22 results on '"Venous tortuosity"'
Search Results
2. Wire countertraction for sheath placement through stenotic and tortuous veins: The 'body flossing' technique
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Fermin C. Garcia, Prakash Goutham Suryanarayana, Jay Giri, Mouhannad M. Sadek, Robert D. Schaller, David S. Frankel, Jeffrey Arkles, and Joshua M. Cooper
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Simultaneous traction ,medicine.medical_specialty ,Percutaneous ,business.industry ,medicine.medical_treatment ,Extraction ,Balloon ,Implantable cardioverter-defibrillator ,medicine.disease ,Tortuosity ,Venous stenosis ,Venous tortuosity ,Stenosis ,Clinical ,Permanent pacemaker ,Snaring ,Implantable cardioverter–defibrillator ,Devices ,Medicine ,Radiology ,Lead Placement ,business ,Venous occlusion - Abstract
Background Innominate vein stenosis and venous tortuosity are common findings during cardiac implantable electronic device upgrades or replacements and present a challenge to the implanting physician. Various techniques have been described to facilitate lead placement, including serial dilation, balloon venoplasty, and percutaneous access medial to the stenosis, each with its own benefits and risks. Objective The purpose of this study was to assess the feasibility, safety, and efficacy of the wire countertraction ("body flossing") technique to facilitate sheath placement through tortuous and stenotic vessels. Methods Patients undergoing cardiac implantable electronic device procedures requiring the body flossing technique due to inability to place vascular sheaths over the wire through stenoses or tortuosity were retrospectively analyzed. Clinical characteristics, procedural equipment, and outcomes were analyzed. Results Simultaneous countertraction was successful in all attempted cases, including 8 patients with stenoses and 2 with tortuosity. In 2 of the stenosis cases, venoplasty had previously failed. No complications occurred. Conclusion Simultaneous countertraction (body flossing) is an effective tool to overcome venous stenosis and tortuosity that are amenable to wire advancement but not to vascular sheaths. It seems to be a safe and effective alternative to other techniques used in these scenarios.
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- 2020
3. Acute Unilateral Vision Loss Due to Optic Neuropathy in a Patient with Systemic Lupus Erythematosus
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Ali A Alsaad, Michael W. Stewart, Michael J. Maniaci, and Alexander Heckman
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Adult ,medicine.medical_specialty ,genetic structures ,030204 cardiovascular system & hematology ,Blindness ,Pupil ,Optic neuropathy ,03 medical and health sciences ,Venous tortuosity ,0302 clinical medicine ,Deaf-Blind Disorders ,Optic Nerve Diseases ,medicine ,Lupus Erythematosus, Systemic ,Humans ,Optic Neuropathy, Ischemic ,Ophthalmologic Complication ,Glucocorticoids ,Lupus erythematosus ,business.industry ,General Medicine ,Articles ,medicine.disease ,Dermatology ,eye diseases ,030220 oncology & carcinogenesis ,Acute Disease ,Optic disc swelling ,Female ,business ,Complication - Abstract
Patient: Female, 44 Final Diagnosis: Optic neuritis Symptoms: Unilateral vision loss Medication: — Clinical Procedure: Fundoscopic examination Specialty: Ophthalmology Objective: Rare disease Background: Systemic lupus erythematosus (SLE) causes sight-threatening, ophthalmologic problems that are frequently challenging to manage. Optic neuropathy is a rare ophthalmological complication of SLE that can progress to total bilateral vision loss if not identified and treated rapidly. We describe a patient with SLE who presented with an acute, painless unilateral optic neuropathy who subsequently experienced partial recovery of vision when treated with high-dose intravenous corticosteroids. Case Report: A 44-year-old female with known SLE presented with 4 days of painless, complete, and gradual vision loss in the right eye. Initial ophthalmologic examination revealed no light perception, afferent pupil defect, 4+ optic disc swelling, and 1+ venous tortuosity of the right eye. No hemorrhage or exudates were noted. Diagnostic workup revealed a lupus flare with elevated inflammatory markers including elevated anti-nuclear antibody, anti-ds-DNA antibody, anti-Sm antibody, and anti-phospholipid IgG antibody. The diagnosis of optic neuropathy was clinically established, and the patient was treated with high-dose intravenous corticosteroids. Her vision improved, and she was transitioned to oral corticosteroids with eventual significant improvement in her vision. Conclusions: Optic neuropathy is a rare and devastating ophthalmologic complication of SLE. The diagnosis can be made by linking key clinical findings on ophthalmologic examination with positive serological studies. If treated rapidly with immunosuppressive therapy, the vision loss can be reversed, and permanent blindness avoided. Although this rare complication is generally bilateral in nature, clinician must also be aware of unilateral disease and treat patients accordingly.
