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Sample records for experimental retinal detachment

  1. Retinal Detachment Vision Simulator

    Science.gov (United States)

    ... What Is a Torn or Detached Retina? Retinal Detachment: Torn or Detached Retina Causes Retinal Detachment: Who Is At Risk for a Torn or Detached Retina? Retinal Detachment: Torn or Detached Retina Symptoms Retinal Detachment: Torn or Detached Retina Diagnosis ...

  2. Retinal Detachment

    Science.gov (United States)

    ... specific questions. Retinal Detachment Defined What is retinal detachment? The retina is the light-sensitive layer of tissue that ... the most common. Tractional —In this type of detachment, scar tissue on the retina’s surface contracts and causes the retina to separate ...

  3. Cyclic GMP in the pig vitreous and retina after experimental retinal detachment

    NARCIS (Netherlands)

    Diederen, R.; Heij, La E.C.; Lemmens, M.A.M.; Kijlstra, A.; Vente, De J.; Hendrikse, F.

    2008-01-01

    Purpose: Earlier studies have revealed a decreased level of cGMP in vitreous fluid obtained from patients with a retinal detachment. To further investigate this phenomenon, we developed an experimental retinal detachment model in pigs. Methods: Experimental unilateral retinal detachments were

  4. Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Adnan Riaz, MD

    2018-04-01

    Full Text Available History of present illness: A 58-year-old female presented to the emergency department reporting six days of progressive, atraumatic left eye vision loss. Her symptoms started with the appearance of dark spots and “spider webs,” and then progressed to darkening of vision in her left eye. She reports mild pain since yesterday. Her review of symptoms was otherwise negative. Ocular physical examination revealed normal external appearance, intact extraocular movements, and visual acuities of 20/25 OD and light/dark sensitivity OS. Fluorescein uptake was negative and slit lamp exam was unremarkable. Significant findings: Bedside ocular ultrasound revealed a serpentine, hyperechoic membrane that appeared tethered to the optic disc posteriorly with hyperechoic material underneath. These findings are consistent with retinal detachment (RD and associated retinal hemorrhage. Discussion: The retina is a layer of organized neurons that line the posterior portion of the posterior chamber of the eye. RD occurs when this layer separates from the underlying epithelium, resulting in ischemia and progressive photoreceptor degeneration, with potentially rapid and permanent vision loss if left untreated.1 Risk factors include advanced age, male sex (60%, race (Asians and Jews, and myopia and lattice degeneration.2 Bedside ultrasound (US performed by emergency physicians provides a valuable tool that has been used by ophthalmologists for decades to evaluate intraocular disease.1,3 Findings on bedside ultrasound consistent with RD include a hyperechoic membrane floating in the posterior chamber. RD usuallyremain tethered to the optic disc posteriorly and do not cross midline, a feature distinguishing them from posterior vitreous detachments. Associated retinal hemorrhage, seen as hyperechoic material under the retinal flap, can often be seen.1,2 US can also distinguish between “mac-on” and “mac-off” detachments. If the retina is still attached to the

  5. Nerve growth factor helps protect retina in experimental retinal detachment.

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    Sun, Xiaodong; Xu, Xun; Wang, Fenghua; Zhang, Xi; Ho, Patrick C P; Liu, Haiyang; Qian, Jin; Yu, Zhang; Lu, Hongfen; Xu, Weiqi

    2008-01-01

    To investigate the expression of nerve growth factor (NGF) and its receptor TrkA on the retina at different time points after retinal detachment (RD) and the protection effect of NGF in experimental RD. Sprague-Dawley rats were used as an RD animal model by injection of 0.1% sodium hyaluronate under the neurosensory retina. The expression of endogenous NGF and its receptor TrkA in the rat retina was detected using immunohistochemistry. The NGF (5 mug/eye) or phosphate-buffered saline were injected separately into vitreous every 4 days after the RD. The rat eyes were then observed at various time points. Morphologic changes were investigated by light microscopy. Retinal gliosis was detected by glial fibrillary acidic protein labeling. The expression of endogenous NGF and TrkA was upregulated during RD procedure. Most of the NGF-treated retina had a well-organized structure. In NGF-treated RD eyes, the cells were still significantly more numerous than in phosphate-buffered-saline-treated retina. Glial fibrillary acidic protein labeling increased quickly after RD; the NGF-treated retina had less reactive gliosis than the control groups. Intravitreal injection of exogenous NGF can protect retinal cells from degeneration in experimental RD. It may exert its protective action by preventing the apoptosis of retinal cells after RD. (c) 2007 S. Karger AG, Basel.

  6. Proteomic Analysis of the Vitreous following Experimental Retinal Detachment in Rabbits

    DEFF Research Database (Denmark)

    Mandal, Nakul; Lewis, Geoffrey P.; Fisher, Steven K.

    2015-01-01

    of the vitreous following experimental retinal detachment using a comparative proteomic based approach. Materials and Methods. Retinal detachment was created in the right eyes of six New Zealand red pigmented rabbits. Sham surgery was undertaken in five other rabbits that were used as controls. After seven days......, and α-1-antiproteinase F. Conclusions. Proteomic investigation of the rabbit vitreous has identified a set of proteins that help further our understanding of the pathogenesis of rhegmatogenous retinal detachment and its complications....

  7. Retinal Detachment: Torn or Detached Retina Symptoms

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    ... Health / Eye Health A-Z Detached or Torn Retina Sections Retinal Detachment: What Is a Torn or ... Detachment Vision Simulator Retinal Detachment: Torn or Detached Retina Symptoms Leer en Español: Síntomas de desgarramiento o ...

  8. Retinal detachment repair

    Science.gov (United States)

    ... area (the macula). This can help prevent further detachment of the retina. It also will increase the chance of preserving ... buckling; Vitrectomy; Pneumatic retinopexy; Laser retinopexy; Rhegmatogenous retinal detachment repair Images ... detachment repair - series References Connolly BP, Regillo ...

  9. Protein changes in the retina following experimental retinal detachment in rabbits

    DEFF Research Database (Denmark)

    Mandal, Nakul; Lewis, Geoffrey P; Fisher, Steven K

    2011-01-01

    Retinal detachment leads to the widespread cellular remodeling of the retina. The purpose of this study was to identify protein changes that accompany these cellular alterations by comparing the proteomic profiles of sham and experimentally detached rabbit retina. Elucidation of the proteins most...

  10. Tauroursodeoxycholic Acid (TUDCA) Protects Photoreceptors from Cell Death after Experimental Retinal Detachment

    Science.gov (United States)

    Mantopoulos, Dimosthenis; Murakami, Yusuke; Comander, Jason; Thanos, Aristomenis; Roh, Miin; Miller, Joan W.; Vavvas, Demetrios G.

    2011-01-01

    Background Detachment of photoreceptors from the underlying retinal pigment epithelium is seen in various retinal disorders such as retinal detachment and age-related macular degeneration and leads to loss of photoreceptors and vision. Pharmacologic inhibition of photoreceptor cell death may prevent this outcome. This study tests whether systemic administration of tauroursodeoxycholic acid (TUDCA) can protect photoreceptors from cell death after experimental retinal detachment in rodents. Methodology/Principal Findings Retinal detachment was created in rats by subretinal injection of hyaluronic acid. The animals were treated daily with vehicle or TUDCA (500 mg/kg). TUNEL staining was used to evaluate cell death. Photoreceptor loss was evaluated by measuring the relative thickness of the outer nuclear layer (ONL). Macrophage recruitment, oxidative stress, cytokine levels, and caspase levels were also quantified. Three days after detachment, TUDCA decreased the number of TUNEL-positive cells compared to vehicle (651±68/mm2 vs. 1314±68/mm2, P = 0.001) and prevented the reduction of ONL thickness ratio (0.84±0.03 vs. 0.65±0.03, P = 0.002). Similar results were obtained after 5 days of retinal detachment. Macrophage recruitment and expression levels of TNF-a and MCP-1 after retinal detachment were not affected by TUDCA treatment, whereas increases in activity of caspases 3 and 9 as well as carbonyl-protein adducts were almost completely inhibited by TUDCA treatment. Conclusions/Significance Systemic administration of TUDCA preserved photoreceptors after retinal detachment, and was associated with decreased oxidative stress and caspase activity. TUDCA may be used as a novel therapeutic agent for preventing vision loss in diseases that are characterized by photoreceptor detachment. PMID:21961034

  11. Cyclic GMP in the pig vitreous and retina after experimental retinal detachment.

    Science.gov (United States)

    Diederen, Roselie M H; La Heij, Ellen C; Lemmens, Marijke A M; Kijlstra, Aize; de Vente, Jan; Hendrikse, Fred

    2008-02-04

    Earlier studies have revealed a decreased level of cGMP in vitreous fluid obtained from patients with a retinal detachment. To further investigate this phenomenon, we developed an experimental retinal detachment model in pigs. Experimental unilateral retinal detachments were induced in pig eyes by subretinal injection of 0.25% sodium hyaluronate. Fourteen days later the vitreous and retinas were analyzed for cGMP expression. Following enucleation, the retinas were incubated in the presence of a nonselective phosphodiesterase inhibitor (IBMX), and the particulate guanylyl cyclase stimulator atrial natriuretic peptide (ANP) or the soluble guanylyl cyclase stimulator sodium nitroprusside (SNP). cGMP was visualized in retinal wholemounts by immunochemistry combined with a computer based stereology system. cGMP levels in vitreous were determined by ELISA. The mean vitreous cGMP level in pig eyes with a retinal detachment (1.45 pmol/ml) was significantly lower compared to the mean level of cGMP in healthy pig eyes (4.61 pmol/ml; p=0.028 was considered significant). In the inner retina, ANP as well as SNP induced cGMP immunoreactivity in both detached and healthy retinas. After incubation with ANP, cGMP could also be detected in the outer nuclear layer of the detached retina, whereas this was not the case in the normal retina. Experimental retinal detachment in the pig eye leads to a decrease of cGMP levels in vitreous similar to that observed in clinical studies. This model may be helpful to analyze the mechanisms involved in cGMP dynamics following retinal detachment.

  12. Retinal Detachment: Torn or Detached Retina Diagnosis

    Science.gov (United States)

    ... Health / Eye Health A-Z Detached or Torn Retina Sections Retinal Detachment: What Is a Torn or ... Detachment Vision Simulator Retinal Detachment: Torn or Detached Retina Diagnosis Leer en Español: Diagnóstico de un desgarramiento ...

  13. Protein changes in the retina following experimental retinal detachment in rabbits.

    Science.gov (United States)

    Mandal, Nakul; Lewis, Geoffrey P; Fisher, Steven K; Heegaard, Steffen; Prause, Jan U; la Cour, Morten; Vorum, Henrik; Honoré, Bent

    2011-01-01

    Retinal detachment leads to the widespread cellular remodeling of the retina. The purpose of this study was to identify protein changes that accompany these cellular alterations by comparing the proteomic profiles of sham and experimentally detached rabbit retina. Elucidation of the proteins most dramatically affected by retinal detachment would add further understanding to the pathophysiology of this condition, and potentially identify therapeutic targets useful in preventing the deleterious effects of detachment, including photoreceptor cell death and the activation of non-neuronal microglial and Müller cells. Retinal detachments were induced in the right eyes of six New Zealand Red pigmented rabbits. Sham surgery was performed in the right eyes of six other rabbits that were used as controls. At seven days, the eyes were enucleated and the retinal tissue was harvested. The individual retinal samples were subjected to high resolution two-dimensional polyacrylamide gel electrophoresis. Differentially expressed protein spots were processed for identification by liquid chromatography-tandem mass spectrometry. Further investigation was undertaken with western blotting, and immunocytochemical studies on a further set of four sham and four detached retinas. Eighteen protein spots were found to be at least twofold differentially expressed between the sham and detached retinas. These protein spots were identified as: vimentin; tubulin β-2C; fragments of α-enolase; fructose-bisphosphate aldolase A; ATP synthase subunit β; mitochondrial creatine kinase; N-terminal fragments of albumin; prohibitin; and transducin-β(1). The differentially expressed proteins determined in this study may play an important role in the cellular responses of the retina after its detachment, subsequent ability to recover following surgical reattachment, as well as in serious complications such as subretinal fibrosis and proliferative vitreoretinopathy.

  14. A novel experimental mouse model of retinal detachment: complete functional and histologic recovery of the retina.

    Science.gov (United States)

    Zeng, Rui; Zhang, Ying; Shi, Fanjun; Kong, Fansheng

    2012-03-26

    To establish an experimental mouse model of retinal detachment (RD) created by corneal puncture (CP). Mouse corneas were punctured with a 30.5-gauge beveled needle, and the anterior chamber was penetrated. Histologic and functional changes of the retina were examined by light microscopy and electroretinography (ERG). Certain retinal cellular responses were examined by immunofluorescence microscopy. Internucleosomal DNA fragmentation in the retina was determined by terminal deoxynucleotidyl transferase-mediated uridine 5'-triphosphate-biotin nick-end labeling (TUNEL). RESULTS. CP caused transient leakage of aqueous humor along the needle shaft and immediate formation of multiple retinal blebs, which shrank and flattened within 24 hours. Bleb formation was associated with detachment of the neuroretina from the retinal pigment epithelium (RPE). After CP, the RPE cells underwent extensive transformation during retinal detachment/reattachment, but they resumed normal morphology on retinal reattachment around 10 to 13 days after CP. Relative to pre-CP ERG amplitudes, the punctured eyes showed decreases of 45% and 24% in scotopic and 7% and 12% in photopic b- and a-wave amplitudes, respectively, within 10 to 20 minutes after CP. The ERG amplitudes recovered fully by 12 hours after CP. No infiltrated cells were observed in the subretinal space, and no proliferating or TUNEL-positive cells were observed in the retina of the punctured eyes. Puncturing the mouse cornea can create transient RD, and the functional and histologic changes in the retina can subsequently recover. This experimental mouse model of RD mimics human traction and serous RD.

  15. [The neuroprotection of brain-derived neurotrophic factor in experimental retinal detachment reattached].

    Science.gov (United States)

    Zeng, Aiping; Xu, Haiyan

    2014-11-01

    To investigate the effect of exogenous brain-derived neurotrophic factor (BDNF) on the retinal repair after experimental retinal detachment (RD) reattached. Experimental study. Forty-eight normal rats were randomly divided into four groups:BDNF group, control group, RD reattached group and normal group. In order to detect the effects of BDNF on retinal degeneration caused by RD, the morphology of retina and the ultrastructure of retinal cells were observed by light microscopy and electron microscopy. The effect of BDNF on the apoptosis of retinal cells after RD reattached was detected by Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL) technique. Data were analyzed using one-way analysis of variance (ANOVA) and secondary analysis for significance with independent-samples t-test. The average automatically reattached time was (31.3 ± 3.5) days. Compared with control group, there were less damage in out segment and inner segment, more retinal cells in outer nuclear layer (ONL) and inner nuclear layer (INL), thicker ONL of retina and better organizational structure of retina in BDNF group. The average thickness of ONL and INL of retina were (21.166 ± 3.087) µm, (23.508 ± 3.679) µm respectively in BDNF group, and (16.084 ± 2.928) µm, (12.885 ± 3.070) µm respectively in control group. The thickness of ONL and INL of retina showed a significant difference in BDNF group compared with control (P retina in BDNF group compared with control. This study indicates that the morphology of retina and the ultrastructure of retinal cells have changed, and the apoptosis of retinal cells are present after RD reattached. Exogenous BDNF can reduce retinal cells degeneration and inhibit the apoptosis of retinal cells and have a certain protection effects on the retinal damage caused by RD.

  16. Retinal Detachment in Preeclampsia

    Directory of Open Access Journals (Sweden)

    Prado Renata Silva do

    2002-01-01

    Full Text Available Preeclampsia is an obstetric disease of unknown cause that affects approximately 5% of pregnant women. The visual system may be affected with variable intensity, being the retinal detachment a rare complication. The retinal detachment in preeclampsia is usually bilateral and serous, and its pathogenesis is related to the choroidal ischemia secondary to an intense arteriolar vasospasm. The majority of patients have complete recovery of vision with clinical management, and surgery is unnecessary. This is a case report of a 27 year old patient who developed the severe form of preeclampsia on her first pregnancy. She had progressive blurred vision, until she could see only shadows. Ophthalmic examination diagnosed spread and bilateral retinal detachment. With blood pressure control at postpartum, the patient had her retina reattached, and recovery of vision.

  17. Retinal Detachment: Torn or Detached Retina Treatment

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    ... in special positions for a time. Do not fly in an airplane or travel at high altitudes until you are ... With an oil bubble, it is safe to fly on an airplane. Most retinal detachment surgeries (80 to 90 percent) ...

  18. Paediatric retinal detachment: a review

    Directory of Open Access Journals (Sweden)

    Raffaele Nuzzi

    2017-10-01

    Full Text Available Paediatric retinal detachment (PRD is an uncommon and challenging disease; it differs from adult detachments in etiology, anatomical characteristics, management and prognosis. PRDs can be particularly challenging, even for the most expert paediatric surgeons due to the higher prevalence of total retinal detachments, late diagnosis and bilateral involvement with respect to those which occur in adulthood. Moreover, the anatomical success, when achieved, is frequently not related to a functional recover. Postsurgical adverse events, refractive errors and amblyopia may additionally undermine the final outcome. Up to date there are few reviews regarding the approach of retinal detachment in children, mainly dealing with rhegmatogenous retinal detachment. In this review, rhegmatogenous, retinopathy of prematurity-related and Coats’-related PRDs were considered. The available literature from the last decades were reviewed and summarized. Epidemiology, etiology and clinical presentation, together with therapeutic approaches and outcomes have been reviewed and discussed.

  19. Retinal Detachment Associated With Atopic Dermatitis.

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    Kothari, Nikisha; Young, Ryan C; Read, Sarah P; Tutiven, Jacqueline; Perez, Victor L; Flynn, Harry W; Berrocal, Audina M

    2017-06-01

    Ocular manifestations related to atopic dermatitis include keratoconus, keratoconjunctivitis, cataract, and retinal detachment. The authors report three cases of retinal detachment associated with atopic dermatitis. Although the pathogenesis is poorly understood, chronic blunt trauma may play a role in the development of retinal detachment. In addition, retinal detachments associated with atopic dermatitis may have lower rates of successful retinal detachment repair. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:513-517.]. Copyright 2017, SLACK Incorporated.

  20. Drusenoid retinal pigment epithelium detachments

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    Miguel Hage Amaro

    2015-10-01

    Full Text Available ABSTRACT The authors make a review of drusenoid retinal pigment epithelium detachments(DPDs, a form of retinal pigment epithelium detachment(PED that evolves from confluent and large soft drusen.Drusenoidretinal pigment epithelial detachments are a recognized element of the "dry" AMD. Until now, no treatment is indicated in drusenoid PEDs. The authors describe the clinical characteristics of drusenoid retinal pigment epithelium detachments (DPEDs and make a review of the DPEDs related in the international literature. We related in this revision paper the multimodal advanced image exams in two cases of dusenoid retinal pigment epithelium detachments (DPEDs and the general characteristics of thisfinding associated with Dry Macular degeneration.Upon examination of the ocular fundusDPEDs emerge as well-circumscribed yellow or yellow–white elevations of the RPE that are usually found within the macula.They may show scalloped borders and a slightly irregular surface. When visualized using fluorescein angiography (FA,DPEDs are typically described as faint hyper-fluorescent in the early phase followed by a slow increase in fluorescence throughout the transit stage of the study without late leakage. With optical coherence tomography (OCT, drusenoid PEDs usually show a smooth contour of the detached hyperreflective RPE band that may have an undulating appearance.Drusenoid PEDs encompass far above the ground possibility type of "dry" AMD that develops in relationship with large confluent soft drusen.At this point no treatment is utilized in drusenoid retinal pigment epithelium detachment(DPEDs.

  1. [Prophylactic treatment of retinal detachment].

    Science.gov (United States)

    Binder, S; Riss, B

    1981-08-01

    The indications for and results of prophylactic treatment of retinal detachment during a period of five years are reported and compared with the results in the literature. Half of the cases (3 out of 6 eyes) which developed a retinal detachment had been horse-shoe tears combined with a vitreous hemorrhage. For this reason a small buckle operation is recommended in these cases, to prevent further traction. Lattice degeneration should rather be observed than treated, except in special cases: This includes eyes where the fellow eye had a detachment from a lattice degeneration, cases in which one eye is blind from an uncured detachment or has no useful visual acuity, and eyes whose fellow eye has giant tears. In aphakic eyes treatment of lattice degeneration is recommended, because the incidence of detachment from these areas is high, especially in young aphakic cases. In one aphakic eye which had been photocoagulated several times the formation of a preretinal membrane was observed.

  2. Missed retinal breaks in rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Brijesh Takkar

    2016-12-01

    Full Text Available AIM: To evaluate the causes and associations of missed retinal breaks (MRBs and posterior vitreous detachment (PVD in patients with rhegmatogenous retinal detachment (RRD. METHODS: Case sheets of patients undergoing vitreo retinal surgery for RRD at a tertiary eye care centre were evaluated retrospectively. Out of the 378 records screened, 253 were included for analysis of MRBs and 191 patients were included for analysis of PVD, depending on the inclusion criteria. Features of RRD and retinal breaks noted on examination were compared to the status of MRBs and PVD detected during surgery for possible associations. RESULTS: Overall, 27% patients had MRBs. Retinal holes were commonly missed in patients with lattice degeneration while missed retinal tears were associated with presence of complete PVD. Patients operated for cataract surgery were significantly associated with MRBs (P=0.033 with the odds of missing a retinal break being 1.91 as compared to patients with natural lens. Advanced proliferative vitreo retinopathy (PVR and retinal bullae were the most common reasons for missing a retinal break during examination. PVD was present in 52% of the cases and was wrongly assessed in 16%. Retinal bullae, pseudophakia/aphakia, myopia, and horse shoe retinal tears were strongly associated with presence of PVD. Traumatic RRDs were rarely associated with PVD. CONCLUSION: Pseudophakic patients, and patients with retinal bullae or advanced PVR should be carefully screened for MRBs. Though Weiss ring is a good indicator of PVD, it may still be over diagnosed in some cases. PVD is associated with retinal bullae and pseudophakia, and inversely with traumatic RRD.

  3. Outcomes in bullous retinal detachment

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    Sarah P. Read

    2017-06-01

    Conclusions and importance: GRTs are an uncommon cause of retinal detachment. While pars plana vitrectomy with tamponade is standard in GRT management, there is variability in the use of scleral buckling and PFO in these cases. This is in contrast to retinal dialysis where scleral buckle alone can yield favorable results. Though a baseball ocular trauma is common, retinal involvement is rare compared to other sports injuries such as those occurring with tennis, soccer and golf. Sports trauma remains an important cause of retinal injury and patients should be counseled on the need for eye protection.

  4. The mechanics of retinal detachment

    Science.gov (United States)

    Chou, Tom; Siegel, Michael

    2013-03-01

    We present a model of the mechanical and fluid forces associated with exudative retinal detachments where the retinal photoreceptor cells separate typically from the underlying retinal pigment epithelium (RPE). By computing the total fluid volume flow arising from transretinal, vascular, and retinal pigment epithelium (RPE) pump currents, we determine the conditions under which the subretinal fluid pressure exceeds the maximum yield stress holding the retina and RPE together, giving rise to an irreversible, extended retinal delamination. We also investigate localized, blister-like retinal detachments by balancing mechanical tension in the retina with both the retina-RPE adhesion energy and the hydraulic pressure jump across the retina. For detachments induced by traction forces, we find a critical radius beyond which the blister is unstable to growth. Growth of a detached blister can also be driven by inflamed tissue within which e.g., the hydraulic conductivities of the retina or choroid increase, the RPE pumps fail, or the adhesion properties change. We determine the parameter regimes in which the blister either becomes unstable to growth, remains stable and finite-sized, or shrinks, allowing possible healing. This work supported by the Army Research Office through grant 58386MA

  5. Morphological recovery in the reattached retina of the toad Bufo marinus: a new experimental model of retinal detachment.

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    Abdal Monaim, Moustafa; Suleiman, Jiab H; Ashraf, Muhammad

    2005-01-01

    The retinal pigment epithelium (RPE) of the toad (Bufo marinus) has been used in many studies as a model for understanding its role and interaction with the neural retina. The toad's retina has been used to establish a new in vitro model of experimental retinal detachment (RD) and replacement . It has been shown that the electrophysiological measures of retinal function recovered following complete RD. The toad was chosen because its RPE is similar to the mammalian RPE . In this report, light microscopy was used to characterize the morphologic changes that occur in the RPE and neural retina following RD/replacement and to correlate these findings with recovery of electrophysiologic function. Retinas from Bufo marinus were studied in vitro. The neural retina completely detached from the RPE and then replaced. At various times after replacement, neural retina-RPE tissues were processed for light microscopy. At 30 min after replacement, the subretinal space was greatly expanded, and the apical processes that normally ensheath the rod outer segments were short and no longer contacted the rod outer segments. The RPE was swollen, contained many vacuoles and the apical surface was rounded. By 2 h after replacement, the subretinal space was significantly resorbed and contained many shredded rod outer segments; RPE cells were still swollen, although less. During the next 5-10 h, the number of phagosomes in the RPE cytoplasm increased and the number of shredded rod outer segments in the subretinal space decreased. RPE cells regained their normal size and interdigitation of apical processes and rod outer segments were observed. These results demonstrate the re-establishment of morphological interactions between the RPE and neural retina within hours following RD/replacement. Morphological recovery coincides with recovery of electrophysiologic parameters. This is a good model to investigate the retinal pigment epithelium (RPE) and neural retina mechanisms involved in retinal

  6. Cellular remodeling in mammalian retina: results from studies of experimental retinal detachment.

    Science.gov (United States)

    Fisher, Steven K; Lewis, Geoffrey P; Linberg, Kenneth A; Verardo, Mark R

    2005-05-01

    Retinal detachment, the separation of the neural retina from the retinal pigmented epithelium, starts a cascade of events that results in cellular changes throughout the retina. While the degeneration of the light sensitive photoreceptor outer segments is clearly an important event, there are many other cellular changes that have the potential to significantly effect the return of vision after successful reattachment. Using animal models of detachment and reattachment we have identified many cellular changes that result in significant remodeling of the retinal tissue. These changes range from the retraction of axons by rod photoreceptors to the growth of neurites into the subretinal space and vitreous by horizontal and ganglion cells. Some neurite outgrowths, as in the case of rod bipolar cells, appear to be directed towards their normal presynaptic target. Horizontal cells may produce some directed neurites as well as extensive outgrowths that have no apparent target. A subset of reactive ganglion cells all fall into the latter category. Muller cells, the radial glia of the retina, undergo numerous changes ranging from proliferation to a wholesale structural reorganization as they grow into the subretinal space (after detachment) or vitreous after reattachment. In a few cases have we been able to identify molecular changes that correlate with the structural remodeling. Similar changes to those observed in the animal models have now been observed in human tissue samples, leading us to conclude that this research may help us understand the imperfect return of vision occurring after successful reattachment surgery. The mammalian retina clearly has a vast repertoire of cellular responses to injury, understanding these may help us improve upon current therapies or devise new therapies for blinding conditions.

  7. Retinal detachment in paediatric patients

    International Nuclear Information System (INIS)

    Zafar, S. N.; Qureshi, N.; Azad, N.; Khan, A.

    2013-01-01

    Objective: To assess the causes of retinal detachment in children and the various operative procedures requiring vitreoretinal surgical intervention for the same. Study Design: Case series. Place and Duration of Study: Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2006 to May 2009. Methodology: A total of 281 eyes of 258 patients, (aged 0 - 18 years) who underwent vitreo-retinal surgical intervention for retinal detachment were included. Surgical log was searched for the type of retinal detachment and its causes. Frequencies of various interventions done in these patients viz. vitrectomy, scleral buckle, use of tamponading agents, laser photocoagulation and cryotherapy were noted. Results were described as descriptive statistics. Results: Myopia was the cause in 62 (22.1%) and trauma in 51 (18.1%) of the eyes. Total retinal detachment (RD) was treated in 94 (33.5%) eyes, sub total RD in 36 (12.8%), recurrent RD in 32 (11.4%), giant retinal tear in 28 (10%), tractional RD in 15 (5.3%) and exudative RD in 2 (0.7%). Prophylactic laser or cryotherapy was applied in 74 (26.3%) of the eyes. Pars plana vitrectomy (PPV) was carried out in 159 (56.6%) eyes while scleral buckle procedure was done in 129 (45.9%) eyes. Silicon oil was used in 149 (53%), perfluorocarbon liquid in 32 (11.4%) and gas tamponade in 20 (7.1%) eyes. Conclusion: The most common cause of retinal detachment in paediatric patients was myopia, followed by trauma. Total RD was more common as compared to the other types. The most common procedure adopted was pars plana vitrectomy followed by scleral buckle procedure. (author)

  8. Increased glutamate levels in the vitreous of patients with retinal detachment

    NARCIS (Netherlands)

    Diederen, R.; Heij, La E.C.; Deutz, N.E.P.; Kijlstra, A.; Kessels, A.G.H.; Eijk, van H.M.; Liem, A.T.A.; Dieudonne, S.; Hendrikse, F.

    2006-01-01

    Experimental models have implicated glutamate in the irreversible damage to retinal cells following retinal detachment. In this retrospective study we investigated a possible role for glutamate and other amino acid neurotransmitters during clinical rhegmatogenous retinal detachment (RRD). Undiluted

  9. Intraretinal proliferation induced by retinal detachment

    Energy Technology Data Exchange (ETDEWEB)

    Fisher, S.K.; Erickson, P.A.; Lewis, G.P.; Anderson, D.H. (Univ. of California, Santa Barbara (USA))

    1991-05-01

    Cellular proliferation after retinal detachment was studied by {sup 3}H-thymidine light microscopic autoradiography in cats that had experimental detachments of 0.5-180 days duration. The animals underwent labeling 2 hr before death with an intraocular injection of 200 microCi of {sup 3}H-thymidine. The number of labeled nuclei were counted in 1-micron thick tissue sections in regions of detachment, in regions of the experimental eyes that remained attached, and in control eyes that had no detachments. In the normal eye, in one that had only the lens and vitreous removed, and in the eyes with 0.5- and 1-day detachments, the number of labeled nuclei ranged from 0/mm (0.5-day detachment) to 0.38/mm (lens and vitreous removed only). By 2 days postdetachment, the number of labeled nuclei increased to 2.09/mm. The highest levels of labeling occurred in two animals with detachments of 3 (7.86/mm) and 4 (7.09/mm) days. Thereafter, the numbers declined steadily until near-baseline counts were obtained at 14 days. The number of labeled nuclei was slightly elevated in the attached regions of two animals with 3-day detachments. Labeled cell types included: Mueller cells, astrocytes, pericytes, and endothelial cells of the retinal vasculature, and both resident (microglial cells) and invading macrophages. In an earlier study RPE cells were also shown to proliferate in response to detachment. Thus, these data show that proliferation is a rapid response to detachment, reaching a maximum within 4 days, and that virtually every nonneuronal cell type in the retina can participate in this response. The data suggest that events leading to such clinical manifestations as proliferative vitreoretinopathy and subretinal fibrosis may have their beginnings in this very early proliferative response.

