Richard H Roe

University of California, Los Angeles, Los Angeles, California, United States

Are you Richard H Roe?

Claim your profile

Publications (12)21.95 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to describe the occurrence of a retinal pigment epitheliopathy associated with macular telangiectasis and intraretinal crystal deposits in three human immunodeficiency virus-positive patients receiving long-term ritonavir as part of highly active antiretroviral therapy. The patient's records were reviewed. The CD4 T-cell counts at presentation were 163 cells per microliter, 464 cells per microliter, and 349 cells per microliter, and viral loads were undetectable in all patients. None of the patients had a concurrent AIDS-defining illness. Other significant medical history included hyperlipidemia in one patient and a remote history of lymphoma and tuberculosis in a second patient. Initial visual acuity ranged from 20/32 to 20/400, with a median of 20/150. Anterior segment examination and intraocular pressures were normal in all eyes. Posterior segment examination revealed bilateral macular retinal pigment epitheliopathy with intraretinal crystalline deposits. No hemorrhage or cotton wool spots were seen consistent with human immunodeficiency virus retinopathy, and there was no evidence of previous or active cystomegalovirus retinitis. Fluorescein angiography revealed parafoveal telangiectasis with late leakage in two of the three patients. Optical coherence tomography showed thickening of the macula in three eyes and inner foveal cysts in two eyes. Autofluorescence performed on one patient revealed complete loss of normal retinal pigment epithelium autofluorescence corresponding to the area of retinal pigment epitheliopathy bilaterally. The only medicine common to all 3 patients was ritonavir, and the duration of ritonavir therapy before presentation was 19 months in one patient, 30 months in the second patient, and 5 years in the third patient. Retinal changes characterized by retinal pigment epitheliopathy, parafoveal telangiectasias, and intraretinal crystal deposits occurred in three human immunodeficiency virus-positive patients on long-term ritonavir as part of highly active antiretroviral therapy.
    Retina (Philadelphia, Pa.) 10/2010; 31(3):559-65. · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To report unexplained severe central vision loss accompanied by a dense central scotoma as an uncommon complication following epiretinal membrane removal. Retrospective, multicentred, case series. Six patients underwent uncomplicated vitrectomy surgery between 2000 and 2007 at four separate retina practices for removal of an epiretinal membrane. Preoperative vision ranged from 20/60 to 20/100, with a median of 20/70. On the first day postoperatively, all patients noted decreased vision ranging from counting fingers to light perception and were found to have a dense central scotoma. Posterior segment examination revealed a white, oedematous macula in all affected eyes. Vision improved minimally during the follow-up period, which ranged from 2 months to 5 years. The final vision ranged from 20/200 to hand movements. No anatomic or physiologic cause for the decreased vision and central scotoma was identified. While uncommon, severe, permanent, central vision loss accompanied by a dense central scotoma can occur following epiretinal membrane removal and should be considered when assessing the risks and benefits of such surgery.
    The British journal of ophthalmology 08/2010; 94(8):1033-9. · 2.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Retina (Philadelphia, Pa.) 06/2010; 30(7):1155-8. · 2.93 Impact Factor
  • Richard H Roe, Emmett T Cunningham
    Canadian Journal of Ophthalmology 02/2010; 45(1):81. · 1.15 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To report findings over 25 years of follow-up on a case of bilateral obliterative idiopathic juxtafoveolar retinal telangiectasis. Method: Case report. Results: A 25-year-old white man with obliterative idiopathic juxtafoveolar retinal telangiectasis presented with a visual acuity of 20/30 in the right eye and 20/40 in the left. Fluorescein angiography revealed bilateral enlarged foveal avascular zones and late perifoveal leakage. Six years after presentation, the foveal avascular zone had enlarged only slightly in both eyes and the leakage had almost entirely subsided. For the next 19 years, the visual acuity and clinical findings have remained unchanged. His most recent visual acuity was 20/25 in the right eye and 20/40 in the left. No treatment was given throughout the entire follow-up period of 25 years. Conclusion: Obliterative idiopathic juxtafoveolar retinal telangiectasis is a rare disorder that may initially progress with subsequent stabilization and good long-term visual outcome.
    Retinal Cases & Brief Reports 12/2009; 4(1):86-90.
  • The British journal of ophthalmology 06/2009; 93(5):701-2. · 2.92 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To describe a patient with angioid streaks and optic nerve head drusen associated with familial tumoral calcinosis (FTC). Design: Retrospective, observational case report. Methods: The patient's records were reviewed. Results: After receiving blunt trauma to the head, the patient presented with loss of vision in the left eye. Fundus examination revealed bilateral angioid streaks, optic nerve head drusen, and choroidal ruptures associated with subretinal hemorrhages. Subsequent physical, laboratory, and radiologic examinations revealed periarticular calcification, elevated serum phosphate levels, and normal calcium levels, consistent with FTC. Conclusions: FTC should be considered in the differential diagnosis for patients presenting with angioid streaks and optic nerve head drusen.
