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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A unique clinical entity of multiple recurrent serosanguineous retinal pigment epithelial detachments in three black women was first described by the authors in 1985. Nine patients with this entity have now been observed, all of whom have developed a vitreous hemorrhage in at least one eye. Vitreous hemorrhage was the initial clinical presentation in seven eyes and developed 63.5 months after initial presentation in another patient who eventually sustained bilateral vitreous hemorrhages. Ultrasonographic examination in this entity often shows a characteristic pattern of irregular choroidal thickening and retinal elevation, which may aid in the diagnosis when the presentation is that of a vitreous hemorrhage of unknown origin. Vitrectomy has been performed in three cases, two of these retaining clear media during subsequent follow-up. Postvitrectomy vision correlated with the extent of macular involvement by the underlying disease. Eight patients had a history of, or evidence of, hypertension. Although choroidal neovascular membranes are a potential cause, the definitive etiology is not known.
Retina 1990
PMID:An update on multiple recurrent serosanguineous retinal pigment epithelial detachments in black women. 218 13

Three young women developed acute macular neuroretinopathy with persistent paracentral scotomas following acute hypertension caused by intravenous sympathomimetics. The temporal relationship of the acute onset of symptoms suggests either acute hypertension or a direct retinal effect of sympathomimetics as the cause of the retinal changes.
Retina 1989
PMID:Acute macular neuroretinopathy following intravenous sympathomimetics. 262 43

Although uncommon, a wide variety of ocular manifestations can be seen in polyarteritis nodosa. These occur as a result of the arteritis or secondary to the associated renal induced hypertension. A case of biopsy documented polyarteritis nodosa is reported in which the patient presented with bilateral iritis, vitritis, and a retinal vasculitis involving both the retinal arteries and veins, a feature not described previously. Patients with this potentially fatal disorder may initially present with ocular involvement; thus ophthalmologists should be familiar with the clinical features of this disease.
Retina 1986
PMID:Retinal vasculitis in polyarteritis nodosa. 288 10

A series of 24 consecutive patients presenting with a fundus picture characterized by a predominance of cotton-wool spots, or a single cotton-wool spot, is reported. Excluded were patients with known diabetes mellitus. Etiologic conditions found included previously undiagnosed diabetes mellitus in five patients, systemic hypertension in five patients, cardiac valvular disease in two patients, radiation retinopathy in two patients, and severe carotid artery obstruction in two patients. Dermatomyositis, systemic lupus erythematosus, polyarteritis nodosa, leukemia, AIDS, Purtscher's retinopathy, metastatic carcinoma, intravenous drug abuse, partial central retinal artery obstruction, and giant cell arteritis were each found in one patient. In only one patient did a systemic workup fail to reveal an underlying cause. The presence of even one cotton-wool spot in an otherwise normal fundus necessitates an investigation to ascertain systemic etiologic factors.
Retina
PMID:Cotton-wool spots. 386 24

We looked at the results of 89 consecutive diabetic eyes with diffuse macular edema that had been treated with grid laser photocoagulation. Sixty (67%) eyes improved anatomically post-laser, ie the amount of edema was less. Fifteen (17%) eyes improved in visual acuity by two or more lines following treatment. Sixty-nine (77%) experienced no change, or changed by only one line; five eyes (6%) experienced a decrease in visual acuity by two or more lines. Clinical findings having significantly poorer visual prognoses were the presence of foveal exudate, hypertension, macular capillary nonperfusion, and poor preoperative visual acuity. Whether or not treated eyes do better than untreated eyes cannot be determined by a retrospective study such as this, and awaits the results of a larger, prospective, randomized, controlled, clinical trial.
Retina
PMID:Grid photocoagulation for diffuse macular edema. 404 61

The clinical and histopathologic features of 29 eyes from 28 patients with central retinal vein occlusion (CRVO) are reported. A fresh or a recanalized thrombus was observed in each eye. This study considers the temporal aspects of the cases, and it notes the different morphologic features of the occlusion. These observations explain most of the variability of the changes observed in previous reports. We believe these different features representthe various stages in the natural evolution of such a thrombus. The interval between CRVO and histopathologic study in our series ranged from six hours to more than ten years. Local and systemic factors were reviewed and were found to be important in the pathogenesis of thrombus formation. Local diseases with a predisposing effect on CRVO included: glaucoma, papilledema, subdural hemorrhage, optic nerve hemorrhage, and drusen of the optic nerve head. Associated systemic diseases included: hypertension, cardiovascular and cerebrovascular disease, diabetes mellitus, and leukemia with thrombocytopenia. A fresh thrombus in the CRVO was observed in three (10.3%), and a recanalized thrombus in 26 eyes (89.7%). Endothelial-cell proliferation was a conspicuous feature in 14 (48.3%) of the eyes. Chronic inflammation in the area of the thrombus and/or vein wall or perivenular area was observed in 14 (48.3%) of the eyes. Arterial occlusive disease was observed in seven eyes (24.6%). Cystoid macular edema was found in 26 (89.7%) of the eyes.
Retina 1981
PMID:Central retinal vein occlusion: a prospective histopathologic study of 29 eyes in 28 cases. 1563 6