  10. Intraretinal proliferation induced by retinal detachment

    International Nuclear Information System (INIS)

    Fisher, S.K.; Erickson, P.A.; Lewis, G.P.; Anderson, D.H.

    1991-01-01

    Cellular proliferation after retinal detachment was studied by 3 H-thymidine light microscopic autoradiography in cats that had experimental detachments of 0.5-180 days duration. The animals underwent labeling 2 hr before death with an intraocular injection of 200 microCi of 3 H-thymidine. The number of labeled nuclei were counted in 1-micron thick tissue sections in regions of detachment, in regions of the experimental eyes that remained attached, and in control eyes that had no detachments. In the normal eye, in one that had only the lens and vitreous removed, and in the eyes with 0.5- and 1-day detachments, the number of labeled nuclei ranged from 0/mm (0.5-day detachment) to 0.38/mm (lens and vitreous removed only). By 2 days postdetachment, the number of labeled nuclei increased to 2.09/mm. The highest levels of labeling occurred in two animals with detachments of 3 (7.86/mm) and 4 (7.09/mm) days. Thereafter, the numbers declined steadily until near-baseline counts were obtained at 14 days. The number of labeled nuclei was slightly elevated in the attached regions of two animals with 3-day detachments. Labeled cell types included: Mueller cells, astrocytes, pericytes, and endothelial cells of the retinal vasculature, and both resident (microglial cells) and invading macrophages. In an earlier study RPE cells were also shown to proliferate in response to detachment. Thus, these data show that proliferation is a rapid response to detachment, reaching a maximum within 4 days, and that virtually every nonneuronal cell type in the retina can participate in this response. The data suggest that events leading to such clinical manifestations as proliferative vitreoretinopathy and subretinal fibrosis may have their beginnings in this very early proliferative response

  11. Suppression of experimental tractional retinal detachment by low-dose radiation therapy

    International Nuclear Information System (INIS)

    Meredith, T.A.; Ficker, L.; Stevens, R.; Olkowski, Z.; Anderson, M.; Hartmann, J.; Crocker, I.

    1988-01-01

    We used a standardized model of traction retinal detachment (TRD) created by cellular membranes in the rabbit to test the effects of low-dose radiation therapy in suppressing TRD. The vitreous and lens were removed from pigmented rabbits, and homologous conjunctival fibroblasts were grown in cell culture. After resolution of postoperative inflammation, 50,000 fibroblasts in 0.1 mL of culture fluid were injected into the vitreous cavity. Ten eyes were maintained as controls. Nineteen eyes received 6 Gy (600 rad) of x-ray irradiation one to three hours after cellular injection. Eyes were monitored weekly for three weeks with indirect ophthalmoscopy. Seven (70%) of ten control eyes developed TRD at one week; no additional TRDs were noted at weeks 2 and 3. Significantly smaller numbers of irradiated eyes developed TRD: at week 1, two (11%) of 19; at week 2, five (28%) of 18; and at week 3, five (29%) of 17

  12. Suppression of experimental tractional retinal detachment by low-dose radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Meredith, T.A.; Ficker, L.; Stevens, R.; Olkowski, Z.; Anderson, M.; Hartmann, J.; Crocker, I.

    1988-05-01

    We used a standardized model of traction retinal detachment (TRD) created by cellular membranes in the rabbit to test the effects of low-dose radiation therapy in suppressing TRD. The vitreous and lens were removed from pigmented rabbits, and homologous conjunctival fibroblasts were grown in cell culture. After resolution of postoperative inflammation, 50,000 fibroblasts in 0.1 mL of culture fluid were injected into the vitreous cavity. Ten eyes were maintained as controls. Nineteen eyes received 6 Gy (600 rad) of x-ray irradiation one to three hours after cellular injection. Eyes were monitored weekly for three weeks with indirect ophthalmoscopy. Seven (70%) of ten control eyes developed TRD at one week; no additional TRDs were noted at weeks 2 and 3. Significantly smaller numbers of irradiated eyes developed TRD: at week 1, two (11%) of 19; at week 2, five (28%) of 18; and at week 3, five (29%) of 17.

  13. Risk factor profile in retinal detachment

    Directory of Open Access Journals (Sweden)

    Azad Raj

    1988-01-01

    Full Text Available 150 cases of retinal detachment comprising 50 patients each of bilateral retinal detachment, unilateral retinal detachment without any retinal lesions in the fellow eve and unilateral retinal detachment with retinal lesions in the fellow eye were studied and the various associated risk factors were statistically analysed. The findings are discussed in relation to their aetiological and prognostic significance in the different types of retinal detachment. Based on these observations certain guidelines are offered which may be of value in decision making, in prophylactic detachment surgery. Tractional breaks in the superior temporal quadrant especially when symptomatic. mandate prophylactic treatment. Urgency is enhanced it′ the patient is aphakic. Associated myopia adds to the urgency. The higher incidence of initial right e′ e involvement in all groups suggests a vascular original possibly ischaemic.

  14. Edaravone, an ROS Scavenger, Ameliorates Photoreceptor Cell Death after Experimental Retinal Detachment

    Science.gov (United States)

    Roh, Mi In; Murakami, Yusuke; Thanos, Aristomenis; Miller, Joan W.

    2011-01-01

    Purpose. To investigate whether edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one), a free radical scavenger, would be neuroprotective against photoreceptor cell death in a rat model of retinal detachment (RD). Methods. RD was induced in adult Brown Norway rats by subretinal injection of sodium hyaluronate. Edaravone (3, 5, or 10 mg/kg) or physiologic saline was administered intraperitoneally once a day until death on day 3 or 5. Oxidative stress in the retina was assessed by 4-hydroxynonenal staining or ELISA for protein carbonyl content. Photoreceptor death was assessed by TUNEL and measurement of the outer nuclear layer thickness. Western blot analysis and caspase activity assays were performed. Inflammatory cytokine secretion and inflammatory cell infiltration were evaluated by ELISA and immunostaining, respectively. Results. RD resulted in increased generation of ROS. Treatment with 5 mg/kg edaravone significantly reduced the ROS level, along with a decrease in TUNEL-positive cells in the photoreceptor layer. A caspase assay also confirmed decreased activation of caspase-3, -8, and -9 in RD treated with edaravone. The level of the antiapoptotic Bcl-2 was increased in detached retinas after edaravone treatment, whereas the levels of the stress-activated p-ERK1/2 were decreased. In addition, edaravone treatment resulted in a significant decrease in the levels of TNF-α, MCP-1, and macrophage infiltration. Conclusions. Oxidative stress plays an important role in photoreceptor cell death after RD. Edaravone treatment may aid in preventing photoreceptor cell death after RD by suppressing ROS-induced photoreceptor damage. PMID:21310909

  15. Pneumatic retinopexy for retinal detachment associated with severe choroidal detachment.

    Science.gov (United States)

    Yeung, Ling; Kokame, Gregg T; Brod, Roy D; Lightman, David A; Lai, James C

    2011-01-01

    The purpose of this study was to evaluate the role of pneumatic retinopexy as an initial management of retinal detachment associated with hypotony, severe choroidal detachment, and vitritis. Retrospective, interventional, noncomparative case series. We included nine eyes from nine patients (six women and three men) with retinal detachment associated with hypotony, severe choroidal detachment, and vitritis managed with pneumatic retinopexy (either SF6 or C3F8) as their initial management between January 1, 1992, and December 31, 2007. Hypotony and choroidal detachment were rapidly and significantly improved 1 to 3 days after pneumatic retinopexy in all patients. The extent of retinal detachment was decreased in five patients. After vitreoretinal surgery for these five patients, all had attached retina. Complete reattachment of the retina was noted in four patients after pneumatic retinopexy. Two of these patients did not require further surgery because the entire retina remained attached at 6 months and 16 months postoperatively. Pneumatic retinopexy is a useful initial procedure in managing retinal detachment associated with hypotony, severe choroidal detachment, and vitritis. By rapidly resolving the hypotony and choroidal detachments, it facilitates subsequent surgical repair of this complicated retinal detachment. In addition, complete retinal reattachment after pneumatic retinopexy alone was initially achieved in 33% of eyes.

  16. Rhegmatogenous retinal detachment and uveitis.

    Science.gov (United States)

    Kerkhoff, Frank T; Lamberts, Querin J; van den Biesen, Pieter R; Rothova, Aniki

    2003-02-01

    To evaluate the frequency, high-risk factors, and visual prognosis of rhegmatogenous retinal detachment (RRD) in patients with uveitis. Retrospective case-control study. We included 1387 consecutive patients with uveitis who consulted our uveitis clinic from January 1990 through December 1997 of whom 43 patients (46 eyes) with RRD were identified. The retinal detachment (RD) controls were 212 consecutive patients with RRD (221 eyes, first occurrence of RD, not associated with uveitis) who were admitted for surgery in the period from April 1999 to April 2000. The uveitis control group consisted of 150 age-matched patients (210 eyes) selected from the entire uveitis series. Retrospective analysis of clinical data. The presence of RRD and eventual risk factors for RRD, such as myopia, retinal lattice degeneration, prior intraocular surgery, anatomic location of uveitis, its specific diagnosis, and clinical manifestations. Furthermore, the surgical and nonsurgical outcomes of RRD, as well as the results of various treatment regimens, were analyzed. RRD was identified in 3.1% of the patients with uveitis. RRD was most frequently associated with panuveitis (6.6%). RRD was associated more frequently with infectious (7.6%) than noninfectious uveitis (2.1%). At the onset of RRD, uveitis was active in most (46%) affected eyes. Proliferative vitreoretinopathy was present in 30% of the uveitic RRD eyes at presentation in contrast to 12% of the RRD control eyes. In uveitic RRD, the retina was reattached in 59% of eyes with a single operation; the final anatomic reattachment rate was 88%. Finally, a visual acuity of less than 20/200 was present in 71% of the uveitic RRD eyes, 10% of which had no light perception. We discovered a high prevalence of RRD in patients with active panuveitis and infectious uveitis and document that uveitis in itself is a risk factor for the development of RRD. The visual prognosis of RRD in uveitis was poor because of the uveitis itself and the

  17. Retinal detachment associated with traumatic chorioretinal rupture.

    Science.gov (United States)

    Papakostas, Thanos D; Yonekawa, Yoshihiro; Wu, David; Miller, John B; Veldman, Peter B; Chee, Yewlin E; Husain, Deeba; Eliott, Dean

    2014-01-01

    Traumatic chorioretinal rupture, also known as sclopetaria, is a full-thickness break of the choroid and retina caused by a high-velocity projectile striking or passing adjacent to, but not penetrating, the globe. Previous reports have emphasized that retinal detachment seldom occurs, and observation alone has been the recommended management strategy. However, the authors present herein a series of consecutive patients with retinal detachment associated with sclopetaria and provide a literature review of the topic. They recommend that patients with traumatic chorioretinal rupture be monitored closely for the development of retinal detachment during the first few weeks after the injury. Copyright 2014, SLACK Incorporated.

  18. [Retinal pneumopexy in the treatment of rhegmatogenous retinal detachment].

    Science.gov (United States)

    Levai, L; Gavriş, Monica; Gábor, Radó; Bagosi, P

    2014-01-01

    To evaluate the efficiency of retinal pneumopexy in patients with rhegmatogenous retinal detachment. This clinical prospective study unrolled between november 2010-june 2012 in the Ophthalmology Department of the Military Hospital in Cluj-Napoca and Satu Mare Emergency Hospital included 20 patients (20 eyes) with rhegmatogenous retinal detachment. Patients were treated with retinal pneumopexy followed by laser photocoagulation. Anatomical and functional results were evaluated 1, 3, 6, 12 and 19 months after treatment. In 17 eyes out of 20, we achieved retinal reattachment and visual recovery. Three cases yelded no success, these being further treated with posterior vitrectomy. Retinal pneumopexy is a minimally invasive treatment method of rhegmatogenous retinal detachment with very good results in well selected cases.

  19. [Intraocular hypertension after retinal detachment surgery].

    Science.gov (United States)

    Muşat, O; Cristescu, R; Coman, Corina; Asandi, R

    2012-01-01

    This papers presents a case of a patient with retinal detachment, 3 days ago operated (posterior vitrectomy, internal tamponament with silicon oil 1000) who developed increased ocular pressure following silicon oil output in the anterior chamber.

  20. Rhegmatogenous retinal detachment following intravitreal ocriplasmin

    NARCIS (Netherlands)

    Madi, Haifa A.; Haynes, Richard J.; Depla, Diana; de la Cour, Morten D.; Lesnik-Oberstein, Sarit; Muqit, Mahi M. K.; Patton, Niall; Price, Nick; Steel, David H. W.

    2016-01-01

    To describe the characteristics and outcomes of patients presenting with rhegmatogenous retinal detachment (RRD) after ocriplasmin (OCP) injection. Retrospective, multi-centre, observational case series with case note review. Eight patients with symptomatic vitreomacular traction (six with

  1. A mechanical model of retinal detachment

    International Nuclear Information System (INIS)

    Chou, Tom; Siegel, Michael

    2012-01-01

    We present a model of the mechanical and fluid forces associated with exudative retinal detachments where the retinal photoreceptor cells separate, typically from the underlying retinal pigment epithelium (RPE). By computing the total fluid volume flow arising from transretinal, vascular and RPE pump currents, we determine the conditions under which the subretinal fluid pressure exceeds the maximum yield stress holding the retina and RPE together, giving rise to an irreversible, extended retinal delamination. We also investigate localized, blister-like retinal detachments by balancing mechanical tension in the retina with both the retina–RPE adhesion energy and the hydraulic pressure jump across the retina. For detachments induced by traction forces, we find a critical radius beyond which the blister is unstable to growth. Growth of a detached blister can also be driven by inflamed lesions in which the tissue has a higher choroidal hydraulic conductivity, has insufficient RPE pump activity, or has defective adhesion bonds. We determine the parameter regimes in which the blister either becomes unstable to growth, remains stable and finite-sized, or shrinks, allowing possible healing. The corresponding stable blister radius and shape are calculated. Our analysis provides a quantitative description of the physical mechanisms involved in exudative retinal detachments and can help guide the development of retinal reattachment protocols or preventative procedures. (paper)

  2. A mechanical model of retinal detachment

    Science.gov (United States)

    Chou, Tom; Siegel, Michael

    2012-08-01

    We present a model of the mechanical and fluid forces associated with exudative retinal detachments where the retinal photoreceptor cells separate, typically from the underlying retinal pigment epithelium (RPE). By computing the total fluid volume flow arising from transretinal, vascular and RPE pump currents, we determine the conditions under which the subretinal fluid pressure exceeds the maximum yield stress holding the retina and RPE together, giving rise to an irreversible, extended retinal delamination. We also investigate localized, blister-like retinal detachments by balancing mechanical tension in the retina with both the retina-RPE adhesion energy and the hydraulic pressure jump across the retina. For detachments induced by traction forces, we find a critical radius beyond which the blister is unstable to growth. Growth of a detached blister can also be driven by inflamed lesions in which the tissue has a higher choroidal hydraulic conductivity, has insufficient RPE pump activity, or has defective adhesion bonds. We determine the parameter regimes in which the blister either becomes unstable to growth, remains stable and finite-sized, or shrinks, allowing possible healing. The corresponding stable blister radius and shape are calculated. Our analysis provides a quantitative description of the physical mechanisms involved in exudative retinal detachments and can help guide the development of retinal reattachment protocols or preventative procedures.

  3. Retinal detachment in black South Africans

    African Journals Online (AJOL)

    Rhegmatogenous retinal detachments seen in black patients attending King Edward VIII Hospital. Ophthalmology Clinic over a 5-year period from January. 1987 to December 1991 were reviewed. Penetrating trauma and diabetic retinopathy were excluded. There were 114 detachments in 112 patients, which gave.

  4. Peripheral retinal degenerations and the risk of retinal detachment.

    Science.gov (United States)

    Lewis, Hilel

    2003-07-01

    To review the degenerative diseases of the peripheral retina in relationship with the risk to develop a rhegmatogenous retinal detachment and to present recommendations for use in eyes at increased risk of developing a retinal detachment. Focused literature review and author's clinical experience. Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and, rarely, zonular traction tufts, can result in a rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic therapy; however, adequate studies have not been performed to date. Well-designed, prospective, randomized clinical studies are necessary to determine the benefit-risk ratio of prophylactic treatment. In the meantime, the evidence available suggests that most of the peripheral retinal degenerations should not be treated except in rare, high-risk situations.

  5. Raised intraocular pressure and recurrence of retinal detachment as complications of external retinal detachment surgery

    International Nuclear Information System (INIS)

    Jawwad, M.; Khan, B.; Shah, M.A.; Qayyum, I.; Aftab, M.; Qayyum, I.

    2015-01-01

    Patients with Rhegmatogenous retinal detachment may develop raised intraocular pressure and recurrence of retinal detachment when they undergo external retinal detachment surgery. The present study was conducted to determine the postoperative rise in intraocular pressure (IOP) and recurrence of retinal detachment. Methods: The present descriptive study was conducted at Eye department of Lady Reading Hospital, Peshawar on 25 patients of both genders from August 2012 to July 2014. Results: Of the 25 patients, 18 (72%) developed raised IOP in the immediate postoperative period; this figure decreased to 12 (48%) at one week. Following medical or surgical intervention in these 12 cases, there was only 1 (4%) case with mildly raised IOP at two weeks postoperative. Five (20%) cases developed recurrent retinal detachment which later resolved with treatment. There were no significant differences by age or gender. Conclusion: External Retinal Detachment Surgery raised intraocular pressure postoperatively and caused recurrence of retinal detachment. These complications were treated medically and surgically with resolution within two weeks. (author)

  6. Repair of Traumatic Rhegmatogenous Retinal Detachment Combined with Congenital Falciform Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Fukutaro Mano

    2018-01-01

    Full Text Available Purpose: To report a case of surgical repair of traumatic rhegmatogenous retinal detachment combined with congenital falciform retinal detachment (FRD. Methods: A retrospective case report. Results: A 36-year-old man with traumatic rhegmatogenous retinal detachment complicating a previously known FRD was successfully treated despite residual FRD following pars plana lensectomy, vitrectomy, and encircling scleral buckling. His best corrected visual acuity improved from hand motion at 50 cm to 20/1,000. Conclusion: We concluded that the root of the FRD is susceptible to trauma because of the contraction of fibrovascular tissue. The early intervention of modern vitrectomy to traumatic rhegmatogenous retinal detachment complicating a previously known FRD is an important consideration for enhanced quality of care and optimal patient outcomes.

  7. [Retinal detachment with retinoschisis--case report].

    Science.gov (United States)

    Cristescu, R; Muşat, O; Toma, Oana; Coma, Corina; Gabej, Ioana; Burcea, M

    2013-01-01

    We present the case of a 43 year old patient diagnosed with rhegmatogenous retinal detachment and retinoschizis, a rare case of disease association. Surgery is recommended and we practice 23 gauge vitrectomy, laser retinopexy, criopexy in the periphery and internal heavy oil tamponade. Postoperatory evolution was favorable.

  8. Posterior vitreous detachment and retinal detachment after cataract surgery.

    Science.gov (United States)

    Ripandelli, Guido; Coppé, Andrea Maria; Parisi, Vincenzo; Olzi, Diego; Scassa, Cecilia; Chiaravalloti, Adele; Stirpe, Mario

    2007-04-01

    To evaluate possible changes of vitreous status in emmetropic eyes after uneventful phacoemulsification surgery, and possible related complications such as the onset of retinal detachment (RD). Retrospective case series. Four hundred fifty-three emmetropic eyes from 453 patients (mean age, 62.03+/-5.57 years) subjected to uneventful phacoemulsification with intraocular lens implantation in the capsular bag were considered in the study. They had a refractive error within +/-0.5 diopters (mean, -0.21+/-0.08). Eyes with peripheral retinal lattice degeneration were included only if asymptomatic and only if the degeneration involved one retinal quadrant. After cataract surgery, the 453 eyes were evaluated preoperatively at days 1, 15, and 30 and months 3, 6, 12, 18, 24, 36, 48, and 60. The whole period of follow-up was 5 years. Evaluation of vitreous status by biomicroscopic examination, indirect binocular ophthalmoscopy, and B-scan ultrasonography. Postoperative onset of posterior vitreous detachment (PVD) and RD. After cataract surgery, a PVD occurred in 107 of 141 (75.88%) eyes without preoperative PVD or lattice degeneration. Posterior vitreous detachment occurred in 41 of 47 eyes (87.23%) with preoperative lattice degeneration and no PVD. Eyes with preoperative lattice degeneration and postoperative PVD showed a higher incidence of RD after cataract surgery (21.27%) than eyes without preoperative PVD or lattice degeneration (0.70%). In all patients with lattice degeneration, RD originated from horseshoe retinal tears on lattice areas located on the superior quadrants. No correlation was observed between the development of RD and age. Our results suggest that the onset of postoperative PVD should be considered an important risk factor for the development of RD after cataract surgery, particularly in eyes with lattice areas.

  9. [Scleral buckling for inferior rhegmatogenous retinal detachments].

    Science.gov (United States)

    Abdellaoui, M; Chraibi, F; Benatiya Andaloussi, I; Tahri, H

    2014-10-01

    To investigate the epidemiological, clinical, therapeutic and prognostic factors in cases of inferior rhegmatogenous retinal detachments (RD) treated by scleral buckling surgery. A retrospective chart review was performed on 45 patients (45 eyes) with inferior RD with only inferior tears (4:00-8:00), who had been treated by scleral buckling surgery over a 6-year period from 2006 to 2011. The parameters studied included patient demographics, refractive status, time until consultation, clinical exam data, treatment modalities and functional and anatomic results. Forty-five cases were included in this study (45 eyes), with an average patient age of 44.5 years (14 to 75 years) and a slight male predominance (56%). Myopia was observed in 60%. Mean time until consultation was 3.5 months. Visual acuity on admission was less than 1/10 in 53.33%. Macular detachment was found in 80%. Causative lesions were holes in 26 eyes. Proliferative vitreoretinopathy was essentially stage B in 48.9%. Scleral buckling surgery was performed in all patients, with drainage of subretinal fluid in 37.8%. Retinal reattachment was obtained in 36 eyes (80%) with a final visual acuity greater than or equal to 1/10 in 71.11%. The mean follow-up in our study was 6.62 months. Inferior retinal detachment has a predilection for young myopes. The time until consultation is often long, and extraocular surgery, although difficult, exhibits documented efficacy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  10. An Unusual Case of Extensive Lattice Degeneration and Retinal Detachment

    OpenAIRE

    Mathew, David J.; Sarma, Saurabh Kumar; Basaiawmoit, Jennifer V.

    2016-01-01

    Lattice degeneration of the retina is not infrequently encountered on a dilated retinal examination and many of them do not need any intervention. We report a case of atypical lattice degeneration variant with peripheral retinal detachment. An asymptomatic 35-year-old lady with minimal refractive error was found to have extensive lattice degeneration, peripheral retinal detachment and fibrotic changes peripherally with elevation of retinal vessels on dilated retinal examination. There were al...

  11. Rhegmatogenous retinal detachment and conventional surgical treatment.

    Science.gov (United States)

    Golubovic, M

    2013-01-01

    The aim of the paper was to present the efficacy and indications for application of conventional surgical treatment of retinal detachment by using external implants, that is,application of encircling band and buckle. This study comprised patients from the University Eye Clinic in Skopje. A total of 33 patients were diagnosed and surgically treated in the period between May 2010 and August 2011. Conventional surgery was applied in smaller number of patients whose changes of the vitreous body were manifested by detachment of posterior hyaloid membrane, syneresis, with appearance of a small number of pigment cells in the vitreous body and synchysis, and the very retina was with fresh detachment without folds or epiretinal changes (that is, PVR A grade). There were a larger number of patients with more distinct proliferative changes of the vitreous body and of the retina, grades PVR B to C1-C2, and who also underwent the same surgical approach. Routine ophthalmologic examinations were performed, including: determination of visual acuity by Snellen's optotypes, determination of eye pressure with Schiotz's tonometer, examination of anterior segment on biomicroscopy, indirect biomicroscopy of posterior eye segment (vitreous body and retina) and examination on biomicroscopy with Goldmann prism, B scan echography of the eyes before and after surgical treatment. Conventional treatment was used by external application of buckle or application of buckle and encircling band. In case of one break, radial buckle was applied and in case of multiple breaks in one quadrant limbus parallel buckle was applied. Besides buckle, encircling band was applied in patients with total or subtotal retinal detachment with already present distinct changes in the vitreous body (PVR B or C1-C2) and degenerative changes in the vitreous body. Breaks were closed with cryopexy. The results obtained have shown that male gender was predominant and that the disease was manifested in younger male adults

  12. Fibrinogen and rhegmatogenous retinal detachment: a pilot prospective study.

    Science.gov (United States)

    Theocharis, Ip

    2010-02-18

    To examine the correlation, if any, between fibrinogen plasma levels (FPL) and the clinical features of rhegmatogenous retinal detachment (RRD). FPL were measured preoperatively in 33 patients with primary RRD. Patient characteristics and detachment features such as the numbers of breaks and the extent of the detachment were recorded; No statistically significant correlation was found between FPL and the number of breaks. A statistically significant correlation was found between FPL and the extent of the RRD, even if the influence of the number of breaks was excluded. FPL correlate with retinal detachment extent, which implicates an acute inflammatory response to detachment traumatic phenomenon or a role of the fibrinogen molecule in retinal adhesiveness.

  13. Anatomical success in patients after retinectomy for complex retinal detachment

    International Nuclear Information System (INIS)

    Mukhtar, A.; Ishaq, M.; Islam, Q.U.

    2015-01-01

    To evaluate the efficacy of primary and redo retinectomy in eyes with complex retinal detachment. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi from Jan 2012 to June 2013. Patients and Methods: Fifty eight eyes (patients) underwent relaxing retinectomies for complex retinal detachment with proliferative vitreoretinopathy or intrinsic retinal shortening. Operative technique included pars plana vitrectomy, proliferative vitreoretinopathy management, use of intraoperative perfluorocarbon liquid, retinectomy, endolaser and intraocular temponade. The main outcome was anatomic success, defined as complete retinal reattachment at four months follow up. Eighteen eyes out of the same primary group underwent second retinectomy because of anatomical failure. Results: Mean age of study population was 53.78 ± 15.11 years, 56.9% of patients were male(s). Anatomic success rate after 1st retinectomy was achieved in 68.96% (40 eyes out of 58). In eighteen eyes that underwent 2nd retinectomy, anatomic success rate was 72.22% (13 eyes out of 18). Overall success rate was 91.3% (53 eyes out of 58) in our study. Conclusions: Relaxing retinectomies for retinal shortening can improve the anatomical success rate in patients with complex RD. (author)

  14. Rhematogenous retinal detachment complicated by severe intraocular inflammation, hypotony, and choroidal detachment.

    OpenAIRE

    Jarrett, W H

    1981-01-01

    An unusual type of rhegmatogenous retinal detachment is described and compared with a control group of patients with detached retina. Features of the condition, in addition to retinal detachment, include severe anterior and posterior uveitis, choroidal detachment, hypotony, deepened anterior chamber, posterior synechiae, iridophakodonesis, and a poor surgical and visual prognosis due to massive periretinal proliferation. The disease occurs in a disproportionately high ratio in blacks. These c...

  15. Lattice degeneration of the retina and retinal detachment.

    Science.gov (United States)

    Semes, L P

    1992-01-01

    Lattice retinal degeneration is considered the most significant peripheral retinal disorder potentially predisposing to retinal breaks and retinal detachment. Lattice degeneration affects the vitreous and inner retinal layers with secondary changes as deep as the retinal pigment epithelium and perhaps the choriocapillaris. Variations in clinical appearance are the rule; geographically, lattice lesions favor the vertical meridians between the equator and the ora serrata. Lattice degeneration begins early in life and has been reported in sequential generations of the same family. Along with its customary bilateral occurrence, lattice shares other characteristics of a dystrophy. The association between the vitreous and retina in lattice lesions may be responsible for the majority of lattice-induced retinal detachments. The tumultuous event of posterior vitreous separation in the presence of abnormally strong vitreoretinal adherence is the trigger for a retinal tear that, in turn, may lead to retinal detachment. Although retinal holes in young patients with lattice degeneration may play a role in the evolution of retinal detachment, the clinical course of lattice degeneration seems to be one of dormancy rather than of progressive change. This discussion outlines the pathophysiology of lattice retinal degeneration and the relationship of pathophysiology to clinical presentation. The epidemiology of lattice degeneration is summarized, as are the possible precursors to retinal detachment. A clinical characterization of the natural history of lattice degeneration is offered, and interventions for complications are described. To conclude, management strategies from a primary-care standpoint are reviewed.

  16. Pathogenesis of rhegmatogenous retinal detachment: predisposing anatomy and cell biology.

    Science.gov (United States)

    Mitry, Danny; Fleck, Brian W; Wright, Alan F; Campbell, Harry; Charteris, David G

    2010-01-01

    The pathogenesis of rhegmatogenous retinal detachment is complex, and our knowledge of the exact mechanism of vitreoretinal attachment and detachment remains incomplete. We performed a Medline, Ovid, and EMBASE search using search words rhegmatogenous, retinal detachment, vitreous, and retinal adhesion. All appropriate articles were reviewed, and the evidence was compiled. Cortical vitreous contains fibrillar collagens type II, V/XI, and IX. The inner limiting membrane of the retina contains collagens type I, IV, VI, and XVIII as well as numerous other glycoproteins and potential adhesion molecules. The distribution and age-related changes in the structure of these molecules play an important role in the formation of a retinal break, which may compromise and disrupt the normal mechanisms of neurosensory retinal adhesion. Rhegmatogenous retinal detachment development is intimately related to changes in the fibrillar structure of the aging vitreous culminating in posterior vitreous detachment with regions of persistent and tangential vitreoretinal traction predisposing to retinal tear formation. A complex interplay of factors such as weakening of vitreoretinal adhesion, posterior migration of the vitreous base, and molecular changes at the vitreoretinal interface are important in predisposing to focal areas of vitreoretinal traction precipitating rhegmatogenous retinal detachment. Once formed, the passage of liquefied vitreous through a retinal break may overwhelm normal neurosensory-retinal pigment epithelium adhesion perpetuating and extending detachment and causing visual loss. To understand the molecular events underlying rhegmatogenous retinal detachment so that new therapies can be developed, it is important to appreciate the structural organization of the vitreous, the biology underlying vitreous liquefaction and posterior vitreous detachment, and the mechanisms of vitreoretinal attachment and detachment.

