org]
Metal Worker
  • Other chapters consider the high risk of ocular injury in some occupations, including engineers, drillers, riveters, iron dressers, blacksmiths, and hot metal workers.[books.google.com]
Ascitic Fluid
  • Tumor cells secrete a vascular permeability factor that promotes accumulation of ascites fluid. ‎[books.google.com]
Pathologist
  • SNOMED CT (R) was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO."[doctor.am]
Heart Failure
  • It affects 30-40% of patients with diabetes and is associated with an increased risk of life-threatening vascular complications, including acute coronary syndrome, congestive heart failure and stroke.[hkuelcn.med.hku.hk]
Retinal Pigmentation
  • The most characteristic ophthalmoscopic findings are narrowing of the retinal arterioles, mottling of the retinal pigment epithelium, and peripheral retinal pigment clumping, referred to as "bone-spicule formation" (Figure 10-19).[oculist.net]
  • H35.711 …… right eye H35.712 …… left eye H35.713 …… bilateral H35.719 …… unspecified eye H35.72 Serous detachment of retinal pigment epithelium H35.721 …… right eye H35.722 …… left eye H35.723 …… bilateral H35.729 …… unspecified eye H35.73 Hemorrhagic[icd10data.com]
  • […] retinopathy [ ret″ĭ-nop ah-the ] any noninflammatory disease of the retina. central serous retinopathy a usually self-limiting condition marked by acute localized detachment of the neural retina or retinal pigment epithelium in the region of the macula[medical-dictionary.thefreedictionary.com]
  • Note the peripheral location, extensive subretinal exudate, and associated retinal pigment epithelial changes.[nature.com]
  • Goal of therapy is to encourage reabsorption of macula oedema by the retinal pigment epithelium. However, macula laser treatments carry significant risk of visual loss, therefore the fovea and its surroundings should be avoided.[hkuelcn.med.hku.hk]
Retinal Lesion
  • Abstract Vasoproliferative tumours are uncommon retinal lesions that may occur in isolation (primary) or in association with another ocular condition (secondary).[nature.com]
  • Berraho Efficacy and safety of the PASCAL photocoagulator to treat peripheral retinal lesions. page 1S56 C. Favard, M.[emvmsa1a.jouve-hdi.com]
  • Since proliferative diabetic retinopathy and diabetic macular oedema may cause no ocular or visual symptoms when the retinal lesions are most amenable to treatment, the overriding concern is to identify eyes at risk of visual loss and ensure that the[hormones.gr]
Background Retinopathy
  • retinopathy and retinal vascular changes H35.00 Unspecified background retinopathy H35.01 Changes in retinal vascular appearance H35.011 …… right eye H35.012 …… left eye H35.013 …… bilateral H35.019 …… unspecified eye H35.02 Exudative retinopathy H35.021[icd10data.com]
Corneal Edema
  • In eyes where there is NVA causing corneal edema from elevated intraocular pressure, dispersed red blood cells in the anterior or posterior segment, or suboptimal dilation due to NVI, intraocular injection of VEGF antagonists may provide quick resolution[healio.com]
Seizure
  • The disorders are usually inherited in an autosomal recessive manner and may be associated with mental retardation, seizures, and renal or muscular abnormalities.[oculist.net]
  • Case Report The patient is a former 26 week premature female with a history of grade IV intraventricular hemorrhage, seizures, and respiratory failure who was diagnosed with Retinopathy of Prematurity (ROP) stage 0 zone 2 on eye examination at 30 weeks[austinpublishinggroup.com]

Treatment

  • Page 152 - The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. ‎[books.google.com]
  • This book provides the correct diagnosis and treatment of many ocular disorders. Organized into 22 chapters, this book begins with an overview of the anatomy and physiology of the eyes.[books.google.com]
  • Early Treatment for Retinopathy of Prematurity Cooperative Group Revised indications for the treatment of retinopathy of prematurity: results of the Early Treatment for Retinopathy of Prematurity randomized trial.[jeos.eg.net]
  • If the vessels do not regress with the initial treatment, further treatment is needed. If the vessels regress, but then begin to grow again after months or years, more treatment is indicated.[avclinic.com]
  • Given financial and resource limitations, many countries are adopting usage of bevacizumab as the sole treatment modality for treatment of ROP.[austinpublishinggroup.com]

