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RYAN’S
RETINA

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RYAN’S
RETINA SEVENTH EDITION
Editor-In-Chief

SriniVas R. Sadda,
Professor of Ophthalmology
MD
Doheny Eye Institute
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, CA, USA

VOLUME 1
Part 1: Retinal Imaging and Diagnostics
Edited by
David Sarraf, MD and K. Bailey Freund, MD
Part 2: Basic Science and Translation to Therapy
Edited by
David R. Hinton, MD

VOLUME 2
Medical Retina
Edited by
Andrew P. Schachat, MD, David Sarraf, MD, and K. Bailey Freund, MD
VOLUME 3
Part 1: Surgical Retina
Edited by
C.P. Wilkinson, MD and Peter Wiedemann, MD, FEBO
Part 2: Tumors of the Retina, Choroid, and Vitreous
Edited by
Andrew P. Schachat, MD

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Ryan’s RETINA
iii

110

SEVENTH EDITION
Editor-In-Chief
SRINIVAS R. SADDA, MD
Professor of Ophthalmology
Doheny Eye Institute
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, CA, USA

VOLUME 1
Part 1: Retinal Imaging and Part 2: Basic Science and Translation
Diagnostics to Therapy
Edited by Edited by
DAVID SARRAF, MD DAVID R. HINTON, MD
Clinical Professor of Ophthalmology Gavin S. Herbert Professor of Retinal Research
Stein Eye Institute Professor of Pathology and Ophthalmology
David Geffen School of Medicine USC Roski Eye Institute
University of California, Los Angeles Keck School of Medicine
Los Angeles, CA, USA University of Southern California
Los Angeles, CA, USA
K. BAILEY FREUND, MD
Clinical Professor
NYU Grossman School of Medicine
New York, NY, USA
Partner
Vitreous Retina Macula Consultants of New York
New York, NY, USA

VOLUME 2
Medical Retina
Edited by
ANDREW P. SCHACHAT, MD K. BAILEY FREUND, MD
Vice Chairman Clinical Professor
Cole Eye Institute NYU Grossman School of Medicine
Cleveland Clinic Foundation New York, NY, USA
Cleveland, OH, USA Partner
Vitreous Retina Macula Consultants of New York
New York, NY, USA
DAVID SARRAF, MD
Clinical Professor of Ophthalmology
Stein Eye Institute
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, CA, USA

VOLUME 3
Part 1: Surgical Retina Part 2: Tumors of the Retina, Choroid, and
Edited by Vitreous
C. P. WILKINSON, MD Edited by
Distinguished Emeritus Chairman ANDREW P. SCHACHAT, MD
Department of Ophthalmology Vice Chairman
Greater Baltimore Medical Center Cole Eye Institute
Professor (Retired), Department of Ophthalmology Cleveland Clinic Foundation
John Hopkins University Cleveland, OH, USA
Baltimore, MD, USA

PETER WIEDEMANN, MD, FEBO


Professor of Ophthalmology
Universität Leipzig
Leipzig, Germany

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© 2023, Elsevier Inc. All rights reserved.


First edition 1989
Second edition 1994
Third edition 2001
Fourth edition 2006
Fifth edition 2013
Sixth edition 2018
Seventh edition 2022

Chapter 10: “Diagnostic Ophthalmic Ultrasound” by Yale L. Fisher, Ronald H. Silverman, Gerardo Ledesma-Gil,
Michael Engelbert: Yale L. Fisher retains copyright of his original videos and images.

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Contents

Video Table of Contents, x 13. Visual Fields in Retinal Disease, 335


Sana Idrees, Amit A. Sangave, Rajeev S. Ramchandran
Contributors, xii
Video Contributors, xxvii PART 2
Dedication, xxix Basic Science and Translation to Therapy
Preface, xxx Edited by David R. Hinton

SECTION 1 Anatomy and Physiology


VOLUME 1
14. The Development of the Retina, 364
PART 1 Thomas A. Reh, Kiara C. Eldred, Akshayalakshmi Sridhar
Retinal Imaging and Diagnostics 15. Function and Anatomy of the Mammalian
Edited by David Sarraf and K. Bailey Freund
Retina, 378
1. Fluorescein Angiography: Basic Principles and Ronald G. Gregg, Joshua Singer, Maarten Kamermans,
Interpretation, 1 Maureen A. McCall, Stephen C. Massey
Judy J. Chen, Michelle Peng, Sara Haug, Arthur D. Fu, 16. Structure and Function of Rod and Cone
Robert N. Johnson, Anita Agarwal, J. Michael Jumper,
Photoreceptors, 421
Emmett T. Cunningham Jr., H. Richard McDonald
Jeannie Chen, Alapakkam P. Sampath
2. Clinical Applications of Diagnostic Indocyanine 17. Cell Biology of the Retinal Pigment
Green Angiography, 44 Epithelium, 443
Giovanni Staurenghi, Mariano Cozzi, Marco Pellegrini,
James T. Handa
Chiara Preziosa, Alessandro Invernizzi
18. Glial Cells of the Fovea, 458
3. Optical Coherence Tomography, 77 Andreas Bringmann, Peter Wiedemann
Nadia K. Waheed, Karen Jeng-Miller, Jay S. Duker
19. Retinal and Choroidal Vasculature: Retinal
4. Optical Coherence Tomography Angiography
Oxygenation, 476
(OCTA), 115 Maria B. Grant, Gerard A. Lutty
Kirk K. Hou, Adrian Au, Giulia Corradetti, SriniVas R. Sadda,
David Sarraf 20. Mechanisms of Normal Retinal Adhesion, 493
Michael F. Marmor
5. Autofluorescence Imaging, 145
Monika Fleckenstein, Steffen Schmitz-Valckenberg, 21. Structure, Function, and Pathology of Bruch’s
Frank G. Holz Membrane, 512
Christine A. Curcio, Mark Johnson
6. Widefield Imaging, 170
Michael A. Klufas, Szilárd Kiss 22. Vitreous and Vitreoretinal Interface, 534
J. Sebag
7. Advanced Imaging Technologies, 203
SriniVas R. Sadda, Pearse A. Keane, Joseph Carroll
SECTION 2 Basic Mechanisms of Injury in the
8. Artificial Intelligence and Advanced Imaging Retina
Analysis, 223
Yue Wu, Aaron Y. Lee 23. Mechanisms of Oxidative Stress in Retinal
Injury, 572
9. Clinical Electrophysiology, 260 Milam A. Brantley Jr., Allison C. Umfress, Paul Sternberg Jr.
Stephen H. Tsang, Graham E. Holder
24. Mechanisms of Endoplasmic Reticulum Stress
10. Diagnostic Ophthalmic Ultrasound, 291 in Retinal Disease, 586
Yale L. Fisher, Ronald H. Silverman, Gerardo Ledesma-Gil,
Sylvia B. Smith
Michael Engelbert
25. Cell Death, Apoptosis, and Autophagy in
11. Color Vision and Night Vision, 312
Dingcai Cao
Retinal Injury, 597
Michael E. Boulton, Carolina Francelin
12. Visual Acuity and Contrast Sensitivity, 327
Gary S. Rubin, Hannah M.P. Dunbar

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vi Contents

26. Inflammation and Immune Responses VOLUME 2


in Retinal Health and Disease, 617
Andrew D. Dick, Richard W. Lee, Rachel R. Caspi
Medical Retina
Edited by Andrew P. Schachat, David Sarraf, and K. Bailey Freund
27. Basic Mechanisms of Pathologic Retinal and
Choroidal Angiogenesis, 631 SECTION 1 Retinal Degenerations and
Takashi Ueta, Demetrios G. Vavvas, Joan W. Miller Dystrophies
28. Blood–Retinal Barrier, Immune Privilege, and 42. Macular Dystrophies, 879
Autoimmunity, 648 Ian C. Han, Robert F. Mullins, Edwin M. Stone, Elliott H. Sohn
Gayathri Tummala, Kathryn L. Pepple
43. Retinitis Pigmentosa and Allied Disorders, 926
29. Mechanisms of Diabetic Macular Edema and Mark E. Pennesi, Paul Yang, Kevin Gregory-Evans
Therapeutic Approaches, 659 44. Abnormalities of Rod and Cone Function, 1005
Alan W. Stitt, Noemi Lois, Antonia M. Joussen Anthony G. Robson, Anthony T. Moore, Jacque L. Duncan
30. Cellular Effects of Detachment and 45. Hereditary Vitreoretinal Degenerations, 1019
Reattachment on the Neural Retina and the Xiaoyan Ding, Yan Luo, Shibo Tang
Retinal Pigment Epithelium, 681
Louisa Wickham, Geoffrey P. Lewis, Steven K. Fisher, 46. Hereditary Choroidal Dystrophies, 1043
David G. Charteris Sandeep Grover, Gerald A. Fishman

31. Retinal Manifestations of Neurodegeneration: SECTION 2 Retinal Vascular Disease


A Focus on Alzheimer Disease, 696
Amir H. Kashani, Maya Koronyo-Hamaoui, Alfredo A. Sadun 47. Diabetic Retinopathy: Etiologic Mechanisms
and Genetics, 1053
SECTION 3 Genetics Jennifer K. Sun, Mohamed Ashraf, Lloyd Paul Aiello

32. Genetic Mechanisms of Retinal Disease, 709 48. Diabetes Mellitus, 1071
Kinga M. Bujakowska, Jason Comander, Ayellet V. Segrè Mario Skugor

33. Mitochondrial Genetics of Retinal Disease, 722 49. Nonproliferative Diabetic Retinopathy
M. Cristina Kenney, Deborah A. Ferrington, Sonali Nashine, and Diabetic Macular Edema, 1077
Nitin Udar Henry E. Wiley, Emily Y. Chew, Frederick L. Ferris III

34. Epigenetic Mechanisms of Retinal Disease, 735 50. Proliferative Diabetic Retinopathy, 1106
Shikun He, Renu Kowluru Jennifer K. Sun, Mohamed Ashraf, Paolo S. Silva, Lloyd Paul Aiello

35. Microbiome and Retinal Disease, 745 51. Telescreening for Diabetic Retinopathy, 1137
Allen Taylor, Sheldon Rowan, Yuilyn A. Chang Chusan Rajiv Raman, Tarun Sharma

52. Hypertension, 1146


SECTION 4 Translational Basic Science Carol Y. Cheung, Tien Yin Wong
36. Gene Therapy for Retinal Disease, 752 53. Retinal Artery and Capillary Occlusions, 1155
Jean Bennett, Albert M. Maguire Purnima S. Patel, SriniVas R. Sadda, David Sarraf
37. Stem Cells and Cellular Therapy for Retinal 54. Acquired Retinal Macroaneurysms, 1172
Degenerative Diseases, 779 Emily Y. Chew
M. Valeria Canto-Soler, Teisha J. Rowland, Tea Soon Park,
Dennis O. Clegg, Kapil Bharti 55. Branch Retinal Vein Occlusion, 1177
Sruthi Arepalli, Angela Bessette, Peter K. Kaiser
38. Nanomedicine in Ophthalmology, 796
Marco A. Zarbin, Mario D. Toro, James F. Leary, 56. Central Retinal Vein Occlusion, 1189
Carlo Montemagno, Robert Ritch, Mark S. Humayun Patrick Oellers, Paul Hahn, Michael S. Ip, Sharon Fekrat