  17. Use of ocular ultrasound for the evaluation of retinal detachment.

    Science.gov (United States)

    Shinar, Zachary; Chan, Linda; Orlinsky, Michael

    2011-01-01

    Retinal detachment is an ocular emergency posing diagnostic difficulty for the emergency practitioner. Direct fundoscopy and visual field testing are difficult to perform and do not completely rule out retinal detachment. Ophthalmologists use ocular ultrasound to enhance their clinical acumen in detecting retinal detachments (RD), and bedside ultrasound capability is readily available to many emergency practitioners (EP). Our study sought to assess whether ocular ultrasound would be a helpful adjunct for the diagnosis of RD for the practicing EP. This was a prospective observational study with a convenience sample of patients. As part of a general course on emergency ultrasonography, practitioners received a 30-min training session on ocular ultrasound before beginning the study. Trained practitioners submitted ultrasound scans with interpretation on patients with signs and symptoms consistent with retinal detachment. Thirty-one of the 72 practitioners trained submitted ocular ultrasound reports on patients presenting to the Emergency Department with concerns for retinal detachments. EPs achieved a 97% sensitivity (95% confidence interval [CI] 82-100%) and 92% specificity (95% CI 82-97%) on 92 examinations (29 retinal detachments). Disc edema and vitreous hemorrhage accounted for false positives, and a subacute retinal detachment accounted for the only false negative. These data show that trained emergency practitioners can use ocular ultrasound as an adjunct to their clinical assessment for retinal detachment. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. Risk of Retinal Detachment After Pediatric Cataract Surgery

    DEFF Research Database (Denmark)

    Haargaard, Birgitte; Andersen, Elisabeth W; Oudin, Anna

    2014-01-01

    was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3...

  19. Incidence and Pattern of Retinal Detachment in a Tertiary Eye ...

    African Journals Online (AJOL)

    Objectives: The aim was to determine the hospital incidence, pattern and clinical presentation of retinal detachment at the Guinness Eye Center, Onitsha, Nigeria. Materials and Methods: Case files of all retinal detachment patients seen at the Guinness Eye Center Onitsha between June 1997 and May 2012 were reviewed.

  20. Ethnic variation in rhegmatogenous retinal detachments

    Science.gov (United States)

    Chandra, A; Banerjee, P; Davis, D; Charteris, D

    2015-01-01

    Purpose We aimed to investigate the clinical variation of rhegmatogenous retinal detachments (RD) in patients of different ethnicities. Methods Patients presenting with a primary RD from two ethnic groups were recruited from our tertiary referral hospital between August 2010 and December 2012. Patients who self-reported their ethnic origin either as European Caucasian (EC) or South Asian (SA) were included. Exclusion criteria included trauma, previous vitreoretinal procedures, age under 18 years, complicated cataract surgery and the presence of syndromes known to be associated with a high prevalence of RD. Detailed phenotypic data were collected. Descriptive and comparative statistical analyses were undertaken. Results 1269 Patients were recruited. 1173 (92.4%) were EC. Mean age of onset was 58.3 years (EC) and 54.5 years (SA) (P=0.006). 75.3% EC and 58.4% SA were phakic (Plattice retinal degeneration in the affected eye (P=0.003). Refractive myopia was greater in SA patients (mean: −6.1DS) than EC (−4.2DS) (P=0.032). Additionally, SA patients had a greater mean axial length (25.65 mm) than EC (25.06 mm) (P=0.014). No differences were demonstrated in laterality, family history, type of retinal break or macular status. Conclusions SA patients present with RD at an earlier age and have a more severe phenotype than ECs. Future management strategies for RD may need to reflect these differences. PMID:25853394

  1. Ocular hemodynamics in patients with rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    N. H. Zavgorodnya

    2014-10-01

    Full Text Available Aim. In case of retinal detachment atrophic processes lead to irreversible loss of functions within 4–6 days, it happens on underlying low ocular blood flow. In order to evaluate the degree of violation of regional hemodynamics in patients with retinal detachment two groups of patients were examined: the main group (52 patients with rhegmatogenous retinal detachment and the control group (24 myopic patients with lattice form of peripheral chorioretinal dystrophy. Methods and results. Doppler and reography results had been compared, significant decrease of blood flow in patients with retinal detachment was found. No differences between affected and fellow eye in these patients, close negative correlation between the level of ocular blood flow and the degree of myopia in the control group. Conclusion. This demonstrates the feasibility of actions to improve regional blood flow in patients operated on for retinal detachment.

  2. Fibrinogen and rhegmatogenous retinal detachment: a pilot prospective study

    Directory of Open Access Journals (Sweden)

    IP Theocharis

    2010-02-01

    Full Text Available IP TheocharisOphthalmology Department, Iaso General Hospital, Athens, GreecePurpose: To examine the correlation, if any, between fibrinogen plasma levels (FPL and the clinical features of rhegmatogenous retinal detachment (RRD.Methods: FPL were measured preoperatively in 33 patients with primary RRD. Patient characteristics and detachment features such as the numbers of breaks and the extent of the detachment were recorded;Results: No statistically significant correlation was found between FPL and the number of breaks. A statistically significant correlation was found between FPL and the extent of the RRD, even if the influence of the number of breaks was excluded. Conclusions: FPL correlate with retinal detachment extent, which implicates an acute inflammatory response to detachment traumatic phenomenon or a role of the fibrinogen molecule in retinal adhesiveness.Keywords: fibrinogen, retinal detachment, pathogenesis

  3. The prognosis of retinal detachment due to lattice degeneration.

    Science.gov (United States)

    Benson, W E; Morse, P H

    1978-09-01

    In a series of 553 consecutive retinal detachments, 29% (120) were due to lattice degeneration. Forty-five percent of these were due to atrophic holes in the lattice degeneration and 55% were due to tears caused by traction posterior to or at the end of a patch of lattice. In phakic patients, retinal detachments due to atrophic holes were most common in young myopes. Detachments due to traction tears were seen in older, less myopic patients. The incidence of massive periretinal proliferation was less (5%) in detachments due to lattice degeneration than in detachments not due to lattice degeneration (6.5%).

  4. Scleral buckling for retinal detachment in patients with retinoblastoma

    International Nuclear Information System (INIS)

    Buzney, S.M.; Pruett, R.C.; Regan, C.D.; Walton, D.S.; Smith, T.R.

    1984-01-01

    Three children (two girls and one boy) with bilateral retinoblastoma each developed a presumed rhegmatogenous retinal detachment in one eye. All three eyes had previously received radiation and cryotherapy. In each case the retinal detachment responded promptly to conventional surgical methods via scleral buckling in the area of treated retinoblastoma and presumed retinal break. All three eyes have retained useful vision for follow-up periods of 3.5 to 12 years

  5. Scleral buckling for retinal detachment in patients with retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Buzney, S.M.; Pruett, R.C.; Regan, C.D.; Walton, D.S.; Smith, T.R.

    1984-10-15

    Three children (two girls and one boy) with bilateral retinoblastoma each developed a presumed rhegmatogenous retinal detachment in one eye. All three eyes had previously received radiation and cryotherapy. In each case the retinal detachment responded promptly to conventional surgical methods via scleral buckling in the area of treated retinoblastoma and presumed retinal break. All three eyes have retained useful vision for follow-up periods of 3.5 to 12 years.

  6. Retinal Detachment due to CrossFit Training Injury

    Directory of Open Access Journals (Sweden)

    Stephanie A. Joondeph

    2013-01-01

    Full Text Available The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions.

  7. Retinal Detachment due to CrossFit Training Injury.

    Science.gov (United States)

    Joondeph, Stephanie A; Joondeph, Brian C

    2013-01-01

    The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions.

  8. Retinal Detachment due to CrossFit Training Injury

    OpenAIRE

    Joondeph, Stephanie A.; Joondeph, Brian C.

    2013-01-01

    The purpose of this paper is to describe a traumatic retinal detachment occurring as a result of CrossFit training using an elastic exercise band. The patient sustained an ocular injury from an elastic band during CrossFit training, resulting in a giant retinal dialysis and retinal detachment, which were successfully repaired. Trainers and athletes need to be aware of the potential for ocular injury from elastic exercise bands and take appropriate precautions.

  9. Does unintentional macular translocation after retinal detachment repair influence visual outcome?

    Science.gov (United States)

    Pandya, Vivek B; Ho, I-Van; Hunyor, Alex P

    2012-01-01

    To document the occurrence of postoperative macular translocation after retinal detachment repair and discuss its influence on visual outcome. Retrospective case series in a tertiary care setting. Five eyes of five patients presenting to our clinic with macula-off rhegmatogenous retinal detachment. All patients underwent surgical repair of the retinal detachment, with regular postoperative follow-up, including macular optical coherence tomography and fundus autofluorescence. Visual acuity and subjective visual symptoms in patients with anatomically successful retinal detachment repair, in whom inadvertent macular translocation was noted. Our series demonstrates the presence of unintentional macular translocation after retinal detachment repair, detected by fundus autofluorescence imaging. In contrast to previous reports, we document inadvertent macular translocation in one patient after scleral buckling surgery. In each case, the retina was fully reattached postoperatively and no other complications were identified. There was variability in the symptoms and objective visual outcomes after surgery. Inadvertent macular translocation can occur following repair of macula-off retinal detachment, and may be a significant contributor to poorer visual outcome after retinal detachment, despite objective surgical success. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  10. Risk of retinal detachment in patients with lattice degeneration.

    Science.gov (United States)

    Sasaki, K; Ideta, H; Yonemoto, J; Tanaka, S; Hirose, A; Oka, C

    1998-01-01

    To determine the risk of retinal detachment in patients with lattice degeneration of the retina, we statistically analyzed the incidence of retinal detachment in these patients. The data of hospital patients with retinal detachment associated with lattice degeneration in Kumamoto Prefecture, Japan, in 1990 were collected. The prevalence of lattice degeneration in Kumamoto was reported to be 9.5% in 1980. Based on population data from the 1990 census, the cumulative incidence of retinal detachment associated with lattice degeneration was calculated in this study. Among 1,840,000 residents in Kumamoto, there were 110 patients with retinal detachment associated with lattice degeneration; 72 with detachment resulting from tractional tears (tears), and 38 with detachment from atrophic holes. The cumulative incidence of retinal detachment from atrophic holes was 1.5% at the age of 40 years; from tears it was 3.6% at the age of 80 years. The cumulative incidence of detachment from both atrophic holes and tears was 5.3% at the age of 80 years. The results of this study are useful for clarifying the natural course of lattice degeneration.

  11. Functional and anatomical remodeling in human retinal detachment.

    Science.gov (United States)

    de Souza, Clairton F; Kalloniatis, Michael; Polkinghorne, Philip J; McGhee, Charles N J; Acosta, Monica L

    2012-04-01

    Rhegmatogenous retinal detachment is by far the most common indication for retinal surgery and a major cause of severe vision loss. Increased levels of glutamate found in the vitreous of human patients and persistent remodeling, even after reattachment, suggest substantial neurochemical, functional and anatomical changes have occurred in the detached retina. Therefore, this study was designed to characterize the morphological changes and glutamate receptor functionality in human rhegmatogenous retinal detachment. A cation channel permeating probe, agmatine (1-amino-4-guanidobutane; AGB), was employed to track endogenous and kainate (KA) driven channel functionality combined with immunocytochemical characterization of cellular remodeling. In the detached retina increased AGB permeability was identified in the outer retina while there was a decrease in the inner retina in basal conditions. KA receptors exhibited increased AGB permeability in ON bipolar cells and decreased permeability in calbindin labeled inner retinal cells. All retinal detachment samples demonstrated ectopic synaptic protein expression, photoreceptor processes extending toward the inner retina, and other remodeling features of retinal degeneration. These anatomical changes have been demonstrated in animal studies and are novel features unreported in primary cases of human retinal detachment. We conclude that deafferentation in retinal detachment leads to alteration of the glutamatergic pathway. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. An Unusual Case of Extensive Lattice Degeneration and Retinal Detachment.

    Science.gov (United States)

    Mathew, David J; Sarma, Saurabh Kumar; Basaiawmoit, Jennifer V

    2016-07-01

    Lattice degeneration of the retina is not infrequently encountered on a dilated retinal examination and many of them do not need any intervention. We report a case of atypical lattice degeneration variant with peripheral retinal detachment. An asymptomatic 35-year-old lady with minimal refractive error was found to have extensive lattice degeneration, peripheral retinal detachment and fibrotic changes peripherally with elevation of retinal vessels on dilated retinal examination. There were also areas of white without pressure, chorioretinal scarring and retinal breaks. All the changes were limited to beyond the equator but were found to span 360 degrees. She was treated with barrage laser all around to prevent extension of the retinal detachment posteriorly. She remained stable till her latest follow-up two years after the barrage laser. This case is reported for its rarity with a discussion of the probable differential diagnoses. To the best of our knowledge, this is the first report of such findings in lattice degeneration.

  13. [Preventive treatment of retinal detachment in aphakic eyes].

    Science.gov (United States)

    Regnault, F; Bregeat, P

    1977-01-01

    We have examined 243 cases with retinal detachment occurring within 6 months following cataract surgery. In 92 of them retinal tear was due to lattice degeneration, in 66 to snail track degeneration and in 17 to equatorial degeneration. 290 other patients had preventive treatments. In this group, there were only 10 cases of retinal detachment. 9 out of 22 patients who had no preventive treatment suffered retinal detachments. There are two reasons for the occurrence of this retinal detachment in the 6 months following cataract surgery in eyes where retinal degenerations are found: (1) surgical trauma even with cryoextraction is responsible for traction of the vitreous base, (2) rapid disappearance of the hyaluronic acid in the aphakic vitreous is responsible for the degradation of the vitreous with formation of large zones of liquid vitreous. When adhesion between the vitreous and the retinal degeneration area remains, the traction is responsible for retinal tear or retinal detachment. The importance of the preventive treatment of retinal lesions prior to cataract surgery should be stressed.

  14. Advantages of diabetic tractional retinal detachment repair

    Directory of Open Access Journals (Sweden)

    Sternfeld A

    2015-10-01

    Full Text Available Amir Sternfeld, Ruth Axer-Siegel, Hadas Stiebel-Kalish, Dov Weinberger, Rita Ehrlich Department of Ophthalmology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel Purpose: To evaluate the outcomes and complications of patients with diabetic tractional retinal detachment (TRD treated with pars plana vitrectomy (PPV.Patients and methods: We retrospectively studied a case series of 24 eyes of 21 patients at a single tertiary, university-affiliated medical center. A review was carried out on patients who underwent PPV for the management of TRD due to proliferative diabetic retinopathy from October 2011 to November 2013. Preoperative and final visual outcomes, intraoperative and postoperative complications, and medical background were evaluated.Results: A 23 G instrumentation was used in 23 eyes (95.8%, and a 25 G instrumentation in one (4.2%. Mean postoperative follow-up time was 13.3 months (4–30 months. Visual acuity significantly improved from logarithm of the minimum angle of resolution (LogMAR 1.48 to LogMAR 1.05 (P<0.05. Visual acuity improved by ≥3 lines in 75% of patients. Intraoperative complications included iatrogenic retinal breaks in seven eyes (22.9% and vitreal hemorrhage in nine eyes (37.5%. In two eyes, one sclerotomy was enlarged to 20 G (8.3%. Postoperative complications included reoperation in five eyes (20.8% due to persistent subretinal fluid (n=3, vitreous hemorrhage (n=1, and dislocated intraocular lens (n=1. Thirteen patients (54.2% had postoperative vitreous hemorrhage that cleared spontaneously, five patients (20.8% required antiglaucoma medications for increased intraocular pressure, seven patients (29.2% developed an epiretinal membrane, and two patients (8.3% developed a macular hole.Conclusion: Patients with diabetic TRD can benefit from PPV surgery. Intraoperative and postoperative complications can be attributed to the complexity of this disease. Keywords: diabetic retinopathy, proliferative

  15. 23-Gauge Sutureless Vitreo-Retinal Surgery for Superior Rhegmatogenous Retinal Detachment

    International Nuclear Information System (INIS)

    Zafar, S.; Mal, W.; Shakir, M.; Kamil, Z.; Bokhari, S. A.; Rizvi, S. F.

    2014-01-01

    Objective: To determine the results of 23-gauge sutureless vitreo-retinal surgery for superior/supero-temporal rhegmatogenous retinal detachment (RRD). Study Design: Quasi experimental study. Place and Duration of Study: LRBT, Free Base Eye Hospital, Karachi, from January 2010 to December 2011. Methodology: Adult patients who underwent 23-gauge sutureless vitreo-retinal surgery along with use of Perfluoropropane (C3F8) gas as internal tamponading agent for fresh (upto 3 weeks) superior/supero-temporal RRD was reviewed. Major outcome measures were anatomical success, best corrected visual acuity (BCVA) with Log Mar and complications during and after surgery. Postoperative follow-up was done on 1st day and at 1st, 4th, 8th and finally at 12th week. Results: Sixty eyes of 60 patients, age between 30 - 60 years including 37 (61.67%) males and 23 (38.33%) females having superior or superatemporal RRD underwent 23-guage sutureless vitreo-retinal surgery with the use of perfluoropropane (C3 F8) gas as internal temponade at the end of procedure. Anatomical success rate was 81.66% (49 out of 60 eyes) with first surgery and raised to 90% (54 cases) with second surgery. Log Mar BCVA significantly improved from mean baseline 0.93 to 0.49 with mean difference of 0.43 (p < 0.001), 95% confidence interval. Postoperative complications were sub-conjunctival haemorrhage in 11 eyes (18.33%), wound leak in 7 eyes (11.66%), anterior chamber became shallow in 6 eyes (10%), cataract developed in 5 eyes (8.33%), re-retinal detachment in 4 eyes (6.66%), ocular hypotony and sterile inflammatory reaction in 3 eyes (5%) each, while iatrogenic breaks developed in 2 eyes (3.33%). Conclusion: The 23-gauge sutureless vitreo-retinal surgery for superior rhegmatogenous retinal detachment achieved high anatomical success and significant visual improvement. Sub-conjunctival haemorrhage was the most frequent procedural complication. (author)

  16. Overexpression of the X-Linked Inhibitor of Apoptosis Protects Against Retinal Degeneration in a Feline Model of Retinal Detachment.

    Science.gov (United States)

    Wassmer, Sarah J; Leonard, Brian C; Coupland, Stuart G; Baker, Adam N; Hamilton, John; Hauswirth, William W; Tsilfidis, Catherine

    2017-06-01

    Retinal detachment is an acute disorder in humans that is caused by trauma or disease, and it can often lead to permanent visual deficits that result from the death of photoreceptors in the retina. The final pathway for photoreceptor cell death is apoptosis and necroptosis. The X-linked inhibitor of apoptosis (XIAP) has been shown to block both of these cell death pathways. This study tested the effects of XIAP on photoreceptor survival in a feline model of retinal detachment. The study was performed in 12 cats, divided into two experimental groups. Six animals received a subretinal injection of adeno-associated virus (AAV) carrying XIAP, and six animals received AAV carrying green fluorescent protein (GFP) as a control. Three weeks after viral delivery, retinas were detached by injecting C 3 F 8 gas into the subretinal space. Optical coherence tomography revealed that the retinal detachments resolved within 3-6 weeks as the gas was slowly resorbed. Analysis of histological sections through the plane of the detachment showed significant preservation of the photoreceptor layer in AAV-XIAP-treated animals compared to AAV-GFP-treated animals at 9 weeks after the detachment. XIAP-treated detached retinas were similar to intact controls. These studies support the potential for XIAP therapy in the treatment of human retinal detachment.

  17. Retinal detachment secondary to ocular perforation during retrobulbar Anaesthesia

    Directory of Open Access Journals (Sweden)

    Gopal Lingam

    1995-01-01

    Full Text Available The clinical characteristics and the retinal breaks associated with rhegmatogenous retinal detachments secondary to accidental globe perforation during local infiltration anaesthesia in five highly myopic eyes are presented. Retinal detachment was total with variable proliferative vitreoretinopathy. The pattern of retinal breaks was rather typical and predictable. Management involved vitreous surgery with internal tamponade by silicone oil in four eyes and perfluoropropane gas in one eye. At the last follow-up, all eyes had attached retina. One eye did not recover useful vision due to possible concurrent optic nerve damage.

  18. Risk of progression in macula-on rhegmatogenous retinal detachment.

    Science.gov (United States)

    Callizo, Josep; Pfeiffer, Sebastian; Lahme, Eva; van Oterendorp, Christian; Khattab, Mohammed; Bemme, Sebastian; Kulanga, Miroslav; Hoerauf, Hans; Feltgen, Nicolas

    2017-08-01

    To identify factors that may lead to a rapid progression in macula-on rhegmatogenous retinal detachment (RRD), in particular, those that may lead to macular involvement. Observational, prospective, single-center study. Patients referred for surgery due to primary rhegmatogenous retinal detachment with the macula on between 2009 and 2013 were included. Relevant factors analyzed included age, time delay until surgery, lens status, myopia, the detachment's location and configuration as well as number, size and type of retinal breaks. Eyes underwent optical coherence tomography to detect macular detachment. A multivariate analysis was performed to investigate the effect of several factors in the progression of retinal detachment. A total of 116 eyes of 116 patients were included. Mean time delay between admission and surgery was 1.8 ± 1.4 days. Progression was observed in 19.8% of the eyes. Of those, 47.8% presented macular detachment. Ten of the 11 (90.9%) eyes presenting progression involving the macula also exhibited a bullous configuration, which was the only parameter that correlated significantly with detachment progression in patients with (p = 0.0036) and without (p = 0.0014) macular involvement. For the first time in a prospective trial, a bullous configuration was found to be a highly significant predictor for progression in macula-on detachments. Our data support prompt surgery in patients diagnosed with bullous macula-on RRD.

  19. Retinal detachment in black South Africans | Peters | South African ...

    African Journals Online (AJOL)

    Rhegmatogenous retinal detachments seen in black patients attending King Edward VIII Hospital Ophthalmology Clinic over a 5-year period from January 1987 to December 1991 were reviewed. Penetrating trauma and diabetic retinopathy were excluded. There were 114 detachments in 112 patients, which gave incidence ...

  20. Bilateral Serous Retinal Detachment as a Complication of ...

    African Journals Online (AJOL)

    preeclampsia and eclampsia for ocular manifestations, which should be helpful for obstetrician in the management of patient. disks (ODs), macula, and tortuous retinal vessels. Bilateral exudative retinal detachments (RD) were detected superotemporal and inferotemporal to the. ODs involving the macula [Figures 1 and 2].

  1. Peripheral 360 degrees retinectomy in complex retinal detachment.

    Science.gov (United States)

    Banaee, Touka; Hosseini, Seyyedeh Maryam; Eslampoor, Alireza; Abrishami, Majid; Moosavi, Mirnaghi

    2009-06-01

    To report the functional and anatomical results and complications of 360 degrees peripheral retinectomy for management of complicated retinal detachment. Patients with complicated retinal detachment underwent pars plana vitrectomy, 360 degrees retinectomy, intraoperative endolaser, and internal tamponade with silicone oil. Postoperative visual acuity, intraocular pressure, retinal status, need for reoperation, and complications are presented. Twenty eyes of 19 patients with a mean age of 32.4 years (8-75 years) underwent pars plana vitrectomy and 360 degrees peripheral retinectomy for complicated retinal detachment due to anterior proliferative vitreoretinopathy, unstable edge of retinal break, anterior hyaloidal fibrovascular proliferation, retinal incarceration in scleral wound, and 300 degrees giant retinal tear. Intraoperative reattachment was achieved in 18 eyes. Mean postoperative follow-up time was 24.2 months (2-70 months). Retina was attached in 14 eyes (70%) in the last visit. Eight eyes (40%) had 5/200 or greater visual acuity. Preoperative and postoperative visual acuities did not have significant correlation (Spearman correlation coefficient = 0.291). There was no relation between diagnosis and anatomical outcome (P > 0.2). Relaxing peripheral 360 degrees retinectomy is an effective procedure for flattening the retina in complicated retinal detachments when no other option is available.

  2. Elucidation of the genetic causes of retinal detachment

    NARCIS (Netherlands)

    Go, S.L.

    2006-01-01

    Rhegmatogenous retinal detachment (RRD) is caused by a break in the neurosensory retina of the eye, thereby allowing fluid from the vitreous space into the space between the sensory retina and the retinal pigment epithelium. Untreated, this disorder can lead to blindness. A case-control study in

  3. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

    OpenAIRE

    Mohamed, Yasser Helmy; Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

    2016-01-01

    Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual ac...

  4. Bilateral Simultaneous Rhegmatogenous Retinal Detachment following Laser in situ Keratomileusis

    Directory of Open Access Journals (Sweden)

    Erhan Yumusak

    2016-06-01

    Full Text Available A 21-year-old woman developed simultaneous rhegmatogenous retinal detachment after laser in situ keratomileusis (LASIK in both eyes. She underwent pars plana vitrectomy surgery combined with endolaser photocoagulation and silicone oil tamponade in the right eye. A week later, pneumatic retinopexy was done in the left eye. As the retinal tear did not seal, 360° scleral buckling surgery was performed and retina was attached. Bilateral simultaneous rhegmatogenous retinal detachment after LASIK for correction of myopia can be a serious complication. Patients should be informed about the possibility of this complication.

  5. Topographic changes of retinal layers after resolution of acute retinal detachment.

    Science.gov (United States)

    Kim, Jae Hui; Park, Do Young; Ha, Hyo Shin; Kang, Se Woong

    2012-10-23

    To investigate changes in thickness profiles of retinal layers after resolution of recent onset rhegmatogenous retinal detachment Spectral domain optical coherence tomography (SD-OCT) scans were performed for 28 patients diagnosed with unilateral inferior half or superior half retinal detachment who underwent retinal reattachment surgery. The thickness of each retinal layer was measured at 3000 μm and 2800 μm in the superior and inferior directions from the foveal center. The thicknesses of each retinal layer of the reattached retina were compared with those of the undetached region of the retina of the same eye. Sixteen patients were diagnosed with superior half and 12 patients were diagnosed with inferior half retinal detachment. The mean duration of retinal detachment was 6.9 ± 3.9 days. SD-OCT scans were performed 10.4 ± 6.9 months after the surgery. The thicknesses of the outer nuclear layer and photoreceptor layer in the reattached retina were significantly thinner than those of the undetached retina (P = 0.012, and P = 0.018, respectively). Our findings suggest that prominent retinal structural sequelae, especially in outer nuclear layer and photoreceptor layer, can be induced by a short duration of retinal detachment. Our findings also underscore the important role of initial retinal injuries that occur within the first several days on the long term structural prognosis. (ClinicalTrials.gov number, NCT01587794).

  6. Frequency of lattice degeneration and retinal breaks in the fellow eye in retinal detachment.

    Science.gov (United States)

    Lorentzen, S E

    1988-04-01

    The fellow eye of 100 consecutively admitted cases of retinal detachment was studied with three-mirror examination for the presence of lattice degeneration and retinal breaks. Lattice degeneration was found in 18% and retinal breaks in 20% of fellow eyes.

  7. Apical atrophy of retinal pigment epithelial detachments in central serous chorioretinopathy

    DEFF Research Database (Denmark)

    Pryds, Anders; Hamann, Steffen; Larsen, Michael

    2012-01-01

    compatible with CSC. RESULTS: A juxtafoveal retinal pigment epithelial detachment with apical atrophy of the retinal pigment epithelium with corresponding severe attenuation of the pigmentation of the retinal pigment epithelium was observed in both patients. One of the patients presented with a serous...... neurosensory retinal detachment with smokestack leakage 7 years after first being seen. The other patient was never seen with a neurosensory detachment. CONCLUSION: Isolated pigment epithelial detachment with apical retinal pigment epithelial atrophy may represent a precursor stage of CSC....

  8. [Prevention of retinal detachment and treatment of retinoschisis].

    Science.gov (United States)

    Messmer, E P

    1990-01-01

    The necessity for prophylactic treatment for degenerative disease in the peripheral retina cannot be evaluated merely on the basis of the ophthalmoscopic findings. Factors such as the patient's history, refraction, the status of the vitreous, and prospective future cataract extraction all have a major impact on the risk of developing retinal detachment. The latter condition can be classified in to three groups: (1) low risk (patients with no history of retinal detachment, intraocular surgery or posterior vitreous detachment, myopia less than three diopters): treatment of atrophic holes and lattice degeneration is not justified, treatment of flap tears according to the circumstances; (2) medium risk (patients with no history of retinal or posterior vitreous detachment; however, myopia of more than three diopters and/or aphakia): the treatment of lattice degeneration is not justified; treatment of breaks according to the circumstances; (3) high risk: (patients with symptoms of posterior vitreous detachment): the treatment of lattice degeneration and atrophic holes is not justified: treatment of tears is necessary; fellow eyes: the treatment of retinal breaks is necessary; treatment of lattice degeneration seems advisable in cases with bilateral symmetric findings or prior to cataract extraction. Treatment of senile retinoschisis is only justified in cases with large and centrally located holes in the outer wall or in the presence of symptomatic schisis detachment.

  9. A Chick Model of Retinal Detachment: Cone Rich and Novel

    Science.gov (United States)

    Cebulla, Colleen M.; Zelinka, Chris P.; Scott, Melissa A.; Lubow, Martin; Bingham, Amanda; Rasiah, Stephen; Mahmoud, Ashraf M.; Fischer, Andy J.