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- 2019
4. PERIPHERAL RETINAL ANGIOGRAPHIC FINDINGS IN MACULAR TELANGIECTASIS TYPE 2
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Stavros N. Moysidis, Michael T. Trese, Prethy Rao, Nicole Koulisis, Bruce R. Garretson, Antonio Capone, Kimberly A. Drenser, Viren K. Govindaraju, Tarek S Hassan, George A. Williams, Jeremy D. Wolfe, Lisa J. Faia, Tamer H. Mahmoud, Alan J. Ruby, Sandeep Randhawa, and Samuel Gamsky
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Male ,medicine.medical_specialty ,03 medical and health sciences ,chemistry.chemical_compound ,Venous tortuosity ,0302 clinical medicine ,Ophthalmology ,Medicine ,Humans ,In patient ,Arterial Tortuosity ,Macula Lutea ,030212 general & internal medicine ,Fluorescein Angiography ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Retinal Vessels ,Retinal ,General Medicine ,Fluorescein angiography ,Peripheral ,Capillaries ,chemistry ,030221 ophthalmology & optometry ,Retinal Telangiectasis ,Female ,business ,Tomography, Optical Coherence - Abstract
Purpose To evaluate the retinal periphery in patients with idiopathic juxtafoveal telangiectasis or macular telangiectasis type 2 (MacTel2), using widefield fluorescein angiography (WFA). Methods Single-center, retrospective, observational case series of 50 eyes of 50 patients with MacTel2 and 50 eyes of 50 age-matched controls. Results Thirty-seven eyes in the MacTel2 group (74%) showed peripheral capillary nonperfusion or dropout, compared to 37 eyes in the control group (74%, p=1.0). Morphologically, the MacTel2 group trended towards having a higher proportion of pruning-type capillary dropout (44%) compared to controls (28%), but this was not statistically significant (p=0.12). Patients with MacTel2 had a higher incidence of microaneurysms compared to controls (MacTel2 56%; Controls 42%; p=0.048), independent of age or systemic risk factors. There was no difference in the incidence of venous-venous shunts (MacTel2 10%; Controls 10%; p=1.0), arteriovenous shunts (MacTel2 14%; Controls 18%; p=0.60), venous tortuosity (MacTel2 60%; Controls 66%; p=0.58), or arterial tortuosity (MacTel2 54%; Controls 68%; p=0.20), which was mild in the majority of cases. Conclusions We note a high incidence of peripheral vascular and retinal findings in both patients with MacTel2 and age-matched controls, using WFA. Patients with MacTel2 had significantly more microaneurysms, independent of age or other systemic risk factors.Summary SUMMARY:: We note a high incidence of peripheral retinal vascular findings in both patients with macular telangiectasis type 2 and age-matched controls. Patients with MacTel2 had significantly more microaneurysms compared to controls, independent of age or other systemic risk factors.
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- 2020
5. Long-term prophylaxis in an immunocompetent patient with Cytomegalovirus retinitis: a case report and review of literature
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Kasra Cheraqpour, Elias Khalili Pour, Bahram Bohrani Sefidan, and Seyed Ali Tabatabaei
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Ganciclovir ,medicine.medical_specialty ,genetic structures ,Retinitis ,Long term prophylaxis ,CMV retinitis in immucocompetent patients ,03 medical and health sciences ,Venous tortuosity ,0302 clinical medicine ,lcsh:Ophthalmology ,Maintenance therapy ,Posterior uveitis ,medicine ,030212 general & internal medicine ,business.industry ,Cytomegalovirus retinitis ,Brief Report ,CMV ,Retinal detachment ,Valganciclovir ,medicine.disease ,eye diseases ,Surgery ,Prevention and control ,Ophthalmology ,Infectious Diseases ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,business ,medicine.drug - Abstract
Background Cytomegalovirus retinitis is an infectious sight-threatening condition that usually occurs in immunosuppressed individuals, but rare cases of Cytomegalovirus retinitis have been reported in immunocompetent patients. Findings A 68-year-old woman without any history of systemic diseases referred to the emergency ward of Farabi eye hospital with a two-week history of decreased vision in her left eye. Fundoscopy of the left eye revealed mild venous tortuosity, hemorrhagic retinitis within the macula, and papillitis. The right eye had a history of Cytomegalovirus retinitis 2 years ago that complicated with rhegmatogenous retinal detachment. Immunologic evaluations were normal without any sign of immunosuppressive conditions. She was treated with intravenous ganciclovir for 2 weeks, intravitreal ganciclovir (twice weekly) for 1 week, and also daily oral valganciclovir as maintenance therapy for 6 months resulted in resolving of retinitis patches and improving her best-visual acuity from hand motions to 20/100. Forty-five days after stopping maintenance therapy recurrence occurred. So we started the treatment again to stabilize the patient. She is currently maintained on valganciclovir 900 mg daily without recurrence for 9 months. Conclusions Cytomegalovirus retinitis can recur in the same or contralateral eye of immunocompetent patients, especially without prophylactic medication.