39. Neuroprotection, 825 57. Macular Telangiectasia Type 2, 1205


Benedetto Falsini, Enrica Strettoi, Paul A. Sieving Emily Y. Chew, Richard F. Spaide

40. Drug Delivery, 849 58. Coats Disease, 1218


Erin B. Lavik, Mark S. Humayun Nikolas J.S. London, Carol L. Shields, Julia A. Haller

41. Retinal Laser Therapy: Biophysical Basis 59. Hemoglobinopathies, 1233


and Applications, 863 Ishrat Ahmed, Adrienne W. Scott, Morton F. Goldberg,
Daniel Palanker, Mark S. Blumenkranz Gerard A. Lutty

60. Radiation Retinopathy, 1250


Julie De Zaeytijd, Leigh Spielberg, Anita Leys

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Contents vii

61. Ocular Ischemic Syndrome, 1260 77. White Spot Syndromes and Related
Gary C. Brown, Sanjay Sharma, Melissa M. Brown Diseases, 1590
Rukhsana G. Mirza, Lee M. Jampol
62. Systemic Coagulopathy Syndromes, 1277
Sandra Liakopoulos, Florian M.A. Heussen, SriniVas R. Sadda, 78. Autoimmune Retinopathies, 1642
David Sarraf Hwei Wuen Chan, Omar A. Mahroo, Anthony G. Robson,
Adnan Tufail, Alan C. Bird, Jose S. Pulido
63. Pediatric Retinal Vascular Diseases, 1283
Aaron Nagiel, Thomas C. Lee, Michael F. Chiang 79. Sarcoidosis, 1657
Aniruddha Agarwal, Yasir Jamal Sepah, Douglas A. Jabs,
SECTION 3 Choroidal Vascular/Bruch’s Quan Dong Nguyen
Membrane Disease 80. Intermediate Uveitis, 1672
Phoebe Lin, Glenn J. Jaffe
64. Epidemiology and Risk Factors for Age-Related
Macular Degeneration, 1307 81. Rheumatic Disease, 1684
Johanna M. Seddon, Lucia Sobrin, Samaneh Davoudi Robert J. Barry, Alastair K. Denniston, Benjamin Rhodes, Mary
Gayed, David Carruthers, Caroline Gordon, Philip I. Murray
65. Pathogenesis of Age-Related Macular
Degeneration, 1325 Infections
Christine A. Curcio, Richard F. Spaide
82. HIV-Associated Infections, 1713
66. Age-Related Macular Degeneration: Non- Igor Kozak, J. Allen McCutchan, Doran Spencer,
Neovascular Early AMD, Intermediate AMD, William R. Freeman
and Geographic Atrophy, 1343
Voraporn Chaikitmongkol, Susan B. Bressler, Neil M. Bressler 83. Mycobacterial Infections, 1744
SR Rathinam, Perumalsamy Namperumalsamy
67. Neovascular Age-Related Macular
Degeneration, 1405 84. Eales Disease, 1754
Dhananjay Shukla, Perumalsamy Namperumalsamy
Enrico Borrelli, Eric H. Souied, Giuseppe Querques

68. Pharmacotherapy of Age-Related Macular 85. Spirochetal Infections, 1762


Julie H. Tsai, Narsing A. Rao
Degeneration, 1426
Greg Budoff, Loh-Shan B. Leung, Peter K. Kaiser, Pravin Dugel, 86. Ocular Toxoplasmosis, 1771
Brian Toy, Mark S. Blumenkranz, Marco A. Zarbin Rubens Belfort Jr, Heloisa Nascimento, Cristina Muccioli
69. Pathologic Myopia, 1473 87. Helminthic Disease, 1776
Kyoko Ohno-Matsui, Tatsuro Ishibashi Marcos Ávila, David L.C. Isaac
70. Angioid Streaks, 1493 88. Endogenous Endophthalmitis: Bacterial
Linda A. Lam and Fungal, 1792
Ajay E. Kuriyan, Stephen G. Schwartz, Janet L. Davis,
71. Ocular Histoplasmosis, 1503
Harry W. Flynn Jr.
Justis P. Ehlers, Andrew P. Schachat

72. Pachychoroid Disease and Its Association With 89. Acute Retinal Necrosis Syndrome, 1802
Sumit Sharma, Sunil K. Srivastava
Polypoidal Choroidal Vasculopathy, 1515
Chui Ming Gemmy Cheung, Won Ki Lee, Xiaoxin Li, 90. Drug Toxicity of the Posterior Segment, 1812
K. Bailey Freund Ivy Zhu, Michael T. Andreoli, Robert A. Mittra, William F. Mieler
73. Central Serous Chorioretinopathy, 1530 91. Photic Retinal Injuries: Mechanisms, Hazards,
Dennis Shun Chiu Lam, Camiel Jan Fons Boon, Nishant Vijay and Prevention, 1852
Radke, Elon Hendrik Cornelis van Dijk Martin A. Mainster, Radwan S. Ajlan
74. Uveal Effusion Syndrome and Hypotony 92. Traumatic Chorioretinopathies, 1869
Maculopathy, 1555 Dean Eliott, Thanos D. Papakostas
Cagri G. Besirli, Mark W. Johnson
93. Retinal and Choroidal Disorders in Pregnancy
SECTION 4 Inflammatory Disease/Uveitis (Pregnancy-Related Diseases), 1884
Sidney A. Schechet, Janet S. Sunness
Inflammation
94. Optic Disc Anomalies, Drusen, Pits,
75. Sympathetic Ophthalmia, 1568 Hypoplasia, and Associated Retinal
Daniel Vítor Vasconcelos-Santos, Narsing A. Rao Pathology, 1900
Rustum Karanjia, Alfredo A. Sadun
76. Vogt–Koyanagi–Harada Disease, 1577
Hiroshi Goto, P. Kumar Rao, Narsing A. Rao 95. Retina-Related Clinical Trials: A Resource
Bibliography, 1913
Barbara S. Hawkins, Jay Chhablani

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viii Contents

VOLUME 3 112. Giant Retinal Tear, 2216


Lingam Gopal, Tarun Sharma, Pramod S. Bhende, Muna Bhende
PART 1 113. Surgery for Ocular Trauma: Principles and
Surgical Retina Techniques of Treatment, 2226
Edited by C.P. Wilkinson and Peter Wiedemann Shriji Patel, Stephen J. Kim, Paul Sternberg Jr.

SECTION 1 The Pathophysiology of Retinal 114. Surgery for Proliferative Diabetic


Detachment and Associated Problems Retinopathy, 2253
Simon Brunner, Susanne Binder
  96. Pathogenetic Mechanisms of Retinal
115. Management of Combined Inflammatory and
Detachment, 1941
Sebastian Wolf, Martin Zinkernagel
Rhegmatogenous Retinal Detachment, 2279
Marc D. de Smet, Mohamad El Wardani
  97. Nonrhegmatogenous Retinal Detachment, 1948
Po-Ting Yeh, Chung-May Yang, Chang-Hao Yang, Chang-Ping Lin
116. High Myopia and the Vitreoretinal
Complications, 2291
  98. Degenerative Retinoschisis, 1971 Yasushi Ikuno, Masahito Ohji
David Reed, Sunir J. Garg
117. Surgical Management of Retinopathy
  99. Pathogenesis of Proliferative of Prematurity, 2301
Vitreoretinopathy, 1978 Matthew R. Starr, Yoshihiro Yonekawa, Lisa J. Faia,
Peter Wiedemann, Yanors Yandiev, Siegfried Priglinger, Michael T. Trese
Yan-Nian Hui
118. Surgery for Pediatric Vitreoretinal
100. Pathophysiology of Ocular Trauma, 1990 Disorders, 2317
Sun Young Lee, Leo A. Kim, Ajay E. Kuriyan Petra Meier, Peter Wiedemann

SECTION 2 Retinal Reattachment: General SECTION 4 Vitreous Surgery for Macular


Surgical Principles and Techniques Disorders
101. The Biomechanics of Scleral Buckles in the 119. Epiretinal Membranes, Vitreoretinal Traction,
Treatment of Retinal Detachment, 2000 Cystoid Macular Edema, and Submacular
John T. Thompson Hemorrhage, 2341
Louisa Wickham, Lazaros Konstantinidis, Daniel S.W. Ting,
102. Techniques of Scleral Buckling, 2013 Thomas J. Wolfensberger
Paul Sullivan, Robert H. Henderson
120. Macular Hole, 2361
103. Principles and Techniques of Vitreoretinal Alain Gaudric, Ramin Tadayoni
Surgery, 2040
Steve Charles 121. Retinal Pigment Epithelium and Choroid
Translocation in Patients With Age-Related
104. Intraoperative OCT Imaging, 2057
Justis P. Ehlers, Cynthia A. Toth
Macular Degeneration, 2383
Jan C. van Meurs, Grazia Pertile, Robert E. MacLaren
105. Primary Vitrectomy in Rhegmatogenous
Retinal Detachment, 2066 SECTION 5 Vitreous Surgery: Additional
Young Hee Yoon, Shwu-Jiuan Sheu, Hiroko Terasaki Considerations
106. Pneumatic Retinopexy, 2076 122. Infectious Endophthalmitis, 2397
Daniel A. Brinton, Jesse J. Jung J. Niklas Ulrich, Roshan T. George, Nathaniel C. Warner,
Travis A. Meredith
107. Special Adjuncts to Treatment, 2092
Keijiro Ishikawa, Toshio Hisatomi, Taiji Sakamoto 123. Diagnostic and Therapeutic Vitrectomy
108. Optimal Procedures for Retinal Detachment for Uveitis, 2421
Hyeong Gon Yu, Un Chul Park
Repair, 2143
Louisa Wickham, G. William Aylward 124. Vitreous, Retinal, and Choroidal Biopsy, 2431
Diana V. Do, Quan Dong Nguyen
109. Prevention of Retinal Detachment, 2154
C.P. Wilkinson 125. Transplantation Frontiers, 2443
Vamsi K. Gullapalli, Ilene K. Sugino, Marco A. Zarbin
SECTION 3 Complicated Forms of Retinal
126. Artificial Vision, 2480
Detachment Lan Yue, Young Hee Yoon, Mark S. Humayun
110. Proliferative Vitreoretinopathy, 2168 127. Pharmacology During Surgery, 2499
Chandrakumar Balaratnasingam, Vignesh Raja, Manish Nagpal
Christos Haritoglou, Anselm Kampik
111. Retinotomies and Retinectomies, 2192 128. Complications and Challenges in Vitreoretinal
Gary W. Abrams, Xihui Lin, Enrique Garcia-Valenzuela,
Sumit K. Nanda
Surgery, 2509
Kourous A. Rezaei

