Faculty Bibliography

The use of indocyanine-green videoangiography as an adjunctive technique to fluorescein angiography in the diagnosis of choroidal neovascularization has recently gained widespread attention. In January 1993, the first international symposium on indocyanine-green angiography was sponsored by the Manhattan Eye, Ear, and Throat Hospital. Approximately 300 retina specialists from all over the world convened at this meeting. Our current knowledge of indocyanine-green videoangiography is reviewed

The presence of subretinal exudation in a patient with neurosensory detachment of the macula frequently suggests the diagnosis of choroidal neovascularisation. A retrospective chart review of newly diagnosed cases of central serous chorioretinopathy revealed 11 patients, seven men and four non-pregnant women, who had plaques of subretinal exudate, which presumably were fibrin. Each of these patients had a solitary plaque that ranged in size from 300 to 1500 microns in diameter. These patients had no signs or a clinical course suggestive of choroidal neovascularisation. In each case the subretinal plaque was overlying an exuberant leak in the retinal pigment epithelium. The exudate was generally present at the initial examination, and usually showed dissolution before or coincident with the resolution of the neurosensory detachment. After resolution of the central serous chorioretinopathy, patients were left with subtle alterations in the retinal pigment epithelium in the areas of the subretinal plaque. These findings are important for two reasons. Firstly, the presence of subretinal exudation does not necessarily rule out the diagnosis of central serous chorioretinopathy. Secondly, pathophysiological theories of central serous chorioretinopathy must explain how the plaques are deposited behind the retina

Of 141 patients who had clinically significant cystoid macular edema (CME) following cataract surgery, 42 had a visual acuity of 20/200 or worse. Logistic regression demonstrated that of all the systemic and ocular factors studied, the best predictors of visual acuity of 20/200 or worse were the presence of iris in the wounds (odds ratio = 2.86, P = .011) and a fluorescein angiogram grade of 4 (odds ratio = 2.91, P = .0076). Entering into the logistic regression variables such as integrity of the posterior capsule, iritis, vitreous in the wound, or type of intraocular lens did not significantly improve the ability of the model to predict which patients would have poor visual acuity. This study suggests that iris incarceration in the wound may have a more important association with poor vision in patients with chronic postsurgical CME than previously thought

Purpose: The study was designed to evaluate the relative anatomic position of the crossing vessels at the site of occlusion in eyes with branch retinal vein occlusion (BRVO). Methods: Fundus photographs of 106 eyes (104 patients) with recent BRVO from the Eye Disease Case-Control Study were used to examine the relative position of artery and vein at occluded crossings. Three separate comparison groups were formed by identifying corresponding arteriovenous crossings for each occluded crossing in: (1) the ipsilateral but opposite vessel arcade within eyes affected by BRVO; (2) the same quadrant in unaffected eyes of BRVO patients; and (3) the same quadrant in eyes of patients without BRVO, matched by age, sex, and race with the BRVO patients. Results: The site of obstruction of the branch vein was an arteriovenous crossing in all affected eyes. In 99% of eyes with BRVO, the artery was located anterior to the vein at the obstructed site. In the three comparison groups, the artery was anterior to the vein in 62%, 61%, and 54% of the crossings, respectively, yielding statistically significant differences for each group of control crossings compared with BRVO crossings (P < 0.001). Conclusion: Finding the vein to be consistently between the more rigid artery and the retina at almost all arteriovenous crossings affected by BRVO suggests a possible role for mechanical obstruction in the pathogenesis of BRVO. $$:

Interferon alfa is used to treat various systemic disorders and recently has been suggested as a possible treatment for choroidal neovascularization. We report 10 cases of retinal ischemia associated with the use of interferon alfa for various illnesses. The retinal findings include cotton-wool spot formation, capillary nonperfusion, arteriolar occlusion, and hemorrhage. The retinal complications may sometimes be reversible when treatment is stopped. Our findings emphasize the need to have patients who are receiving interferon alfa therapy monitored for these retinal complications, which may rarely be associated with permanent loss of vision secondary to closure of retinal capillaries