San-Ni Chen1, Chen-Cheng Chao, Jiunn-Feng Hwang, Chung-May Yang. 1. *Department of Ophthalmology, Changhua Christian Hospital, Changhua City, Taiwan; †School of Medicine, Chung-Shan Medical University, Taichung, Taiwan; ‡School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; §Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan; and ¶School of Medicine, National Taiwan University, Taipei, Taiwan.
Abstract
PURPOSE: To report the clinical characteristics of central retinal artery occlusion in eyes of proliferative diabetic retinopathy with previous vitrectomy and panretinal photocoagulation. METHODS: Retrospective case series. RESULTS: Twelve eyes in 12 patients (4 women and 8 men) with a mean age of 55.3 ± 6.2 years of age were included in this study. All patients had successful previous surgery for complications of proliferative diabetic retinopathy and complete panretinal photocoagulation performed. All patients had sudden visual deterioration and fluorescein angiography confirmed central retinal artery occlusion. Prominent cherry-red spot was noted in only two eyes. The other eyes either had less prominent or incomplete, or invisible cherry-red spots. Sequential optical coherence tomography in 7 of the 12 eyes showed increased optical reflectivity at inner retinal layer in 6 of the 7 eyes. Rubeosis iridis developed later in six eyes and neovascular glaucoma in four eyes. Vision worsening was noted in five eyes, improved in three eyes, and stable in four eyes after an averaged follow-up of 4 months. CONCLUSION: Less typical cherry-red spots, higher possibility of rubeosis despite previous complete panretinal photocoagulation, are the characteristic features of central retinal artery occlusion in patients with proliferative diabetic retinopathy with previous vitrectomy.
PURPOSE: To report the clinical characteristics of central retinal artery occlusion in eyes of proliferative diabetic retinopathy with previous vitrectomy and panretinal photocoagulation. METHODS: Retrospective case series. RESULTS: Twelve eyes in 12 patients (4 women and 8 men) with a mean age of 55.3 ± 6.2 years of age were included in this study. All patients had successful previous surgery for complications of proliferative diabetic retinopathy and complete panretinal photocoagulation performed. All patients had sudden visual deterioration and fluorescein angiography confirmed central retinal artery occlusion. Prominent cherry-red spot was noted in only two eyes. The other eyes either had less prominent or incomplete, or invisible cherry-red spots. Sequential optical coherence tomography in 7 of the 12 eyes showed increased optical reflectivity at inner retinal layer in 6 of the 7 eyes. Rubeosis iridis developed later in six eyes and neovascular glaucoma in four eyes. Vision worsening was noted in five eyes, improved in three eyes, and stable in four eyes after an averaged follow-up of 4 months. CONCLUSION: Less typical cherry-red spots, higher possibility of rubeosis despite previous complete panretinal photocoagulation, are the characteristic features of central retinal artery occlusion in patients with proliferative diabetic retinopathy with previous vitrectomy.
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