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Contents ix

PART 2 143. Pathology of Choroidal Melanoma, 2691


Tumors of the Retina, Choroid, and Vitreous Martina C. Herwig-Carl, Hans E. Grossniklaus
Edited by Andrew P. Schachat 144. Overview of Management of Posterior Uveal
Melanoma, 2708
SECTION 1 Tumors of the Retina Carol L. Shields, Jerry A. Shields
129. Retinoblastoma, 2517 145. Enucleation for Choroidal Melanomas, 2715
Jonathan W. Kim, Jesse L. Berry, A. Linn Murphree Julian D. Perry, Arun D. Singh, Brian Chon
130. Cavernous Hemangioma, 2557 146. Brachytherapy for Choroidal Melanoma, 2720
Anita Agarwal, Paul Sternberg Jr. Elaine M. Binkley, Timothy G. Murray, Arnold M. Markoe,
H. Culver Boldt
131. Hemangioblastoma of the Retina and von
Hippel–Lindau Disease, 2564 147. Charged-Particle Irradiation of Uveal
Henry E. Wiley, Emily Y. Chew Melanoma, 2736
Evangelos S. Gragoudas, Anne Marie Lane, Ivana K. Kim
132. Tuberous Sclerosis and the Eye, 2577
Alan F. Cruess, Sanjay Sharma 148. Surgical Resection of Choroidal
133. Phakomatoses, 2585 Melanoma, 2746
Bertil E. Damato, Armin R. Afshar, Carl Groenewald,
Carol L. Shields, Jerry A. Shields
Heinrich Heimann
134. Retinal Metastases, 2600
Arthi Venkat, Sunil K. Srivastava
149. Laser Treatment of Choroidal Melanoma, 2756
Nakul Singh, Sari Yordi, Arun D. Singh
135. Remote Effects of Cancer: Paraneoplastic
150. Systemic Evaluation and Management of
Autoimmune Retinopathies, 2615
Vishal Raval, Arun D. Singh
Patients With Metastatic Uveal Melanoma, 2766
Anna C. Pavlick, Paul T. Finger
136. Optic Disc Melanocytoma, 2627
Carol L. Shields, Leonard Joffe, Jerry A. Shields
151. Collaborative Ocular Melanoma Study, 2771
Barbara S. Hawkins, Andrew P. Schachat
137. Congenital Hypertrophy of the Retinal Pigment
152. Choroidal Metastases, 2779
Epithelium, 2633 Jasmine H. Francis
Carsten H. Meyer, Eduardo B. Rodrigues
153. Choroidal Osteoma, 2785
138. Combined Hamartoma of the Retinal Pigment Carol L. Shields, Gary C. Brown, Jerry A. Shields
Epithelium and Retina, 2639
Polly A. Quiram, Antonio Capone Jr. 154. Circumscribed Choroidal Hemangioma, 2795
Ramsudha Narala, Shelley Day Ghafoori, Prithvi Mruthyunjaya
SECTION 2 Tumors of the Choroid
SECTION 3 Hematologic and Miscellaneous
139. Choroidal Nevi, 2646
Hillary C. Stiefel, Daniel M. Albert
Tumors
140. Epidemiology of Posterior Uveal 155. Miscellaneous Uveal Tumors, 2813
Alison H. Skalet
Melanoma, 2660
Tara A. McCannel 156. Leukemias and Lymphomas, 2822
Diana V. Do, Ranjit S. Dhaliwal, Sarah E. Coupland,
141. Prognosis of Posterior Uveal Melanoma, 2668 Andrew P. Schachat
Martine J. Jager, Mette M. Bagger, Jens F. Kiilgaard,
Johanna M. Seddon 157. Primary Vitreoretinal Lymphoma, 2839
Mary E. Aronow, David M. Peereboom, Arun D. Singh
142. Molecular Genetics of Choroidal
Melanoma, 2683
Emine Kiliç, Marc-Henri Stern Index, I-1

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Video Table of Contents

VOLUME I, PART I VOLUME I, PART II


Retinal Imaging and Diagnostics Basic Science and Translation to Therapy
  10.1 Young Adult With Formed Vitreous Attached
Yale L. Fisher – Chapter 10
SECTION IV Translational Basic Science
  10.2 Partial Formed Vitreous Separation Still   36.1 Perfluoron Placement and Subretinal
Attached to the Optic Nerve Injection Procedure
Jean Bennett, Albert M. Maguire – Chapter 36
Yale L. Fisher – Chapter 10

  10.3 Complete Separation of the Formed Vitreous VOLUME II


Yale L. Fisher – Chapter 10 Medical Retina
  10.4 Retinal Tear With Formed Vitreous
Attachment to the Tip of the Tear SECTION II Retinal Vascular Disease
Yale L. Fisher – Chapter 10   59.1 Sickle Cell Retinopathy With Combined
  10.5 Asteroid Hyalosis Tractional and Rhegmatogenous Retinal
Yale L. Fisher – Chapter 10 Detachment
Sally S. Ong, Adrienne W. Scott – Chapter 59
  10.6 Asteroid Hyalosis, Detached Vitreous
Yale L. Fisher – Chapter 10 VOLUME III, PART I
  10.7 Endophthalmitis After Intravitreal Injection Surgical Retina
With Strong Reflections From Silicone Oil
Remnants SECTION II Retinal Reattachment: General
Yale L. Fisher – Chapter 10 Surgical Principles and Techniques
  10.8 Developing Choroidal Detachment in 102.1 Techniques of Scleral Buckling
Endophthalmitis Paul Sullivan – Chapter 102
Yale L. Fisher – Chapter 10
104.1 Comparing Handheld and Microscope-
  10.9 Emulsified Silicone Oil Droplets of Vitreous Mounted Optical Coherence Tomography
and Optic Nerve Head Imaging Systems
Yale L. Fisher – Chapter 10 Justis P. Ehlers, Cynthia A. Toth – Chapter 104

10.10 Localized Liquified Suprachoroidal 104.2 Three-Dimensional Reconstruction of a


Hemorrhage Full-Thickness Macular Hole With Associated
Yale L. Fisher – Chapter 10 Vitreomacular Traction Utilizing a
10.11 Anterior Chamber Hyphema Microscope Integrated Swept Source Optical
Yale L. Fisher – Chapter 10 Coherence Tomography System
Justis P. Ehlers, Cynthia A. Toth – Chapter 104
10.12 Lens Capsule Cysts Obstructing Pupil
Yale L. Fisher – Chapter 10 104.3 Real-Time Volumetric Peeling With Forceps
Visualized With a Swept Source Optical
10.13 Traumatic Injury With Loss of Superior Iris, Coherence Tomography System
Tilted IOL and Angle Closure Inferiorly Justis P. Ehlers, Cynthia A. Toth – Chapter 104
Yale L. Fisher – Chapter 10
104.4 Real-Time Volumetric Peeling With
10.14 Diabetic Neovascularization From the Nerve Diamond-Dusted Membrane Scraper
Head Attached to the Vitreous Face Visualized With a Swept Source Optical
Yale L. Fisher – Chapter 10 Coherence Tomography System
Justis P. Ehlers, Cynthia A. Toth – Chapter 104

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Video Table of Contents xi

104.5 Intraoperative Optical Coherence   128.2 Trauma With Contact Lens


Tomography Feedback During Macular Hole Carl Claes – Chapter 128
Surgery   128.3 Subfoveal Perfluoro-n-octane Heavy Liquid
Justis P. Ehlers, Cynthia A. Toth – Chapter 104
Homayoun Tabandeh – Chapter 128
105.1 A Case of Primary Vitrectomy for Treating   128.4 Intraocular Scissors
Rhegmatogenous Retinal Detachment Khalid Sabti – Chapter 128
Young Hee Yoon – Chapter 105
  128.5 Dexamethasone Implant Migration into the
105.2 Primary Vitrectomy for Rhegmatogenous Anterior Chamber
Retinal Detachment Maurício Maia, Denise Marinho – Chapter 128
Hiroko Terasaki – Chapter 105
  128.6 Dexamethasone Implant Induced Retinal
108.1 Optimal Procedures for Retinal Detachment Break
Repair Andre Maia – Chapter 128
Louisa Wickham, G. William Aylward – Chapter 108
  128.7 Iatrogenic Retinal Break During Silicone Oil
SECTION III Complicated Forms of Retinal Removal
Detachment Kazuaki Kadonosono – Chapter 128

110.1 Relaxing Retinotomy and Retinectomy for   128.8 Iatrogenic Breaks During Proliferative
Scarred Contracted Retina and Recurrent Vitreoretinopathy Surgery
David Xu, Carl Regillo – Chapter 128
Inferior Retinal Detachment due to
Proliferative Vitreoretinopathy   128.9 Globe Perforation During Posterior
Ian J. Constable – Chapter 110 Sub-Tenon Triamcinolone Injection
Steven S. Saraf, Kasra A. Rezaei – Chapter 128
110.2 Case of Retinal Detachment With PVR and a
Large Inferior Tear 128.10 Scleral Perforation During Scleral Buckling
Chandrakumar Balaratnasingam, Vignesh Raja, Manish Procedure
Nagpal – Chapter 110 Geoffrey G. Emerson – Chapter 128
110.3 Case of Recurrent Retinal Detachment due 128.11 Macular Fold
to PVR Fabio Patelli – Chapter 128
Chandrakumar Balaratnasingam, Vignesh Raja, Manish
Nagpal – Chapter 110 128.12 Choroidal Detachment as a Complication of
Pars Plana Vitrectomy
110.4 Case of Recurrent Retinal Detachment due to Siegfried Priglinger – Chapter 128
Migration of Silicone Oil into the Subretinal
Space as a Result of Retinal Contraction 128.13 Challenging Macular Hole Surgery
Chandrakumar Balaratnasingam, Vignesh Raja, Manish Jerzy Nawrocki – Chapter 128
Nagpal – Chapter 110
128.14 Complications During Chandelier Light
112.1 Ultrasonography in an Eye With Opaque Assisted Scleral Buckling Surgery
Media and Underlying Giant Retinal Tear Manish Nagpal – Chapter 128
(GRT) 128.15 Scleral Buckling Surgery With the Slit-Lamp
Lingam Gopal, Tarun Sharma, Pramod S. Bhende, Muna
of the Microscope
Bhende – Chapter 112
Ramin Tadayoni – Chapter 128
112.2 Surgery for GRT 128.16 Autologous Internal Limiting Membrane
Lingam Gopal, Tarun Sharma, Pramod S. Bhende, Muna
Bhende – Chapter 112 Flap Technique for Optic Nerve Pit
Maculopathy
José García-Arumí – Chapter 128
SECTION IV Vitreous Surgery for Macular
Disorders 128.17 Scleral Inlay for Recurrent Optic Nerve Pit
Maculopathy
120.1 Posterior Hyaloid Detachment Grazia Pertile – Chapter 128
Alain Gaudric, Ramin Tadayoni – Chapter 120

120.2 Epiretinal Membrane Peeling VOLUME III, PART II


Alain Gaudric, Ramin Tadayoni – Chapter 120 Tumors of the Retina, Choroid, and Vitreous
120.3 Internal Limiting Membrane Peeling
Alain Gaudric, Ramin Tadayoni – Chapter 120
SECTION II Tumors of the Choroid
148.1 Exoresection of Choroidal Melanoma
126.1 ARGUS II Array Implantation Bertil E. Damato – Chapter 148
Young Hee Yoon – Chapter 126