    2012-01-01

    Background Development of retinal detachment models in small animals can be difficult and expensive. Here we create and characterize a novel, cone-rich retinal detachment (RD) model in the chick. Methodology/Principal Findings Retinal detachments were created in chicks between postnatal days 7 and 21 by subretinal injections of either saline (SA) or hyaluronic acid (HA). Injections were performed through a dilated pupil with observation via surgical microscope, using the fellow eye as a control. Immunohistochemical analyses were performed at days 1, 3, 7, 10 and 14 after retinal detachment to evaluate the cellular responses of photoreceptors, Müller glia, microglia and nonastrocytic inner retinal glia (NIRG). Cell proliferation was detected with bromodeoxyuridine (BrdU)-incorporation and by the expression of proliferating cell nuclear antigen (PCNA). Cell death was detected with terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). As in mammalian models of RD, there is shortening of photoreceptor outer segments and mis-trafficking of photoreceptor opsins in areas of RD. Photoreceptor cell death was maximal 1 day after RD, but continued until 14 days after RD. Müller glia up-regulated glial fibriliary acidic protein (GFAP), proliferated, showed interkinetic nuclear migration, and migrated to the subretinal space in areas of detachment. Microglia became reactive; they up-regulated CD45, acquired amoeboid morphology, and migrated toward outer retina in areas of RD. Reactive NIRG cells accumulated in detached areas. Conclusions/Significance Subretinal injections of SA or HA in the chick eye successfully produced retinal detachments and cellular responses similar to those seen in standard mammalian models. Given the relatively large eye size, and considering the low cost, the chick model of RD offers advantages for high-throughput studies. PMID:22970190

  10. Bilateral Rhegmatogenous Retinal Detachment during External Beam Radiotherapy

    Directory of Open Access Journals (Sweden)

    Takako Hidaka

    2016-06-01

    Full Text Available Herein, we report a case of nontraumatic bilateral rhegmatogenous retinal detachment (RRD during external beam radiotherapy for nonocular tumor, presented as an observational case study in conjunction with a review of the relevant literature. A 65-year-old male was referred to our hospital due to bilateral RRD. He underwent a biopsy for a tumor of the left frontal lobe 4 months prior to presentation, and the tumor had been diagnosed as primary central nerve system B-cell type lymphoma. He received chemotherapy and external beam radiotherapy for 1 month. There were no traumatic episodes. Bilateral retinal detachment occurred during a series of radiotherapies. Simultaneous nontraumatic bilateral retinal detachment is rare. The effects of radiotherapy on ocular functionality, particularly in cases involving retinal adhesion and vitreous contraction, may include RRD. Thus, it is necessary to closely monitor the eyes of patients undergoing radiotherapy, particularly those undergoing surgery for retinal detachment and those with a history of photocoagulation for retinal tears, a relevant family history, or risk factors known to be associated with RRD.

  11. WIDE-FIELD INFRARED IMAGING: A Descriptive Review of Characteristics of Retinoschisis, Retinal Detachment, and Schisis Detachments.

    Science.gov (United States)

    Ho, Vincent Y; Wehmeier, Jarrod M; Shah, Gaurav K

    2016-08-01

    Retinoschisis and retinal detachments are primarily differentiated based on characteristic examination findings. In diagnostically challenging cases, noncontact wide-field infrared imaging can help diagnosis and visualize the extent/margins of retinoschisis, retinal detachment, or combined schisis detachments by comparing reflectivity patterns. This is a retrospective, observational, descriptive case series of 14 eyes of 14 nonconsecutive patients, ranging from 28 to 89 years old (mean 61), diagnosed with retinoschisis, retinal detachment, or schisis detachment from May 5, 2014 to March 4, 2015. Patients with secondary retinoschisis and/or retinal detachment from other causes were not included in the study. Heidelberg Wide-Field Module lens and Heidelberg Spectralis HRA+OCT machine (Heidelberg Engineering, Heidelberg, Germany) were used to obtain noncontact, wide-field infrared images on each study eye. Seven eyes with retinal detachments, four with retinoschises, and three with schisis detachments were imaged using this novel wide-field infrared technique. Retinoschisis appears light and translucent with prominent vasculature, retinal detachments appear dark and opaque, and combined retinoschisis/retinal detachment exhibit mixed reflectivity patterns. Wide-field infrared imaging provides a quick, noncontact, noninvasive method to accurately diagnose and to monitor for progression of retinoschisis, retinal detachment, or combined schisis detachments.

  12. The fluid mechanics of scleral buckling surgery for the repair of retinal detachment.

    Science.gov (United States)

    Foster, William Joseph; Dowla, Nadia; Joshi, Saurabh Y; Nikolaou, Michael

    2010-01-01

    Scleral buckling is a common surgical technique used to treat retinal detachments that involves suturing a radial or circumferential silicone element on the sclera. Although this procedure has been performed since the 1960s, and there is a reasonable experimental model of retinal detachment, there is still debate as to how this surgery facilitates the re-attachment of the retina. Finite element calculations using the COMSOL Multiphysics system are utilized to explain the influence of the scleral buckle on the flow of sub-retinal fluid in a physical model of retinal detachment. We found that, by coupling fluid mechanics with structural mechanics, laminar fluid flow and the Bernoulli effect are necessary for a physically consistent explanation of retinal reattachment. Improved fluid outflow and retinal reattachment are found with low fluid viscosity and rapid eye movements. A simulation of saccadic eye movements was more effective in removing sub-retinal fluid than slower, reading speed, eye movements in removing subretinal fluid. The results of our simulations allow us to explain the physical principles behind scleral buckling surgery and provide insight that can be utilized clinically. In particular, we find that rapid eye movements facilitate more rapid retinal reattachment. This is contradictory to the conventional wisdom of attempting to minimize eye movements.

  13. Serous retinal detachment after trabeculectomy in angle recession glaucoma

    Directory of Open Access Journals (Sweden)

    Roy, Avik Kumar

    2015-12-01

    Full Text Available An 18-year-old male with 360 degree angle recession after blunt trauma in his right eye developed uncontrolled intraocular pressure (IOP despite four antiglaucoma medications (AGM with advancing disc damage. He underwent trabeculectomy with intraoperative mitomycin-c (MMC application. There was an intraoperative vitreous prolapse which was managed accordingly. On post-surgery day 1, he had shallow choroidal detachment superiorly with non-recordable IOP. This was deteriorated 1 week postoperatively as choroidal detachment proceeded to serous retinal detachment. He was started with systemic steroid in addition to topical route. The serous effusions subsided within 2 weeks time. At the last follow up at 3 months, he was enjoying good visual acuity, deep anterior chamber, diffuse bleb, an IOP in low teens off any AGM and attached retina. This case highlights the rare occurrence of serous retinal detachment after surgical management of angle recession glaucoma.

  14. Posterior vitreous detachment and retinal detachment after implantation of the Visian phakic implantable collamer lens.

    Science.gov (United States)

    Bamashmus, Mahfouth A; Al-Salahim, Seddique A; Tarish, Nabil A; Saleh, Mahmoud F; Mahmoud, Hatem A; Elanwar, Mohamed F; Awadalla, Mohamed A

    2013-01-01

    To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana'a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evaluation included manifest and cycloplegic refractions, uncorrected (UCVA) and best spectacle-corrected visual acuity (BSCVA), slit-lamp biomicroscopy, intraocular pressure and dilated retinal examination. Investigations included corneal topography, central corneal thickness, anterior chamber depth and white to white diameter. Retinal diseases and complications were recorded and analyzed preoperatively and postoperatively. Preoperatively, 61 (9.9%) eyes had posterior segment pathology requiring prophylactic laser photocoagulation. One eye developed spontaneous rhegmatogenous retinal detachment (RRD), one eye developed traumatic retinal detachment and two eyes required laser treatment postoperatively. The overall retinal detachment rate post-ICL was 0.32%. Posterior segment complications are rare after ICL implantation but dilated vitreoretinal assessment is important before and after the procedure. Patients with suspicious retinal lesions need a comprehensive vitreoretinal evaluation by a retinal specialist. If a patient develops floaters or blurry vision he/she requires further assessment by a vitreoretinal specialist.

  15. Epidemiologic characteristics of retinal detachment surgery at a specialized unit in Denmark

    DEFF Research Database (Denmark)

    Poulsen, Christina Doefler; Peto, Tunde; Grauslund, Jakob

    2016-01-01

    PURPOSE: To examine the incidence of retinal detachments and to evaluate patient profiles and surgical characteristics. METHODS: Retrospective review of patients operated for primary retinal detachment (RD) and redetachment between 2010 and 2012 at the Department of Ophthalmology, Odense Universi...

  16. Giant Retinal Tear With Retinal Detachment in Regressed Aggressive Posterior Retinopathy of Prematurity Treated by Laser.

    Science.gov (United States)

    Chandra, Parijat; Tewari, Ruchir; Salunkhe, Nitesh; Kumawat, Devesh; Kumar, Vinod

    2017-06-29

    Rhegmatogenous retinal detachment after successfully regressed retinopathy of prematurity is a rare occurrence. Late onset rhegmatogenous retinal detachment has been reported infrequently. The authors report a case of aggressive posterior retinopathy of prematurity that underwent uneventful regression after laser photocoagulation and later developed an inoperable closed funnel retinal detachment due to a giant retinal tear. This case represents the earliest development of such complications in regressed aggressive posterior retinopathy of prematurity treated by laser. Development of a giant retinal tear has also not been previously reported after laser treatment. This case highlights that successful regression of severe retinopathy of prematurity does not safeguard against future complications and requires frequent long-term follow-up. [J Pediatr Ophthalmol Strabismus. 2017;54:e34-e36.]. Copyright 2017, SLACK Incorporated.

  17. Bilateral iris, choroid, optic nerve colobomas and retinal detachment ...

    African Journals Online (AJOL)

    Rabah M. Shawky

    2013-12-05

    Dec 5, 2013 ... Bilateral iris, choroid, optic nerve colobomas and retinal detachment in an Egyptian patient with mild Baraitser–Winter syndrome. Rabah M. Shawky *, Heba Salah Abd-Elkhalek Elabd, Radwa Gamal. Pediatric Department, Genetics Unit, Ain Shams University, Egypt. Received 26 October 2013; accepted 4 ...

  18. Bilateral orbital infarction and retinal detachment in a previously ...

    African Journals Online (AJOL)

    In this report, we present a case of an 11‑year‑old previously undiagnosed sickle cell disease Nigerian girl with severe acute bilateral orbital infarction and retinal detachment to highlight that hemoglobinopathy induced orbital infarction should be considered in African children with acute onset proptosis with or without ...

  19. Cataract and Retinal Detachment Following Electric Shock Injury in ...

    African Journals Online (AJOL)

    Aim: To report a case of cataract and retinal detachment following an electrical injury in an adult Nigerian male. C a se report: A 28-year-old man presented with a history of progressive and painless loss of vision in the right eye, three years after an electric shock injury. There was no history of mechanical trauma.

  20. Blindness from bilateral bullous retinal detachment: tragedy of a ...

    African Journals Online (AJOL)

    Objective: To present a scourge of blindness possibly due to an inherited condition causing retinal detachment in 3 siblings. Methods: In February 2004, three siblings from a monogamous family from Ipetu-Ijesha in Osun state, Nigerian presented to the author consecutively with history of visual impairment/ blindness.

  1. Incidence and Pattern of Retinal Detachment in a Tertiary Eye ...

    African Journals Online (AJOL)

    giant tears; 6 (6.5%) had dialysis and 3 (3.2%) had coexisting macula holes; in 73.1% the tears were located in the superior retina. Conclusions: Retinal ... factor in 33 (35.5%) patients. In no patient was the detachment restricted to one quadrant. .... Health education of eye patients and the general public on the symptoms of ...

  2. Silicone oil removal after rhegmatogenous retinal detachment: comparing techniques

    NARCIS (Netherlands)

    Tan, H. S.; Dell'omo, R.; Mura, M.

    2012-01-01

    Purpose To assess the outcome of silicone oil removal after rhegmatogenous retinal detachment (RRD) surgery, and to compare results of a two-port (infusion-extraction) versus a three-port (full vitrectomy) approach. Methods Primary outcome measure was the rate of redetachment. Secondary outcome

  3. Air versus gas tamponade in retinal detachment surgery

    NARCIS (Netherlands)

    Tan, H. Stevie; Oberstein, Sarit Y. Lesnik; Mura, Marco; Bijl, Heico M.

    2013-01-01

    Objective To compare the outcome of air tamponade with gas tamponade in primary vitrectomy for the treatment of rhegmatogenous retinal detachment (RRD). Methods We examined the records of 524 cases of 523 patients that underwent primary vitrectomy for RRD with air or sulphur hexafluoride 20% gas

  4. SUPRACHOROIDAL BUCKLING FOR THE MANAGEMENT OF RHEGMATOGENOUS RETINAL DETACHMENTS SECONDARY TO PERIPHERAL RETINAL BREAKS.

    Science.gov (United States)

    El Rayes, Ehab N; Mikhail, Mikel; El Cheweiky, Hala; Elsawah, Kareem; Maia, Andre

    2017-04-01

    To evaluate functional and anatomical outcomes of eyes undergoing suprachoroidal buckling for the management of peripheral retinal breaks in rhegmatogenous retinal detachment. Retrospective cohort study of 41 eyes of 41 patients undergoing suprachoroidal buckling for the management of rhegmatogenous retinal detachment secondary to single or multiple retinal breaks. Suprachoroidal indentation was achieved through the introduction of filler material using a 23-gauge (23-G) olive-tipped, suprachoroidal cannula. This allowed for the creation of a suprachoroidal dome and chorio-retinal apposition. Healon5 (Abbott Medical Optics) was used as filler material in all eyes. Combined 25-G vitrectomy was performed in 5 eyes. Cryopexy and laserpexy were used in 37 and 4 eyes, respectively. Mean visual acuity gain was the primary outcome measure. Final retinal reattachment rate, single-surgery reattachment rate, and complications were secondary outcome measures. Mean best-corrected distance visual acuity improved from 20/1,100 to 20/42. Single surgery reattachment rate was 92.7% (38/41 eyes). Final retinal reattachment was achieved in all 41 eyes (100%). There was no statistically significant difference in visual acuity gain or anatomical reattachment in terms of retinal break quadrant or extent. No major complications were observed. Two localized suprachoroidal hemorrhages occurred at the entry site for the cannula. These resolved without further intervention. Suprachoroidal buckling using a specially designed cannula is a safe and effective procedure for the management of rhegmatogenous retinal detachment secondary to peripheral retinal breaks.

  5. Surgical and Visual Outcome for Recurrent Retinal Detachment Surgery

    Directory of Open Access Journals (Sweden)

    Constantin Pournaras

    2014-01-01

    Full Text Available Purpose. To evaluate the anatomical and functional outcome of repeated surgeries for recurrent retinal detachment. Methods. We retrospectively reviewed 70 cases with refractory retinal detachment of various etiologies that required multiple operations. Anatomical success (attached retina or failure (totally/partially-detached retina was assessed biomicroscopically. The BCVA was used for the evaluation of the functional outcome, at presentation and at the end of follow-up. Various pre-, intra-, and postoperative factors were associated with anatomical success or failure as well as with final functionality. Results. The mean number of surgeries was 4 (range: 2 to 10. The anatomical success rate was 80% (56 attached cases, 14 detached cases. 29% of the attached cases had a BCVA better than 20/40 (Snellen chart. The number of operations doesn’t seem to affect significantly the final visual acuity. The PVR was found to affect both the anatomical and functional outcome (P=0.014 & P=0.002, respectively. Conclusions. In the present study, it is suggested that multiple operations for refractory retinal detachment may result in successful anatomic results, with a fare functional outcome at the same time. Eventually, we verified that the existence of PVR worsens the prognosis.

  6. Evolution of Outer Retinal Folds Occurring after Vitrectomy for Retinal Detachment Repair

    NARCIS (Netherlands)

    Dell'Omo, Roberto; Tan, H. Stevie; Schlingemann, Reinier O.; Bijl, Heico M.; Lesnik Oberstein, Sarit Y.; Barca, Francesco; Mura, Marco

    2012-01-01

    PURPOSE. To assess the evolution of outer retinal folds (ORFs) occurring after repair of rhegmatogenous retinal detachment (RRD) using spectral domain-optical coherence tomography (sd-OCT) and fundus autofluorescence (FAF), and to discuss their pathogenesis. METHODS. Twenty patients were operated on

  7. Factors predisposing to rhegmatogenous retinal detachment among ...

    African Journals Online (AJOL)

    Bernt Lindtjørn

    also increase correspondingly. As a result, in developing countries like Ethiopia, where there is lack of optimal operating facilities and few vitreoretinal surgeons, blindness from retinal diseases like RD, diabetic retinopathies and age-related macular degeneration will increase unless a strategy is designed to increase the.

  8. Bilateral Patching in Retinal Detachment: Fluid Mechanics and Retinal “Settling”

    Science.gov (United States)

    2011-01-01

    Purpose. When a patient suffers a retinal detachment and surgery is delayed, it is known clinically that bilaterally patching the patient may allow the retina to partially reattach or “settle.” Although this procedure has been performed since the 1860s, there is still debate as to how such a maneuver facilitates the reattachment of the retina. Methods. Finite element calculations using commercially available analysis software are used to elucidate the influence of reduction in eye movement caused by bilateral patching on the flow of subretinal fluid in a physical model of retinal detachment. Results. It was found that by coupling fluid mechanics with structural mechanics, a physically consistent explanation of increased retinal detachment with eye movements can be found in the case of traction on the retinal hole. Large eye movements increase vitreous traction and detachment forces on the edge of the retinal hole, creating a subretinal vacuum and facilitating increased subretinal fluid. Alternative models, in which intraocular fluid flow is redirected into the subretinal space, are not consistent with these simulations. Conclusions. The results of these simulations explain the physical principles behind bilateral patching and provide insight that can be used clinically. In particular, as is known clinically, bilateral patching may facilitate a decrease in the height of a retinal detachment. The results described here provide a description of a physical mechanism underlying this technique. The findings of this study may aid in deciding whether to bilaterally patch patients and in counseling patients on pre- and postoperative care. PMID:21666245

  9. [Neurotrophic keratitis after vitrectomy and circumferential endophotocoagulation for retinal detachment].

    Science.gov (United States)

    Auchère Lavayssiere, C; Lux, A-L; Degoumois, A; Stchepinsky Launay, M; Denion, E

    2016-02-01

    Circumferential (360°) endophotocoagulation is frequently implemented during vitrectomies for retinal detachment. This photocoagulation may result in neurotrophic keratitis by damaging the ciliary nerves in the suprachoroidal space on their way to the pupil. We report a series of 4 cases of neurotrophic keratitis following a circumferential endophotocoagulation. A retrospective observational case series of 4 non-diabetic patients having presented with a neurotrophic keratitis following a retinal detachment treated with vitrectomy and circumferential endophotocoagulation (532 nm) at Caen University Hospital. We report the various forms of corneal lesions and the diagnostic criteria allowing for the diagnosis of neurotrophic keratitis. Neurotrophic keratitis is caused by lesions occurring at various levels of corneal innervation. Endophotocoagulation may cause a neurotrophic keratitis by damaging the short and long ciliary nerves on their way to the pupil in the suprachoroidal space. The sequelae of this condition can limit visual recovery. Hence, it is probably advisable to screen for corneal anesthesia or severe hypesthesia following a retinal detachment treated with vitrectomy and circumferential endophotocoagulation and to implement prophylactic treatment (intensive lubricant therapy; preservative-free eye drops) if needed. The risk of neurotrophic keratitis should be weighed against the dose of laser retinopexy necessary and sufficient to obtain a sustained retinal reattachment. If circumferential endophotocoagulation is implemented, it is probably sensible to monitor corneal sensitivity and to adapt postoperative treatment if necessary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Retinal Detachment in Down Syndrome: Characteristics and Surgical Outcomes

    Directory of Open Access Journals (Sweden)

    Badr O. AlAhmadi

    2016-01-01

    Full Text Available Purpose. To determine the functional and anatomic outcomes of rhegmatogenous retinal detachment (RRD surgery in patients with Down syndrome. Methods. A retrospective chart review was performed of patients with Down syndrome who had undergone surgery for RRD at King Khalid Eye Specialist Hospital between 1995 and 2014. Results. A total of 245 patients with Down syndrome were evaluated during the study period. Eighteen eyes of 15 patients (6.1% with RRD were identified. Three out of 15 patients (20% presented with bilateral retinal detachment. All eyes presented with macula off retinal detachment. The retina was successfully reattached in 16/18 (88.8% eyes after a mean follow-up of 48 months. The final postoperative visual acuity ranged from light perception to 20/125 (median: hand motion (11/18 eyes. Conclusions. The anatomic success rate of retinal reattachment surgery in patients with Down syndrome is comparable to the general population. Patients with Down syndrome should undergo regular ophthalmic examinations for early diagnosis. Despite late diagnosis and the presence of proliferative vitreoretinopathy (PVR in some patients, favorable anatomical outcomes can be achieved.

  11. Timing of acute macula-on rhegmatogenous retinal detachment repair.

    Science.gov (United States)

    Ehrlich, Rita; Niederer, Rachael L; Ahmad, Nadeem; Polkinghorne, Philip

    2013-01-01

    To determine if same-day or next available surgery changed the outcome of patients presenting with acute macula-on rhegmatogenous retinal detachments. A retrospective review of patients presenting with acute macula-on rhegmatogenous retinal detachments treated with small-gauge vitrectomy was performed. Data collection included subjects' demographics, duration of symptoms, location and extent of the retinal detachment, and timing of surgery. The primary outcome was anatomical and functional success rate for patients having same-day surgery compared with those for whom surgery was delayed. One hundred and fourteen patients were included in this study. Sixty-two patients operated on day of presentation, 46 patients operated the day after presentation, and in 6 patients, surgery was delayed from 2 to 5 days. Time to surgery in hours ranged between 1 and 120 hours (mean 14.5 ± 15.05 hours). Retinal reattachment was achieved in 95.6% of patients, with 80% requiring only one procedure. Mean initial visual acuity was logarithm of the minimum angle of resolution 0.42 (SD 0.6), and mean final visual acuity was logarithm of the minimum angle of resolution 0.39 (SD 0.67) (P = 0.53). Time to surgery was not found to effect final anatomical outcome (P = 0.56). No statistically significant association was observed between change in visual acuity and time to surgery (P = 0.99). Modest delay in timing of surgery for macula-on rhegmatogenous retinal detachment did not adversely impact on patients' outcome.

  12. PRIMARY SCLERAL BUCKLING FOR PEDIATRIC RHEGMATOGENOUS RETINAL DETACHMENT.

    Science.gov (United States)

    Errera, Marie-Hélène; Liyanage, Sidath E; Moya, Rene; Wong, S Chien; Ezra, Eric

    2015-07-01

    To evaluate the anatomical outcomes of primary scleral buckling (SB) procedures for pediatric rhegmatogenous retinal detachments. Retrospective consecutive case series. One hundred and four eyes of 99 consecutive nonselected pediatric patients undergoing primary SB were identified. Baseline factors recorded were demographics, presenting clinical examination findings, previous ocular surgery, predisposing factors. Intraoperative factors recorded were the type of buckle, number and distribution of retinal breaks, number of retinal quadrants detached, macular status (involved vs. uninvolved), the use of subretinal fluid drainage, and surgical complications. Anatomical reattachment rate at last follow-up. Subgroup analysis was carried out to identify any predisposing factors for failure of primary surgery, effect of age on outcome, intraoperative pathology, effect of posterior versus anterior SB, and redetachment and secondary-procedure complications specific to SB. The initial surgery was segmental SB alone in 87 eyes (83.6%). Retinal reattachment was achieved with 1 operation in 73% (76 of 104 eyes). Of the 28 cases that redetached, 14 eyes underwent a repeat SB procedure (success rate of this second operation: 85.7% [12 of 14 eyes]), 13 eyes underwent vitrectomy (success rate of this second operation: 38.4% [5 of 13 eyes]), and 1 case was not reoperated. Overall, the final success rate was 94% (98 of 104 eyes). Factors associated with a statistically significant increased risk of failure included more than one break; three or more quadrants of detachment; horseshoe tears; no breaks seen on preoperative examination; Stickler syndrome. In selected cases, primary SB is an effective treatment for pediatric, rhegmatogenous retinal detachment.

  13. [Surgical treatment of very advanced rhegmatogenous retinal detachment].

    Science.gov (United States)

    Hejsek, L; Ernest, J; Němec, P; Rejmont, L; Manethová, K; Stepanov, A; Rozsíval, P

    2013-12-01

    Rhegmatogenous retinal detachment is a serious ocular pathology. Therapeutic options are surgical only. Surgery is in advanced stages technically and financially demanding. In this paper, we consider the results operated detachments, which were for their advancement, with respect to the technical possibilities of the present intraocular surgery, on the border of the surgical possibilities. The group consisted of 37 eyes of 37 patients who were followed prospectively and had in the affected eye very advanced (old) rhegmatogenous retinal detachment. As a method to confirtm any visual functions were used visual evoked potentials in flash monocular stimulation (F-VEP). All patients had a cerclage performed 12 mm from the limbus, 20G pars plana vitrectomy (PPV), in 2 was also performed cataract surgery (phacoemulsification with implantation of an artificial intraocular lens to the bag). Surgery was done in 23 of 37 patients (62 % of the whole group), with the remaining 14 eyes was not due to the severity of finding highly advanced retinal detachment. Attached retina at the end of the observation period had 14 eyes (61% of the patients, 38% of the whole group). In 5 eyes was due to local re-detachment in the periphery only stabilized finding (22% of operated eyes, 14% of all). The values ​​of visual acuity in the subgroup of operated eyes were statistically significantly increased after surgery (Wilcoxon p = 0.036). The values ​​of F-VEP were not statistically significantly different between operated and non-operated patients and was not found any statistically significant correlation between the vision (and even after surgery) and F-VEP in operated eyes. Anatomical success of surgical treatment of advanced retinal detachment is possible. But the correlation was not found in visual acuity and F-VEP or the severity of preoperative disturbed visual function, even in the improvement in the postoperative period. F-VEP is not a suitable marker for determining the

  14. Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment.

    Science.gov (United States)

    Wilkinson, Charles P

    2014-09-05

    Asymptomatic retinal breaks and lattice degeneration are visible lesions that are risk factors for later retinal detachment. Retinal detachments occur when fluid in the vitreous cavity passes through tears or holes in the retina and separates the retina from the underlying retinal pigment epithelium. Creation of an adhesion surrounding retinal breaks and lattice degeneration, with laser photocoagulation or cryotherapy, has been recommended as an effective means of preventing retinal detachment. This therapy is of value in the management of retinal tears associated with the symptoms of flashes and floaters and persistent vitreous traction upon the retina in the region of the retinal break, because such symptomatic retinal tears are associated with a high rate of progression to retinal detachment. Retinal tears and holes unassociated with acute symptoms and lattice degeneration are significantly less likely to be the sites of retinal breaks that are responsible for later retinal detachment. Nevertheless, treatment of these lesions frequently is recommended, in spite of the fact that the effectiveness of this therapy is unproven. The objective of this review was to assess the effectiveness and safety of techniques used to treat asymptomatic retinal breaks and lattice degeneration for the prevention of retinal detachment. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 2), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to February 2014), EMBASE (January 1980 to February 2014), PubMed (January 1948 to February 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials

  15. The fellow eye of patients with phakic rhegmatogenous retinal detachment from atrophic holes of lattice degeneration without posterior vitreous detachment.

    Science.gov (United States)

    Gonzales, C R; Gupta, A; Schwartz, S D; Kreiger, A E

    2004-11-01

    Primary phakic rhegmatogenous retinal detachment (RRD) without posterior vitreous detachment (PVD) represents a unique clinical entity that behaves differently from RRD associated with PVD. While previous studies have reported the long term findings in the fellow eye of patients with RRD and PVD, the outcome of the fellow eye of patients with RRD without PVD is not known. Consecutive patients with RRD not associated with PVD were studied retrospectively. The authors evaluated the fellow eye for retinal detachment or other vision threatening pathology. 27 patients (mean age 32 years) were studied with follow up of between 9 and 326 months (mean 111 months). 24 (89%) were myopic. Bilateral retinal detachment occurred in eight patients (30%). On initial examination, 17 patients (63%) had retinal findings (including lattice degeneration, atrophic holes, and/or cystic retinal tufts) in the fellow eye that might predispose them to retinal detachment. 14 vision threatening events or diagnoses occurred (nine of which were rhegmatogenous in nature) in the fellow eye including eight retinal detachments, one traumatic PVD without retinal tears, one retinal tear after PVD, one diagnosis of pigmentary glaucoma needing trabeculectomy, two visually significant cataracts, and one diagnosis of chorioretinitis. 23 patients (85%) maintained visual acuity better than 20/50, with most retaining 20/20 vision in the fellow eye. Patients who experience RRD without PVD are at risk of developing vision threatening events in the contralateral eye and, as such, the fellow eye should be followed carefully.

  16. PERIPHERAL RETINAL DEGENERATIONS AND RHEGMATOGENOUS DETACHMENT IN PRIMARY CONGENITAL GLAUCOMA.

    Science.gov (United States)

    Gupta, Shikha; Gogia, Varun; Jose, Cijin; Chanana, Bhuvan; Bypareddy, Ravi; Kapoor, Kulwant Singh; Gupta, Viney

    2016-01-01

    To determine the prevalence of peripheral retinal degenerations (PRD) and rhegmatogenous retinal detachment in patients with primary congenital glaucoma (PCG). Records of all patients with PCG operated from year 2000 onwards were evaluated to look for the prevalence of rhegmatogenous retinal detachment. Of these, those children who were old enough to cooperate and had sufficient medial clarity were screened with an indirect ophthalmoscopy in a cross-sectional evaluation from 2010 to 2014. Peripheral retina was examined, and prevalence of PRD was estimated in this subset. For statistical purposes, only one eye of each patient was considered in this cross-sectional analysis. Of the 310 eyes (180 patients with PCG) operated from the year 2000 onwards, a rhegmatogenous retinal detachment was noted in 13 eyes (4%). Mean axial length of these eyes was 26.3 ± 3.2 mm (range, 19.8-34.7 mm). Among the eyes screened for PRD (n = 60), prevalence of pathologic PRD (lattices with/without atrophic holes and isolated holes/tears) was 15%. The average follow-up between glaucoma filtering surgery and the date of last examination was 8.55 ± 3.98 years (range, 5-20 years) in this subset. Mean axial length was significantly greater in eyes with pathologic PRD than in those without (28.1 ± 3.3 mm vs. 25.8 ± 2.6 mm; P = 0.01). For axial length ≥ 26 mm, the odds of having a pathologic PRD were 14.4 times more than those with axial length < 26 mm (P < 0.001; 95% confidence interval, 1.7-120.5). Prevalence of PRD among eyes with PCG is high. Peripheral retinal screening should be performed in eyes with PCG, especially those with axial lengths ≥ 26 mm.

  17. In vitro biomechanical modulation--retinal detachment in a box.

    Science.gov (United States)

    Ghosh, Fredrik; Arnér, Karin; Taylor, Linnéa

    2016-03-01

    To illustrate the importance of biomechanical impact on tissue health within the central nervous system (CNS), we herein describe an in vitro model of rhegmatogenous retinal detachment (RRD) in which disruption and restoration of physical tissue support can be studied in isolation. Adult retinal porcine explants were kept in culture for 3 or 12 hours without any tissue support, simulating clinical RRD, after which they were either maintained in this state or reattached to the culture membrane for an additional 48 hours. In vitro detachment resulted in gliosis and severe progressive loss of retinal neurons. In contrast, if the explant was reattached, gliosis and overall cell death was attenuated, ganglion cell death was arrested, and the number of transducin-expressing cone photoreceptors increased. These results support the hypothesis that removal of the elastic retina from its normal physical environment results in degenerative damage, and, if restored, rescues retinal neurons. Our study reinforces the notion of a strong relationship between the biomechanical environment and homeostasis within the retina, which has significant bearing on pathologic events related to RRD, and may also have impact on other regions within the CNS under biomechanical influence.