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- 2020
6. Purtscher-like retinopathy associated with dermatomyositis and hemophagocytic lymphohistiocytosis
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I. Calvo Penadés, M.L. Senent Peris, M. Cerdà-Ibáñez, H. Barranco González, A. Barreiro-González, I. Azorín Villena, and M.A. Harto Castaño
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Purstcher's retinopathy ,medicine.medical_specialty ,Thrombotic microangiopathy ,Hemophagocytic lymphohistiocytosis ,Blindness ,Lymphohistiocytosis, Hemophagocytic ,Dermatomyositis ,03 medical and health sciences ,Venous tortuosity ,0302 clinical medicine ,Retinal Diseases ,Microangiopatia trombotica ,030225 pediatrics ,Purtscher like retinopathy ,medicine ,Humans ,Linfohistiocitosis hemofagocitica ,Child ,Retinopatia Purtscher-like ,Abstract case ,Dermatomiositis ,business.industry ,General Medicine ,Progressive muscle weakness ,medicine.disease ,Retinopatia de Purtscher ,Dermatology ,Purtscher-like retinopathy ,030221 ophthalmology & optometry ,Female ,business ,Retinopathy - Abstract
Case report An 11 year-old girl with progressive muscle weakness due to dermatomyositis and hemophagocytic lymphohistiocytosis in which multiple cotton exudates, venous tortuosity and flame hemorrhages are detected in the funduscopic examination, leading to the diagnosis of Purtscher-like retinopathy. Discussion Purstcher's retinopathy is a microvascular disorder with clinical signs of probable thrombotic origin. Its treatment is controversial, with systemic corticosteroids being the most widespread choice.
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- 2018
7. Ocular Morbidity at High Altitude in Nepal
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Sabina Shrestha, Sushan Man Shresthatha, and Aparajita Manoranjan
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medicine.medical_specialty ,Intraocular pressure ,genetic structures ,Cross-sectional study ,business.industry ,Effects of high altitude on humans ,medicine.disease ,eye diseases ,Pterygium ,Retinal hemorrhages ,Venous tortuosity ,Altitude ,Ophthalmology ,medicine ,sense organs ,business ,Pseudophakia - Abstract
Introduction: Certain changes occur in high altitude which can be organic, motor or functional. This study was conducted to find out ocular morbidity at high altitude in Nepal. Methods: A cross sectional study was conducted at four different places at altitudes of 2710 m (Jomsom), 2900 m (Kagbeni), 3500 m (Jharkot) and 3800 m (Muktinath) of Mustang district of Nepal using convenient sampling method. A total of 222 subjects (444 eyes) were included. They were examined for vascular engorgement and tortuosity, arteriovenous ratio changes, retinal hemorrhages, cataract, pterygium, color vision and intraocular pressure. The motor changes like esodeviation and exodeviation were studied. Results: Of the total 222 participants, 164 (77.5%) were more than 40 years of age and 58 (22.5%) were less than 40 years. The male to female ratio was 1:1.1. The duration of stay at high altitude was >10 years in 96.6%, >15 years 88.3% and >20 years 83.8%. The prevalence of cataract was 19.8% and pseudophakia 17.1%. Other organic changes like venous engorgement, arterio-venous ratio changes and venous tortuosity was also found at high altitude. There was no significant change in intraocular pressure at high altitude. Esodeviation was present in 14%. The prevalence of pterygium was present in 39.6%. Similarly, the prevalence of red green color vision deficiency was 45.1%. Conclusion: Cataract, pterygium, red green color vision deficiency, esodeviation, venous engorgement and venous tortuosity were found to be prevalent at high altitude of Nepal.
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- 2017
8. Multiple retinal hemorrhages in bilateral congenital venous tortuosity
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Alba Martín-Prieto, María Soledad Rubio-Martínez, and Víctor Manuel Asensio-Sánchez
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medicine.medical_specialty ,Visual acuity ,genetic structures ,Posterior pole ,Case Report ,030204 cardiovascular system & hematology ,Fundus (eye) ,03 medical and health sciences ,Venous tortuosity ,Retinal hemorrhages ,0302 clinical medicine ,Acute onset ,Ophthalmology ,medicine ,business.industry ,General Medicine ,Retinal vascular tortuosity ,recurrent retinal hemorrhages ,eye diseases ,retinal vascular tortuosity ,unexplained retinal hemorrhages ,venular tortuosity ,030221 ophthalmology & optometry ,Vomiting ,sense organs ,medicine.symptom ,business - Abstract
We present a case of a previously healthy 52-year-old woman with acute onset of scotomas in both eyes. It was associated with headache and vomiting for the past 1 week after a cold. The best-corrected visual acuity was 20/20 in both eyes. The examination of bilateral fundus revealed a venous tortuosity and mild dilatation in the posterior pole, with pre- and intraretinal hemorrhages. However, vasculatures were normally straight in the mid-peripheral and peripheral retina of both eyes. Hemorrhages showed complete resolution without treatment. There was no change in the appearance and shape of the vasculature. Ophthalmologists should be aware of congenital venous tortuosity as a possible cause of retinal hemorrhages.