128.1 Subluxated Intraocular Lens


Maria Berrocal – Chapter 128

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Contributors

Gary W. Abrams, MD Sruthi Arepalli, MD Robert J. Barry, BMedSc, MBChB,


Professor Cole Eye Institute PhD, PGCHE, FHEA, FRCOphth
Department of Ophthalmology Cleveland Clinic Senior Lecturer Ophthalmology
Kresge Eye Institute Cleveland, OH, USA Institute of Clinical Sciences
Wayne State University University of Birmingham Medical
Mary E. Aronow, MD
Detroit, MI, USA School
Assistant Professor of Ophthalmology
Retina Service Birmingham, West Midlands, UK;
Armin R. Afshar, MD, MBA
Massachusetts Eye and Ear Infirmary Consultant Ophthalmologist
Assistant Professor of Ophthalmology
Harvard Medical School Birmingham & Midland Eye Centre
University of California, San
Boston, MA, USA Sandwell & West Birmingham Hospitals
Francisco
NHS Trust
San Francisco, CA, USA
Mohamed Ashraf, MD Birmingham, West Midlands, UK
Aniruddha Agarwal, MD Beetham Eye Institute
Rubens Belfort Jr., MD, PhD, MBA
Vitreoretinal Surgeon and Uveitis Joslin Diabetes Center
Boston, MA, USA; Full Professor, Head of Ophthalmology
Specialist
Department of Ophthalmology Federal University of São Paulo
Department of Ophthalmology
Alexandria University President, IPEPO – Vision Institute
The Eye Institute
Faculty of Medicine President, Brazilian Medical Academy
Cleveland Clinic Abu Dhabi
Alexandria, Egypt São Paulo, Brazil
Abu Dhabi, United Arab Emirates
Jean Bennett, MD, PhD
Anita Agarwal, MD Adrian Au, MD
EyeSTAR Resident Professor
Professor of Ophthalmology
Retina Disorders and Ophthalmic Ophthalmology; Cell and
Vanderbilt Eye Institute
Genetics Developmental Biology
Vanderbilt University
Stein Eye Institute University of Pennsylvania
Nashville, TN, USA
UCLA Perelman School of Medicine
Ishrat Ahmed, MD, PhD Philadelphia, PA, USA;
Los Angeles, CA, USA
Resident Director
Department of Ophthalmology Marcos Ávila, MD, PhD Center for Advanced Retinal and Ocular
Wilmer Eye Institute Head Professor Therapeutics
Baltimore, MD, USA Department of Ophthalmology University of Pennsylvania
Federal University of Goias Perelman School of Medicine
Lloyd Paul Aiello, MD, PhD
Goiania, Brazil Philadelphia, PA, USA;
Professor
G. William Aylward, FRCS,
Scientist
Department of Ophthalmology
FRCOphth, MD
Center for Cellular and Molecular
Harvard Medical School
Consultant Ophthalmologist Therapeutics
Boston, MA, USA;
Department of Vitreoretinal Surgery The Children’s Hospital of Philadelphia
Director
Moorfields Eye Hospital Philadelphia, PA, USA
Beetham Eye Institute
Joslin Diabetes Center London, UK Jesse L. Berry, MD
Boston, MA, USA Associate Professor of Ophthalmology
Mette M. Bagger, PhD
Postdoctoral Fellow Clinical Scholar
Radwan S. Ajlan, MB, BCh, FRCS(C)
Department of Ophthalmology Department of Ophthalmology
Assistant Professor of Ophthalmology
Copenhagen University Hospital University of Southern California
Department of Ophthalmology
Rigshopitalet Keck School of Medicine
University of Kansas School of
Copenhagen/Glostrup, Denmark Los Angeles, CA, USA;
Medicine
Associate Director
Prairie Village, KS, USA
Chandrakumar Balaratnasingam, Ocular Oncology
Daniel M. Albert, MD, MS MD, PhD, FRANZCO The Vision Center at Children’s
Professor of Ophthalmology Associate Professor Hospital Los Angeles
Casey Eye Institute Consultant Ophthalmologist and Los Angeles, CA, USA
Oregon Health Sciences University Vitreoretinal Surgeon
Cagri G. Besirli, MD, PhD
Portland, OR, USA Lions Eye Institute
University of Western Australia Associate Professor
Michael T. Andreoli, MD Department of Ophthalmology and
Perth, Australia
Wheaton Eye Clinic Visual Sciences
Wheaton, IL, USA University of Michigan
Ann Arbor, MI, USA

xii

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Contributors xiii

Angela Bessette, MD Michael E. Boulton, PhD Simon Brunner, MD


Strong Flaum Eye Center Susan and Dowd Ritter/RPB Endowed Senior Physician
University of Rochester Chair Vitreoretinal Surgeon
Rochester, NY, USA Department of Ophthalmology & Visual Department of Ophthalmology
Sciences Clinic Landstrasse
Kapil Bharti, PhD
University of Alabama at Birmingham Vienna, Austria
Senior Investigator
Birmingham, AL, USA
National Eye Institute Greg Budoff, MD
Bethesda, MD, USA Milam A. Brantley Jr., MD, PhD Stein Eye Institute
Associate Professor UCLA
Muna Bhende, MS
Vanderbilt Eye Institute Los Angeles, CA, USA
Medical and Vision Research
Vanderbilt University Medical Center
Foundations Kinga M. Bujakowska, MSc, PhD
Nashville, TN, USA
Sankara Nethralaya Assistant Professor
Chennai, India Neil M. Bressler, MD Department of Ophthalmology
Editor in Chief, JAMA Ophthalmology Massachusetts Eye and Ear Infirmary
Pramod S. Bhende, MS
Past Chief, Retina Division – James P. Harvard Medical School
Medical and Vision Research
Gills Professor of Ophthalmology Boston, MA, USA
Foundations
Wilmer Eye Institute
Sankara Nethralaya M. Valeria Canto-Soler, PhD
Department of Ophthalmology
Chennai, Indiama Associate Professor
Johns Hopkins University School of
Department of Ophthalmology
Susanne Binder, MD Medicine
University of Colorado
Professor of Ophthalmology Baltimore, MD, USA
Aurora, CO, USA
Past Chief, Department of Ophthalmology
Susan B. Bressler, MD
Clinic Landstrasse Dingcai Cao, PhD
Julia G. Levy, PhD Professor of
Vienna, Austria Associate Professor
Ophthalmology
Ophthalmology and Visual Sciences
Elaine M. Binkley, MD Department of Ophthalmology
University of Illinois at Chicago
Assistant Professor Johns Hopkins University School of
Chicago, IL, USA
Department of Ophthalmology and Medicine
Visual Sciences Baltimore, MD, USA Antonio Capone Jr., MD
University of Iowa Associated Retinal Consultants
Andreas Bringmann, PhD
Iowa City, IA, USA William Beaumont Hospital
Associate Professor
Royal Oak, MI, USA
Alan C. Bird, MD Department of Ophthalmology and Eye
Professor Hospital Joseph Carroll, PhD
Institute of Ophthalmology University of Leipzig Director, Dennis P. Han, MD Advanced
University College London Leipzig, Germany Ocular Imaging Program
London, UK Richard O. Schultz, MD/ Ruth Works
Daniel A. Brinton, MD
Professor in Ophthalmology
Mark S. Blumenkranz, MD Assistant Clinical Professor
Department of Ophthalmology & Visual
Byers Eye Institute Department of Ophthalmology
Sciences
Stanford University University of California, San Francisco
Medical College of Wisconsin
Palo Alto, CA, USA San Francisco, CA, USA;
Milwaukee, WI, USA
East Bay Retina Consultants
H. Culver Boldt, MD
Oakland, CA, USA David Carruthers, PhD, FRCP
The Marion and Frederick Fuerste
Consultant Rheumatologist
Professor of Vitreoretinal Surgery Gary C. Brown, MD, MBA
Sandwell & West Birmingham Hospitals
Department of Ophthalmology and Professor of Ophthalmology
NHS Trust
Visual Sciences Wills Eye Hospital
Birmingham, UK;
University of Iowa Sidney Kimmel Medical College
Honorary Senior Lecturer in
Iowa City, IA, USA Thomas Jefferson University
Rheumatology
Philadelphia, PA, USA;
Camiel Jan Fons Boon, MD, PhD, Institute of Inflammation and Ageing
Professor of Ophthalmology
FEBOphth University of Birmingham
Jefferson Medical College
Professor Birmingham, UK
Philadelphia, PA, USA;
Department of Ophthalmology
Chief Medical Officer Rachel R. Caspi, PhD
Leiden University Medical Center
Pharmacoeconomics Head, Immunoregulation Section
Leiden, The Netherlands;
Center for Value-Based Medicine Laboratory of Immunology, NEI
Professor
Hilton Head, SC, USA; National Institutes of Health
Department of Ophthalmology
Adjunct Clinical Professor of Bethesda, MD, USA;
Amsterdam University Medical Center
Ophthalmology Lab Chief
University of Amsterdam
Emory University School of Medicine Laboratory of Immunology, NEI
Amsterdam, The Netherlands
Atlanta, GA, USA National Institutes of Health
Enrico Borrelli, MD Bethesda, MD, USA
Melissa M. Brown, MD, MN, MBA
Medical Retina Specialist
Professor of Ophthalmology Voraporn Chaikitmongkol, MD
Department of Ophthalmology
Wills Eye Hospital Assistant Professor
San Raffaele Hospital
Sidney Kimmel Medical College Department of Ophthalmology
University Vita-Salute San Raffaele
Thomas Jefferson University Faculty of Medicine
Milan, Italy
Philadelphia, PA, USA Chiang Mai University
Amphur Muang, Chiang Mai, Thailand