  18. Surgical management of retinal diseases: proliferative diabetic retinopathy and traction retinal detachment.

    Science.gov (United States)

    Cruz-Iñigo, Yousef J; Acabá, Luis A; Berrocal, Maria H

    2014-01-01

    Current indications for pars plana vitrectomy in patients with proliferative diabetic retinopathy (PDR) include vitreous hemorrhage, tractional retinal detachment (TRD), combined tractional and rhegmatogenous retinal detachment (CTRRD), diabetic macular edema associated with posterior hyaloidal traction, and anterior segment neovascularization with media opacities. This chapter will review the indications, surgical objectives, adjunctive pharmacotherapy, microincision surgical techniques, and outcomes of diabetic vitrectomy for PDR, TRD, and CTRRD. With the availability of new microincision vitrectomy technology, wide-angle microscope viewing systems, and pharmacologic agents, vitrectomy can improve visual acuity and achieve long-term anatomic stability in eyes with severe complications from PDR. © 2014 S. Karger AG, Basel

  19. Structural recovery of the detached macula after retinal detachment repair as assessed by optical coherence tomography.

    Science.gov (United States)

    Joe, Soo Geun; Kim, Yoon Jeon; Chae, Ju Byung; Yang, Sung Jae; Lee, Joo Yong; Kim, June-Gone; Yoon, Young Hee

    2013-06-01

    To investigate correlations between preoperative and postoperative foveal microstructures in patients with macula-off rhegmatogenous retinal detachment (RRD). We reviewed the records of 31 eyes from 31 patients with macula-off RRD who had undergone successful re-attachment surgery. We analyzed data obtained from complete ophthalmologic examinations and optical coherence tomography (OCT) before and 9 to 12 months after surgery. All postoperative OCT measurements were taken with spectral-domain OCT, but a subset of preoperative OCT measurements were taken with time-domain OCT. The mean duration of macular detachment was 15.5 ± 15.2 days, and mean preoperative best-corrected visual acuity (BCVA, logarithm of the minimum angle of resolution) was 1.03 ± 0.68. Preoperative visual acuity was correlated with retinal detachment height (p macula-off duration. The final BCVA was significantly correlated with integrity of the junction between the photoreceptor inner and outer segments (IS/OS) combined with the continuity of external limiting membrane (ELM) (p = 0.025). The presence of IRS and OLU on a detached macula were highly correlated with the final postoperative integrity of the IS/OS junction and the ELM (p = 0.017). Eyes preoperatively exhibiting IRS and OLU showed a higher incidence of disruption to the photoreceptor IS/OS junction and the ELM at final follow-up. Such a close correlation between preoperative and postoperative structural changes may explain why ultimate visual recovery in such eyes is poor.

  20. The fellow eye of patients with phakic lattice retinal detachment.

    Science.gov (United States)

    Folk, J C; Arrindell, E L; Klugman, M R

    1989-01-01

    A retrospective study was performed to determine whether the prophylactic treatment of areas of lattice degeneration, holes, or breaks reduced the risk of subsequent new breaks or detachment in the fellow undetached phakic eyes of patients with a phakic lattice retinal detachment (RD). Three hundred eighty-eight consecutive patients who presented to the University of Iowa between 1959 and 1984 were followed for a mean of 7.9 +/- 5.8 years after the detachment in the first eye. Fellow eyes which received no prophylactic treatment had a 2.5 times greater risk of a new break or RD over 7 years than eyes receiving full prophylactic treatment (19.4 versus 7.5%; P = 0.0002). Fellow eyes receiving no treatment also had a greater risk of a new RD over 7 years than eyes receiving full treatment (5.1 versus 1.8%; P = 0.0125). These results do not allow us to make recommendations concerning which fellow eyes, if any, should be prophylactically treated. On the one hand, prophylactic treatment did significantly reduce the risk of new breaks and detachments. On the other hand, however, prophylactic treatment reduced the risk of new RD alone in the fellow eye only from 5.1 to 1.8% over 7 years. In addition, prophylactic treatment did not reduce the risk of detachment in the higher risk eyes with high myopia or extensive lattice.

  1. Primary rhegmatogenous retinal detachment - surgical methods and anatomical outcome.

    Science.gov (United States)

    Haugstad, Marta; Moosmayer, Stefan; Bragadόttir, Ragnheiður

    2017-05-01

    The aim of the study was to evaluate the anatomical success of surgical management of primary rhegmatogenous retinal detachment (RRD) and to compare the anatomical outcomes from different surgical techniques. During 2012, 517 consecutive eyes (514 patients) were operated by 11 surgeons at the Department of Ophthalmology, Oslo University Hospital. Patient records were retrospectively analysed with no exclusions. Main outcome measures were primary and final anatomical success. Primary anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations excluded. Final anatomical success was defined as retinal reattachment 6 months after primary surgery with reoperations included. Incidence of RRD was 18.6 eyes per 100 000 person-years. The macula was detached in 50.5% of the eyes at baseline. Of 517 operated eyes, 317 (61.3%) underwent pars plana vitrectomy (PPV), 23 (4.5%) pars plana vitrectomy together with a scleral buckle (PPV-SB), 175 (33.9%) scleral buckle (SB) surgery and two (0.4%) pneumatic retinopexy (PR). Primary anatomical success was 89.0% in the PPV group, 87.0% in the PPV-SB group and 85.7% in the SB group. Final anatomical success was 98.1% in the PPV group, 100% in the PPV-SB group and 99.4% in the SB group. Factors which were correlated to the redetachment were detachment of more than 6 clock hours (p = 0.003) and visual acuity (VA) on Snellen chart retina were large detachment and low VA. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  2. Two Cases of Rhegmatogenous Retinal Detachment Associated with Asteroid Hyalosis

    Directory of Open Access Journals (Sweden)

    Yoshitaka Okuda

    2018-01-01

    Full Text Available Background: To report two cases of rhegmatogenous retinal detachment (RRD associated with asteroid hyalosis (AH. Case Presentation: Two patients presented with RRD originating from a flap tear. Case 1 involved a 62-year-old male who was found to have bullous RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface, from the center to the periphery. A bimanual method was then used in conjunction with the vitrectomy to create an artificial posterior vitreous detachment. After surgery, the retina was successfully reattached, and his corrected visual acuity (VA improved. Case 2 involved a 70-year-old male who was found to have localized RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface. After surgery, the retina was successfully reattached, and his corrected VA improved. Conclusions: RRD associated with AH presents with stronger vitreoretinal adhesion compared to typical RRD, thus requiring a more complicated surgical technique to properly treat the patient.

  3. Extent of Detached Retina and Lens Status Influence Intravitreal Protein Expression in Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Pollreisz, Andreas; Sacu, Stefan; Eibenberger, Katharina; Funk, Marion; Kivaranovic, Danijel; Zlabinger, Gerhard J; Georgopoulos, Michael; Schmidt-Erfurth, Ursula

    2015-08-01

    The aim of the study was to compare intravitreal cytokines and chemokines to clinical parameters in patients with rhegmatogenous retinal detachment (RRD). In this prospective study vitreous samples were taken undiluted from 60 patients with RRD and 20 age-matched controls with idiopathic epiretinal membranes at the beginning of primary vitrectomy. The following clinical parameters were assessed from RRD patients prior to surgery: number of quadrants detached, RD height, lens status, symptom duration, and refractive power. Concentrations of 40 different proteins in the vitreous of RRD eyes were measured by multiplex protein array, compared with controls and correlated to clinical parameters. Ten cytokines and chemokines were significantly upregulated in the vitreous of RRD eyes compared with controls (tissue inhibitors of metalloproteinases [TIMP]-1 and -2, macrophage inflammatory protein [MIP]-1α, monocyte chemoattractant protein [MCP]-1, IL-6, and -8, inducible protein (IP)-10, brain-derived neurotrophic factor [BDNF], TGFβ-3, and platelet-derived growth factor [PDGF]-AB/BB). Linear regression analysis revealed that IL-8 and TGFβ-3 increased with the number of retinal quadrants detached, while TIMP-1 rose in eyes with greater RD heights. Concentrations of IP-10 and myeloperoxidase (MPO) peaked in eyes with two or more quadrants detached, while TIMP-2 was highest expressed in the vitreous of eyes with great RD height. In pseudophakic eyes with higher detachment height levels of vascular cell adhesion molecule (VCAM)-1 were significantly increased, while neural cell adhesion molecule (NCAM) was decreased in pseudophakic patients with shallow RD height. Extent of RRD and lens status significantly influence intravitreal proinflammatory, profibrotic, and proapoptotic protein expression. These data contribute to the fundamental understanding of pathophysiological mechanisms in RRD and may serve as a basis for development of adjunct therapeutics to facilitate

  4. Phosphorus 32P test in primary retinal detachment

    International Nuclear Information System (INIS)

    Mondelski, S.; Pytlarz, E.

    1980-01-01

    In 20 patients with primary retinal detachment the 32 P radioisotope test was performed injecting intravenously 500-750 μCi of the isotope and doing measurements with a F-Messeelektronik counter after 48 and 72 hours. The radioisotope index calculated at the site of greater detachment in 17 eye-balls in relation to the sites with apposed retina in the same eye or the other eye differed in these cases. Among the obtained results the large number of negative indices calls for attention (12 out of 17 cases) and in 2 cases the obtained values were +30 and +59 which may cause diagnostic errors in cases with suspected intraocular neoplasm. (author)

  5. Phosphorus /sup 32/P test in primary retinal detachment

    Energy Technology Data Exchange (ETDEWEB)

    Mondelski, S.; Pytlarz, E. (Akademia Medyczna, Poznan (Poland))

    1980-01-01

    In 20 patients with primary retinal detachment the /sup 32/P radioisotope test was performed injecting intravenously 500-750 ..mu..Ci of the isotope and doing measurements with a F-Messeelektronik counter after 48 and 72 hours. The radioisotope index calculated at the site of greater detachment in 17 eye-balls in relation to the sites with apposed retina in the same eye or the other eye differed in these cases. Among the obtained results the large number of negative indices calls for attention (12 out of 17 cases) and in 2 cases the obtained values were +30 and +59 which may cause diagnostic errors in cases with suspected intraocular neoplasm.

  6. Total retinal detachment occurring after minor head trauma.

    Science.gov (United States)

    Mircea, Pienaru; Ramona, Serban; Mircea, Filip; Andrei, Filip

    2015-01-01

    The objective of this article is to present the case of a patient with a severe decrease of visual acuity that occurred after an apparently minor head injury. Following the investigations, the patient was diagnosed with rhegmatogenous retinal detachment that was triggered by a fall from the same level and which occurred on a background of lattice degeneration. In this case, a minor trauma caused a severe complication because the patient had a contributing factor for the complication. The patient was operated and the end result was satisfactory.

  7. Current Understanding of the Genetic Architecture of Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Johnston, Timothy; Chandra, Aman; Hewitt, Alex W

    2016-06-01

    Rhegmatogenous retinal detachment (RRD) is a common and potentially blinding surgical retinal disease. While the precise molecular mechanisms leading to RRD are poorly understood, there is an increasing body of literature supporting the role of heritable factors in the pathogenesis of the condition. Much work has been undertaken investigating genes important in syndromic forms of RRD (e.g., Stickler, Wagner Syndrome, etc.) and research pertaining to genetic investigations of idiopathic or non-syndromic RRD has also recently been reported. To date, at least 12 genetic loci have been implicated in the development of syndromes of which RRD is a feature. A recent GWAS identified five loci implicated in the development of idiopathic RRD.This article provides an overview of the genetic mechanisms of both syndromic and idiopathic RRD. The genetics of predisposing conditions, such as myopia and lattice degeneration, are also discussed.

  8. Recovery of retinal function after recent-onset rhegmatogenous retinal detachment in relation to type of surgery.

    Science.gov (United States)

    Schatz, Patrik; Andréasson, Sten

    2010-01-01

    To investigate retinal function and structure after recent-onset rhegmatogenous retinal detachment in relation to type of surgery. Thirteen consecutive patients with rhegmatogenous retinal detachment of detached retina and fovea improved significantly at follow-up. Also similar to after scleral buckling surgery, full-field ERG rod function, combined rod-cone, and cone 30-Hz flicker amplitudes improved but significance was not reached. Full-field ERG responses remained reduced compared with normal. However, in contrast to after scleral buckling surgery, full-field ERG 30-Hz flicker implicit times were delayed at follow-up (P = 0.004), indicating a specific inner retinal dysfunction. Previously not described, significant differences were seen in the pattern of regeneration of inner retinal function after vitrectomy compared with after scleral buckling surgery for recent-onset rhegmatogenous retinal detachment.

  9. FACTORS ASSOCIATED WITH VISUAL OUTCOME AFTER MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT SURGERY.

    Science.gov (United States)

    Park, Dae Hyun; Choi, Kyung Seek; Sun, Hae Jung; Lee, Sung Jin

    2018-01-01

    To evaluate preoperative factors influencing the visual outcome and postoperative factors associated with the changes in visual acuity, after reattachment surgery to treat macula-off rhegmatogenous retinal detachment. A total of 180 eyes of 180 patients who underwent reattachment surgery to treat macula-off rhegmatogenous retinal detachment, and who were followed up for more than 12 months, were reviewed retrospectively. Preoperative and postoperative characteristics, including optical coherence tomography findings, were comprehensively analyzed using univariate and multivariate models to evaluate preoperative factors influencing best-corrected visual acuity 12 months after macula-off rhegmatogenous retinal detachment surgery and postoperative factors associated with changes in best-corrected visual acuity after surgery. Preoperatively, the extent of detachment (P = 0.037), macula-off duration (P macula-off rhegmatogenous retinal detachment surgery were the extent of detachment, macula-off duration, and external limiting membrane integrity. Postoperatively, predictive factors were the outer retinal microstructures, particularly the photoreceptor outer segment layer.

  10. TWENTY-FIVE-GAUGE PARS PLANA VITRECTOMY IN COMPLEX RETINAL DETACHMENTS ASSOCIATED WITH GIANT RETINAL TEAR.

    Science.gov (United States)

    Kumar, Vinod; Kumawat, Devesh; Bhari, Anju; Chandra, Parijat

    2018-04-01

    To study the structural and functional outcomes of 25-gauge pars plana vitrectomy in giant retinal tear-associated retinal detachments. Seventeen eyes of 17 patients with giant retinal tear, who underwent 25-gauge pars plana vitrectomy over a period of 15 months at a tertiary eye care center by a single surgeon, were recruited in this retrospective interventional study. Giant retinal tears were mostly traumatic (35.3%) or associated with myopia (35.3%) and occurred in young (mean age 25.7 years) males (94.1%). Most eyes had best-corrected visual acuity ≤20/1,200 (in 82.3%), foveal detachment (in 88.2%), and proliferative vitreoretinopathy ≤Grade B (in 82.3%). The giant retinal tear extent was more than 180° in 29.4% and the fellow eye was involved in 35.2% of eyes. All eyes underwent 25-gauge pars plana vitrectomy with encircling band in 41.1%, perfluorocarbon liquid use in 82.3%, and endotamponade with sulphur hexafluoride (23.6%) or silicone oil (76.4%). At mean follow-up of 10.2 months, reattachment rate was 88.2%. Only 35.2% of eyes achieved final visual acuity ≥20/80 with a cause of poor vision being cataract, secondary glaucoma, macular pucker, and corneal edema. Twenty-five-gauge pars plana vitrectomy can achieve excellent attachment rates in eyes with giant retinal tear-associated retinal detachment. It can be as efficient as larger-gauge vitrectomy, at the same time retaining all advantages of smaller-gauge surgery.

  11. Retinal Detachment Due to Retinal Dialysis: Surgical Outcome After Scleral Buckling.

    Science.gov (United States)

    Jan, Sanaullah; Hussain, Zakir; Khan, Umer; Khan, Mohammad Tariq; Karim, Samina

    2015-01-01

    The aim of this study was to determine the efficacy and safety of scleral buckling surgery in retinal detachment due to retinal dialysis. This study was a prospective, interventional case series. A total of 48 eyes of 48 consecutive patients were included after obtaining informed written consent. Besides taking a thorough history, all eyes were examined by a retinal surgeon. The macula status, site, and extent of retinal dialysis and rhegmatogenous retinal detachment (RRD) were particularly noted. Proliferative vitreoretinopathy grading was done. Buckling was performed by a single surgeon. At every follow-up, visual acuity, intraocular pressure, retina status, and buckle position were noted. Any complication found was recorded. Follow-up was done for at least 6 months. SPSS version 16 was used for data analysis. We included 48 cases of RRD due to retinal dialysis. The mean ± SD age of the patients was 26.85 ± 15.1 years. The macula was detached in 85.4% of the cases, and proliferative vitreoretinopathy grade C was found in 25% of the cases. A surgical reattachment rate of 95.8% was attained after a single primary buckling procedure. Final Snellen best-corrected visual acuity of 6/18 or better was attained in 12.5% of the cases. However, 62.5% of the cases had best-corrected visual acuity in the range of 6/24 to 6/60. Subretinal hemorrhage occurred in 8.3% of cases intraoperatively after subretinal fluid drainage. We conclude that scleral buckling has a definite role in the management of RRD due to retinal dialysis.

  12. Glaucoma associated with the management of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Mangouritsas G

    2013-04-01

    Full Text Available George Mangouritsas, Spyridon Mourtzoukos, Dimitra M Portaliou, Vassilios I Georgopoulos, Anastasia Dimopoulou, Elias Feretis Eye Clinic, General Hospital "Hellenic Red Cross", Athens, Greece Abstract: Transient or permanent elevation of intraocular pressure (IOP is a common complication following vitreoretinal surgery. Usually secondary glaucoma, which develops after scleral buckling procedures, or pars plana vitrectomy for repair of rhegmatogenous retinal detachment, is of multifactorial origin. It is essential, for appropriate management, to detect the cause of outflow obstruction. An exacerbation of preexisting open-angle glaucoma or a steroid-induced elevation of IOP should also be considered. Scleral buckling may be complicated by congestion and anterior rotation of the ciliary body resulting in secondary angle closure, which can usually resolve with medical therapy. The use of intravitreal gases may also induce secondary angle-closure with or without pupillary block. Aspiration of a quantity of the intraocular gas may be indicated. Secondary glaucoma can also develop after intravitreal injection of silicone oil due to pupillary block, inflammation, synechial angle closure, or migration of emulsified silicone oil in the anterior chamber and obstruction of the aqueous outflow pathway. In most eyes medical therapy is successful in controlling IOP; however, silicone oil removal with or without concurrent glaucoma surgery may also be required. Diode laser transscleral cyclophotocoagulation and glaucoma drainage devices constitute useful treatment modalities for long-term IOP control. Cooperation between vitreoretinal and glaucoma specialists is necessary to achieve successful management. Keywords: retinal detachment, intraocular pressure elevation, glaucoma, vitrectomy, intravitreal gas, silicone oil

  13. Evolution of outer retinal folds occurring after vitrectomy for retinal detachment repair.

    Science.gov (United States)

    dell'Omo, Roberto; Tan, H Stevie; Schlingemann, Reinier O; Bijl, Heico M; Lesnik Oberstein, Sarit Y; Barca, Francesco; Mura, Marco

    2012-12-03

    To assess the evolution of outer retinal folds (ORFs) occurring after repair of rhegmatogenous retinal detachment (RRD) using spectral domain-optical coherence tomography (sd-OCT) and fundus autofluorescence (FAF), and to discuss their pathogenesis. Twenty patients were operated on with 25-gauge pars plana vitrectomy and 20% sulfur hexafluoride gas injection for primary macula-off RRD repair and were followed prospectively. Sd-OCT and FAF images were recorded at 1, 3 and 6 months postoperatively. ORFs appeared on sd-OCT as hyperreflective lesions consisting of folded inner segment/outer segment of photoreceptors band and external limiting membrane band. Corresponding lines of increased or decreased autofluorescence were observed on FAF. Over the follow-up, the thick hypoautofluorescent lines progressively evolved to thick hyperautofluorescent lines and to thin hyperautofluorescent lines and eventually disappeared. Concomitantly, OCT scans revealed that the corresponding hyperreflective lesions decreased in number, height, and size. In six cases FAF assessment at month 6 was precluded by cataract development. ORFS tend to resolve spontaneously within a few months from operation leaving no or subtle abnormalities at the level of the outer retinal layers. OCT is superior to FAF to follow the evolution of orfs in phakic eyes. The following factors might be involved in ORFS pathogenesis: structural changes occurring in the detached retina, residual pockets of subretinal fluid after retinal reattachment, intravitreal gas, unintentional retinal translocation, and intraoperative or perioperative hypotony.

  14. Retrospective Review of Ocular Point-of-Care Ultrasound for Detection of Retinal Detachment

    Science.gov (United States)

    Jacobsen, Bradley; Lahham, Sari; Lahham, Shadi; Patel, Amy; Spann, Sophia; Fox, John C.

    2016-01-01

    Introduction Retinal detachment is an ocular emergency that commonly presents to the emergency department (ED). Ophthalmologists are able to accurately make this diagnosis with a dilated fundoscopic exam, scleral depression or ophthalmic ultrasound when a view to the retina is obstructed. Emergency physicians (EPs) are not trained to examine the peripheral retina, and thus ophthalmic ultrasound can be used to aid in diagnosis. We assessed the accuracy of ocular point-of-care ultrasound (POCUS) in diagnosing retinal detachment. Methods We retrospectively reviewed charts of ED patients with suspected retinal detachment who underwent ocular POCUS between July 2012 and May 2015. Charts were reviewed for patients presenting to the ED with ocular complaints and clinical concern for retinal detachment. We compared ocular POCUS performed by EPs against the criterion reference of the consulting ophthalmologist’s diagnosis. Results We enrolled a total of 109 patients. Of the 34 patients diagnosed with retinal detachment by the ophthalmologists, 31 were correctly identified as having retinal detachment by the EP using ocular POCUS. Of the 75 patients who did not have retinal detachment, 72 were ruled out by ocular POCUS by the EP. This resulted in a POCUS sensitivity of 91% (95% CI [76–98]) and specificity of 96% (95% CI [89–99]). Conclusion This retrospective study suggests that ocular POCUS performed by EPs can aid in the diagnosis of retinal detachment in ED. PMID:26973752

  15. Retrospective Review of Ocular Point-of-Care Ultrasound for Detection of Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Bradley Jacobsen, BS

    2016-03-01

    Full Text Available Introduction: Retinal detachment is an ocular emergency that commonly presents to the emergency department (ED. Ophthalmologists are able to accurately make this diagnosis with a dilated fundoscopic exam, scleral depression or ophthalmic ultrasound when a view to the retina is obstructed. Emergency physicians (EPs are not trained to examine the peripheral retina, and thus ophthalmic ultrasound can be used to aid in diagnosis. We assessed the accuracy of ocular point-ofcare ultrasound (POCUS in diagnosing retinal detachment. Methods: We retrospectively reviewed charts of ED patients with suspected retinal detachment who underwent ocular POCUS between July 2012 and May 2015. Charts were reviewed for patients presenting to the ED with ocular complaints and clinical concern for retinal detachment. We compared ocular POCUS performed by EPs against the criterion reference of the consulting ophthalmologist’s diagnosis. Results: We enrolled a total of 109 patients. Of the 34 patients diagnosed with retinal detachment by the ophthalmologists, 31 were correctly identified as having retinal detachment by the EP using ocular POCUS. Of the 75 patients who did not have retinal detachment, 72 were ruled out by ocular POCUS by the EP. This resulted in a POCUS sensitivity of 91% (95% CI [76-98] and specificity of 96% (95% CI [89-99]. Conclusion: This retrospective study suggests that ocular POCUS performed by EPs can aid in the diagnosis of retinal detachment in ED.

  16. Surgical challenges and outcomes of rhegmatogenous retinal detachment in albinism.

    Science.gov (United States)

    Sinha, M K; Chhablani, J; Shah, B S; Narayanan, R; Jalali, S

    2016-03-01

    To report the outcomes and surgical difficulties during rhegmatogenous retinal detachment (RRD) repair in patients with albinism. Retrospective analysis of 10 eyes of 9 patients with albinism that underwent RRD repair was performed. Collected data included demographic details, preoperative examination details, surgical procedure, surgical difficulties, anatomical, and visual outcomes. Outcome measures were retinal reattachment and visual acuity at the last follow-up. Mean preoperative best-corrected visual acuity (BCVA) was logMAR (Logarithm of the Minimum Angle of Resolution) 2.15 (range 0.9-3.0) with preoperative localization of causative break in six eyes. One eye had proliferative vitreoretinopathy grade C1 preoperatively. Four eyes underwent scleral buckling (SB) and six underwent 20G pars plana vitrectomy (PPV) with silicone oil injection. Intraoperative complication as iatrogenic retinal break occurred in four eyes. For retinopexy during vitrectomy, endolaser delivery was possible in three out of six eyes, whereas three eyes had cryopexy. The mean follow-up was 12 months in SB group (range 1-12; median 12 months) and 5.33 months (range 1-12; median 3 months) in PPV group. Among vitrectomized eye, two eyes had recurrence at 3 months with oil in situ. Rest of the eyes had attached retina at last follow-up. Mean BCVA at last follow-up was logMAR -1.46 (range 0.7-2.0) with mean improvement of -0.57 logMAR. Identification of break, induction of posterior vitreous detachment, and endolaser delivery may be difficult during RRD repair in patients with albinism. The incidence of PVR appeared less in these eyes. Both SB and PPV were efficacious and appear to be good surgical techniques for use in this patient population.

  17. EARLY SIMULTANEOUS FUNDUS AUTOFLUORESCENCE AND OPTICAL COHERENCE TOMOGRAPHY FEATURES AFTER PARS PLANA VITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT

    NARCIS (Netherlands)

    Dellʼomo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y.; Bijl, Heico; Tan, H. Stevie

    2012-01-01

    Purpose: To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Methods: Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the

  18. Phakic retinal detachment associated with atrophic hole of lattice degeneration of the retina.

    Science.gov (United States)

    Murakami-Nagasako, F; Ohba, N

    1983-01-01

    Forty patients with phakic nontraumatic retinal detachment caused by atrophic retinal hole of lattice degeneration were reviewed. The condition was characterized by insidious, slowly developing shallow detachment, with frequent formation of demarcation lines. Often, the patients did not recognize their visual problems until the detachment had extended to the macular region. Young patients under 40 years of age were more common than older patients. Myopic refractive errors were frequently associated. The results of surgical repair were favorable. The risk of retinal detachment in lattice degeneration with atrophic holes was estimated to be about 1 in 90 patients, and prophylactic treatment for this common anomaly is not readily recommended.

  19. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment

    Directory of Open Access Journals (Sweden)

    Yasser Helmy Mohamed

    2016-01-01

    Full Text Available Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV after primary rhegmatogenous retinal detachment (RRD. Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA. The primary outcome measures were anatomical (primary and final and functional success (visual acuity better than 6/60. Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7±11.2 years. The single-operation reattachment rate (primary anatomical success was 89.8%. The final anatomical success rate was 100% after 2–6 operations (mean = 3.14±1.03. Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P=0.002 and the presence of multiple tears (P=0.01. Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

  20. Success Rates of Vitrectomy in Treatment of Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Mohamed, Yasser Helmy; Ono, Kozue; Kinoshita, Hirofumi; Uematsu, Masafumi; Tsuiki, Eiko; Fujikawa, Azusa; Kitaoka, Takashi

    2016-01-01

    Aim. To investigate the anatomical success rates of pars plana vitrectomy (PPV) after primary rhegmatogenous retinal detachment (RRD). Methods. This retrospective study was conducted between December 2008 and October 2014 at Nagasaki University Hospital. The preoperative data recorded included the lens status, location of the retinal tear, whether a tear was visualized, presence of multiple tears, macula status, presence of peripheral lattice retinal degeneration, and best-corrected visual acuity (BCVA). The primary outcome measures were anatomical (primary and final) and functional success (visual acuity better than 6/60). Results. This study evaluated 422 eyes of 411 patients with a mean age of 57.7 ± 11.2 years. The single-operation reattachment rate (primary anatomical success) was 89.8%. The final anatomical success rate was 100% after 2-6 operations (mean = 3.14 ± 1.03). Functional success rate after the primary reattachment operation was 96.7%, while it was 97.2% at the end of the follow-up. Multiple logistic regression analysis of the possible risk factors for the primary anatomical failure showed a significant relation with the 25 G instruments (P = 0.002) and the presence of multiple tears (P = 0.01). Conclusion. The primary anatomical success of PPV for primary uncomplicated RRD was 89.8% and the final anatomical success rate was 100%.

  1. Rhegmatogenous retinal detachment in an eye of retinoblastoma treated by radiation and cryocoagulation

    International Nuclear Information System (INIS)

    Inoue, Makoto; Tanaka, Yasuhiko; Kawai, Masataka; Nii, Seiji; Katsura, Hiroshi; Kaneko, Akihiro

    1999-01-01

    A 4-month-old female infant was diagnosed as bilateral retinoblastoma. The left eye was treated by enucleation and the right by radiation. The right eye received repeated thermochemotherapy, cryocoagulation and photocoagulation for recurrence. Total retinal detachment was detected after surgery for complicated cataract at the age of 2 years 9 months. Vitreous surgery led to the detection of posterior vitreous detachment and retinal breaks in the coagulated scar areas with vitreoretinal adhesion around the calcified tumor. During the following one year, the retina has been attached with no reoccurrence of the tumor. This case illustrates that rhegmatogenous retinal detachment is a possibility in retinoblastoma treated by radiation or retinal coagulations. (author)

  2. Rhegmatogenous retinal detachment in an eye of retinoblastoma treated by radiation and cryocoagulation

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Makoto; Tanaka, Yasuhiko; Kawai, Masataka; Nii, Seiji [Keio Univ., Tokyo (Japan). School of Medicine; Katsura, Hiroshi; Kaneko, Akihiro

    1999-08-01

    A 4-month-old female infant was diagnosed as bilateral retinoblastoma. The left eye was treated by enucleation and the right by radiation. The right eye received repeated thermochemotherapy, cryocoagulation and photocoagulation for recurrence. Total retinal detachment was detected after surgery for complicated cataract at the age of 2 years 9 months. Vitreous surgery led to the detection of posterior vitreous detachment and retinal breaks in the coagulated scar areas with vitreoretinal adhesion around the calcified tumor. During the following one year, the retina has been attached with no reoccurrence of the tumor. This case illustrates that rhegmatogenous retinal detachment is a possibility in retinoblastoma treated by radiation or retinal coagulations. (author)

  3. Vitrectomy, lensectomy and silicone oil tamponade in the management of retinal detachment associated with choroidal detachment

    Directory of Open Access Journals (Sweden)

    Jian-Di Liu

    2013-06-01

    Full Text Available AIM: To report the results of combined vitrectomy, lensectomy and silicone oil (SO tamponade in treating primary rhegmatogenous retinal detachment (RRD associated with choroidal detachment (CD.METHODS: A retrospective, consecutive and case series study of 21 subjects with concurrent RRD associated with CD was conducted. All subjects underwent a standard three-port 20G pars plana vitrectomy (PPV with lensectomy and silicone oil tamponade. Mean follow-up time was 8 months (rang from 4 to 19 months. The primary and final anatomic success rate, visual acuity and final intraocular pressure(IOP were recorded and analyzed.RESULTS: Of 21 subjects, 8 were women and 13 were men. Age at presentation ranged from 22 to 75 years (mean 57.4 years. The presenting vision ranged from light perception to 0.15. The initial IOP ranged from 3mmHg to 12mmHg (mean 6.2mmHg. All eyes were phakic except one pseudophakic. No intraocular lens was implanted during the primary surgical intervention. Fifteen of 21 (71.4% eyes had retina reattached after one operation. Six eyes had recurrent inferior retinal detachment due to proliferation. Five of them were successfully reattached after one or more additional operations. Mean IOP at final follow-up was 15.2mmHg (range from 8mmHg to 20mmHg. One case declined for further operation. The final reattachment rate was 95.2%. Visual acuity improved in 19 (90.5% eyes, was unchanged in 1 (4.8% eye and decreased in 1 (4.8% eye.CONCLUSION: Combination of vitrectomy, lensectomy and silicone tamponade is an effective method in treating RRD associated with CD, reducing the incidence of postoperative hypotony.