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- 2017
9. Anaemia induced vision loss
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Kai Ching Peter Leung and Kenneth K. W. Li
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medicine.medical_specialty ,genetic structures ,business.industry ,Retinal ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,eye diseases ,03 medical and health sciences ,Venous tortuosity ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Central retinal vein occlusion ,Ophthalmology ,medicine ,Optic disc swelling ,sense organs ,030212 general & internal medicine ,business ,Perfusion ,Retinal haemorrhage - Abstract
This funduscopic image shows right eye optic disc swelling, retinal haemorrhage, and venous tortuosity (arrows), all suggestive of central retinal vein occlusion; and a lack of retinal perfusion over …
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- 2020
10. Retinal and Cerebral Microvasculopathy:Relationships and Their Genetic Contributions
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Elles Konijnenberg, Pieter Jelle Visser, H. Stevie Tan, Frederik Barkhof, Jacoba A. van de Kreeke, H Ton Nguyen, Jori Tomassen, Dorret I. Boomsma, Frank D. Verbraak, Anouk den Braber, Carole H. Sudre, Mara ten Kate, Biological Psychology, APH - Mental Health, APH - Methodology, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, Ophthalmology, Neurology, Amsterdam Neuroscience - Neurodegeneration, Radiology and nuclear medicine, and Amsterdam Reproduction & Development (AR&D)
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Male ,Netherlands Twin Register (NTR) ,medicine.medical_specialty ,Cardiovascular risk factors ,Monozygotic twin ,Tortuosity ,White matter ,Cohort Studies ,03 medical and health sciences ,Venous tortuosity ,chemistry.chemical_compound ,0302 clinical medicine ,Retinal Diseases ,Risk Factors ,Ophthalmology ,Medicine ,Humans ,Registries ,Aged ,medicine.diagnostic_test ,business.industry ,Retinal Vessels ,Magnetic resonance imaging ,Retinal ,Twins, Monozygotic ,Middle Aged ,Twin study ,Magnetic Resonance Imaging ,White Matter ,Cerebrovascular Disorders ,medicine.anatomical_structure ,chemistry ,Cardiovascular Diseases ,030221 ophthalmology & optometry ,Female ,Gene-Environment Interaction ,business ,030217 neurology & neurosurgery - Abstract
Purpose: Retinal microvasculopathy may reflect small vessel disease in the brain. Here we test the relationships between retinal vascular parameters and small vessel disease, the influence of cardiovascular risk factors on these relationships, and their common genetic background in a monozygotic twin cohort.Methods: We selected 134 cognitively healthy individuals (67 monozygotic twin pairs) aged ≥60 years from the Netherlands Twin Register for the EMIF-AD PreclinAD study. We measured seven retinal vascular parameters averaged over both eyes using fundus images analyzed with Singapore I Vessel Assessment. Small vessel disease was assessed on MRI by a volumetric measurement of periventricular and deep white matter hyperintensities. We calculated associations between RVPs and WMH, estimated intratwin pair correlations, and performed twin-specific analyses on relationships of interest.Results: Deep white matter hyperintensities volume was positively associated with retinal tortuosity in veins (P = 0.004) and fractal dimension in arteries (P = 0.001) and veins (P = 0.032), periventricular white matter hyperintensities volume was positively associated with retinal venous width (P = 0.028). Intratwin pair correlations were moderate to high for all small vessel disease/retinal vascular parameter variables (r = 0.49-0.87, P < 0.001). Cross-twin cross-trait analyses showed that retinal venous tortuosity of twin 1 could predict deep white matter hyperintensities volume of the co-twin (r = 0.23, P = 0.030). Within twin-pair differences for retinal venous tortuosity were associated with within twin-pair differences in deep white matter hyperintensities volume (r = 0.39, P = 0.001).Conclusions: Retinal arterial fractal dimension and venous tortuosity have associations with deep white matter hyperintensities volume. Twin-specific analyses suggest that retinal venous tortuosity and deep white matter hyperintensities volume have a common etiology driven by both shared genetic factors and unique environmental factors, supporting the robustness of this relationship.