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xiv Contributors

Hwei Wuen Chan, MBBS, MMed Emily Y. Chew, MD Mariano Cozzi, MSC
(Ophth), FAMS, FRCOphth Director of Division of Epidemiology and Eye Clinic
Doctor Clinical Applications Luigi Sacco Hospital
Department of Ophthalmology Division of Epidemiology and Clinical University of Milan
National University Hospital Applications Milan, Italy
Singapore; National Eye Institute/National
Alan F. Cruess, MD, FRCSC
Assistant Professor Institutes of Health
Professor
Department of Ophthalmology Bethesda, MD, USA
Department of Ophthalmology and
National University Singapore
Jay Chhablani, MD Visual Sciences
Singapore
Ophthalmologist Dalhousie University
Yuilyn A. Chang Chusan, MS Vitreoretina Halifax, Nova Scotia, Canada
Staff Assistant LV Prasad Eye Institute
Emmett T. Cunningham Jr., MD, PhD,
Laboratory for Nutrition and Vision Hyderabad, India
MPH
Research
Michael F. Chiang Director, The Uveitis Service
JM-USDA Human Nutrition Research
Knowles Professor West Coast Retina
Center on Aging
Ophthalmology & Medical Informatics Clinical Professor of Ophthalmology
Tufts University
and Clinical Epidemiology California Pacific Medical Center
Boston, MA, USA
Oregon Health & Science University San Francisco, CA, USA;
Steve Charles, MD Portland, OR, USA Adjunct Clinical Professor of
Founder & CEO Ophthalmology
Brian Chon, MD
Retina Stanford University School of Medicine
Advanced Eye Care Center
Charles Retina Institute Stanford, CA, USA
Wayne, NJ, USA
Germantown, TN, USA;
Christine A. Curcio, PhD, FARVO
Clinical Professor Dennis O. Clegg, PhD
White-McKee Endowed Professor
Department of Ophthalmology Professor
Department of Ophthalmology and
University of Tennessee Center for Center for Stem Cell Biology and
Visual Sciences
Health Sciences Engineering
The University of Alabama at
Memphis, TN, USA University of California (UC) Santa
Birmingham
Barbara
David G. Charteris, FRCOphth MD Birmingham, AL, USA
Santa Barbara, CA, USA
Research Lead
Bertil E. Damato, MD, PhD, FRCOphth
Vitreoretinal Unit Jason Comander, MD, PhD
Senior Clinical Research Fellow
Moorfields Eye Hospital Associate Director
Nuffield Department of Clinical
London, UK; Inherited Retinal Disorders Service
Neurosciences
Professor of Ophthalmology Massachusetts Eye and Ear Infirmary
University of Oxford
Institute of Ophthalmology Boston, MA, USA;
Oxford, UK;
University College Assistant Professor of Ophthalmology
Consultant Ocular Oncologist
London, UK Harvard Medical School
Moorfields Eye Hospital
Boston, MA, USA
Jeannie Chen, PhD London, UK;
Professor Giulia Corradetti, MD Professor Emeritus
Department of Physiology & Retina Disorders and Ophthalmic Department of Ophthalmology
Neuroscience Genetics University of California, San Francisco
University of Southern California Stein Eye Institute San Francisco, CA, USA
Los Angeles, CA, USA UCLA
Janet L. Davis, MD
Los Angeles, CA, USA;
Judy J. Chen, MD Leach Chair in Ophthalmology
Doheny Image Reading Center
Vitreoretinal Surgeon Bascom Palmer Eye Institute
Doheny Eye Institute
West Coast Retina University of Miami Miller School
Los Angeles, CA, USA
San Francisco, CA, USA of Medicine
Sarah E. Coupland, MBBS, PhD, Miami, FL, USA
Carol Y. Cheung, PhD
FRCPath
Associate Professor Samaneh Davoudi, MD
George Holt Chair of Pathology
Department of Ophthalmology Department of Ophthalmology
Molecular and Clinical Cancer Medicine
and Visual Sciences University of Florida
University of Liverpool
The Chinese University of Hong Kong Gainesville, FL, USA
Liverpool, Merseyside, UK;
Hong Kong
Consultant Histopathologist Shelley Day Ghafoori, MD
Chui Ming Gemmy Cheung, FRCOphth Liverpool Clinical Laboratories Austin Retina Associates
Senior Consultant Royal Liverpool University Hospital Austin, TX, USA;
Medical Retina Department Liverpool, Merseyside, UK The University of Texas at Austin Dell
Singapore National Eye Center Medical School
Singapore; Austin, TX, USA
Professor
Duke-NUS Medical School
National University of Singapore
Singapore

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Contributors xv

Alastair K. Denniston, PhD, FRCOphth Jay S. Duker, MD Benedetto Falsini, MD


Consultant Ophthalmologist Director Professor
Department of Ophthalmology New England Eye Center Department of Ophthalmology
University Hospitals Birmingham NHS Tufts Medical Center Universita Cattolica del Sacro Cuore,
Foundation Trust Boston, MA, USA; Policlinico Gemelli
Birmingham, UK; Professor and Chair Rome, Italy
Honorary Professor Department of Ophthalmology
Sharon Fekrat, MD, FACS
Academic Unit of Ophthalmology Tufts University School of Medicine
Professor of Ophthalmology
University of Birmingham Boston, MA, USA
Associate Professor of Surgery
Birmingham, UK
Hannah M.P. Dunbar, PhD, MCOptom Duke University School of Medicine
Marc D. de Smet, MD, CM, BSc(hon), Senior Research Associate Durham, NC, USA;
PhD, FRCSC, FRCOphth, FARVO, Visual Neuroscience and Function Vitreoretinal Surgeon
FEBOphth, FMH Institute of Ophthalmology Private Diagnostic Clinic
Honorary Professor of Ophthalmology University College London Duke Eye Center
University of Leiden London, UK; Durham, NC, USA
Leiden, The Netherlands; Specialist Low Vision Optometrist
Deborah A. Ferrington, PhD
Director – Helvetia Retina Associates Moorfields Eye Hospital NHS
Professor
MIOS sa Foundation Trust
Department of Ophthalmology and
Lausanne, Switzerland; Optometry Department
Visual Neurosciences
Co-founder and CMO – PRECEYES London, UK
University of Minnesota
BV – A medical robotics company
Jacque L. Duncan, MD Minneapolis, MN, USA
Eindhoven, The Netherlands
Professor of Ophthalmology, Vice Chair
Frederick L. Ferris III, MD
Julie De Zaeytijd, MD of Clinical Trials
Director
Department of Ophthalmology Department of Ophthalmology
Ophthalmic Research Consultants
Ghent University Hospital University of California, San Francisco
Waxhaw, NC, USA
Ghent, Belgium San Francisco, CA, USA
Paul T. Finger, MD
Ranjit S. Dhaliwal, MD, FRCSC, FACS Justis P. Ehlers, MD
Director
Vitreoretinal Surgeon The Norman C. and Donna L. Harbert
Department of Ophthalmic Oncology
Retina Consultants PC Endowed Chair for Ophthalmic
The New York Eye Cancer Center
Augusta, GA, USA; Research
New York, NY, USA;
Adjunct Faculty Cole Eye Institute
Clinical Professor of Ophthalmology
Department of Ophthalmology Cleveland Clinic
Department of Ophthalmology
Emory University Cleveland, OH, USA
New York University School of
Atlanta, GA, USA;
Kiara C. Eldred, PhD Medicine
Adjunct Faculty
Postdoctoral Research Fellow New York, NY, USA;
Department of Ophthalmology
Department of Biological Structure Director
Queen’s University
University of Washington School of Ocular Tumor Services
Kingston, Ontario, Canada
Medicine The New York Eye and Ear Infirmary
Andrew D. Dick, MBBS, MD Seattle, WA, USA at Mt. Sinai
Professor of Ophthalmology New York, NY, USA
Dean Eliott, MD
Academic Unit of Ophthalmology
Director, Retina Service Steven K. Fisher, PhD
University of Bristol
Retina Service Research Professor
Bristol, UK;
Massachusetts Eye and Ear Infirmary Neuroscience Research Institute
Duke Elder Chair of Ophthalmology
Boston, MA, USA; University of California
Institute of Ophthalmology
Stelios Evangelos Gragoudas Professor Santa Barbara, CA, USA;
University College London
Harvard Medical School Professor Emeritus
London, UK
Boston, MA, USA Molecular, Cellular & Developmental
Xiaoyan Ding, MD, PhD Biology
Mohamad El Wardani, MD, FEBO
Zhongshan Ophthalmic Center University of California
Helvetia Retina Associates
Sun Yat-Sen University Santa Barbara, CA, USA
MIOS sa
Guangzhou, China
Lausanne, Switzerland Yale L. Fisher, MD
Diana V. Do, MD Vitreous Retina Macula Consultants
Michael Engelbert, MD, PhD
Professor of Ophthalmology of New York
Research Assistant Professor
Vice Chair for Clinical Affairs New York, NY, USA;
Department of Ophthalmology
Byers Eye Institute Clinical Professor of Ophthalmology
New York University
Stanford University School of Medicine (Voluntary)
New York, NY, USA
Palo Alto, CA, USA Department of Ophthalmology
Lisa J. Faia, MD Bascom Palmer Eye Institute
Pravin Dugel, MD
Associated Retinal Consultants Miami, FL, USA;
President
William Beaumont Hospital Clinical Professor of Ophthalmology
IvericBio
Royal Oak, MI, USA (Voluntary)
Cranbury, NJ, USA
Department of Ophthalmology
Weill Cornell Medical Center
New York, NY, USA

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xvi Contributors

Gerald A. Fishman, MD Mary Gayed, MRes, MRCP Carl Groenewald, MD


Professor Emeritus of Ophthalmology Specialist Registrar in Rheumatology Consultant Ophthalmologist
University of Illinois at Chicago University Hospitals Birmingham NHS Department of Ophthalmology
Chicago, IL, USA Foundation Trust Royal Liverpool University Hospital
Birmingham, UK; Liverpool, UK
Monika Fleckenstein, MD
Honorary Research Associate
Professor Hans E. Grossniklaus, MD, MBA
Institute of Inflammation and Ageing
John A. Moran Eye Center Professor of Ophthalmology and Pathology
University of Birmingham
University of Utah Department of Ophthalmology
Birmingham, UK
Salt Lake City, UT, USA Emory University School of Medicine
Roshan T. George, MD Atlanta, GA, USA
Harry W. Flynn Jr., MD
Department of Ophthalmology
J. Donald M. Gass Distinguished Chair Sandeep Grover, MD
University of North Carolina
in Ophthalmology Director, Inherited Retinal Diseases &
Chapel Hill, NC, USA
Bascom Palmer Eye Institute Electrophysiology Services
University of Miami Miller School of Morton F. Goldberg, MD Professor of Ophthalmology
Medicine Director Emeritus Associate Chair, Department of
Miami, FL, USA Wilmer Eye Institute Ophthalmology
Johns Hopkins University University of Florida
Carolina Francelin, PhD
School of Medicine Jacksonville, FL, USA
Postdoctoral Fellow
Baltimore, MD, USA
Department of Ophthalmology & Visual Vamsi K. Gullapalli, MD, PhD
Sciences Lingam Gopal, MS, FRCSEd, DNBE Associate
University of Alabama at Birmingham National University Health System Central Minnesota Retina Specialists
Birmingham, AL, USA Singapore Sartell, MN, USA
Jasmine H. Francis, MD, FACS Caroline Gordon, MD, FRCP Paul Hahn, MD, PhD
Associate Attending Professor of Rheumatology Partner
Ophthalmic Oncology Service Institute of Inflammation and Ageing NJRetina
Department of Surgery University of Birmingham Teaneck, NJ, USA
Memorial Sloan Kettering Cancer Center Birmingham, UK;
Julia A. Haller, MD
New York, NY, USA Honorary Consultant Rheumatologist
Ophthalmologist-in-Chief
Sandwell & West Birmingham
William R. Freeman, MD Wills Eye Hospital
Hospitals NHS Trust
Distinguished Professor of Philadelphia, PA, USA
Birmingham, UK
Ophthalmology
Ian C. Han, MD
Director of the Jacobs Retina Center Hiroshi Goto, MD
Assistant Professor
University of California, San Diego Professor and Chairman
Department of Ophthalmology and
La Jolla, CA, USA Department of Ophthalmology
Visual Sciences
Tokyo Medical University
K. Bailey Freund, MD University of Iowa Carver College
Tokyo, Japan
Clinical Professor of Medicine
NYU Grossman School of Medicine Evangelos S. Gragoudas, MD Iowa City, IA, USA
New York, NY, USA; Professor of Ophthalmology
James T. Handa, MD
Partner Harvard Medical School
Robert Bond Welch Professor
Vitreous Retina Macula Consultants of Department of Ophthalmology
Chief, The Retina Division
New York Ocular Melanoma Center
The Wilmer Eye Institute
New York, NY, USA Retina Service
Johns Hopkins University
Boston, MA, USA
Arthur D. Fu, MD Baltimore, MD, USA
West Coast Retina Maria B. Grant, MD
Christos Haritoglou, MD
Chief of Retina Service Professor
Professor of Ophthalmology
Clinical Professor of Ophthalmology Department of Ophthalmology
Chief Ophthalmologist
California Pacific Medical Center University of Alabama-Birmingham
Herzog Carl Theodor Eye Hospital
San Francisco, CA, USA Birmingham, AL, USA
Munich, Germany
Enrique Garcia-Valenzuela, MD, PhD Ronald G. Gregg, PhD
Sara Haug, MD, PhD
Vitreoretinal Surgeon Professor and Chair
West Coast Retina
Midwest Retina Consultants Department of Biochemistry &
Clinical Professor of Ophthalmology
Des Plaines, IL, USA Molecular Biology
California Pacific Medical Center
University of Louisville
Sunir J. Garg, MD, FACS San Francisco, CA, USA
Louisville, KY, USA
Professor of Ophthalmology
Barbara S. Hawkins, MS, PhD
The Retina Service of Wills Eye Hospital Kevin Gregory-Evans, MD, PhD, FRCS,
Professor Emeritus of Ophthalmology
Thomas Jefferson University FRCOphth, FRCSC
The Wilmer Eye Institute
Philadelphia, PA, USA Professor
The Johns Hopkins School of Medicine
Department of Ophthalmology and
Alain Gaudric, MD Baltimore, MD, USA;
Visual Sciences
Emeritus Professor of Ophthalmology Professor of Epidemiology
University of British Columbia
Université de Paris Department of Epidemiology
Vancouver, British Columbia, Canada
AP-HP, Hôpital Lariboisière The Johns Hopkins Bloomberg School
Paris, France of Public Health
Baltimore, MD, USA