Guidelines originally were published in 2002 based on best available scientific data as well as consensus of expert opinion in the absence of controlled clinical trial data to assist ophthalmologists with selection of patients for whom photodynamic therapy with verteporfin (Visudyne, Novartis AG, Basel, Switzerland), termed "verteporfin therapy," should be considered, and to offer suggestions regarding initial treatment, follow-up, and additional courses of treatment at follow-up. Consensus was based on results of clinical trials and expert opinion. Additional input and advice were received from representatives on behalf of the American Society of Retina Specialists, the Macula Society, and the Retina Society, as well as principal investigators of randomized clinical trials evaluating verteporfin therapy. Since 2002, additional information relevant to clinical care was published in the peer-reviewed literature; therefore, revisions to the originally published guidelines judged warranted are provided here. Patient selection criteria include the following: (1) in cases due to age-related macular degeneration (AMD), lesion composition of (a) predominantly classic choroidal neovascularization (CNV), (b) occult with no classic CNV with presumed recent disease progression, or (c) relatively small minimally classic lesions; (2) CNV location subfoveal or so close to the foveal center that conventional laser photocoagulation treatment almost certainly would extend under the center; (3) etiology of CNV from AMD, pathologic myopia, or other causes in which the outcome without treatment is likely to be worse than with treatment; and (4) vision at a level where further loss would be recognized as detrimental to the quality of life of the patient. Criteria include lesion size for AMD patients with either a minimally classic lesion composition (where treatment usually should be considered only for relatively smaller lesions) or occult with no classic lesions (where treatment usually should be considered for relatively smaller lesions or those >4 Macular Photocoagulation Study disc areas with a relatively lower or poorer best-corrected visual acuity) but not patient age, history of systemic arterial hypertension, or prior laser photocoagulation. Therapy should be initiated ideally within 1 week of the initial fluorescein angiogram on which the clinical decision to treat is based. Patients should return for follow-up at least as often as every 3 months (+/-2 weeks) after any initial or subsequent treatment to determine if there is fluorescein leakage from CNV. Additional courses of treatment should be considered as often as every 3 months (+/-2 weeks) if fluorescein leakage from CNV is noted at that time. Additional courses of treatment could be deferred if the biomicroscopic and fluorescein angiographic appearances of the lesion are unchanged and show minimal fluorescein leakage, especially when there is no subretinal fluid or fluorescein leakage from CNV underlying the center of the foveal avascular zone. Patients should avoid exposure of skin or eyes to direct sunlight or bright indoor light for 48 hours after treatment or until resolution of any swelling or discoloration from extravasation. Follow-up of relatively larger minimally classic lesions and occult with no classic lesions that initially do not undergo therapy appears indicated so therapy can be considered if a predominantly classic lesion develops or, in the case of occult with no classic lesions, if visual acuity declines slightly to a lower (poorer) level without a marked increase in lesion size. Additional revisions of these guidelines may be required as new data become available.
Retina
PMID:Guidelines for using verteporfin (Visudyne) in photodynamic therapy for choroidal neovascularization due to age-related macular degeneration and other causes: update. 1568

Retina vessel analyzer (RVA) provides the functional examination of retinal vessels based on the analysis of the extent (size) of their dilation and constriction. The RVA measures continuously on-line the diameter of retinal arteries and veins after different kind of stimulation. Beyond dynamic vessel analysis, another possibility of the RVA's utilization is a static vessel assessment, measuring the arterial and venous diameter ratio (A/V ratio), which provides the information about the rate of arterial vasoconstriction. The aim of the presented study was to investigate static and dynamic retinal vessel changes in patients with central retinal vein occlusion (Group 1). The second investigated group consists of patients with arterial hypertension; as a control group, healthy persons without any vascular disease were examined. Altogether 40 eyes were examined. Statistically significant differences of A/V ratio were observed in the static vessel analysis in all three investigated groups. The dynamic analysis showed statistically significant differences in arterial dilatation and constriction between all investigated groups as well. The presented results confirm that the degree of retinal vessels endothelial dysfunction is one of the determinating ethiopathological factors of central retinal vein occlusion.
 ...
PMID:[Functional examination of retinal vessels in patients with central retinal vein occlusion]. 1741 21

To correlate Heidelberg Retina Tomograph (HRT) derived macular edema (DME) index with severity of diabetic retinopathy and systemic factors. A total of 300 diabetic patients were recruited for the study for each of them a value for the macular edema index was obtained using the HRT II. Patients' age, gender, duration and type of diabetes mellitus, latest HbA1c result and presence or absence of co-morbid factors (hypertension, ischemic heart disease, nephropathy) were recorded together with the stage of diabetic retinopathy. These were correlated with DME. Out of 300 patients, HRT defined macula edema was seen in 68 patients (22.6%). There is a wider and higher range (95% percentile) of macula edema index in the severe non proliferative diabetic retinopathy (NPDR) group. Independent samples t test showed significant difference between the severe NPDR group and no DR group (p<0.001), mild NPDR group (p<0.05) and moderate NPDR group (p<0.05). A higher macula edema index was also found to have a low degree of correlation with more advanced stages of retinopathy (r=0.310; p<0.001). Also nephropathy showed a strong and significant correlation with DME. Hypertension had moderately significant correlation with DME. This study found no correlation between ischemic heart disease and DME. HRT derived scanning laser edema index is a reliable objective tool to evaluate diabetic retinopathy and systemic risk factors.
 ...
PMID:Scanning laser edema index: a reliable tool to correlate with diabetic retinopathy and systemic risk factors? 2252 Mar 99

Ambrisentan (Letairis; Gilead Sciences, Foster City, CA) is an endothelin receptor antagonist approved by the U.S. Food and Drug Administration for the treatment of pulmonary arterial hypertension. The authors describe the occurrence of bilateral cotton wool spots soon after initiation of ambrisentan treatment in a 29-year-old woman. Fluorescein angiography, optical coherence tomography, and fundus autofluorescence were performed. After discontinuation of ambrisentan, the cotton wool spots resolved without recurrence. To the authors' knowledge, this is the first report of retinopathy in the form of cotton wool spots associated with the use of an endothelin receptor antagonist.
Ophthalmic Surg Lasers Imaging Retina
PMID:Bilateral cotton wool spots after use of an endothelin receptor antagonist. 2445


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