- Published
- 2018
11. Parafoveal OCT Angiography Features in Diabetic Patients without Clinical Diabetic Retinopathy: A Qualitative and Quantitative Analysis
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Mayer Srour, Alexandra Miere, Eric H. Souied, Oudy Semoun, Mathilde Goudot, Camille Jung, Anne Sikorav, Blandine Courbebaisse, and Joseph G. Freiha
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medicine.medical_specialty ,Article Subject ,genetic structures ,Fundus (eye) ,03 medical and health sciences ,Venous tortuosity ,0302 clinical medicine ,Qualitative analysis ,Oct angiography ,lcsh:Ophthalmology ,Ophthalmology ,medicine ,business.industry ,Diabetic retinopathy ,Foveal avascular zone ,medicine.disease ,Surgery ,Capillary density ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,sense organs ,business ,Quantitative analysis (chemistry) ,030217 neurology & neurosurgery ,Research Article - Abstract
Purpose. To evaluate the capacity of OCT angiography (OCTA) for detecting infraclinical lesions in parafoveal capillaries in diabetic patients without diabetic retinopathy (DR). Methods. This prospective observational cross-sectional case-control study analyzed the superficial and deep capillary plexuses (SCP and DCP) on macular OCTA scans (3 × 3 mm) centered on the fovea. We compared 22 diabetic patients (34 eyes included) without DR diagnosis on color fundus photographs, with 22 age- and gender-matched nondiabetic controls (40 eyes included). Qualitative analysis concerned morphological ischemic capillary alterations. Quantitative analysis measured foveal avascular zone (FAZ) size, parafoveal capillary density, and enlargement coefficient of FAZ between SCP and DCP. Results. Neither the qualitative nor quantitative parameters were significantly different between both groups. No microaneurysms or venous tortuosity was observed in any of the analyzed images. On the SCP, the mean FAZ area was 0.322 ± 0.125 mm2 in diabetic patients and 0.285 ± 0.150 mm2 in controls, P=0.31. On the DCP, the mean FAZ area was 0.444 ± 0.153 mm2 in cases and 0.398 ± 0.138 mm2 in controls, P=0.20. Conclusion. OCTA did not detect infraclinical qualitative or quantitative differences in parafoveal capillaries of diabetic patients without DR in comparison with nondiabetic controls.
- Published
- 2017
12. Plus Disease in Retinopathy of Prematurity: More Than Meets the ICROP?
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J. Peter Campbell, Sang Jin Kim, Susan Ostmo, Michael F. Chiang, R.V. Paul Chan, and Layla Ghergherehchi
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Diagnostic Imaging ,0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Diagnostic methods ,Magnification ,Disease ,Diagnostic Techniques, Ophthalmological ,Article ,03 medical and health sciences ,Venous tortuosity ,0302 clinical medicine ,medicine ,Humans ,Retinopathy of Prematurity ,Clinical care ,business.industry ,Infant, Newborn ,Childhood blindness ,Retinopathy of prematurity ,General Medicine ,medicine.disease ,Plus disease ,Ophthalmology ,030104 developmental biology ,030221 ophthalmology & optometry ,business ,Infant, Premature - Abstract
Retinopathy of prematurity (ROP), a vasoproliferative retinal disease affecting premature infants, is a leading cause of childhood blindness throughout the world. Plus disease, defined as venous dilatation and arteriolar tortuosity within the posterior retinal vessels greater than or equal to that of a standard published photograph, is the most critical finding in identifying treatment-requiring ROP. Despite an internationally accepted definition of plus disease, there is significant variability in diagnostic process and outcome, producing variable levels of reported intra- and interexpert agreement. Several potential explanations for poor agreement have been proposed, including attention to undefined vascular features such as venous tortuosity, focus on narrower or wider field of view, unfamiliarity with digital images, the magnification and apparent severity of the standard photograph, and cut-off point differences among experts as to the level of tortuosity and dilation sufficient for “plus disease” along a continuum. Moreover, differences in diagnostic consistency among groups of experts separated both geographically and chronologically have been reported. These findings have implications for clinical care, research, and education, and highlight the need for a more precise definition of plus disease and objective diagnostic methods for ROP.
- Published
- 2017
13. Whole organ vascular casting and microCT examination of the human placental vascular tree reveals novel alterations associated with pregnancy disease
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John D. Aplin, Edward D. Johnstone, Toluwalope O. Junaid, Robert S. Bradley, and Rohan M. Lewis
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0301 basic medicine ,Adult ,Pathology ,medicine.medical_specialty ,Biometry ,Science ,Placenta ,Biology ,Article ,03 medical and health sciences ,Venous tortuosity ,Young Adult ,Imaging, Three-Dimensional ,Pregnancy ,medicine ,Image Processing, Computer-Assisted ,Humans ,General ,Fetus ,Multidisciplinary ,Length density ,Vascular casting ,Human placenta ,Blood flow ,Anatomy ,X-Ray Microtomography ,medicine.disease ,Pregnancy Complications ,030104 developmental biology ,Intercurrent disease ,Medicine ,Female - Abstract
Experimental methods that allow examination of the intact vascular network of large organs, such as the human placenta are limited, preventing adequate comparison of normal and abnormal vascular development in pregnancy disease. Our aims were (i) to devise an effective technique for three-dimensional analyses of human placental vessels; (ii) demonstrate the utility of the technique in the comparison of placental vessel networks in normal and fetal growth restriction (FGR) complicated pregnancies. Radiopaque plastic vessel networks of normal and FGR placentas (n = 12/group) were created by filling the vessels with resin and corroding the surrounding tissues. Subsequently, each model was scanned in a microCT scanner, reconstructed into three-dimensional virtual objects and analysed in visualisation programmes. MicroCT imaging of the models defined vessel anatomy to our analyses threshold of 100 µm diameter. Median vessel length density was significantly shorter in arterial but longer in venous FGR networks compared to normals. No significant differences were demonstrable in arterial or venous tortuosity, diameter or branch density. This study demonstrates the potential effectiveness of microCT for ex-vivo examination of human placental vessel morphology. Our findings show significant discrepancies in vessel length density in FGR placentas. The effects on fetoplacental blood flow, and hence nutrient transfer to the fetus, are unknown.