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Contributors xvii

Shikun He, MD Frank G. Holz, MD, FEBO Douglas A. Jabs, MD, MBA
Associate Professor Professor and Chairman Professor
Departments of Pathology, Department of Ophthalmology Epidemiology
Ophthalmology University of Bonn Johns Hopkins University
USC Roski Eye Institute Bonn, Germany Bloomberg School of Public Health
Keck School of Medicine of the Baltimore, MD, USA;
Kirk K. Hou, MD, PhD
University of Southern Professor
Fellow
California, Los Angeles Department of Ophthalmology
Retina Disorders and Ophthalmic Genetics
Los Angeles, CA, USA Johns Hopkins University
Stein Eye Institute
School of Medicine
Heinrich Heimann UCLA
Baltimore, MD, USA
Consultant Ophthalmic Surgeon Los Angeles, CA, USA
Department of Ophthalmology Glenn J. Jaffe, MD
Yan-Nian Hui, MD
Royal Liverpool University Hospital Robert Machemer M.D. Distinguished
Department of Ophthalmology
Liverpool, UK Professor of Ophthalmology
Xijing Hospital
Duke University
Robert H. Henderson, BSc, MBBS, Fourth Military Medical University
Durham, NC, USA
MD, FRCOphth Xi’an, China
Consultant Paediatric Ophthalmologist Martine J. Jager, MD, PhD
Mark S. Humayun, MD, PhD
& Vitreoretinal Surgeon Professor of Ophthalmology
Roski Eye Institute
Vitreoretinal Surgery Department of Ophthalmology
University of Southern California,
Moorfields Eye Hospital Leiden University Medical Center
Los Angeles
London, UK; Leiden, The Netherlands
Los Angeles, CA, USA;
Consultant Paediatric Ophthalmologist
Ginsburg Institute for Biomedical Lee M. Jampol, MD
& Vitreoretinal Surgeon
Therapeutics Louis Feinberg Professor
Paediatric Ophthalmology
University of Southern California, Department of Ophthalmology
Great Ormond Street Hospital for
Los Angeles Northwestern University
Children
Los Angeles, CA, USA Feinberg School of Medicine
London, UK;
Chicago, IL, USA
Honorary Associate Professor Sana Idrees, MD
Developmental Biology and Genetics Vitreoretinal Surgeon Karen Jeng-Miller, MD, MPH
GOSH-UCL Institute of Child Health Monmouth Retina Consultants Vitreoretinal Surgery Fellow
London, UK Little Silver, NJ, USA New England Eye Center
Boston, MA, USA
Martina C. Herwig-Carl, MD Yasushi Ikuno, MD
Priv.-Doz. Dr. Med. Director and Founder Leonard Joffe, MD, MB, BCH, FCS(SA),
Department of Ophthalmology Ikuno Eye Center FRCS
University Hospital Bonn Osaka, Japan Retina Specialists of Southern Arizona
Bonn, Germany Tucson, AZ, USA
Alessandro Invernizzi, MD
Florian M.A. Heussen, MD Researcher – Assistant Professor Mark Johnson, PhD
Senior Consultant Eye Clinic Professor
Vitreoretinal Surgery and Ocular Department of Biomedical and Clinical Department of Biomedical Engineering
Oncology Science “Luigi Sacco” Northwestern University
Stadtspital Waid und Triemli University of Milan Evanston, IL, USA
Zürich, Switzerland Milan, Italy
Mark W. Johnson, MD
Toshio Hisatomi, MD, PhD Michael S. Ip, MD Professor and Chief, Vitreoretinal Service
Department of Ophthalmology Professor of Ophthalmology Department of Ophthalmology and
Fukuoka University Chikushi Hospital Doheny Eye Institute Visual Sciences
Chikushino, Japan David Geffen School of Medicine University of Michigan
UCLA Ann Arbor, MI, USA
Graham E. Holder, PhD, FARVO
Pasadena, CA, USA
Hong-Leong Visiting Professor Robert N. Johnson, MD
Department of Ophthalmology David L.C. Isaac, MD, PhD West Coast Retina
Yong Loo Lin School of Medicine Associate Professor Clinical Professor of Ophthalmology
National University of Singapore Department of Ophthalmology California Pacific Medical Center
Singapore; Federal University of Goias San Francisco, CA, USA
Visiting Professor Goiania, Brazil
Antonia M. Joussen, MD
Tan Tock Seng Hospital
Tatsuro Ishibashi, MD, PhD Professor and Chair
Singapore;
Dean Department of Ophthalmology
Visiting Consultant
Kyushu University Charité, University Medicine Berlin
Singapore National Eye Centre
Fukuoka, Japan Berlin, Germany
Singapore;
Honorary Professor Keijiro Ishikawa, MD, PhD J. Michael Jumper, MD
Institute of Ophthalmology Associate Professor West Coast Retina
University College London Department of Ophthalmology Clinical Professor of Ophthalmology
London, UK; Graduate School of Medical Sciences California Pacific Medical Center
Honorary Professor Kyushu University Co-Director, Vitreoretinal Fellowship
University of Sydney Medical School Fukuoka, Japan Program
Sydney, Australia San Francisco, CA, USA

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xviii Contributors

Jesse J. Jung, MD Ivana K. Kim, MD Igor Kozak, MD, PhD


East Bay Retina Consultants, Inc. Associate Professor of Ophthalmology Senior Academic Consultant
Oakland, CA, USA; Harvard Medical School King Khaled Eye Specialist Hospital
Department of Ophthalmology Department of Ophthalmology Riyadh, Saudi Arabia
University of California, San Francisco Ocular Melanoma Center
Ajay E. Kuriyan, MD, MS
San Francisco, CA, USA Retina Service
Associate Professor
Massachusetts Eye and Ear Infirmary
Peter K. Kaiser, MD Mid Atlantic Retina
Boston, MA, USA
Chaney Family Endowed Chair in Wills Eye Hospital
Ophthalmology Research Jonathan W. Kim, MD Thomas Jefferson University
Cole Eye Institute Director of Ocular Oncology Philadelphia, PA, USA
Cleveland Clinic Department of Ophthalmology
Dennis Shun Chiu Lam, MD,
Cleveland, OH, USA; USC Keck School of Medicine
FRCOphth
Professor of Ophthalmology Los Angeles, CA, USA;
C-MER International Eye Research
Cleveland Clinic Lerner Director of Retinoblastoma Service
Center of The Chinese University
College of Medicine The Vision Center
of Hong Kong (Shenzhen)
Cleveland, OH, USA Children’s Hospital Los Angeles
Shenzhen, China;
Los Angeles, CA, USA
Maarten Kamermans, PhD C-MER Dennis Lam & Partners Eye
Professor Leo A. Kim, MD, PhD Center
Retinal Signal Processing Lab Assistant Professor of Ophthalmology C-MER International Eye Care Group
Netherlands Institute for Neuroscience Harvard Medical School Hong Kong, China
Amsterdam, The Netherlands Department of Ophthalmology
Linda A. Lam, MD, MBA
Schepens Eye Research Institute
Anselm Kampik, MD Professor and Vice Chair, Clinical
Massachusetts Eye and Ear
Professor Satellite Affairs
Boston, MA, USA
Department of Ophthalmology Department of Ophthalmology
Ludwig-Maximilans University Stephen J. Kim, MD USC Roski Eye Institute
Munich, Germany Jean Ewing Love and James Randle Love USC Keck School of Medicine
Directorship in Ophthalmology Los Angeles, CA, USA
Rustum Karanjia, MD, PhD, FRCSC
Professor
Assistant Professor and Vice Chair Anne Marie Lane, MPH
Chief, Retina Division
(Research) Lecturer on Ophthalmology
Vanderbilt Eye Institute
Department of Ophthalmology Harvard Medical School
Nashville, TN, USA
University of Ottawa Department of Ophthalmology
Ottawa, Ontario, Canada; Szilárd Kiss, MD Ocular Melanoma Center
Researcher Director, Clinical Research Retina Service
Department of Ophthalmology Chief, Retina Service Massachusetts Eye and Ear Infirmary
David Geffen School of Medicine Department of Ophthalmology Boston, MA, USA
at UCLA Weill Cornell Medicine
Erin B. Lavik, ScD
Los Angeles, CA, USA New York, NY, USA
Associate Dean for Research and Faculty
Amir H. Kashani, MD, PhD Michael A. Klufas, MD Development
Associate Professor of Ophthalmology Retina Service of Wills Eye Hospital College of Engineering and Information
Wilmer Eye Institute Assistant Professor of Ophthalmology Technology
Johns Hopkins School of Medicine Thomas Jefferson University Chemical, Biochemical, and
Baltimore, MD, USA Philadelphia, PA, USA Environmental Engineering
University of Maryland, Baltimore
Pearse A. Keane, MD, FRCOphth, Lazaros Konstantinidis, MD
County
MRCSI Hôpital Ophtalmique Jules-Gonin
Baltimore, MD, USA
NIHR Biomedical Research Centre University of Lausanne
Moorfields Eye Hospital NHS Lausanne, Switzerland James F. Leary, PhD
Foundation Trust Professor Emeritus
Maya Koronyo-Hamaoui, PhD
London, UK Purdue University
Associate Professor in Neurosurgery and
West Lafayette, IN, USA
M. Cristina Kenney, MD, PhD Biomedical Sciences
Professor Department of Neurosurgery Gerardo Ledesma-Gil, MD
Gavin Herbert Eye Institute Maxine Dunitz Neurosurgical Research Attending Physician
University California Irvine Institute Retina Department
Irvine, CA, USA Department of Biomedical Sciences Institute of Ophthalmology Fundación
Division of Applied Cell Biology and Conde de Valenciana
Jens F. Kiilgaard, MD, PhD, FEBO
Physiology Mexico City, Mexico
Associate Professor of Ophthalmology
Cedars-Sinai Medical Center
Department of Ophthalmology Aaron Y. Lee, MD, MSCI
Los Angeles, CA, USA
Copenhagen University Hospital Department of Ophthalmology
Rigshopitalet Renu Kowluru, PhD University of Washington
Copenhagen/Glostrup, Denmark Professor Seattle, WA, USA
Department of Ophthalmology, Visual
Emine Kiliç, MD
and Anatomical Sciences
Associate Professor
Kresge Eye Institute
Department of Ophthalmology
Wayne State University
Erasmus University Medical Center
Detroit, MI, USA
Rotterdam, The Netherlands