  4. Cost-Utility of Evaluation for Posterior Vitreous Detachment and Prophylaxis of Retinal Detachment.

    Science.gov (United States)

    Yannuzzi, Nicolas A; Chang, Jonathan S; Brown, Gary C; Smiddy, William E

    2018-01-01

    To evaluate the costs and cost-utility of examination for posterior vitreous detachment (PVD) and treatment of associated pathology, and of managing various other peripheral retinal disorders to prevent retinal detachment (RD). A decision analysis model of cost-utility. There were no participants. Published retrospective data on the natural course of PVD, retinal tears, and lattice degeneration were used to quantitate the visual benefits of examination and treatment. Center for Medicare and Medicaid Services data were used to calculate associated modeled costs in a hospital/facility-based and nonfacility/ambulatory surgical center (ASC)-based setting. Published standards of utility for a given level of visual acuity were used to derive costs and quality-adjusted life years (QALYs). Cost of evaluation and treatment, utility of defined health states, QALY, and cost per QALY. The modeled cost of evaluation of a patient with PVD and treatment of associated pathology in the facility/hospital (nonfacility/ASC)-based setting was $65 to $190 ($25-$71) depending on whether a single or 2-examination protocol was used. The cost per QALY saved was $255 to $638/QALY ($100-$239/QALY). Treatment of a symptomatic horseshoe tear resulted in a net cost savings of $1749 ($1314) and improved utility, whereas treatment of an asymptomatic horseshoe tear resulted in $2981/QALY ($1436/QALY). Treatment of asymptomatic lattice degeneration in an eye in which the fellow eye had a history of RD resulted in $4414/QALY ($2187/QALY). Evaluation and management of incident acute PVD (and symptomatic horseshoe tears) offer a low cost and a favorable cost-utility (low $/QALY) as a result of the minimization of the cost and morbidity associated with the development of RD, thus justifying current practice standards. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  5. Post-operative hospitalization in retinal detachment correlation to recurrences

    Directory of Open Access Journals (Sweden)

    Enzo Maria Vingolo

    2013-12-01

    Full Text Available PURPOSE: To evaluate relationships between the incidence of re-detachment and postoperative days of hospitalization in patients with diagnosis of retinal detachment (RD who underwent surgery either through ab-externo approach (scleral buckling and encircling or ab-interno approach (vitrectomy and oil-gas tamponade. METHODS: This retrospective study included 268 patients (268 eyes with diagnosis of primary RD: 127 males (47% and 141 (53% females, mean age of 64.1 ± 17.3 years. 46 patients (17% underwent a surgical ab-externo approach (group A, while 222 patients (83% underwent an ab-interno surgical approach. Each RD was graded according to the "Retinal detachment grading system of Royal College of Ophthalmologists" and treated within 5 days after diagnosis. The redetachment (RT related to a surgical failure was considered within 30 days after first operation. RESULTS: In the group 1 without night hospitalization (day surgery global RT rate was 3.5% (4.17% for ab-interno technique and 0% for ab-externo techniques. In the group 2 with one day of hospitalization global RT rate was 1.33% (1.49% for ab-interno technique and 0% for ab-externo techniques. In the group 3 with 2 days of hospitalization global RT rate was 3.80% (4.62% for ab-interno techniques and 0% for ab-externo techniques. In the group 4 with 3 or more days of hospitalization global RT rate was 12.28% (14.29% for ab-interno techniques for 6.67% ab-externo techniques. The incidence of RT in group 1, day surgery, is comparable to the other groups and it is less compared to group 4 (3 or more days of hospitalization. CONCLUSIONS: The incidence of retinal redetachment (RRD is not increased in day surgery mode. These data support outpatient management of RD patients to reduce medical cost and problems related to the hospitalization. Further studies are needed for patients' security.

  6. A rare case of bilateral tractional retinal detachment following snakebite

    Directory of Open Access Journals (Sweden)

    Nicey Roy Thomas

    2017-01-01

    Full Text Available A 13-year-old female presented with diminution of vision in both eyes for 3 months following snakebite. Best-corrected visual acuities were hand movement in both eyes. Fundoscopy showed vitreous hemorrhage, and B-scan ultrasonography revealed an underlying tractional retinal detachment (TRD involving the macula in both eyes. Patient underwent 25-gauge pars plana vitrectomy in conjunction with belt buckling, endolaser, and silicone oil tamponade in the left eye. At 6 weeks postoperatively, best-corrected visual acuity of the left eye was noted to be 20/200 with settled TRD and attached retina. Bilateral proliferative retinopathy with TRD is a hitherto unreported complication of snake bite.

  7. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy.

    Science.gov (United States)

    Schwartz, Stephen G; Flynn, Harry W; Lee, Wen-Hsiang; Ssemanda, Elizabeth; Ervin, Ann-Margret

    2009-10-07

    Retinal detachment (RD) with proliferative vitreoretinopathy (PVR) often requires surgery. During surgery, a tamponade agent is needed to reduce the rate of recurrent retinal detachment. The objective of this review was to evaluate the benefits and adverse outcomes of surgery with various tamponade agents. We searched the Cochrane Controlled Register (CENTRAL), MEDLINE, EMBASE, Latin America and Carribbean Health Sciences (LILACS) and the UK Clinical Trials Gateway (UKCTG). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 9 July 2009. We included randomized clinical trials comparing patients treated with various tamponade agents. Two individuals screened the search results independently. One study with two trials was eligible for inclusion in the review. One study with two trials was included in the review. The first trial randomized 151 eyes to receive either silicone oil or sulfur hexafluoride (SF(6)) gas tamponades; the second trial randomized 271 eyes to receive either silicone oil or perfluropropane (C(3)F(8)) gas tamponades. In patients with RD associated with PVR, pars plana vitrectomy and infusion of either silicone oil or perfluropropane gas appear comparable for a broad variety of cases. Sulfur hexafluoride gas was associated with worse anatomic and visual outcomes than either silicone oil or perfluropropane gas. The use of either C(3)F(8) or silicone oil appears reasonable for most patients with RD associated with PVR. Because there do not appear to be any major differences in outcomes between the two agents, the choice of a tamponade agent should be individualized for each patient.

  8. Peripheral Retinal Vascular Patterns in Patients with Rhegmatogenous Retinal Detachment in Taiwan

    Science.gov (United States)

    Chen, San-Ni; Hwang, Jiunn-Feng; Wu, Wen-Chuan

    2016-01-01

    This is an observational study of fluorescein angiography (FA) in consecutive patients with rhegmatogenous retinal detachment (RRD) in Changhua Christian Hospital to investigate the peripheral retinal vascular patterns in those patients. All patients had their age, sex, axial length (AXL), and refraction status (RF) recorded. According to the findings in FA of the peripheral retina, the eyes were divided into 4 groups: in group 1, there was a ramified pattern of peripheral retinal vasculature with gradual tapering; in group 2, there was an abrupt ending of peripheral vasculature with peripheral non-perfusion; in group 3, there was a curving route of peripheral vasculature forming vascular arcades or anastomosis; and in group 4, the same as in group 3, but with one or more wedge-shaped avascular notches. Comparisons of age, sex, AXL, and RF, association of breaks with lattice degeneration and retinal non-perfusion, surgical procedures utilized, and mean numbers of operations were made among the four groups. Of the 73 eyes studied, there were 13 eyes (17.8%) in group 1, 3 eyes (4.1%) in group 2, 40 eyes (54.8%) in group 3 and 17 eyes (23.3%) in group 4. Significant differences in age, AXL and RF, and association of retinal breaks to non-perfusion were noted among the four groups. Patients in group 1 had older ages, while younger ages were noted in groups 3 and 4. Eyes in group 1 had the shortest average AXL and were least myopic in contrast to the eyes in groups 3 and 4. Association of retinal breaks and retinal non-perfusion was significantly higher in groups 2, 3 and 4 than in group 1. In conclusion, peripheral vascular anomalies are common in cases with RRD. Patients with peripheral non-perfusion tend to be younger, with longer axial length and have the breaks associated with retinal non-perfusion. PMID:26909812

  9. Peripheral Retinal Vascular Patterns in Patients with Rhegmatogenous Retinal Detachment in Taiwan.

    Directory of Open Access Journals (Sweden)

    San-Ni Chen

    Full Text Available This is an observational study of fluorescein angiography (FA in consecutive patients with rhegmatogenous retinal detachment (RRD in Changhua Christian Hospital to investigate the peripheral retinal vascular patterns in those patients. All patients had their age, sex, axial length (AXL, and refraction status (RF recorded. According to the findings in FA of the peripheral retina, the eyes were divided into 4 groups: in group 1, there was a ramified pattern of peripheral retinal vasculature with gradual tapering; in group 2, there was an abrupt ending of peripheral vasculature with peripheral non-perfusion; in group 3, there was a curving route of peripheral vasculature forming vascular arcades or anastomosis; and in group 4, the same as in group 3, but with one or more wedge-shaped avascular notches. Comparisons of age, sex, AXL, and RF, association of breaks with lattice degeneration and retinal non-perfusion, surgical procedures utilized, and mean numbers of operations were made among the four groups. Of the 73 eyes studied, there were 13 eyes (17.8% in group 1, 3 eyes (4.1% in group 2, 40 eyes (54.8% in group 3 and 17 eyes (23.3% in group 4. Significant differences in age, AXL and RF, and association of retinal breaks to non-perfusion were noted among the four groups. Patients in group 1 had older ages, while younger ages were noted in groups 3 and 4. Eyes in group 1 had the shortest average AXL and were least myopic in contrast to the eyes in groups 3 and 4. Association of retinal breaks and retinal non-perfusion was significantly higher in groups 2, 3 and 4 than in group 1. In conclusion, peripheral vascular anomalies are common in cases with RRD. Patients with peripheral non-perfusion tend to be younger, with longer axial length and have the breaks associated with retinal non-perfusion.

  10. Macula-Sparing rhegmatogenous retinal detachment: Is emergent surgery necessary?

    Directory of Open Access Journals (Sweden)

    Sasan Mahmoudi

    2016-01-01

    Full Text Available The status of the macula is a significant factor in determining final visual outcomes in rhegmatogenous retinal detachment (RRD and should be considered in the timing of surgical repair. Several studies have shown that macula-involving RRDs attain similar visual and anatomic outcomes when surgery is performed within seven days as compared to emergent surgery (within 24 hours. In contrast, surgery prior to macular detachment in macula-sparing RRDs generally yields the best visual outcomes. In the case of macula-sparing RRDs, it is not clear how long the macula may remain attached, therefore, standard practice dictates emergent surgery. Timing of presentation, examination findings, case complexity, co-existing medical conditions, surgeon expertise, and timing and quality of access to operating facilities and staff, however, should all be considered in determining whether a macula-sparing RRD requires immediate intervention or if equivalent visual and possibly better overall outcomes can be achieved with scheduled surgery within an appropriate time frame.

  11. Vitreous Microparticle Shedding in Retinal Detachment: A Prospective Comparative Study.

    Science.gov (United States)

    Tumahai, Perle; Saas, Philippe; Ricouard, Fanny; Biichlé, Sabéha; Puyraveau, Marc; Laheurte, Caroline; Delbosc, Bernard; Saleh, Maher

    2016-01-01

    Microparticles (MPs) are membrane-derived vesicles measuring less than 1 μm in diameter. They are shed from nearly every activated or preapoptotic cell and may exhibit biologic activities in inflammation or apoptosis settings. The main purpose of this study was to determine whether MP shedding was higher in the vitreous of patients with retinal detachment (RD). This was a prospective, comparative study. Levels of vitreous MPs (including phosphatidylserine [PS]-expressing MPs, photoreceptor cell-derived MPs, and photoreceptor cell-derived MPs expressing PS) and soluble proinflammatory factors (i.e., monocyte chemoattractant protein-1, intercellular adhesion molecule-1, and IL-6) were analyzed by flow cytometry. Samples were obtained from 49 eyes undergoing RD surgery and 41 control eyes. Vitreous levels of all the MPs studied were significantly increased in the RD group. Vitreous MP levels were correlated with levels of at least one proinflammatory factor depending on MP subsets. Concerning clinical parameters, vitreous PS-expressing MP and PS-expressing photoreceptor cell-derived MP levels were higher depending on the duration of RD at surgery, the detached retina surface, and the macula status and were found more sensitive than proinflammatory factors only for the duration of RD at surgery. Vitreous concentrations of MPs (mainly derived from photoreceptor cells) are higher after rhegmatogenous RD and found to be correlated with soluble proinflammatory factors.

  12. The Development of a Cat Model of Retinal Detachment and Re-attachment.

    Science.gov (United States)

    Wassmer, Sarah; Leonard, Brian C; Coupland, Stuart G; Baker, Adam; Hamilton, John; Torlone, Renée; Zacks, David N; Tsilfidis, Catherine

    2016-01-01

    We present an optimized surgical technique for feline retinal detachment which allows for natural re-attachment, reduces retinal scarring and vitreal bands, and allows central placement of the detachment in close proximity to the optic nerve. This enables imaging via Optical Coherence Tomography (OCT) and multifocal electroretinography (mfERG) analysis. Ideal detachment conditions involve a lensectomy followed by a three-port pars plana vitrectomy. A 16-20 % retinal detachment is induced by injecting 8 % C3F8 gas into the subretinal space in the central retina with a 42G cannula. The retinal detachment resolves approximately 6 weeks post-surgery. Imaging is enhanced by using a 7.5 and 20 diopter lens for OCT and mfERG fundus imaging, respectively, to compensate for the removed lens.

  13. Silicone oil removal after rhegmatogenous retinal detachment: comparing techniques.

    Science.gov (United States)

    Tan, H S; Dell'omo, R; Mura, M

    2012-03-01

    To assess the outcome of silicone oil removal after rhegmatogenous retinal detachment (RRD) surgery, and to compare results of a two-port (infusion-extraction) versus a three-port (full vitrectomy) approach. Primary outcome measure was the rate of redetachment. Secondary outcome measures were visual acuity, rate of intraoperative and postoperative epiretinal membrane removal and complications. We included 147 consecutive cases. There were 15 cases of giant retinal tear, 26 cases of RRD without proliferative vitreoretinopathy (PVR) and 106 cases of RRD with PVR. The overall redetachment rate after silicone oil removal was 17.7%. In the group treated with the two-port technique (n=95), the retina redetached in 16 cases (16.8%), and in the group treated with the three-port technique (n=52), redetachment occurred in 10 cases (19.2%). This difference was not statistically significant (P=0.717; χ (2)-test). There was a significantly higher redetachment rate in cases with a short oil tamponade duration of <2 months. We reconfirm a relatively high redetachment rate after silicone oil removal. The risk of redetachment is not lower with the three-port compared with the two-port approach.

  14. Vitrectomy combined with periocular/intravitreal injection of steroids for rhegmatogenous retinal detachment associated with choroidal detachment.

    Science.gov (United States)

    Wei, Yong; Wang, Ningli; Chen, Fenghua; Wang, Huaizhou; Bi, Chuncao; Zu, Zhongqiao; Yang, Xingguang

    2014-01-01

    To study the anatomical outcome of rhegmatogenous retinal detachment combined with choroidal detachment after pars plana vitrectomy with periocular/intravitreal injection of steroids. Seventy-seven eyes that have rhegmatogenous retinal detachment combined with choroidal detachment were treated by pars plana vitrectomy with oral prednisolone (Group A) or periocular/intravitreal injection of steroids (Group B) and then divided into 5 subgroups according to different intraocular tamponade agents; Group A1: oral steroids and silicone oil, Group A2: oral steroids and C(3)F(8), Group B1: periocular/intravitreal steroid injections and silicone oil, Group B2: periocular steroid injection and silicone oil, and Group B3: periocular steroid injection and C(3)F(8). Anatomical reattachment of the retina was measured at 12 months after surgery. There was no significant difference in retinal reattachment rate between eyes in Group A and eyes in Group B (77.4% vs. 73.9%, P = 0.726). The retinal reattachment rates were 83.3% in Group A1, 69.2% in Group A2, 82.4% in Group B1, 73.3% in Group B2, and 64.3% in Group B3. There was no statistical difference in the retinal reattachment rates between any of the groups. For the treatment of rhegmatogenous retinal detachment combined with choroidal detachment, pars plana vitrectomy with periocular/intravitreal corticosteroids was comparable in reattachment rate to pars plana vitrectomy with systemic steroids, suggesting an acceptable alternative for patients with this condition who cannot tolerate systemic steroids.

  15. Characteristics of rhegmatogenous retinal detachment and their relationship to success rates of surgery.

    Science.gov (United States)

    Williamson, Tom H; Lee, Edward J K; Shunmugam, Manoharan

    2014-07-01

    To determine features of rhegmatogenous retinal detachment predictive of anatomical success with surgical procedure. All patients undergoing surgery at a tertiary referral practice had contemporaneous data collection in an electronic database. Overall, 847 eyes from 847 patients undergoing surgical procedure for rhegmatogenous retinal detachment were included in this study. Mean age was 62.2 years with 60% male subjects and 56% right eyes. Mean postoperative follow-up was 9.6 months (range, 6 weeks to 10 years). With univariate analysis, the presence of superotemporal breaks was associated with a reduction in the chance of failed primary surgery (P = 0.005); detached inferonasal breaks (P = 0.002), proliferative vitreoretinopathy (PVR) (P detached inferior retina (P detachment (P detached inferior breaks, increased number of breaks, and 4-quadrant detachment remained associated with an increased risk of failure, and superotemporal detached breaks with the reduced risk of failure (r(2) = 0.08). For patients without PVR, only inferonasal detached breaks and 3 to 4 quadrants of detachment remained predictive of failure (r(2) = 0.04). For patients with PVR (n = 120), multivariate analysis showed that PVR C4-12 and posterior breaks increased the failure risk and detached superotemporal breaks reduced the risk of failure (r(2) = 0.22). Number of breaks, inferior positioning of breaks, the extent of rhegmatogenous retinal detachment, and PVR are associated with failed primary surgery.

  16. [Stickler's syndrome (dystrophia vitreoretinalis hereditaria). Results of surgery for retinal detachment].

    Science.gov (United States)

    Karel, I; Dolezalová, J; Oudová, P

    2001-05-01

    Stickler's syndrome (SS) is an autosomal dominant hereditary disease of the collagenous connective tissue where impaired development of the vitreous body gel and peripheral retina and detachment of the retina are associated with general manifestations. The objective of the retrospective study was to evaluate the long-term results of surgery of retinal detachment in SS. The group of patients comprised 7 patients, 6 men and 1 woman aged 4 to 45 years, average age 16.8 years. Autosomal dominant heredity was obvious in 6 members (85.7%) of two families. General manifestations of SS included abnormalities of the facial skeleton (6 patients), cleft palate (4 patients), impaired hearing (2 patients), marfanoid habitus (2 patients) and hyperextensibility of the joints (4 patients). In the eyes with SS was manifested by myopia from -1 to -9 D and a liquid vitreous body. Multiple foci of lattice degeneration supplemented the finding in 6 patients (85.7%). Detachment of the retina was a manifestation of SS in 12 of 14 eyes (85.7%). It was manifested in 5 of 7 patients concurrently or within 12 years in both eyes. The causes of retinal detachment were multiple equatorial and postequatorial tears due to lattice degeneration in 8 eyes (66.7%) or a giant tear in 4 eyes (33.3%). Advanced proliferative vitreoretinopathy (PVR) was associated with retinal detachment in 8 eyes (66.7%) and in 6 eyes (50%) it was not possible to assess the beginning of retinal detachment. In 3 of 5 patients with bilateral retinal detachment the adverse course of retinal detachment on the first eye was followed 8 to 12 years previously in another department: two retinal detachments with giant tears were evaluated as inoperable and one inveterated detachment with advanced PVR was operated unsuccessfully. Retinal detachment was operated in 9 eyes of 7 patients, in two patients both eyes were operated simultaneously. The patients were followed up after surgery for 11 months to 15 years, on average for 65

  17. Surgical and visual outcomes of retinal detachment surgery in eyes with chorio-retinal coloboma

    International Nuclear Information System (INIS)

    Zafar, S.A.; Qureshi, N.A.; Pathan, A.H.K.

    2016-01-01

    Objective: To evaluate the anatomical and visual outcome of surgical management of retinal detachment associated with chorio-retinal coloboma. Study Design: Prospective interventional case series Place and Duration of Study: This study was conducted at Al-Shifa Trust Eye Hospital Rawalpindi from Jan 2012 to Dec 2013. Material and Methods: Twenty one eyes (21 patients) that underwent surgery for retinal detachment associated with chorio-retinal colobomas were selected. Evaluation was done on the basis of type of intervention, final visual acuity and anatomical outcome and complications. Out of 21, 19(90.47 percent) eyes underwent pars plana vitrectomy with silicone oil (SO) and 2(9.52 percent) underwent primary scleral buckling surgery. SO was removed in 9 (47.36 percent) eyes at final follow up. Encircling band was placed in 12 (63.15 percent) eyes based on peroperative judgment of surgeon. Intra-operative lensectomy was performed in 6 (28.57 percent) eyes. The main outcome measures were retinal re-attachment and visual recovery. Statistical analysis was performed using IBM statistical package for social sciences (SPSS) Statistics (version 17.0, Chicago, Illinois, USA). Qualitative variables were described using percentage; quantitative data were defined using mean +- standard deviation. The pre op and post op frequency of best corrected visual acuity (BVA) was compared using Wilcoxan Signed Ranks Test. Confidence interval was 95 percent (level of significance p<0.05). Results: The mean number of operations per eye were 1.57+- 0.74; mean follow-up was 13.1 months (range 12-18). The retina remained attached in 18 eyes (85.71 percent) at final follow-up. The post op BCVA improved significantly as compared to pre op BCVA (p< 0.01). Mean pre op BCVA was counting fingers (CF) and mean post op value of BCVA was 3/60. Conclusion: Pars plana vitrectomy along with silicon oil tamponade for retinal detachment related to choroiretinal coloboma improves the long

  18. Fibulin 2, a tyrosine O-sulfated protein, is up-regulated following retinal detachment.

    Science.gov (United States)

    Kanan, Yogita; Brobst, Daniel; Han, Zongchao; Naash, Muna I; Al-Ubaidi, Muayyad R

    2014-05-09

    Retinal detachment is the physical separation of the retina from the retinal pigment epithelium. It occurs during aging, trauma, or during a variety of retinal disorders such as age-related macular degeneration, diabetic retinopathy, retinopathy of prematurity, or as a complication following cataract surgery. This report investigates the role of fibulin 2, an extracellular component, in retinal detachment. A major mechanism for detachment resolution is enhancement of cellular adhesion between the retina and the retinal pigment epithelium and prevention of its cellular migration. This report shows that fibulin 2 is mainly present in the retinal pigment epithelium, Bruch membrane, choriocapillary, and to a lesser degree in the retina. In vitro studies revealed the presence of two isoforms for fibulin 2. The small isoform is located inside the cell, and the large isoform is present inside and outside the cells. Furthermore, fibulin 2 is post-translationally modified by tyrosine sulfation, and the sulfated isoform is present outside the cell, whereas the unsulfated pool is internally located. Interestingly, sulfated fibulin 2 significantly reduced the rate of cellular growth and migration. Finally, levels of fibulin 2 dramatically increased in the retinal pigment epithelium following retinal detachment, suggesting a direct role for fibulin 2 in the re-attachment of the retina to the retinal pigment epithelium. Understanding the role of fibulin 2 in enhancing retinal attachment is likely to help improve the current therapies or allow the development of new strategies for the treatment of this sight-threatening condition.

  19. [Clinical Characteristics of Rhegmatogenous Retinal Detachment in Highly Myopic and Phakic Eyes].

    Science.gov (United States)

    Orihara, Tadashi; Hirota, Kazunari; Yokota, Reiji; Kunita, Daisuke; Itoh, Yuji; Rii, Tosho; Koto, Takashi; Hiraoka, Tomoyuki; Inoue, Makoto; Hirakata, Akito

    2016-05-01

    To evaluate clinical characteristics of rhegmatogenous retinal detachment in high myopic and phakic eyes. The subjects were 1174 eyes of phakic rhegmatogenous retinal detachment detected in 1199 eyes that underwent initial vitreoretinal surgery between April 2006 and March 2011. Eyes with macular hole retinal detachment or secondary retinal detachment were excluded. The 486 eyes with high myopia (spherical equivalent ≤ -6.0 D or axial length ≥ 26.5 mm) and the 688 eyes with non-high myopia were compared. The mean age was significantly younger in the high myopia group (42.7 ± 14.2 years old, p lattice degeneration were more frequent (16.7%, 20.4%, respectively). The incidences of the retinal detachment in younger age and those caused by retinal holes were higher in the high myopia group. Higher incidence of retinal detachment and lattice degeneration in the fellow eyes of the high myopia group indicated that careful observation also in the fellow eyes was recommended.

  20. Retinal changes detected by wide-field autofluorescence imaging of patients with primary rhegmatogenous retinal detachment

    DEFF Research Database (Denmark)

    Poulsen, Christina Døfler; Grauslund, Jakob; Peto, Tunde

    2014-01-01

    .2 million inhabitants. Methods: A clinical prospective study of 99 eyes in 99 patients undergoing surgery for primary RRD between 1st of January 2013 and 12th of July 2013. All patients underwent surgery with pars plana vitrectomy (PPV) and had either gas or silicone oil tamponade. Patients were examined...... and 2 months follow-up and 59 had gradable images with characteristics studied in this part of the study. Exclusions were: poor images (n=8), major surgery or changes on fellow-eye (n=11), no baseline or 2-month image (n=7), re-detachment at 2-month follow-up (n=1) and eyes traumas (n=2). Retinal...

  1. Characteristics and pattern of rhegmatogenous retinal detachment in pakistan.

    Science.gov (United States)

    Jamil, Muhammad Hannan; Farooq, Nesr; Khan, Muhammad Tariq; Jamil, Ahmed Zeeshan

    2012-08-01

    To determine the presenting characteristics of rhegmatogenous retinal detachment (RRD) in a consecutive series of Pakistani patients. Case series. Layton Rahmatullah Benevolent Trust (LRBT), Lahore, from June 2010 to October 2011. A total of 107 eyes underwent RRD surgery. Detailed diagrams were drawn pre-operatively for all. Other recorded details included, bio-data, age, gender, visual acuity, autorefractometery, predisposing risk factors, lens state and duration of symptoms. The data was analyzed with respect to age and gender distribution, frequency of various risk factors for RRD, duration of RRD and its various presenting characteristics. Mean age of the patients were 33.1 ± 1.5 years, 85% were males. Bilateral RRD was discovered in 2.8% patients. No identifiable risk factor for RRD was present in 28%, while in rest of the 72% eyes, the commonest risk factors were intraocular surgery, trauma and peripheral myopic degeneration in decreasing order of frequency. There were 70.1% phakic, 23.4% pseudophakic and 6.5% aphakic eyes. Majority (93.5%) presented with macula off detachment. There was an overall average time lapse of 97.24 ± 16.95 days between presenting and first occurrence of symptoms. In 31.8% of eyes no break could be found pre-operatively, while 38.3% had 1 and 29.9% eyes had ³ 2 breaks. Majority of the primary breaks were horse-shoe tears (42.1%). Total RRD was found in 35.5% eyes. Infero-temporal and supero-temporal were the most frequently involved quadrants (93.5% and 86.9% respectively). Intraocular surgery, trauma and lattice degeneration in myopia are established common risk factors for RRD. These patients deserve meticulous fundus examination with indentation indirect ophthalmoscopy by trained professionals.

  2. [Rhegmatogenous retinal detachment in a patient with previous penetrating keratoplasty (clinical case)].

    Science.gov (United States)

    Burcea, M; Muşat, O; Gheorghe, Andreea; Mahdi, Labib; Colta, Diana; Cernat, Corina; Mansour, Agajani

    2014-01-01

    We present the case of a 54 year old patient diagnosed with rhegmatogenous retinal detachment and perforating keratoplasty. Surgery is recommended and we performed posterior vitrectomy, endolaser, and internal heavy oil tamponade. The post-operative course was favorable.

  3. USE OF 25-GAUGE VITRECTOMY IN THE MANAGEMENT OF PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT

    NARCIS (Netherlands)

    Mura, Marco; Tan, Stevie H.; de Smet, Marc D.

    2009-01-01

    Purpose: To evaluate the anatomical and functional results of 25-gauge transconjuctival vitrectomy in the management of primary rhegmatogenous retinal detachment (RRD). Methods: A retrospective, noncomparative interventional case series including 131 consecutive patients who underwent 25-gauge

  4. The effect of normal childbirth on eyes with abnormalities predisposing to rhegmatogenous retinal detachment.

    Science.gov (United States)

    Landau, D; Seelenfreund, M H; Tadmor, O; Silverstone, B Z; Diamant, Y

    1995-09-01

    Pregnant women who have high myopia, a history of retinal detachment or retinal holes, or have known lattice degeneration are frequently referred to an ophthalmologist for advice concerning the management of pregnancy and labor, i.e. whether a spontaneous vaginal delivery can be allowed and whether prophylaxis for high-risk retinal pathology is indicated. Many obstetricians still believe that pregnant women with ocular abnormalities predisposing to rhegmatogenous retinal detachment should have an instrumental delivery, and a few even advocate cesarian section. Very little has been written about the management of pregnant women with high-risk retinal pathology, and opinions differ considerably. Patient data on this subject are scarce. We studied 10 women who had 19 deliveries (10 prospective and 9 retrospective) and who had a history of retinal detachment, had been diagnosed as having extensive lattice degeneration, or had been treated for symptomatic retinal holes or breaks. The women were followed from the third trimester of pregnancy through labor and delivery into the postpartum period, looking for changes in the retinal status. We found no changes in the retinal status in the postpartum examination. We conclude that prenatal treatment of asymptomatic retinal pathology is not indicated and that spontaneous vaginal delivery may be allowed to take place in women with high-risk retinal pathology.