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- 2016
14. The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation?
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Kwon-Duk Seo, Keung Sik Kim, Chul Hwan Park, In Kook Park, Yoo Jin Hong, Sang Hyun Suh, Geetanjali B. Tomar, and Tae Sub Chung
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Adult ,Male ,Hemangioma, Cavernous, Central Nervous System ,Medullary cavity ,Sensitivity and Specificity ,Hemangioma ,Venous tortuosity ,Developmental venous anomaly ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Vein ,Aged ,Neuroradiology ,medicine.diagnostic_test ,Brain Neoplasms ,business.industry ,Reproducibility of Results ,Magnetic resonance imaging ,Blood flow ,Anatomy ,Middle Aged ,medicine.disease ,Cerebral Veins ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Female ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business - Abstract
The aim of this paper was to evaluate the angioarchitectural factors that can induce concurrent cavernous malformation (CM) in the territory of developmental venous anomaly (DVA). From January 2006 to December 2007, 21 patients with 23 CMs in the territory of DVA were retrospectively analyzed (M; F = 12; 9, mean age = 53.3). Gadovist®-enhanced three-dimensional spoiled gradient-echo images on a 3 T magnetic resonance (MR) scanner were used. We investigated the presence of angioarchitectural factors: factor 1, the angulated course of curved medullary or draining vein in the distal portion of CM; factor 2, narrowing of distal draining vein; factor 3, severe medullary venous tortuosity. These were also analyzed for control group of 23 subjects (M; F = 11; 12, mean age = 46). Factor 1 was demonstrated in 22 cases (97%) and the CM occurred in a position of 90° or less of an abrupt angulated medullary or draining vein in 15 cases (65%) of the study group. Factor 2 was found in 13 cases (57%) with the diameter reduction of 50% or more in five cases. The mean ratio of diameter reduction was 0.53. Factor 3 was found in 17 cases (74%). Analyzing the independent factors, the p values for factors 1 and 3 were
- Published
- 2010
15. Fundus changes in thalassemia in Egyptian patients
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Ola Dabous, Passant Sayed Saif, and Ahmed Tamer Saif
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Retinal venous tortuosity ,medicine.medical_specialty ,Thalassemia ,Fundus (eye) ,Gastroenterology ,color vision defect ,03 medical and health sciences ,Venous tortuosity ,0302 clinical medicine ,Internal medicine ,Medicine ,retinal venous tortuosity ,medicine.diagnostic_test ,business.industry ,RE1-994 ,medicine.disease ,University hospital ,Pediatric clinic ,Ophthalmology ,030221 ophthalmology & optometry ,Serum iron ,thalassemia major ,iron chelators ,c/d ratio ,sense organs ,Hemoglobin ,business ,030217 neurology & neurosurgery - Abstract
Aim The aim of this study was to evaluate the fundus changes in thalassemic patients in Giza and Fayoum Governorates. Patients and methods Thirty thalassemic patients recruited from the Pediatric Hematology Clinic in Fayoum University Hospital, Misr University Hospital, and NILES Pediatric Clinic were included in the present study. All patients underwent complete ophthalmic examination and laboratory investigations. Results The mean age was 10.7±5.9 (6–36) years. There were 20 male patients (66.7%), with a mean duration of disease of 7.1±7.1 years (3 months to 36 years). Patients were classified on the basis of hemoglobin (Hb) level into two groups: 7 g/dl or less (thalassemia major) and greater than 7 g/dl (thalassemia intermediate and thalassemia minor). There was a significant correlation between cup/disc (C/D) ratio and Hb level (P
- Published
- 2017
16. Visual disturbance as the presenting symptom in acute promyelocytic leukaemia
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Vivek B. Pandya, Cheryl P. Au, and Julia Starte
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Male ,Retina ,Pathology ,medicine.medical_specialty ,business.industry ,Vision Disorders ,Retinal ,Middle Aged ,medicine.disease ,Cotton wool spots ,Ophthalmology ,Venous tortuosity ,chemistry.chemical_compound ,medicine.anatomical_structure ,Leukemia, Promyelocytic, Acute ,chemistry ,Visual Disturbance ,medicine ,Humans ,In patient ,Acute promyelocytic leukaemia ,medicine.symptom ,business ,Optometry ,Retinopathy - Abstract
Retinopathy in patients with haematological malignancy is a common finding, characterised by venous tortuosity, retinal haemorrhages, cotton wool spots and white‐centred haemorrhages (Roth spots).1...