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Another random document with
no related content on Scribd:
Qvando yo ui que no lo ueya, miré
a la parte donde Laureola estaua,
por uer si la ueia, e uila con tanto
pesar y los ojos bañados en agua,
que no como ella era hermosa,
mas como si uerdaderamente
estuuiera muerta, estaua amarilla,
perdida la habla, uencida la
fuerça y en tal disposicion la ui,
que mas conpassion hauia de
uella, que de Leriano, aunque
estaua muerto; e de uer tal el vno
y el otro en peor peligro estaua
tan desesperado, que diziendo
uerdad yo quisiera mas
acompañar a Leriano muerto que
seguir a Laureola biua; la qual
con mucha tristeza dissimulando
quanto podia la pena que la
muerte de Leriano le daua,
forçando las lagrimas como
discreta, començó a hablarme en
esta manera.

LAUREOLA AL AVCTOR
Verdaderamente con mas
coraçon e mejor uoluntad me
despidiera de la uida e tomara la
muerte, que salir de tu posada,
sino creyesse que saliendo me
hauia de salir el alma. Porque
cierto es que si creyera que
viendo a Leriano tal me hauia de
uer, nunca en tal me pusiera,
antes suffriera la pena de su
ausencia que la gloria de uelle,
pues no podia remediarle, que
nunca pense que assi me penara,
porque quanto mas sus seruicios
e lealtad delante mi ponia para
algo querelle, tanto mi bondad e
la grandeza de mi estado me lo
estoruaua; e no porque contra
esto esperaua yr, antes la uida de
mi fe uaya, saluo que con más
trabajo e menos oluido trabajara
con el rey mi señor en libertad,
aunque a mi no era dado, para
que entrasse en la corte e huuiera
lugar de uerme, e con esto segun
se dezia y en muerte
manifestaua, e con la esperança
que le daua huuiera lugar de no
desesperar; pero si yo con mi
crueza lo consentia, con la
passion lo he pagado y espero
pagar tambien, que para mi salud
estuuiera tambien hazello como
para mi bondad por qualquiera
parte negallo. Mas de la
hermosura que Dios me dió me
quexo, y él deue quexarse, que
esta pudo más ayna que mi
condicion ni uoluntad engañarse;
e porque el tiempo es corto e la
passion es larga, no quiero mas
dezirte, saluo que te hago cierto,
que aunque Leriano segun mi
estado e linaje por mujer no me
merescia, nunca deuiera él perder
la esperança. E pues a él no
puedo pagar sus obras e buenos
seruicios, a ti te ruego que de la
corte no te partas, aunque el
desseo de tu naturaleza te pene,
porque conozcas en las mercedes
que te haré aqui si biuieres, las
honras que a Leriano hiziera
biuiendo.

EL AVCTOR
Qvando Laureola acabó de
hablarme quedó tan triste, e tan
llenas sus uestiduras de lagrimas
de sus ojos que en gran manera
me ponia más manzilla su penada
uida que la muerte del muerto; e a
todo lo que me dixo quisiera
mucho respondelle,
agradesciendole las mercedes
que queria hazerme, como la
cortesia con que me hablaua,
saluo que qvando mas seguro e
pensatiuo en lo que me hauia
dicho estaua, se partió de mi con
vn gran sospiro, e con vna boz
con que pudo recordarme que
dezia: Ya no puede más doler la
muerte, aunque está cierta, que la
uida que está muerta.

EL AVCTOR
Despves que miré al derredor e ui
que hauia quedado solo, halléme
tan triste e tan embeleñado, que
no sabia lo que de mi hiziesse, ni
de lo que hauia soñado que
pensasse. E como no tenia con
quien hablar, estaua tan
pensatiuo que mill uezes con mis
manos quisiera darme la muerte,
si creyera hallar en ella lo que con
ella perdi; e como pense que con
mi muerte no se cobraua la uida
del muerto, ui que era yerro
perder el anima sin gozar del
cuerpo; e como es cierta
esperiencia que la musica cresce
la pena donde halla, e
accrescienta el plazer en el
coraçon contento, tomé la
uihuela, e mas como desatinado
que con saber cierto lo que hazia,
començe a tañer esta cancion e
uillancico:

Cancion.
No te pene de penar,
coraçon, en esta uida,
que lo que ua de uencida
no puede mucho durar.
Porque segun es mortal
el mal que se muestra, e
fuerte,
¿para qué es tomar la muerte
pues la uida es mayor mal?
Comiença te a consolar,
no muestres fuerça uencida;
que lo que mata la uida
con muerte se ha de ganar.

Uillancico.
Pues porque es buena la
uida
sin la muerte,
se toma por mejor suerte.
Quien muere muerte
biuiendo
no haze mucho su suerte,
mas el que biue muriendo
sin la muerte,
¿qué mal ni pena hay mas
fuerte?
Quien puede suffrir su mal
o quexallo a quien lo haze,
con su mal se satisfaze
su uida aunque es mortal,
pero el dolor desigual
de mal e pena tan fuerte
¿quien lo suffre que no
acierte?

EL AVCTOR
Acabada de dezir la cancion e
desecha lo menos mal que yo
pude, dexé la uihuela, sin mas
pensar lo que deuia hazer, mandé
ensillar, porque me parescia que
era tiempo e bien de partir a mi
tierra; e despedido de los que
hallé por la calle, sali de la corte,
más acompañado de pesar que
consolado de plazer. E tanto mi
tristeza crescia e mi salud
menguaua, que nunca pense
llegar biuo a Castilla, e despues
que començe a entrar por mi
camino, uinieronme tantas cosas
a la fantasia, que no tuuiera por
mal perder el seso, por perder el
pensamiento dellas. Pero
membrandome como no hauia
ningun prouecho pensar más en
ello, trabajaua conmigo quanto
podia por me defender de traellas
a la memoria. E assi trabajando el
cuerpo en le camino, y el ánima
en el pensamiento, llegué aqui a
Peñafiel como Diego de Sant
Pedro, do quedo besando las
manos de uuestras mercedes.
NOTAS:
[283] Parece que debe leerse «cuando en el cabo dél es dicho».
SERMON
ORDENADO