Prognosis

  • Prognosis 90% of Stage 1 and Stage 2 disease regresses spontaneously. Approximately 50% of Stage 3 disease can regress spontaneously. Prognosis for stage 4 and 5 disease is poor, with a high incidence of visual problems and retinal detachment.[pedclerk.bsd.uchicago.edu]
  • .[9] (See below for more discussion on prognosis).[webeye.ophth.uiowa.edu]
  • Prognosis: Visual prognosis is not good in infants developing retinal detachment. Retinal detachments commonly occur at 38-42 weeks postmenstrual age, in untreated patients. Treatment of ROP reduces the risk and incidence of unfavourable outcome.[nhp.gov.in]
  • A PPV, with induction of posterior vitreous detachment (PVD) and clearance of the pre-retinal blood avoids fibrosis and a subsequent dismal visual prognosis.[atlasrleye.com]
  • Visual Prognosis of Coats Disease. J AAPOS 1998;2:356-359. 14. Schefler AC, Berrocal AM, Murray TG. Advanced Coats’ disease. Management with repetitive aggressive laser ablation therapy. Retina 2008;28:38-41. 15. Reichstein DA, Recchia FM.[reviewofophthalmology.com]

Etiology

  • Etiology The exact etiology of ROP is unknown but is likely multifactorial. Oxygen administration originally was thought to contribute to the development of ROP. This is now being debated.[pedclerk.bsd.uchicago.edu]
  • Delcourt Etiologies of visual disabilities in 350 athletes examined during the last Paralympics Games of Bejing 2009 page 1S48 G. Challe, P. Le Hoang, B.[emvmsa1a.jouve-hdi.com]
  • The etiology and treatment of retinopathy of prematurity as well as the recommended screening protocols are discussed in Chapter 17.[oculist.net]
  • DIAGNOSIS Coats Disease DISCUSSION Etiology/Pathophysiology Coats disease was first described by Dr.[webeye.ophth.uiowa.edu]

Epidemiology

  • Ferris at the Division of Biometry and Epidemiology, 31 Center Dr., MSC-2510, Bldg. 31, Rm. 6A52, Bethesda, MD 20892-2510, or at [email protected] .[nejm.org]
  • Bodaghi Epidemiology of ocular trauma from november 2007 to november 2008: about 70 cases page 1S48 V. Sebilleau, P.L. Cornut, M. de Bats, P. Denis, C. Burillon Visual impairment in elderly falling patients page 1S48 H. Baiz, H. Bulckaen, J.J.[emvmsa1a.jouve-hdi.com]
  • An epidemiologic and Fluorescein angiographic study. Albrecht Von Graefes Arch Klin Exp Ophthalmol 1975;195(4):241-250. [PMID 1080374] Egerer I, Tasman W, Tomer TT. Coats disease. Arch Ophthalmol 1974;92(2):109-112.[webeye.ophth.uiowa.edu]
  • Epidemiology In African-Americans in North America, the incidence of sickle cell trait (AS) is about 8%, while that of SCD is 0.4%.[eyewiki.aao.org]
  • Epidemiology Retinal vasoproliferative tumours may be idiopathic (74%) or secondary to a pre-existing ocular disease (26%). 8 Idiopathic (primary) are usually solitary lesions (87%) in contrast to secondary tumours that are often multiple in nature (42%[nature.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology It is postulated that there are two causal events: Vasoconstriction and obliteration of the capillary network in response to a vascular insult (possibly high supplemental O2 concentration) Vasoproliferation possibly a response by the hypoxic[pedclerk.bsd.uchicago.edu]
  • Pathophysiology Normal blood cells that are round and oval can easily pass through smaller blood vessels including capillaries.[eyewiki.aao.org]
  • DIAGNOSIS Coats Disease DISCUSSION Etiology/Pathophysiology Coats disease was first described by Dr.[webeye.ophth.uiowa.edu]
  • Michels R, 1981 Proliferative diabetic retinopathy: Pathophysiology of extraretinal complications and principles of vitreous surgery. Retina 1: 1-17. 20.[hormones.gr]

Prevention

  • Early diagnosis and treatment are essential in this disease to enhance a final visual outcome of stabilization and prevention of further loss of vision.[medical-dictionary.thefreedictionary.com]
  • Ocular Therapy Diabetic retinopathy carries a risk of vision loss that can be prevented or minimized with timely ocular therapy. 1.[hkuelcn.med.hku.hk]
  • The goal of PRP is to induce regression of existing neovascular tissue and to prevent progressive neovascularization.[healio.com]
  • The STOP ROP (Supplemental Therapeutic Oxygen to Prevent ROP) study investigated whether supplemental therapeutic oxygen for premature infants reduced the proportion of infants that progressed to threshold ROP.[pedclerk.bsd.uchicago.edu]
  • Early coagulation of this lesion may prevent a poor outcome. Keywords Visual Loss Retinal Detachment Toxoplasmosis Fluorescein Angiography Indocyanine Green These keywords were added by machine and not by the authors.[link.springer.com]

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