- Published
- 2017
17. Computer-Based Image Analysis for Plus Disease Diagnosis in Retinopathy of Prematurity: Performance of the 'i-ROP' System and Image Features Associated With Expert Diagnosis
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Deniz Erdogmus, Michael F. Chiang, Samir N Patel, Susan Ostmo, Jayashree Kalpathy-Cramer, R.V. Paul Chan, Verónica Bolón-Canedo, Alican Bozkurt, Esra Ataer-Cansizoglu, J. Peter Campbell, and Karyn Jonas
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medicine.medical_specialty ,business.industry ,Biomedical Engineering ,Computer based ,Retinopathy of prematurity ,Pattern recognition ,Articles ,medicine.disease ,Plus disease ,Ophthalmology ,Venous tortuosity ,Feature (computer vision) ,Medicine ,Dilation (morphology) ,Artificial intelligence ,business ,Grading (tumors) ,Reference standards - Abstract
We developed and evaluated the performance of a novel computer-based image analysis system for grading plus disease in retinopathy of prematurity (ROP), and identified the image features, shapes, and sizes that best correlate with expert diagnosis.A dataset of 77 wide-angle retinal images from infants screened for ROP was collected. A reference standard diagnosis was determined for each image by combining image grading from 3 experts with the clinical diagnosis from ophthalmoscopic examination. Manually segmented images were cropped into a range of shapes and sizes, and a computer algorithm was developed to extract tortuosity and dilation features from arteries and veins. Each feature was fed into our system to identify the set of characteristics that yielded the highest-performing system compared to the reference standard, which we refer to as the "i-ROP" system.Among the tested crop shapes, sizes, and measured features, point-based measurements of arterial and venous tortuosity (combined), and a large circular cropped image (with radius 6 times the disc diameter), provided the highest diagnostic accuracy. The i-ROP system achieved 95% accuracy for classifying preplus and plus disease compared to the reference standard. This was comparable to the performance of the 3 individual experts (96%, 94%, 92%), and significantly higher than the mean performance of 31 nonexperts (81%).This comprehensive analysis of computer-based plus disease suggests that it may be feasible to develop a fully-automated system based on wide-angle retinal images that performs comparably to expert graders at three-level plus disease discrimination.Computer-based image analysis, using objective and quantitative retinal vascular features, has potential to complement clinical ROP diagnosis by ophthalmologists.
- Published
- 2015
18. Early bevacizumab treatment of central retinal vein occlusion
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Hideki Koizumi, Daniela Ferrara, and Richard F. Spaide
- Subjects
Male ,Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Visual acuity ,genetic structures ,Bevacizumab ,Visual Acuity ,Angiogenesis Inhibitors ,Antibodies, Monoclonal, Humanized ,Early initiation ,Retina ,Injections ,Venous tortuosity ,chemistry.chemical_compound ,Central retinal vein occlusion ,Ophthalmology ,Retinal Vein Occlusion ,medicine ,Head swelling ,Humans ,Aged ,Retrospective Studies ,business.industry ,Antibodies, Monoclonal ,Retinal ,medicine.disease ,eye diseases ,Surgery ,Vitreous Body ,chemistry ,Optic nerve ,Female ,sense organs ,medicine.symptom ,business ,Tomography, Optical Coherence ,medicine.drug - Abstract
Purpose To evaluate the change in visual acuity and retinal appearance in patients after early initiation of intravitreal bevacizumab treatment for central retinal vein occlusion (CRVO). Design Retrospective, interventional case series. Methods Patients with CRVO of fewer than three months' duration receiving intravitreal bevacizumab as primary treatment were evaluated. Patients received an intravitreal 1.25 mg (0.05 ml) bevacizumab injection. Changes in visual acuity, central macular thickness, venous tortuosity and diameter, and optic disk edema were noted. Results Six eyes of five consecutive patients with CRVO treated with intravitreal bevacizumab injection were reviewed retrospectively. The patients did not have other ocular conditions that could have compromised visual acuity. The mean baseline visual acuity was 20/428 (logarithm of the minimum angle of resolution [logMAR] units, 1.33). The mean follow-up period was 12 months (range, seven to 15 months), and the number of bevacizumab injections ranged from four to 10. The patients showed a statistically significant decrease in optic nerve head swelling, venous tortuosity, and venous diameter, with the largest proportion of change occurring within one month of the first bevacizumab injection. The mean visual acuity at last follow-up was 20/53 (logMAR units, 0.42; P = .035, as compared with baseline). In no patient did collateral vessels at the optic nerve head develop. Conclusions The patients experienced a dramatic improvement in the visual acuity and clinical fundus appearance, without collateral vessel formation. These findings are difficult to explain with current theories of the pathophysiologic features of CRVO. These findings also suggest early initiation of anti–vascular endothelial growth factor (VEGF) treatment should be studied in a larger trial for CRVO.