POR
DIEGO DE SANT
PEDRO

PORQUE DIXERON
VNAS SEÑORAS QUE
LE DESSEAUAN OYR
PREDICAR

Para que toda materia sea bien


entendida y notada, conuiene que
el razonamiento del que dize sea
conforme a la condicion del que lo
oye; de cuya verdad nos queda
que si ouieremos de hablar al
cauallero, sea en los actos de la
caualleria. E si al deuoto en los
meritos de la pasion. E si al
letrado, en la dulçura de la
sciencia. E assi por el
consiguiente en todos los otros
estados. Pues siguiendo esta
ordenança para conformar mis
palabras con vuestros
pensamientos; porque sea mejor
escuchado, paresceme que deuo
tratar delas enamoradas
passiones; pero porque sin gracia
ninguna obra se puede començar,
ni mediar, ni acabar, roguemos al
amor (en cuya obediencia
biuimos) que ponga en mi lengua
mi dolor; porque manifieste en el
sentir lo que fallesciere en el
razonar. E porque esta gracia nos
sea otorgada, pongamos por
medianera entre amor e nosotros
la Fe que tenemos en los
coraçones. E para mas la obligar,
offrecerle hemos sendos sospiros
porque nos alcance gracia; a mi
para dezir, e a vosotras señoras,
para escuchar; e a todos
finalmente para bien amar.
Dice el lhema: In patiencia vestra
sustinete dolores vestros.
Lastimados señores, y
desagradecidas señoras: Las
palabras que tomé por
fundamento de mi intencion, son
escriptas en el libro de la muerte,
a los siete capitulos de mi desseo.
Da testimonio dellas el
Evangelista Aficion. E traydas del
latin a nuestra lengua, quieren
dezir. En vuestra paciencia
sostened vuestros dolores. E para
conclusion del tema, será el
sermon partido en tres partes.
La primera será vna ordenança
para mostrar como las amigas se
deuen seguir. La segunda será vn
consuelo en que se esfuercen los
coraçones tristes. La tercera, vn
consejo para que las señoras que
son seruidas remedien a los que
la siruen. E para aclaracion de la
primera parte, digo que todo
edificio para que dure, conuiene
ser fundado sobre cimiento firme,
si quiere el edificador tener su
obra segura. Pues luego conuiene
que lo que edificare el desseo en
el coraçon catiuo, sea sobre
cimiento del secreto, si quisiera
su labor sostener e acabar sin
peligro de verguença. Donde por
essa conparacion paresce que
todo amador deue antes perder la
vida, que escurecer la fama de la
que siruiere, auiendo por mejor
recebir la muerte callando su
pena, que merecerla, trayendo su
cuydado a publicacion. Pues para
remedio deste peligro en que los
amadores tantas vezes
tronpieçan, deue traer en las
palabras mesura, y en el meneo
honestidad, y en los actos
cordura, y en los ojos auiso, y en
las muestras soffrimiento, y en los
desseos tenplança, y en las
platicas dissimulacion, y en los
mouimientos mansedunbre. E lo
que más deue proueer, es que no
lieue la persona tras el desseo,
porque no yerre con priessa, lo
que puede acertar con espacio;
que le hará passar muchas vezes
por donde no cunple, e buscar
mensajeros que no le conuienen,
y embiar cartas que le dañen, e
bordar inuenciones que lo
publiquen. E porque competencia
suele sacar el seso de sus
recogimientos honestos, poniendo
en coraçon sospechas, y en el
mal desesperacion, y en las
consideraciones discordia, y en el
sentimiento rauia; deue el que
ama templarse e suffrirle, porque
en tales casos quien buscare su
remedio, hallará su perdicion. E
quando al que compete le
paresciere que su competedor
lleuó mas fauor de su amiga que
no él, entonces deue mas
recogerse. E aquel mudar dela
color, e aquel encarniçar de los
ojos, e aquel temblar dela boz, e
aquel atenaçar delos dientes, e
aquella sequedad de la boca que
traen disfauores, deuelo cerrar en
el juyzio, cerrando la puerta con el
aldaba del soffrimiento, hasta que
gaste la razon los accidentes de
la ira; que las armas con que se
podria rengar, cortarian la fama
de la amiga, cosa que más que la
muerte se deue temer. Bien sé yo,
señoras, que lo que trato en mi
sermon con palabras, aueys
sentido vosotras en obras. De
manera que son mis razones
molde de vuestros sentimientos.
Empero porque muchas vezes la
passion ciega los ojos del
entendimiento, es bien recordar
os la haz y el enues destas
ocasiones. Sean los passos del
que ama espaciosos, e las
passadas por do está su amiga,
tardias; e tenga en publico tristeça
tenplada; porque esta es vn rastro
por donde van las sospechas a
dar en la celada de los
pensamientos; cosa de que todo
enamorado se deue apercibir,
porque diuersas vezes las
aparencias del rostro son testigos
de los secretos del coraçon; e no
dudo que no peneys mucho en
hazer esto, porque más
atormentan los plazeres forçosos
que las tristeças voluntarias; mas
todo se deue suffrir en amor y
reuerencia de la fama de la
amiga, e guardaos, señores, de
vna erronía que en la ley
enamorada tienen los galanes,
comentando en la primera letra de
los nombres de la que siruen sus
inuenciones o cimeras o
bordaduras, porque semejante
gentileça es vn pregon con que se
haze justicia de la infamia dellas.
Ved qué cosa tan errada es
manifestar en la bordadura avn lo
que en el pensamiento se deue
guardar. Y no menos, señores, os
escusad de vestidos de sus
colores, porque aquello no es otra
cosa sino vn espejo do se
muestra que la seruis. E porque
los ojos suelen descobrir lo que
guarda la voluntad, sea vuestro
mirar general, por quitar de tino
los sospechosos. Conuiene a
todo enamorado ser virtuoso, en
tal manera, que la bondad rija el
esfuerço, aconpañe la franqueça;
e la franqueça adorne la
tenplança, e la tenplança afeyte la
conuersacion, e la conuersacion
ate la buena criança, por via que
las vnas virtudes de las otras se
alumbren, que de semejantes
passos se suele hazer el escalera
por do suben los tristes a aquella
bienaventurada esperança que
todos deseamos. Nunca vuestro
juyzio responda á las bozes de la
pena; e quando ella se aquexa
con dolor rija el seso la tenplança,
atando el cuerpo con consejo,
porque no se vaya tras el
pensamiento haziendo asomadas
y meneos. No segun la ley del
discreto lo establesce, mas segun
la priessa de la pena lo pide. E
porque suelen recrescerse a los
penados acaescimientos de tanta
angustia que dessean hablar la,
porque la passion comunicada
duele menos, no so yo de consejo
que a nadie se descubra porque
quien a otro su secreto descubre,
hagale señor de si.
Pues porque no rebiente el que
se viere en tal estrechura,
apartase a tal lugar solo, y
sentado en medio de sus
pensamientos, trate y participe
con ellos sus males; porque
aquellos solo son compañia fiel. E
si vn pensamiento le traxere
desesperaciones, otro le traerá
esperança. E si vno hallase torpe,
otro hallará tan agudo que le
procure su remedio. E si vno le
dixere que desespere segun su
desdicha, otro le dirá que espere
segun su fe, e si vno le
aconsejare que acorte con la
muerte la vida e los males, otro le
dirá que no lo haga, porque con
largo biuir todo se alcança; otro le
dirá que tiene su amiga graue
condicion como desamorada, otro
le dirá que tiene piedad natural
segun muger; otro le consejará
que calle, que muera e suffra; e
otro que sirua e hable e siga. De
manera que él de si mismo se
podra consolar y desconsolar.
Direys vosotros, señores, que
todavia querria desconsolacion e
consejo de amigo, porque los
honbres ocupados de codicia, o
amor, o desseo no pueden
determinar bien en sus cosas
propias, lo qual yo no reprueuo.
Pero assi como en los otros casos
lo conozco, assi para esto lo
niego; porque en las otras
negociaciones se turba la razon, y
en los dolores de este mal se
aguza el seso. E si sobre todo
esto la ventura vos fuese
contraria, en vuestra paciencia
sostened vuestros dolores.

LA SEGUNDA PARTE
La segunda parte de mi sermon
dixe que seria vn consuelo de los
coraçones tristes. Para
fundamento de lo qual conuiene
notar que todos los que catiuaren
sus libertades, deuen primero
mirar al merescer de la que
causare la captiuidad, porque el
afficion justa aliuia la pena. De
donde se aprende; el mal que se
sufre con razon, se sana con ella
misma. De cuya causa las
passiones se consuelan e suffren.
E avn que las lagrimas vos
cerquen, e angustias vos
congoxen, e sospechas vos
lastimen, nunca, señores, vos
aparteys de seguir e seruir e
querer, que no ay conpañia mas
amigable que el mal que vos
viene de quien tanto quereys,
pues ella lo quiere. E si no
hallardes piedad en quien la
buscays, ni esperança de quien la
quereys, esperad en vuestra Fe, y
confiad en vuestra firmeza; que
muchas vezes la piedad responde
quando firmeza llama a sus
puertas. E pues soys obedientes
a vuestros desseos, soffrid el mal
de la pena por el bien de la
causa. ¡Que, señores, si bien lo
miramos quantos bienes
recebimos de quien siempre nos
quexamos! La soledad causa
desesperacion algunas vezes,
donde nuestras amigas siempre
nos socorren, dando nos quien
nos acompañe e ayude en
nuestra tribulacion. Embian nos a
la memoria el desseo que su
hermosura nos causa, e la
passion que su gracia nos pone; y
el tormento que su discrecion nos
procura; y el trabajo que su
desamor nos da. E porque estas
cosas mejor conpañia nos hagan
crezcan nuestros coraçones con
ellas; en manera que por venir de
do vienen avn que el pensamiento
se adolezca, la voluntad se
satisfaze; porque no nos dexen
desesperar. Y es esto como las
feridas que los caualleros receben
con honrra, avn que las sienten
en las personas con dolor, las
tienen en la fama por gloria. O
amador! si tu amiga quisiere que
penes, pena; e si quisiera que
mueras, muere; e si quisiera
condenarte, vete al infierno en
cuerpo y en ánima. ¿Qué más
beneficio quieres que querer lo
que ella quiere? Haz ygual el
coraçon a todo lo que te pueda
venir. E si fuere bien, amalo. E si
fuere mal, suffrelo. Que todo lo
que de su parte te viniere, es
galardon para ti. Direys a esto
que vos dé fuerça para suffrir, y
que vosotros me dareys voluntad
para penar. Mirad bien, señores,
quan engañados en esto biuis;
que si podeys sostener tan graue
pena, cobrareys estimacion. E si
el suffrimiento cansare y os
traxere a estado de muerte, no
puede veniros cosa más
bienauenturada; que quien bien
muere, nunca muere; pues qué fin
más honrrado espera ninguno
que acabar debaxo de la seña de
su señor: por fe y firmeça e
lealtad e razon? Por donde
estaua bien vn mote mio, que
decia, que en la muerte está la
vida. Dize vn varon sabio, que no
vido honbre tan desuenturado,
como aquel que nunca le vino
desuentura; porque este ni sabe
de si para quanto es, ni los otros
conoscen lo que podria si de
fortuna fuesse prouado. Pues qué
mas quereys de vuestras amigas
sino que con sus penas
esperimenteys vuestra fortaleça?
Que no hallo yo por menos
coraçon recebir la muerte con
voluntad, que sostener la vida con
tormento; porque en lo vno se
muestra resistencia fuerte, y en lo
otro obediencia justa; de forma,
que con el mal que amor os
ordena, os procura alabança.
Esforçad vos en la vida, e sed
obedientes en la muerte. Pues
luego bien dize el tema: que
sostengays en vuestra paciencia
vuestros dolores.

LA TERCERA PARTE
Dixe que la tercera parte de mi
sermon seria vn consejo para que
las señoras que son seruidas
remedien a quien las sirue. Pero
primero que venga a las razones
desto, digo que quisiera, señoras,
conosceros con seruicio, antes
que ayudaros con consejo:
porque lo vno hiziera con sobra
de voluntad, y haré lo otro con
mengua de discrecion; mas como
desseo librar vuestras obras de
culpa, e vuestras almas de pena,
dezir vos he mi parecer lo menos
mal que pudiere. Pues para
començar el proposito, solo por
salud de vuestras animas,
deveriades remediar los que
penays; que incurris por el
tormento que les days en quatro
pecados mortales; en el de
soberuia que es el primero,
pecays por esta razon: Quando
veys que vuestra hermosura y
valer puede guarescer los
muertos e matar los biuos, e
adolescer los sanos, e sanar los
dolientes, creeys que podeys
hazer lo mismo que Dios, al qual
por esta manera offendeys por
este peccado. E no menos en el
de auaricia; que como recogeys la
libertad e la voluntad e la
memoria y el coraçon de quien os
dessea, guardays todo esto con
tanto recaudo en vuestro
desconocimiento que no les
volvereys vna sola cosa destas,
fasta que muera por lleuarle la
vida con ellas. Pecays assi
mesmo en el pecado de la yra;
que como los que aman, siempre
siguen, es forçado que alguna vez
enojen, e importunadas de sus
palabras e porfias, tomays yra
con desseo de vengança. En el
pecado de la pereça no podeys
negar que tambien no caeys, que
los catiuos del aficion, avn que
mas os escriuan y os hablen, e os
embien a dezir, teneys tan
perezosa la lengua, que por cosa
del mundo no abris la boca para
dar vna buena repuesta. E si esta
razon no bastare para la
redenpcion de los catiuos, sea por
no cobrar mala estimacion. ¿Qué
os paresce que dirá quien sopiere
que quitando las vidas
galardonays los seruicios? Para el
leon e la sierpe es bueno el
matar. Pues dexar, señoras, por
Dios, vsar a cada vno su officio;
que para vosotras es el amor, e la
buena condicion y el redimir; el
consolar. E si por aqui no aprueuo
bien el consejo que os do, sea por
no ser desconocidas; culpa de tan
gran grauedad. ¿Cómo, señoras;
no es bien que conozcays la
obediente voluntad con que
vuestros siervos no quieren ser
nada suyos por serlo del todo
vuestros, que trasportados en
vuestro merescimiento, ni tienen
seso para fablar, ni razon para
responder, ni sienten donde van,
ni saben por do vienen, ni fablan
a proposito, ni se mudan con
concierto: estando en la yglesia y
cabo el altar, preguntan si es hora
de comer? ¡O quantas vezes les
acaesce tener el manjar en la
mano, entre la boca y el plato por
gran espacio, no sabiendo de
desacordados quién lo ha de
comer, ellos o el platel! Quando
se van a acostar, preguntan si
amanesce, e quando se levantan
preguntan si es ya de noche.
Pues si tales cosas desconoceys,
a la mi fe, señoras, ni podeys
quitar las condiciones de culpa, ni
las ánimas de pena, quando por

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