    Retinal Cases & Brief Reports 12/2008; 3(1):54-56.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: To describe a patient with a giant pigment epithelial detachment (PED) successfully treated with intravitreal bevacizumab. Design: Retrospective, observational case report. Methods: The patient's records were reviewed. Results: An 81-year-old man with history of age-related macular degeneration was seen on routine follow-up examination with an asymptomatic PED temporal to the macula in the right eye and visual acuity of 20/40. The patient was observed. Ten months later, the patient was found to have decreased vision to 20/80 and massive enlargement of the PED, with extension from the temporal equator into the macula. Optical coherence tomography of the macula showed a PED with overlying intraretinal cysts. The patient was given injections of intravitreal bevacizumab for every 4 months (1.25 mg) with complete resolution of the PED and return to baseline visual acuity of 20/40. Conclusion: Giant PED secondary to exudative age-related macular degeneration can be successfully treated with intravitreal bevacizumab.
    Retinal Cases & Brief Reports 12/2008; 3(2):130-132.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe a patient with HLA-B27-associated anterior uveitis who developed hypotony maculopathy. Visual acuity, biomicroscopic slit-lamp examination, and fluorescein angiogram. Following an episode of acute anterior nongranulomatous HLA-B27-associated uveitis, the patient developed decreased vision, choroidal folds, optic disc edema, and a serous exudative detachment characteristic of hypotony maculopathy. The intraocular pressure was noted to be 4 mmHg. Following therapy with topical 1% prednisolone acetate and 5% homatropine, both the intraocular pressure and retinal anatomy normalized. Hypotony maculopathy may be seen in patients with HLA-B27-associated uveitis and should be considered as a cause of vision loss in patients with this condition.
    Ocular immunology and inflammation 01/2008; 16(3):107-8. · 0.72 Impact Factor
  • International Ophthalmology Clinics 01/2008; 48(3):93-105.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe a patient with oculoleptomeningeal amyloidosis associated with infiltration of the vitreous, elevated intraocular pressures (IOPs), and seizures caused by a TTR Val30Gly mutation in the transthyretin gene. Interventional clinicopathologic report. A 44-year-old man with refractory bilateral intermediate uveitis, elevated IOPs, and seizures. The patient underwent diagnostic pars plana vitrectomy in both eyes. Intraocular and intracerebral pressures were controlled by trabeculectomy and cerebroventricular shunt placement, respectively. Visual acuity, histopathologic analysis of vitreous and leptomeningeal tissue, genetic testing, and magnetic resonance imaging of the brain. After failure of the patient to respond to topical and periocular corticosteroid therapy, a pars plana vitrectomy was performed and revealed amorphous material that showed green birefringence and dichroism on Congo red staining, establishing the diagnosis of vitreous amyloidosis. A full medical workup, including genetic testing, revealed a TTR Val30Gly mutation in the transthyretin gene. The patient subsequently developed elevated IOPs requiring bilateral trabeculectomy surgery and episodic seizures associated with leptomeningeal enhancement on magnetic resonance imaging. Histopathological analysis of a leptomeningeal biopsy taken at the time of surgery revealed amyloid infiltration, confirming the diagnosis of oculoleptomeningeal involvement by his amyloidosis. A ventriculoperitoneal shunt was placed. Amyloidosis should be considered in patients who present with vitritis that is unresponsive to corticosteroid therapy. Vitreous biopsy with histopathological analysis is recommended in these cases. Additionally, sequencing of the transthyretin gene should be considered in patients with vitreous amyloidosis to help establish known genetic syndromes and predict both ocular and systemic comorbidities. Although not described previously, elevated IOP may develop in patients with vitreous amyloidosis due to a TTR Val30Gly mutation in the transthyretin gene.
    Ophthalmology 12/2007; 114(11):e33-7. · 5.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    Retina 11/2006; 26(8):954-9. · 2.83 Impact Factor

Publication Stats

30 Citations
21.95 Total Impact Points

Institutions

  • 2010
    • University of California, Los Angeles
      Los Angeles, California, United States
    • University of California, San Francisco
      San Francisco, California, United States
    • Retina-Vitreous Associates Medical Group
      Los Angeles, California, United States
  • 2008
    • California Pacific Medical Center Research Institute
      • Department of Ophthalmology
      San Francisco, CA, United States
  • 2007
    • New York University
      • Department of Ophthalmology
      New York City, NY, United States