  5. Retinal detachment and gyrate atrophy of the choroid and retina: case report.

    Science.gov (United States)

    Berbel, Rodrigo Fabri; Rauen, Paulo Igor; Pallone, Raphael Frangiote; Casella, Antônio Marcelo Barbante

    2012-01-01

    To report a case of gyrate atrophy of the choroid and retina associated with retinal detachment. Hyperornithinemia confirmed the diagnosis of gyrate atrophy. Pars plana vitrectomy with silicone oil infusion was performed with good anatomical results, despite the persistence of low visual acuity. Retinal detachment is a rare complication of gyrate atrophy and can be managed with pars plana vitrectomy and silicone oil. We discuss the possible mechanisms that led to low visual acuity.

  6. Association Between Oral Fluoroquinolone Use and Retinal Detachment.

    Science.gov (United States)

    Raguideau, Fanny; Lemaitre, Magali; Dray-Spira, Rosemary; Zureik, Mahmoud

    2016-04-01

    Several studies have focused on the current use of oral fluoroquinolones and the risk for retinal detachment (RD), but the existence of this association is under debate. Given the widespread fluoroquinolone use, investigation of this association is essential. To assess the association between oral fluoroquinolone use and the risk for RD, including the rhegmatogenous and exudative types. This case-crossover study included 27,540 adults with RD from French health care databases from July 1, 2010, through December 31, 2013. Patients with a history of RD or retinal break, endophthalmitis, intravitreal injection, choroidal retinal vitreal biopsy, and human immunodeficiency virus infection or those hospitalized within 6 months of RD were excluded. The risk period of primary interest was current use, defined as exposure to fluoroquinolones within 10 days immediately before RD surgery, according to previous findings. Oral fluoroquinolone use was assumed to start on the day the prescription was dispensed. Exposure to fluoroquinolones during the risk period (1-10 days) compared with the control period (61-180 days). The association was also assessed regarding use in the recent (11-30 days) and past (31-60 days) intermediate risk period, type of fluoroquinolone, and type of RD. Of the 27,540 eligible patients (57% men; mean [SD] age, 61.5 [13.6] years), 663 patients with RD were exposed to fluoroquinolones during the observation period, corresponding to 80 cases exposed during the 10-day risk period (≤10 days before RD) and 583 cases exposed during the control period (61-180 days). We found a significant increased risk for RD during the 10-day period after the dispensing of oral fluoroquinolones, with an adjusted odds ratio of 1.46 (95% CI, 1.15-1.87). The risk was significantly increased for rhegmatogenous and exudative RD, with adjusted odds ratios of 1.41 (95% CI, 1.04-1.92) and 2.57 (95% CI, 1.46-4.53), respectively. Recent and past use of fluoroquinolones were not

  7. OUTCOMES OF RETINAL DETACHMENT REPAIR AFTER POSTERIOR OPEN GLOBE INJURY.

    Science.gov (United States)

    Reed, David C; Juhn, Alexander T; Rayess, Nadim; Hsu, Jason; Chiang, Allen

    2016-04-01

    To report outcomes of retinal detachment (RD) repair following posterior open globe injury. This retrospective, consecutive case series examined patients who underwent RD repair following Zone II and/or III open globe injury repair between January 1, 2007 and October 31, 2013. Patients with retina was achieved in 25 (83%) during the first vitreoretinal surgical procedure and 5 (17%) were deemed inoperable intraoperatively. Ten patients (30%) developed recurrent RD, and 8 underwent additional surgery. At last follow-up, reattachment was observed in 4 of these 8. The overall rate of final reattachment was 63% (19 patients). The mean number of surgeries for RD was 1.5 (range, 1-3). Fifteen patients (50%) achieved final visual acuity of counting fingers or better. Mean follow-up from the last vitreoretinal surgery was 23 months (range, 3-52). Although RD following posterior open globe injury confers a grave prognosis, successful anatomic reattachment of the retina was achieved in the majority of patients in this series, with half achieving ambulatory vision.

  8. Retinal detachment repair and cataract surgery in patients with atopic dermatitis.

    Science.gov (United States)

    Gnana Jothi, V; McGimpsey, S; Sharkey, J A; Chan, W C

    2017-09-01

    PurposeThe aim of this study is to report a case series of ocular complications including retinal detachment (RD) and cataract in atopic dermatitis (AD) and surgical management involving a majority of Caucasian patients.Patients and methodsThis study is an observational case series, originally designed as an audit. It involves detailed discussion of history, clinical features, and surgical management of patients presenting with retinal detachment and cataracts secondary to severe AD. Six consecutive patients with diagnosis of severe AD requiring posterior segment and cataract surgery were included in the study.ResultsEight eyes of six patients had retinal detachment. Most of them involved the temporal retina. The retinal breaks were located anteriorly close to the ora serrata in six eyes and Giant tear retinal (GRT) detachment was found in two eyes. Five eyes had proliferative vitreo-retinopathy (PVR) at presentation. All six patients had bilateral cataracts and cataract surgery was performed in eleven eyes. Bilateral simultaneous surgery was essential in two patients. Three eyes had secondary intra-ocular lens (IOL) implantation with pars plana vitrectomy for subluxed lens implant.ConclusionsAnterior retinal breaks and temporal RD are common in retinal detachment secondary to AD. PVR is often present, which makes surgical management difficult. Cataract formation is quite often and late subluxation of IOL may occur.

  9. Surgically Induced Focal Retinal Detachment Does Not Cause Detectable SD-OCT Retinal Changes in Normal Human Retina.

    Science.gov (United States)

    Kogachi, Kaitlin; Wolfe, Jeremy D; Kashani, Amir H

    2017-10-01

    Induction of focal retinal detachment (RD) for subretinal delivery of stem cells and gene therapy is increasingly common. In order to determine if this procedure has an adverse impact on the retina, we use spectral-domain optical coherence tomography (SD-OCT) to evaluate the pre- and postoperative retinal anatomy of the incidentally detached normal retina surrounding large submacular hemorrhages (SMH) during surgical displacement procedures. Retrospective, observational study of human subjects with monocular SMH evaluated before and after surgical displacement using clinical exam, fundus photography, and SD-OCT. Manual measurements of the inner retinal thickness (IRT), outer retinal thickness (ORT), and full retinal thickness (FRT) were made in regions involving the SMH and surrounding normal retina. Comparison of retinal thickness measurements was made using the Wilcoxon signed-rank test. Seven eyes were included in this study. All eyes successfully underwent surgical displacement of SMH. Visual acuity improved in 6/7 subjects and was unchanged in the remaining subject. Incidental RD of the normal retinal regions surrounding the SMH did not cause any significant change in IRT, ORT, or FRT that was detectable by SD-OCT. In contrast, mean FRT overlying regions with SMH was significantly greater before surgery compared to after displacement of SMH or normal adjacent retina. Surgically induced focal RD does not cause detectable retinal changes in the incidentally detached normal retina surrounding large SMH. Therefore, surgical induction of focal RD should not be considered to have the same adverse impact on the retina as pathologic RD.

  10. Fasudil, a Clinically Used ROCK Inhibitor, Stabilizes Rod Photoreceptor Synapses after Retinal Detachment.

    Science.gov (United States)

    Townes-Anderson, Ellen; Wang, Jianfeng; Halász, Éva; Sugino, Ilene; Pitler, Amy; Whitehead, Ian; Zarbin, Marco

    2017-06-01

    Retinal detachment disrupts the rod-bipolar synapse in the outer plexiform layer by retraction of rod axons. We showed that breakage is due to RhoA activation whereas inhibition of Rho kinase (ROCK), using Y27632, reduces synaptic damage. We test whether the ROCK inhibitor fasudil, used for other clinical applications, can prevent synaptic injury after detachment. Detachments were made in pigs by subretinal injection of balanced salt solution (BSS) or fasudil (1, 10 mM). In some animals, fasudil was injected intravitreally after BSS-induced detachment. After 2 to 4 hours, retinae were fixed for immunocytochemistry and confocal microscopy. Axon retraction was quantified by imaging synaptic vesicle label in the outer nuclear layer. Apoptosis was analyzed using propidium iodide staining. For biochemical analysis by Western blotting, retinal explants, detached from retinal pigmented epithelium, were cultured for 2 hours. Subretinal injection of fasudil (10 mM) reduced retraction of rod spherules by 51.3% compared to control detachments ( n = 3 pigs, P = 0.002). Intravitreal injection of 10 mM fasudil, a more clinically feasible route of administration, also reduced retraction (28.7%, n = 5, P ROCK, was decreased with 30 μM fasudil ( n = 8-10 explants, P ROCK signaling with fasudil reduced photoreceptor degeneration and preserved the rod-bipolar synapse after retinal detachment. These results support the possibility, previously tested with Y27632, that ROCK inhibition may attenuate synaptic damage in iatrogenic detachments.

  11. Postoperative recovery of visual function after macula-off rhegmatogenous retinal detachment

    NARCIS (Netherlands)

    van de Put, Mathijs A. J.; Croonen, Danna; Nolte, Ilja M.; Japing, Wouter J.; Hooymans, Johanna M. M.; Los, Leonoor I.

    2014-01-01

    Purpose: To determine which factors affect the recovery of visual function in macula-off rhegmatogenous retinal detachment (RRD). Methods: In a prospective study of forty-five patients with a primary macula-off RRD of 24 hours to 6 weeks duration, the height of the macular detachment was determined

  12. Bilateral Asymmetric Rhegmatogenous Retinal Detachment in a Patient with Stickler Syndrome

    Directory of Open Access Journals (Sweden)

    Caner Öztürk

    2018-04-01

    Full Text Available Here we present the long-term anatomical and visual outcomes of bilateral asymmetric rhegmatogenous retinal detachment repair in a patient with Stickler syndrome. A 17-year-old girl presented with decreased visual acuity in both eyes for more than one year. Her best-corrected visual acuity (BCVA was 0.1 in the right eye and 0.05 in the left eye. Slit-lamp anterior segment examination revealed subcapsular cataract in both eyes. Fundus examination showed bilateral rhegmatogenous retinal detachment, chronic retinal detachment accompanied by multiple retinal holes, tears and membranous fibrillary vitreous in the peripheral retina. Grade C2 proliferative vitreoretinopathy was observed in the left eye. Scleral buckling surgery was performed initially for both eyes. After the primary surgical procedure, retinal reattachment was achieved in the right eye and the left eye underwent phacoemulsification, intraocular lens implantation, pars plana vitrectomy (PPV, and silicone oil injection. After these surgical procedures retinal reattachment was achieved in the left eye. Silicone oil removal was performed six months after PPV surgery. After surgical treatment, BCVA was 0.6 in the right eye at the end of the 3.5-year follow-up period. After silicone oil removal, BCVA reached 0.2 in the left eye after 36 months of follow-up and retinal reattachment was achieved in both eyes. Scleral buckling surgery and PPV are effective and confidential methods for the treatment of chronic retinal detachment cases in Stickler syndrome.

  13. Prophylactic treatment of the fellow eye of patients with retinal detachment: a retrospective study.

    Science.gov (United States)

    Avitabile, Teresio; Bonfiglio, Vincenza; Reibaldi, Michele; Torrisi, Benedetto; Reibaldi, Alfredo

    2004-03-01

    Controversy exists over the prophylactic treatment of predisposing lesions to prevent retinal detachment. Seven hundred sixty consecutive phakic fellow eyes with rhegmatogenous retinal detachment in the first eye were examined by the same vitreoretinal surgeon before detachment surgery and for a follow-up period ranging from 1 to 72 months, with a mean of 36 months. During this period, in 305 fellow eyes (40.1%) predisposing retinal lesions were present and prophylactic treatments (photocoagulation, cryotherapy or scleral buckle) were performed independently of vitreous status. The results were then compared with the incidence of bilateral RD without prophylaxis reported in Folk and Burton's study of 1982; the two study's data were well matched and showed no significant difference in regards to age, sex, incidence myopia > or =-2.5 and incidence of lattice degeneration. The objective was to investigate whether or not prophylactic treatment is able to avert retinal detachment in the fellow eye. The age of the patients with peripheral retinal lesions was correlated inversely with the presence of myopia. Nine eyes out of 305 eyes treated (2.9%) developed a retinal detachment, reducing the rate of bilateral retinal detachment to 1.2% (9 eyes out of 760). This incidence of bilaterality (1.2%) was lower than the incidence of retinal detachment in fellow eyes not prophylactically treated as reported in the literature, and there exists a highly statistically significant difference between this study's data of 1.2% after prophylaxis and a 13.4% rate of bilaterality as reported by Folk without prophylaxis (P=0.0000).

  14. Early activation of inflammation- and immune response-related genes after experimental detachment of the porcine retina.

    Science.gov (United States)

    Hollborn, Margrit; Francke, Mike; Iandiev, Ianors; Bühner, Eva; Foja, Christian; Kohen, Leon; Reichenbach, Andreas; Wiedemann, Peter; Bringmann, Andreas; Uhlmann, Susann

    2008-03-01

    To determine early alterations in retinal gene expression in a porcine model of rhegmatogenous retinal detachment. Local detachment was created in eyes of adult pigs by subretinal application of sodium hyaluronate. The gene expression in control tissues and retinas detached for 24 hours was analyzed with a pig genome microarray. Genes with at least three-fold expression changes were detected in the detached retina and in the attached retinal tissue surrounding the local detachment in situ. Structural alterations of the retina were examined by light and electron microscopy. Identified were 85 genes that were upregulated and 7 that were downregulated in the detached retina. Twenty-eight genes were identified as upregulated in the nondetached retina of the surgical eyes. The genes upregulated in detached retinas were related to inflammation and immune responses (n = 52), antioxidants and metal homeostasis (n = 7), intracellular proteolysis (n = 6), and blood coagulation/fibrinolysis (n = 4). The upregulation of at least 15 interferon-stimulated genes indicates elevated interferon levels after detachment. Gene expression of blue-sensitive opsin was not detectable in the detached retinal tissue, suggesting an early reduction in phototransduction, especially in blue cones. Electron microscopy revealed an accumulation of microglial cells in the inner retinal tissue and of polymorphonuclear leukocytes in the vessels of detached and peridetached retinas. Differentially expressed genes in the retina early after experimental detachment are mainly related to inflammation and immune responses, intracellular proteolysis, and protection against oxidative stress. A local immune and inflammatory response may represent a major causative factor for reactive changes in the retina after detachment. The inflammatory response is not restricted to the detached retina but is also observed in the nondetached retina; this response may underlie functional changes in these regions described in

  15. Tamponade in surgery for retinal detachment associated with proliferative vitreoretinopathy.

    Science.gov (United States)

    Schwartz, Stephen G; Flynn, Harry W; Lee, Wen-Hsiang; Wang, Xue

    2014-02-14

    Retinal detachment (RD) with proliferative vitreoretinopathy (PVR) often requires surgery to restore normal anatomy and to stabilize or improve vision. PVR usually occurs in association with recurrent RD (that is, after initial retinal re-attachment surgery) but occasionally may be associated with primary RD. Either way, a tamponade agent (gas or silicone oil) is needed during surgery to reduce the rate of postoperative recurrent RD. The objective of this review was to assess the relative safety and effectiveness of various tamponade agents used with surgery for retinal detachment (RD) complicated by proliferative vitreoretinopathy (PVR). We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 5), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to June 2013), EMBASE (January 1980 to June 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2013), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 26 June 2013. We included randomized controlled trials (RCTs) of participants undergoing surgery for RD associated with PVR that compared various tamponade agents. Two review authors screened the search results independently. We used the standard methodological procedures expected by The Cochrane Collaboration. The review included 516 participants from three RCTs. One study was conducted in the USA and consisted of two trials: the first trial randomized 151 adults to receive either silicone oil or sulfur hexafluoride (SF6) gas tamponades; and the second trial randomized 271 adults to receive either

  16. Early rhegmatogenous retinal detachment following laser in situ keratomileusis for high myopia.

    Science.gov (United States)

    Farah, M E; Höfling-Lima, A L; Nascimento, E

    2000-01-01

    Four eyes had early rhegmatogenous retinal detachment within 3 months of laser in situ keratomileusis (LASIK) for correction of high myopia using the microkeratome, Clear Corneal Molder. In two eyes, retinal detachment resulted from horseshoe tears, one occurring in an otherwise normal region of the retina and the other at the margin of an area of lattice degeneration detected during preoperative examination. The first eye was treated with retinopexy using a 287 encircling scleral exoplant, drainage of subretinal fluid, and laser photocoagulation by indirect ophthalmoscopy. The other eye was treated with pneumatic retinopexy and cryotherapy. In the other eyes, retinal detachment was the result of giant tears with no evidence of prior retinal degeneration. These eyes were treated with pars plana vitrectomy, fluid-gas exchange with 15% perfluoropropane (C3F8), endolaser photocoagulation, and a 42 encircling scleral exoplant. After treatment, the first two eyes achieved spectacle-corrected visual acuity of 20/40. In the last two eyes, final spectacle-corrected visual acuity was 20/400 in one eye and light perception in the other. Although no cause-effect relationship between LASIK and retinal detachment can be stated, these cases suggest that LASIK may be associated with retinal detachment, particularly in highly myopic eyes. Further studies are necessary to determine high-risk patient characteristics.

  17. Evaluation of the macular architecture of patients operated on from macula-off rhegmatogenous retinal detachment using optical coherence tomography

    International Nuclear Information System (INIS)

    Ramos Lopez, Meisy; Obret Mendive, Isabel; Hernandez Silva, Juan Raul

    2010-01-01

    With the support of optical coherence tomography, to evaluate the macular condition of the patients operated on from rhegmatogenous retinal detachment, with detached macula, who underwent buckling surgery and pars plana vitrectomy

  18. Retinal layer measurements after successful macula-off retinal detachment repair using optical coherence tomography.

    Science.gov (United States)

    Menke, Marcel N; Kowal, Jens H; Dufour, Pascal; Wolf-Schnurrbusch, Ute E; Ceklic, Lala; Framme, Carsten; Wolf, Sebastian

    2014-09-04

    Optical coherence tomography (OCT) was used to analyze the thickness of various retinal layers of patients following successful macula-off retinal detachment (RD) repair. Optical coherence tomography scans of patients after successful macula-off RD repair were reanalyzed with a subsegmentation algorithm to measure various retinal layers. Regression analysis was performed to correlate time after surgery with changes in layer thickness. In addition, patients were divided in two groups. Group 1 had a follow-up period after surgery of up to 7 weeks (range, 21-49 days). In group 2, the follow-up period was >8 weeks (range, 60-438 days). Findings were compared to a group of age-matched healthy controls. Correlation analysis showed a significant positive correlation between inner nuclear-outer plexiform layer (INL-OPL) thickness and time after surgery (P=0.0212; r2=0.1551). Similar results were found for the ellipsoid zone-retinal pigment epithelium complex (EZ-RPE) thickness (P=0.005; r2=0.2215). Ganglion cell-inner plexiform layer thickness (GCL-IPL) was negatively correlated with time after surgery (P=0.0064; r2=0.2101). For group comparison, the retinal nerve fiber layer in both groups was thicker compared to controls. The GCL-IPL showed significant thinning in group 2. The outer nuclear layer was significantly thinner in groups 1 and 2 compared to controls. The EZ-RPE complex was significantly thinner in groups 1 and 2 compared to controls. In addition, values in group 1 were significantly thinner than in group 2. Optical coherence tomography retinal layer thickness measurements after successful macular-off RD repair revealed time-dependent thickness changes. Inner nuclear-outer plexiform layer thickness and EZ-RPE thickness was positively correlated with time after surgery. Ganglion cell-inner plexiform layer thickness was negatively correlated with time after surgery. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  19. Vitrectomy for circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy

    Directory of Open Access Journals (Sweden)

    Shukla Dhananjay

    2007-01-01

    Full Text Available We report successful surgical management of a circumscribed choroidal hemangioma with exudative retinal detachment refractory to transpupillary thermotherapy (TTT. A 33-year-old man with symptomatic serous macular detachment in the left eye (Snellen acuity: 20/200 secondary to a paramacular choroidal hemangioma was treated with TTT. The nonresponsive detachment was subsequently managed by vitrectomy, endophotocoagulation and silicon-oil tamponade. It resulted in complete resolution of the tumor and the detachment. Silicon oil was removed at four months. Visual acuity improved to 20/80 by the last follow-up visit at 10 months without any recurrence.

  20. [The incidence of retinal tears in patients with posterior vitreous detachment].

    Science.gov (United States)

    Karaman, Ksenija; Gverović-Antunica, Antonela; Bućan, Kajo; Znaor, Ljubo; Bulović, Dijana; Skelin, Sinia

    2006-01-01

    Posterior vitreous detachment (PVD) is a common finding in older patients, characterized by detachment of the posterior hyaloid membrane (PHM) from the retinal surface. The detachment of PHM normally occurs without complications, however, one has to be aware that retinal tear is its most common complication. The aim of the study was to determine the incidence of retinal tears in eyes with PVD. A series of 40 patients (70 eyes) with PVD were included in this retrospective study. Eyes with a history of ocular trauma, surgery or intraocular inflammation were excluded. Patient charts were reviewed to collect the following information: age, sex, profession, type and duration of symptoms, best corrected visual acuity, refractive status, prior ocular disease, coincidental retinal pathology-lattice degeneration, number, type and location of retinal tears and treatment. Statistical analysis was done with the SPSS 11.0.3 software (SPSS Inc., USA). Besides descriptive statistics, Student's t-test and chi2-test were used. Among all study eyes with PVD, 34 (48.6%) were myopic, 24 (34.3%) hypermetropic and 12 (17.1%) emetropic; statistical analysis showed a significant difference (chi2 = 10.40, df=2, p lattice malignant degeneration of peripheral retinal was diagnosed. Thorough examination of the fundus periphery revealed 16 (22.8%) eyes with PVD were found to have retinal tears, 11 (15.7%) had only one retinal tear and 5 (7.1%) two retinal tears. All retinal tears were treated with argon laser photocoagulation. Superotemporal eye quadrant was the most common localization of retinal tears (56.25%). These results indicate that thorough fundus periphery examination should be done in all patients with PVD because it can cause rather rarely though retinal tears that represent a potentially sight threatening condition.

  1. Transcriptomic analysis of human retinal detachment reveals both inflammatory response and photoreceptor death.

    Directory of Open Access Journals (Sweden)

    Marie-Noëlle Delyfer

    Full Text Available BACKGROUND: Retinal detachment often leads to a severe and permanent loss of vision and its therapeutic management remains to this day exclusively surgical. We have used surgical specimens to perform a differential analysis of the transcriptome of human retinal tissues following detachment in order to identify new potential pharmacological targets that could be used in combination with surgery to further improve final outcome. METHODOLOGY/PRINCIPAL FINDINGS: Statistical analysis reveals major involvement of the immune response in the disease. Interestingly, using a novel approach relying on coordinated expression, the interindividual variation was monitored to unravel a second crucial aspect of the pathological process: the death of photoreceptor cells. Within the genes identified, the expression of the major histocompatibility complex I gene HLA-C enables diagnosis of the disease, while PKD2L1 and SLCO4A1 -which are both down-regulated- act synergistically to provide an estimate of the duration of the retinal detachment process. Our analysis thus reveals the two complementary cellular and molecular aspects linked to retinal detachment: an immune response and the degeneration of photoreceptor cells. We also reveal that the human specimens have a higher clinical value as compared to artificial models that point to IL6 and oxidative stress, not implicated in the surgical specimens studied here. CONCLUSIONS/SIGNIFICANCE: This systematic analysis confirmed the occurrence of both neurodegeneration and inflammation during retinal detachment, and further identifies precisely the modification of expression of the different genes implicated in these two phenomena. Our data henceforth give a new insight into the disease process and provide a rationale for therapeutic strategies aimed at limiting inflammation and photoreceptor damage associated with retinal detachment and, in turn, improving visual prognosis after retinal surgery.

  2. Senile retinoschisis versus retinal detachment, the additional value of peripheral retinal OCT scans (SL SCAN-1, Topcon).

    Science.gov (United States)

    Stehouwer, Marilette; Tan, Stevie H; van Leeuwen, Ton G; Verbraak, Frank D

    2014-05-01

    A peripheral senile retinoschisis is sometimes difficult to distinguish from a retinal detachment by biomicroscopy alone. This study evaluated spectral domain OCT (SD-OCT) scans of the far peripheral retina to improve the differentiation between these diseases. Patients were included in whom the distinction between retinal detachment and senile retinoschisis was not clear based on biomicroscopy alone, or who had a presumed clinical diagnosis of senile retinoschisis. OCT scans were made with the SLSCAN-1, through a hand-held lens and a 3-mirror contact lens, while the area of interest was simultaneously observed with the slit lamp. The SLSCAN-1 is a SD-OCT integrated into a slit lamp, superluminescent diode light source with a central wavelength of 830 nm, bandwidth 30 nm, scan resolution 8-9 μm in tissue, scan depth 2 mm, scan speed 5000 A-scans per second. In the 11 patients with an uncertain diagnosis, OCT scans showed a senile retinoschisis in four and a retinal detachment in seven patients. Fifteen of the 18 patients with a presumed diagnosis of retinoschisis showed a retinoschisis on OCT. In five of them, the OCT scans revealed a schisis detachment. Interestingly, three of the 18 patients had a retinal detachment. Senile retinoschisis may mimic a peripheral retinal detachment and vice versa. Differentiation is important with respect to therapeutic decisions. OCT scans of the far peripheral retina, which can be made with the SLSCAN-1 through a 3-mirror contact lens, can contribute significantly to this differentiation. The obtained scans of the far peripheral retina clearly visualize the anatomic differences between both diseases. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  3. [Two cases of retinal detachment following laser in Situ keratomileusis repaired by scleral buckling surgery].

    Science.gov (United States)

    Onguchi, Tatsuya; Eshita, Tadahiko; Mita, Shinji; Ishida, Susumu; Shinoda, Kei; Kitamura, Shizuaki; Kawashima, Shinichi; Inoue, Makoto; Oguchi, Yoshihisa; Toda, Ikuko; Kato, Naoko

    2002-02-01

    As laser in situ keratomileusis (LASIK) becomes the treatment of choice in the field of refractive surgery, postoperative rhegmatogenous retinal detachment has also begun to occur. However, since it has not been reported yet here in Japan, we report two cases of retinal detachment following LASIK with suggestions based on our experience. A 34-year-old male(Case 1) and a 26-year-old male(Case 2) suffered from retinal detachment one month and eight months after LASIK, respectively. Contributing retinal breaks were a horseshoe tear in Case 1 and atrophic holes in the lattice degeneration in Case 2. Each patient underwent partial scleral buckling with no intraoperative complication, resulting in successful retinal reattachment. Postoperatively, myopic changes developed and persisted one month in Case 1 and several months in Case 2. Great attention should be paid to the possibility of postoperative myopia after a repair of retinal detachment following LASIK. Thus, we stress the necessity of close cooperation between LASIK surgeons and vitreoretinal surgeons to settle the matter.

  4. Scleral buckling procedure with chandelier illumination for pediatric rhegmatogenous retinal detachment

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    Yokoyama T

    2015-01-01

    Full Text Available Toshiyuki Yokoyama, Koki Kanbayashi, Tamaki YamaguchiDepartment of Ophthalmology, Juntendo University Nerima Hospital, Tokyo, JapanPurpose: To assess the treatment of pediatric patients with rhegmatogenous retinal detachment (RRD by scleral buckling with chandelier illumination.Methods: Three eyes were treated in three patients, healthy boys aged 7 years, 12 years, and 11 years, with RRD, macular involvement, and small retinal holes, of which two were preoperatively undetectable. Conventional scleral buckling with cryoretinopexy was performed under the contact lens for vitreous surgery or noncontact wide-angle viewing system using 27-gauge twin chandelier illumination.Results: The only known predisposing factor for retinal detachment was myopia stronger than 3 D with lattice retinal degeneration in two of the three patients. Retinal reattachment was achieved in all cases without intra- or postoperative complications. However, visual recovery was limited in one of the three patients.Conclusion: Scleral buckling with chandelier illumination is effective for pediatric RRD, especially if the retinal hole is difficult to detect preoperatively. However, visual recovery was sometimes limited because of macular involvement due to late diagnosis, which is one of the characteristic features of pediatric RRD.Keywords: pediatric rhegmatogenous retinal detachment, chandelier illumination, scleral buckling

  5. Senile retinoschisis versus retinal detachment, the additional value of peripheral retinal OCT scans (SL SCAN-1, Topcon)

    NARCIS (Netherlands)

    Stehouwer, Marilette; Tan, Stevie H.; van Leeuwen, Ton G.; Verbraak, Frank D.

    2014-01-01

    A peripheral senile retinoschisis is sometimes difficult to distinguish from a retinal detachment by biomicroscopy alone. This study evaluated spectral domain OCT (SD-OCT) scans of the far peripheral retina to improve the differentiation between these diseases. Patients were included in whom the

  6. Management of retinal detachment in block related globe perforation with pneumatic retinopexy

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    Karandeep Rishi

    2013-01-01

    Full Text Available Retinal detachment after ocular perforation related to local anesthesia is a common complication, which is usually associated with a poor prognosis despite complex vitreoretinal surgical procedures. We report a case of 62-year-old male with cataract surgery done 4 weeks back with nasal retinal detachment with a posterior break. Pneumatic retinopexy was performed and laser barrage of the breaks was done the next day when the retina got attached. A vision of 20/30 was achieved at the end of 2 months. To the best of our knowledge, this is a first case report in literature where pneumatic retinopexy was used to manage a retinal detachment caused by block-related perforation.

