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      Hemorrhagic intraretinal macrocyst: Differential diagnoses and report of an unusual case

      case-report

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          Abstract

          Retinal ‘cysts’ may be single or multiple, ranging from two-to-ten disc diameters in size, and occur in eyes with longstanding retinal detachment. The authors describe a retinal macrocyst larger than ten disc diameters, with a blood-filled cavity, and its ultrasound findings. Improved retinal nourishment following retinal reattachment gradually reverses the process responsible for cystic degeneration, with the eventual collapse of the cyst (within days or weeks). Surprisingly, this giant cyst did not collapse for almost three years despite retinal reattachment. The internal mobile echogenic contents were suggestive of blood. The possible reason of blood in the cyst could be rupture of the retinal blood vessels in the cyst cavity. This could be a recurrent phenomenon, which did not allow the cyst to collapse. The Hemorrhagic Intraretinal Macrocyst needs to be differentiated from mimicking clinical conditions, namely, retinoschisis, choroidal melanoma, subretinal abscess, choroidal hemangioma, and the like. It could take up to a few years to collapse spontaneously, following successful retinal reattachment.

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          Most cited references12

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          Intraretinal macrocysts in retinal detachment.

          Seven cases of retinal detachment were associated with ophthalmoscopically visible macrocysts. These cysts were associated with long-standing retinal detachment, particularly of the traumatic type with retinal dialysis. They arose from the outer plexiform layer of the retina. In four cases, the macrocyst extended to the ora serrata. Most macrocysts require no specific attention during retinal detachment repair. If the cyst prevents closure of the primary retinal break, we advocate its surgical drainage. Four cases in the present series required surgical collapse of the macrocyst.
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            Coats' disease: a study of 62 histologically confirmed cases.

            We studied 62 eyes submitted to the Armed Forces Institute of Pathology (AFIP) from 1958 through 1980 that satisfied our criteria for the histologic diagnosis of Coats' disease. Our histopathologic definition of Coats' disease was the presence of a primary vascular lesion consisting of retinal telangiectasia with leakage of plasma to form intraretinal and subretinal exudates. In the cases we reviewed, Coats' disease occurred more frequently in boys, it usually affected only one eye, and was generally detected in the first decade of life. In 52 cases (79%) the clinical manifestations, strabismus and leukokoria, were thought to be caused by retinoblastoma. Angle closure glaucoma was present in 36 cases (58%). In all but one of the cases studied, the lesion was located peripheral to the equator. We further identified diffuse involvement of capillaries in the peripheral retina using trypsin-digest preparations. Associated histologic findings included: rubeosis iridis, cataract, vitreous neovascularization, and nodules resulting from fibrous metaplasia of the retinal pigment epithelium. These fibrous nodules typically occurred in the macular area and occasionally contained calcium or bone.
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              Tumors of the Eye

              AB Reese (1963)
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                Author and article information

                Journal
                Oman J Ophthalmol
                OJO
                Oman Journal of Ophthalmology
                Medknow Publications (India )
                0974-620X
                0974-7842
                Jan-Apr 2011
                : 4
                : 1
                : 28-31
                Affiliations
                [1]Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18, College Road, Chennai - 600 006, India
                Author notes
                Correspondence: Dr. Pukhraj Rishi, Sankara Nethralaya, 18, College Road, Chennai - 600 006, Tamil Nadu, India. E-mail: docrishi@ 123456yahoo.co.in
                Article
                OJO-4-28
                10.4103/0974-620X.77660
                3110444
                21713238
                396b87d4-6a1f-47e5-9d3b-25c1f0fc9b91
                Copyright: © 2011 Rishi P, et al

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Categories
                Case Report

                Ophthalmology & Optometry
                posterior scleritis,scleral buckling,retinal detachment,choroidal hemangioma,ultrasound,retinoschisis,subretinal abscess,hemorrhagic intraretinal macrocyst,malignant melanoma,retinal cyst

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