- Published
- 2007
19. Decreased venous tortuosity associated with resolution of macular edema after intravitreal injection of triamcinolone
- Author
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Alain Gaudric, José Sahel, Jean-François Girmens, Valérie Krivosic, Michel Paques, and Céline Giraud
- Subjects
Adult ,Male ,medicine.medical_specialty ,Triamcinolone acetonide ,Visual Acuity ,Triamcinolone Acetonide ,Macular Edema ,Injections ,Venous tortuosity ,Ophthalmology ,medicine ,Humans ,Fluorescein Angiography ,Macular edema ,Glucocorticoids ,Intraocular Pressure ,business.industry ,Resolution (electron density) ,General Medicine ,Middle Aged ,medicine.disease ,Retinal Vein ,Vitreous Body ,Female ,business ,medicine.drug - Published
- 2005
20. Arterial Tortuosity Syndrome
- Author
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Xavier Jeunemaitre, Florence Casagrande, Nicolas Hugues, Dorothée Ducreux, Fabienne Giuliano, Pamela Moceri, Philippe Benoit, Christian Dageville, Pierre Cerboni, Marie Saint-Faust, Caroline Devos, and Juliette Albuisson
- Subjects
medicine.medical_specialty ,Arterial tortuosity syndrome ,Aorta ,business.industry ,medicine.disease ,Tortuosity ,Surgery ,Venous tortuosity ,medicine.anatomical_structure ,Internal medicine ,medicine.artery ,Intensive care ,Circulatory system ,Cardiology ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Vein ,Artery - Abstract
[Figure][1] [![Graphic][3] ][3] A newborn, first child of consanguineous parents was admitted to intensive care because of persistent pulmonary hypertension. The diagnosis of arterial tortuosity syndrome (ATS) was suspected due to severe tortuosity of the aorta (A) and pulmonary
- Published
- 2013
21. Retinal abnormalities associated with anemia
- Author
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Anita M. Goodman, Mindy L. Aisen, Bruce R. Bacon, and Edward M. Chester
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Anemia ,Hematocrit ,Significant negative correlation ,Venous tortuosity ,chemistry.chemical_compound ,Retinal Diseases ,Internal medicine ,Medicine ,Humans ,Aged ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Retinal Hemorrhage ,Retinal ,Middle Aged ,Control subjects ,medicine.disease ,Retinal Vein ,Ophthalmology ,medicine.anatomical_structure ,chemistry ,Chronic Disease ,Cardiology ,Female ,business ,Optic disc - Abstract
• The incidence of clinically apparent retinal changes in 35 anemic patients and 35 age- and sex-matched control subjects was studied. Retinal photographs of all subjects were obtained. From these, all vascular and extravascular retinal lesions were noted. No retinal abnormalities were observed in the control subjects. Seven (20%) of the anemic patients exhibited extravascular lesions. There was no relationship detected between the occurrence of these changes and the severity or the cause of the anemia. Employing the assumption that true venous length for a given net distance traveled correlates with the degree of venous tortuosity, venous length over a standard radial distance from the optic disc was assessed with a curvometer. A significant negative correlation was determined between venous length and the level of hematocrit, thereby implying that retinal venous tortuosity is directly related to severity of anemia.
- Published
- 1983
22. Optic Nerve Decompression
- Author
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Rodney I. Kellen and Ronald M. Burde
- Subjects
medicine.medical_specialty ,genetic structures ,Pseudotumor cerebri ,Decompression ,business.industry ,Retrobulbar optic nerve ,Clinical settings ,medicine.disease ,eye diseases ,Surgery ,Raised intracranial pressure ,Ophthalmology ,Venous tortuosity ,Visual function ,medicine ,business ,Optic nerve decompression - Abstract
To the Editor. —In their article, Hupp et al 1 reviewed their experience with retrobulbar optic nerve decompression in a variety of clinical settings. The longest follow-up period in their series was nine years. In their review of the literature, they referred to a case of pseudotumor cerebri in which we reported successful reversal of visual loss following bilateral optic nerve decompression. 2 We are now able to provide follow-up information 13 years later. Although the patient was an extremely poor complier in terms of medications and weight reduction and despite persistently raised intracranial pressure, she had visual acuities of 20/25 OU with full kinetic visual fields when last seen, in April 1986. Both discs were flat and pink with very mild blurring of the nasal margins and some residual venous tortuosity. This excellent long-term result confirms our belief that optic nerve decompression is valuable in protecting visual function in
- Published
- 1987
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