  7. Photorefractive keratectomy for visual rehabilitation of anisometropia induced by retinal detachment surgery.

    Science.gov (United States)

    Bilgihan, K; Ozdek, S C; Gürelik, G; Adigüzel, U; Onol, M; Hasanreisoglu, B

    2000-01-01

    To evaluate the efficacy of unilateral photorefractive keratectomy to correct anisometropia induced by retinal detachment surgery. Photorefractive keratectomy was performed in 10 eyes of 10 patients with anisometropia induced by previous retinal detachment surgery. The Aesculap Meditec MEL 60 excimer laser was used. Preoperative mean spherical equivalent refraction was -5.20 D. Mean postoperative spherical equivalent refraction was -0.25 D after a mean follow-up of 12.9 months. Mean preoperative spherical equivalent refraction difference between two eyes of 4.87 D was decreased to a mean 0.60 D postoperatively (t-test, P < .0001). All patients were free of anisometropic symptoms after laser surgery. Unilateral photorefractive keratectomy seems to be an effective method to correct anisometropia induced by conventional retinal detachment surgery, especially for patients with spectacle and contact lens intolerance.

  8. Visual and anatomical outcomes of macular epiretinal membrane peeling after previous rhegmatogenous retinal detachment repair.

    Science.gov (United States)

    Weng, Christina Y; Gregori, Ninel Z; Moysidis, Stavros N; Shi, Wei; Smiddy, William E; Flynn, Harry W

    2015-01-01

    To report outcomes and prognostic factors after epiretinal membrane peeling in patients with previous rhegmatogenous retinal detachment repair. A consecutive case series. Best-corrected visual acuity and optical coherence tomography characteristics were analyzed before and after epiretinal membrane surgery. Fifty-three eyes were analyzed. Best-corrected visual acuity improved by a mean of 10 letters at 1 month (N = 45; P = 0.001), 15 at 3 months (N = 42; P detachment repair resulted in significant improvements in visual acuity and optical coherence tomography thickness, even in eyes with previous macula-involving rhegmatogenous retinal detachment. Better preoperative visual acuity and intact outer retinal layers by optical coherence tomography were the main prognostic factors for visual outcomes.

  9. A SECOND CASE OF BILATERAL RHEGMATOGENOUS RETINAL DETACHMENTS REPAIRED WITH SIMULTANEOUS BILATERAL PNEUMATIC RETINOPEXY.

    Science.gov (United States)

    Rubin, Uriel; De Jager, Cornelis; Zakour, Moayed; Gonder, J Thomas

    2017-01-01

    To present a case of a patient with simultaneous bilateral retinal detachments treated successfully with bilateral pneumatic retinopexy. Case report. This is a case of an otherwise healthy 49-year-old woman with no remarkable ocular history that presented with simultaneous phakic superior bilateral rhegmatogenous retinal detachments. Treatment on the day of presentation included laser retinopexy of the inferior lattice degeneration in the left eye and bilateral intravitreal injection of 0.4 cc of 100% C3F8 gas preceded by topical anesthesia. After 48 hours, both retinas were completely reattached, and bilateral laser retinopexy was performed to the superior tears. After a review of the literature, the authors could find only two reported cases of simultaneous bilateral retinal detachments treated successfully with pneumatic retinopexy. This is not only a cost-effective procedure but also allows treatment when there is no immediate operating room availability or a when a quick referral for surgery is not possible.

  10. A case of Alagille syndrome complicated by intraocular lens subluxation and rhegmatogenous retinal detachment

    Science.gov (United States)

    Fukumoto, Masanori; Ikeda, Tsunehiko; Sugiyama, Tetsuya; Ueki, Mari; Sato, Takaki; Ishizaki, Eisuke

    2013-01-01

    This case report describes a case of Alagille syndrome with developing intraocular lens subluxation and rhegmatogenous retinal detachment 4 years after cataract surgery. A 15-year-old female patient with Alagille syndrome-associated cataracts in both eyes underwent phacoemulsification aspiration and intraocular lens implantation. Four years postoperative, intraocular lens subluxation developed in her left eye. For treatment, extraction of the dislocated intraocular lens, anterior vitrectomy, and intraocular lens fixation was performed. Three weeks later, the patient developed rhegmatogenous retinal detachment, which was well-treated by pars plana vitrectomy. Cataract surgery needs to be performed carefully in patients with Alagille syndrome due to the weakness of the zonule of Zinn. Careful postoperative observation is necessary for patients with Alagille syndrome who have undergone intraocular surgery in order to facilitate early detection of a possible rhegmatogenous retinal detachment. PMID:23898221

  11. Round atrophic holes in lattice degeneration--an important cause of phakic retinal detachment.

    Science.gov (United States)

    Tillery, W V; Lucier, A C

    1976-01-01

    Round atrophic holes in lattice degeneration are an important cause of phakic retinal detachment. Detachments due solely to round holes in lattice accounted for almost 2.8% of all retinal detachments treated at Wills Eye Hospital from January 1970 to August 1973. These detachments had the following important characteristics: 1. One of the patients were under the age of 30 years. 2. Over 75% of the patients had refractive errors more myopic than -3 D spherical equivalent. 3. Inferior detachments were slightly more common than superior detachments. When located inferiorly, there was a tendency for slow progression as indicated by the frequent presence of pigmented demarcation lines. 4. Surgical repair with standard scleral buckling techniques was successful in 98% of these detachments. Young, moderate to highly myopic patients with round holes in areas of lattice degeneration seem to have a greater risk of developing this type of detachment. Patients with the triad of youth, myopia, and round holes in lattice degeneration deserve close observation.

  12. Densiron® 68 as an intraocular tamponade for complex inferior retinal detachments

    Directory of Open Access Journals (Sweden)

    Hussain RN

    2011-05-01

    Full Text Available Rumana N Hussain, Somnath BanerjeeLeicester Royal Infirmary, Leicester, UKIntroduction: Densiron® 68 is a high-density liquid used to tamponade inferior retinal detachments. We present a case series of 12 patients treated with Densiron as an intraocular tamponade agent.Methods: A retrospective analysis of 12 eyes in 12 patients was carried out. The primary endpoint was anatomic reattachment of the retina following removal of Densiron oil.Results: All patients had inferior detachments; 33% had associated proliferative vitreoretinopathy (PVR. Densiron was utilized as a primary agent in five patients (42%; the remaining patients had prior unsuccessful surgery for retinal reattachment, including pars plana vitrectomy, cryotherapy, laser, encirclement, gas (C3F8 or C2F6, or silicone oil. Eleven patients (91% had successful reattachment of the retina at 3 months following removal of Densiron; one patient had extensive PVR, total retinal detachment, preretinal macula fibrosis, and chronic hypotony, and surgical intervention was unsuccessful. Six patients (50% had raised intraocular pressure (IOP, resolving in the majority of cases following Densiron removal; two patients had long-term raised IOP requiring topical or surgical therapy. Of the six phakic patients, 50% developed significant cataract in the operated eye. Of those with successful retinal reattachment, visual outcome was variable, with 36% patients gaining two to four lines on Snellen, 27% remaining objectively the same, and 36% losing one to two lines.Conclusion: The anatomic success rate is high (91% in patients requiring Densiron tamponade for inferior retinal detachments with or without evidence of PVR either as a primary or secondary intervention. A common complication is raised IOP; however, this most often resolves following removal of the oil.Keywords: intraocular tamponade, silicone oil, retinal detachment, retinal reattachments

  13. Persistent subretinal fluid due to central serous chorioretinopathy after retinal detachment surgery

    OpenAIRE

    Moreno-L?pez, Mar?a; P?rez-L?pez, Marta; Casas-Llera, Pilar; Jarr?n, Elena; Mu?oz-Negrete, Francisco Jos?

    2011-01-01

    María Moreno-López, Marta Pérez-López, Pilar Casas-Llera, Elena Jarrín, Francisco José Muñoz-NegreteOphthalmology Unit, Hospital Ramón y Cajal, Madrid, SpainBackground: The causes of persistent submacular detachment after successful rhegmatogenous retinal detachment (RRD) surgery remain unknown. Its presence is associated with poor postoperative visual acuity, but due to its spontaneous resolution no addit...

  14. MRt in the recurrent retinal detachment diagnosis after intraocular tamponade media injection: state of the art

    International Nuclear Information System (INIS)

    Manfre, L.; Midiri, M.; Casto, A.; Angileri, T.; Cardinale, A.

    1994-01-01

    Inraocular Silicon (SO), Fluorosilicon (FSO) oil or Perfluorocarbon fluid (PFCL) injection is a new succesfull surgical technique in the treatment detachment. After personal casu istic review, we report our experience in 37 patients, who underwent pars plana vitrectomy with intraocular SO, FSO or PFCL in injection for retinal detachment, monitored with Magnetic Resonance Imaging controls. MRI, showing no significant oil-related artifcats, revealed as a confident, non-invasive imaging modality in evaluating patient undergone tamponade media intraocular injection

  15. Persistent subretinal fluid due to central serous chorioretinopathy after retinal detachment surgery

    Directory of Open Access Journals (Sweden)

    Moreno-López M

    2011-10-01

    Full Text Available María Moreno-López, Marta Pérez-López, Pilar Casas-Llera, Elena Jarrín, Francisco José Muñoz-NegreteOphthalmology Unit, Hospital Ramón y Cajal, Madrid, SpainBackground: The causes of persistent submacular detachment after successful rhegmatogenous retinal detachment (RRD surgery remain unknown. Its presence is associated with poor postoperative visual acuity, but due to its spontaneous resolution no additional therapeutic or diagnostic procedure is recommended.Case report: A case of central serous chorioretinopathy (CSC that simulated persistent subfoveal fluid after RRD surgery is presented.Conclusion: To the authors' knowledge, no other case of visual impairment after successful retinal detachment surgery due to CSC has been reported in the PubMed database. In view of this report, CSC should be considered in the differential diagnosis of persistent subretinal fluid after successful retinal detachment surgery.Keywords: persistent subretinal fluid, retinal detachment surgery, central serous chorioretinopathy, vitrectomy

  16. Intravitreal bevacizumab therapy for idiophatic juxtafoveolar retinal telangiectasis associated with serous macular detachment

    Directory of Open Access Journals (Sweden)

    Paulo Escarião

    2014-01-01

    Full Text Available The authors describe a 50-year-old woman with group 2 juxtafoveolar retinal telangiectasis and macular detachment treated with a single-dose of intravitreous bevacizumab injection. There was an improvement in her visual acuity, with a decrease in retinal thickness showed by the optical coherence tomography and fluorescein leakage in the angiography on follow-up visits. No adverse events were observed as a result of the treatment used. After one year of follow-up, the vision remained stable and macular detachment did not recur.

  17. Using patient positioning to promote resorption of subretinal fluid in rhegmatogenous retinal detachment before pneumatic retinopexy.

    Science.gov (United States)

    Dorrepaal, Stephen J; Gale, Jeffrey

    2014-03-01

    The purpose of this study was to determine if the volume of subretinal fluid in patients with acute rhegmatogenous retinal detachment may be reduced through patient positioning before pneumatic retinopexy. This was a prospective, masked nonrandomized cohort study examining the change in subretinal fluid volume in patients with rhegmatogenous retinal detachment before and after a 1-hour period of specific head positioning, as measured using B-scan ultrasonography. A series of B-scans, each 2 mm apart in the sagittal plane, were acquired for each eye both before and after the positioning period with the patient lying in a supine position. Ten patients with acute unilateral rhegmatogenous retinal detachment were enrolled. All patients experienced a reduction in subretinal fluid volume, from a mean prepositioning volume of 0.89 ± 0.63 mL to a mean postpositioning volume of 0.45 ± 0.43 mL. The mean relative reduction in subretinal fluid measured as a percentage of prepositioning subretinal fluid volume was 55.4% ± 20%, ranging from 35.3% to 93.5%. In patients with acute rhegmatogenous retinal detachment that fall within the classic indications for pneumatic retinopexy, significant reduction of subretinal fluid volume may be obtained through a 1-hour period of patient positioning in a retinal break-dependent manner.

  18. Incidence, risk factors, and clinical characteristics of unexplained visual loss after intraocular silicone oil for macula-on retinal detachment

    NARCIS (Netherlands)

    Scheerlinck, Laura M.; Schellekens, Peter A.; Liem, Albert T.; Steijns, Daan; van Leeuwen, R

    2016-01-01

    Purpose: To investigate the incidence, risk factors, and clinical characteristics of unexplained visual loss after macula-on rhegmatogenous retinal detachment (RRD). Methods: Retrospective cohort of patients with primary macula-on rhegmatogenous retinal detachment treated by vitrectomy with gas or

  19. Scleral buckling procedure with chandelier illumination for pediatric rhegmatogenous retinal detachment

    OpenAIRE

    Yokoyama, Toshiyuki; Kanbayashi, Koki; Yamaguchi, Tamaki

    2015-01-01

    Toshiyuki Yokoyama, Koki Kanbayashi, Tamaki YamaguchiDepartment of Ophthalmology, Juntendo University Nerima Hospital, Tokyo, JapanPurpose: To assess the treatment of pediatric patients with rhegmatogenous retinal detachment (RRD) by scleral buckling with chandelier illumination.Methods: Three eyes were treated in three patients, healthy boys aged 7 years, 12 years, and 11 years, with RRD, macular involvement, and small retinal holes, of which two were preoperativel...

  20. Strain Difference in Photoreceptor Cell Death After Retinal Detachment in Mice

    Science.gov (United States)

    Matsumoto, Hidetaka; Kataoka, Keiko; Tsoka, Pavlina; Connor, Kip M.; Miller, Joan W.; Vavvas, Demetrios G.

    2014-01-01

    Purpose. To evaluate the potential for mouse genetic background to effect photoreceptor cell death in response to experimental retinal detachment (RD). Methods. Retinal detachment was induced in three inbred mouse strains (C57BL/6, BALB/c, and B6129SF2) by subretinal injection of sodium hyaluronate. A time course of photoreceptor cell death was assessed by TUNEL assay. Total photoreceptor cell death was analyzed through comparing the outer nuclear layer (ONL)/inner nuclear layer (INL) ratio 7 days post RD. Western blot analysis or quantitative real-time PCR (qPCR) were performed to assess cell death signaling, expression of endogenous neurotrophin, and levels of apoptosis inhibitors 24 hours after RD. Inflammatory cytokine secretion and inflammatory cell infiltration were quantified by ELISA and immunostaining, respectively. Results. The peak of photoreceptor cell death after RD was at 24 hours in all strains. Photoreceptor cell death as well as monocyte chemoattractant protein 1 and interleukin 6 secretion at 24 hours after RD was the highest in BALB/c, followed in order of magnitude by C57BL/6 and B6129SF2. Conversely, nerve growth factor expression and ONL/INL ratio were the lowest in BALB/c. Apoptosis signaling was higher in C57BL/6, whereas necroptosis signaling was higher in C57BL/6 and BALB/c. Autophagic signaling was higher in BALB/c. X-linked inhibitor of apoptosis (XIAP) and survivin protein levels were lower in C57BL/6 and BALB/c, respectively. Macrophage/microglia infiltration was higher in C57BL/6 and BALB/c at 24 hours after RD. Conclusions. Photoreceptor cell death after RD was significantly different among the three strains, suggesting the presence of genetic factors that affect photoreceptor cell death after RD. PMID:24854853

  1. Characteristics and Surgical Outcomes of Rhegmatogenous Retinal Detachment Following Myopic LASIK

    Science.gov (United States)

    Daftarian, Narsis; Dehghan, Mohammad-Hossein; Ahmadieh, Hamid; Soheilian, Masoud; Karkhaneh, Reza; Lashay, Alireza; Mirshahi, Ahmad; Parhizkar, Hamid; Kazemimoghadam, Mohsen; Modarreszadeh, Mehdi; Hashemi, Masih; Fadaei, Mojtaba; Entezari, Morteza

    2009-01-01

    Purpose To describe the clinical features and surgical outcomes of rhegmatogenous retinal detachment (RRD) following myopic laser in situ keratomileusis (LASIK). Methods In a retrospective, non-comparative case series, 46 eyes that had undergone vitreoretinal surgery for management of RRD following myopic LASIK were identified. Data was reviewed with emphasis on characteristics of the RRD, employed surgical techniques, and anatomic and visual outcomes. Results Mean pre-LASIK myopia was −9.7±3.9 (range −4.00 to −18.00) diopters (D). Mean interval between LASIK and development of RRD was 11.6±11.2 months. Posterior vitreous detachment was present in 44 eyes (95.6%). The retinal breaks included flap tears in 36 (78.3%) eyes, giant tears in 8 (17.4%) eyes and atrophic holes in 2 (4.3%) eyes. In eyes with flap tears, the breaks were multiple, large or posterior to the equator in 24(66.7%) eyes. Retinal breaks were related to lattice degeneration in 20 (43.5%) eyes of which, three had history of prophylactic barrier laser photocoagulation. Scleral buckling was performed as the initial procedure in 32 (69.6%) eyes and primary vitrectomy was undertaken in 14 (30.4%) eyes. The initial surgical procedure failed in 14 (30.4%) eyes due to proliferative vitreoretinopathy (PVR). Retinal reattachment was finally achieved in 43 (93.4%) eyes. Postoperative visual acuity ≥20/40 and ≥20/200 was achieved in 16 (34.8%) and 25 (54.3%) eyes, respectively. Conclusion Post-LASIK retinal detachment has a complex nature in eyes with moderate to high myopia. The retinal detachment is complex in terms of size, number and location of retinal breaks, is associated with a high rate of PVR and entails unfavorable visual outcomes. PMID:23198065

  2. Unintentional displacement of the retina after standard vitrectomy for rhegmatogenous retinal detachment.

    Science.gov (United States)

    Shiragami, Chieko; Shiraga, Fumio; Yamaji, Hidetaka; Fukuda, Kouki; Takagishi, Mai; Morita, Misako; Kishikami, Takehiro

    2010-01-01

    To study unintentional displacement of the retina after standard vitrectomy for rhegmatogenous retinal detachment (RRD). Prospective interventional case series. Forty-three eyes of 43 consecutive patients with cystic RRD involving 1 or more quadrants underwent successful standard vitrectomy with 20% sulfur hexafluoride gas injection. Neither scleral buckling nor retinotomy was performed. Fundus autofluorescence (FAF) imaging was subsequently recorded to detect displacement of the retina using the Topcon TRC-50DX (Topcon, Tokyo, Japan) at 10 days and 1, 3, and 6 months postoperatively. Fluorescein angiography was also recorded using standard techniques for patients with abnormal FAF findings. Cyclotorsion and vertical deviation were measured postoperatively. The proportion of eyes with postoperative retinal displacement detected by FAF imaging. The mean age of these 43 patients was 60 years with a range of 39 to 77 years. Of the 43 eyes, retinal detachment involved 1 quadrant in 2 eyes, 2 quadrants in 31 eyes, 3 quadrants in 8 eyes, and 4 quadrants in 2 eyes. After complete reattachment of the retina, FAF photography demonstrated hyperfluorescent lines superiorly parallel to retinal vessels within the vascular arcade in 27 of the 43 eyes (62.8%). Fluorescein angiography did not demonstrate any abnormalities corresponding to the linear autofluorescence. This autofluorescence was hypothesized to originate from increased metabolic activity of the retinal pigment epithelium that had been preoperatively located under the major retinal vessels and was postoperatively exposed to light because of downward displacement of the retina. Of the 27 eyes with retinal displacement, 1 to 5 degrees of extorsion were seen in 16 eyes (59.3%), and 1 to 4 degrees of vertical deviation were seen in 13 eyes (48.1%). None of the 27 patients had diplopia or slant. The extent of retinal detachment (P = 0.019) and the macular status (on or off) (P = 0.016) were significantly associated with

  3. Experimental results from detached plasmas in TFTR

    International Nuclear Information System (INIS)

    Strachan, J.D.; Boody, F.P.; Bush, C.E.

    1986-10-01

    Detached plasmas are formed in TFTR which have the principal property of the boundary to the high temperature plasma core being defined by a radiating layer. This paper documents the properties of TFTR ohmic-detached plasmas with a range of plasma densities at two different plasma currents

  4. Retinal detachment associated with thalassemia major and Marfan′s syndrome-A case report

    Directory of Open Access Journals (Sweden)

    Chatterjee Pranab

    1987-01-01

    Full Text Available The thalassaemias, unlike a few other disorders of the haemopoietic system, are very rarely accompanied by ophthalmological changed. Marfan′s Syndrome, on the other hand, exhibits a number of ocular manifestations 2. This article describes a case of uniocular retinal detachment associated with both these conditions

  5. The fellow eye in patients with unilateral retinal detachment: findings and prophylactic treatment.

    Science.gov (United States)

    Laatikainen, L

    1985-10-01

    During a 4-year period, 1978-1981, 312 patients were operated on for unilateral rhegmatogenous detachment of the retina. Of the fellow eyes, 11% showed moderate (VA 0.15-0.4) and 5% severe (VA less than or equal to 0.1) visual impairment. Of the fellow eyes 49% were myopic (- 1.0 D. or more), and aphakia was present in 14%. Details of the peripheral fundus were adequately recordable for 260 fellow eyes. Degenerations considered to predispose to retinal detachment were found in 98 eyes (38%): lattice degeneration in 54 (21%), granular tuft in 17 (7%), retinal tear(s) in 12 (5%), and retinoschisis in 15 (6%). Prophylactic treatment of predisposing degenerations was performed in 91 of the 98 eyes using cryo- or photocoagulation (argon laser). No intra- or permanent post-operative complications were noticed. One of the treated fellow eyes (1.1%) detached 10 months after prophylactic treatment due to new tears. In the untreated group, 6 of the 221 eyes detached (2.7%). The difference was not statistically significant, but the groups were not comparable because 93% of the eyes showing predisposing degenerations were treated. None of the eyes treated for retinal breaks or lattice degeneration has detached. In these cases prophylactic treatment of the fellow eye is recommended. In most eyes cryocoagulation seems to be preferable to photocoagulation.

  6. Bilateral giant retinal tear and retinal detachment in a young emmetropic man after Jarish-Herxheimer reaction in ocular syphilis.

    Science.gov (United States)

    Pournaras, J-A C; Laffitte, E; Guex-Crosier, Y

    2006-05-01

    Giant retinal tears were previously described in patients affected by panuveitis. We report the case of a patient presenting giant retinal tears in both eyes affected by ocular syphilis. A 45-year-old patient presented a 5 days history of sudden bilateral drop of vision, two weeks after penicillin therapy for secondary syphilis. The best visual acuity was 0.5 RE and light perception LE. Biomicroscopy showed an intense vitritis associated with bilateral giant tear and retinal detachment. Both TPHA and VDRL were positive. Lumbar puncture showed lymphoplasmocytosis with intrathecal synthesis of IgM. Topical steroids treatment was applied and intravenous penicillin was given during 14 days. Pars plana vitrectomy with silicon oil tamponade was performed in association with endophotocoagulation in the left eye and cryocoagulation in the right eye. Vitreous PCR was negative. Evolution was successful with an attached retina. This represents the first reported case of giant retinal tear with retinal detachment in a patient presenting a syphilitic panuveitis.

  7. Microperimetry and optical coherent tomography in patients operated on y the conventional retinal detachment surgery

    International Nuclear Information System (INIS)

    Guerra Garcia, Roberto Alejandro; Rodriguez Rodriguez, Beatriz N; Eguia Martinez, Frank

    2008-01-01

    A descriptive study was made to determine the visual acuity, microperimetry and optical coherence tomography in patients operated on by the conventional rhegmatogenous retinal detachment at 'Ramon Pando Ferrer' Cuban Ophthalmologic Institute from October 2006 to March 2007. Twenty six patients, who had gone to the hospital with normal values in ophthalmoscopy and biomicroscopy and three-six months of disease development. Better corrected visual acuity, fixation, average sensitivity, morphology and macular thickness were obtained after surgery. Average visual acuity was 0,41 and fixation was stable in most of patients; average retinal sensitivity was 11 decibels. The most frequent finding was serum detachment. Average macular thickness was 246,3 micras. There was no statistical relation between preoperative time of disease development and the macular characteristics of detachment in these tests. (Author)

  8. Pars plana vitrectomy for retinal detachment due to internal posterior ophthalmomyiasis after cataract extraction.

    Science.gov (United States)

    Billi, B; Lesnoni, G; Audisio, P; Giuliano, M A; Rossi, T; Costi, E; Stirpe, M

    1997-04-01

    The authors report a case of posterior internal ophthalmomyiasis causing vitreous haemorrhage and retinal detachment after uncomplicated cataract extraction. The patient suffered an abrupt vitreous haemorrhage 9 days after ECCE and posterior chamber IOL implantation. After 2 months the haemorrhage did not clear up and a retinal detachment arose. The patient underwent encircling scleral buckle, pars plana vitrectomy and fluid-gas exchange. In course of intervention the surgeon removed from the vitreous chamber a 14-mm-long round worm subsequently identified as a dipterous larva of the Sarcophagidae family. The patient showed no sign of subretinal tracking or retinal breaks or holes. The sclerocorneal surgical wound seems the most likely site of entrance of the parasite, and this would then be the first reported case of myiasis with no RPE tracking.

  9. A systematic review on delayed absorption of subretinal fluid after scleral buckling for rhegmatogenous retinal detachment.

    Science.gov (United States)

    Fu, J L; Shi, G; Liu, Z X; Su, G F; Kang, Z C

    Rhegmatogenous retinal detachment is a vision-threatening disease and is treated by either scleral buckling or pars planar vitrectomy. Rapid absorption of the subretinal fluid (SRF) helps in the early recovery of the vision. The absorption of SRF after the scleral buckling procedure is rapid, provided that the retinal break or breaks are closed at or after surgery. However, in some patients with rhegmatogenous retinal detachment, complete absorption of the SRF occur several weeks or months after the surgery. In this review, we discuss the factors influencing the rate of SRF absorption and the role of delayed absorption on visual recovery. We also discuss the therapeutic options for delayed SRF absorption and the available additional therapeutic options. Knowledge of the factors that influence the rate of SRF absorption, would enable the surgeon to predict the outcomes more accurately.

  10. Long-term follow-up of patients after retinal detachment surgery.

    Science.gov (United States)

    Coakes, R L; Ramsay, J H; Tarbuck, D T

    1978-04-01

    The value of long-term follow-up of patients after retinal detachment surgery depends on the number of further detachments prevented. This in turn depends on the frequency with which predisposing lesions are found and treated and also the risk of leaving them untreated. In a retrospective study of 128 patients who had attended the Retina Clinic at Moorfields, High Holborn, for at least 10 years, the frequency with which asymptomatic retinal breaks were detected was less than two per hundred patients per year of follow-up. The risk of such lesions progressing to detachment if left untreated is estimated to be no more than 12 per cent and on this basis it is likely that no more than four or five detachments were prevented in our series. During the same period 66 new or re-detachments occurred, in spite of regular examination and treatment of predisposing lesions found, and it is concluded that long-term follow-up is of doubtful value in the prevention of further detachments.

  11. Correlation of visual recovery with macular height in macula-off retinal detachments.

    Science.gov (United States)

    Mowatt, L; Tarin, S; Nair, R G; Menon, J; Price, N J

    2010-02-01

    To determine the relationship between the preoperative macular height of a macular detachment and visual outcome of the post retinal reattachment. Prospective case series of 26 patients who presented to the Wolverhampton Eye Infirmary with a primary rhegmatogenous macula-off retinal detachment. Macular detachment height was assessed by B-scan ultrasound (10 Mhz) in the seated and supine postures before surgery. Age, gender, duration of the detachment, type of surgery, preoperative (pre-op) and postoperative (post-op) visual acuities at 3 and 6 months and status of the fellow eye were noted. A total of 26 eyes of 26 patients (mean age: 61.4 years+/-15.56 SD) were recruited. The mean logMAR pre- and post-op visual acuities at 3 and 6 months were 1.5+/-1.1 SD (range: 0.2-3), 0.38+/-0.23 SD (range: 0-0.84), and at 6 months 0.29+/-0.22 SD (range: 0-1.0). The median period of the macular detachment was 4.5 days (95% CI: 2-8 days). There was no significant difference between the mean macular heights while seated 2.42 mm+/-1.2 or supine 2.39 mm+/-1.0 (t-test, P=0.9). Correlation showed that the pre-op macular height is a statistical predictor of post-op visual acuity in our group of patients with macula-off retinal detachments. The shallower the macular detachment the greater the likelihood of a good visual outcome.

  12. Scleral buckling procedure with chandelier illumination for pediatric rhegmatogenous retinal detachment.

    Science.gov (United States)

    Yokoyama, Toshiyuki; Kanbayashi, Koki; Yamaguchi, Tamaki

    2015-01-01

    To assess the treatment of pediatric patients with rhegmatogenous retinal detachment (RRD) by scleral buckling with chandelier illumination. Three eyes were treated in three patients, healthy boys aged 7 years, 12 years, and 11 years, with RRD, macular involvement, and small retinal holes, of which two were preoperatively undetectable. Conventional scleral buckling with cryoretinopexy was performed under the contact lens for vitreous surgery or noncontact wide-angle viewing system using 27-gauge twin chandelier illumination. The only known predisposing factor for retinal detachment was myopia stronger than 3 D with lattice retinal degeneration in two of the three patients. Retinal reattachment was achieved in all cases without intra- or postoperative complications. However, visual recovery was limited in one of the three patients. Scleral buckling with chandelier illumination is effective for pediatric RRD, especially if the retinal hole is difficult to detect preoperatively. However, visual recovery was sometimes limited because of macular involvement due to late diagnosis, which is one of the characteristic features of pediatric RRD.

  13. Scleral buckling for retinal detachment in Ibadan, Sub-Saharan Africa: anatomical and visual outcome

    Directory of Open Access Journals (Sweden)

    Oluleye TS

    2013-05-01

    Full Text Available TS Oluleye, OA Ibrahim, BA OlusanyaRetina and Vitreous Unit, Department of Ophthalmology, University College Hospital, Ibadan, NigeriaBackground: Scleral buckle surgery is not a commonly performed surgical procedure in Sub-Saharan Africa due to a paucity of trained vitreo retinal surgeons. The aim of the study was to review sclera buckle procedures with a view to evaluating the anatomical and visual outcomes.Methods: Case records of patients that had scleral buckle surgery at the Retina Unit of the University College Hospital, Ibadan, Nigeria, between 2007 and 2010 were reviewed. Information retrieved included patients' demographics, duration of symptoms, and presenting vision. Other information included site of retinal break, extent of retinal detachment, involvement of the fellow eye, and macular involvement. Postoperative retina reattachment and postoperative visual acuity were also recorded. Proportions and percentages were used to analyze data.Results: Forty five eyes of 42 patients were studied with a male to female ratio of 1.6:1. The mean age was 47.7 years (±17.6 years. The median duration before presentation was 3 months (range: 5 days – 156 months. Subtotal retinal detachment was found in 35 eyes (77.8% while total retinal detachment occurred in ten eyes (22.2%. Thirty four eyes (75.6% had "macular off" detachments. At 6 weeks, there was an improvement in visual acuity in 23 eyes (51.1%, while visual acuity remained the same in nine eyes (20% and was worse in 13 eyes (28.9%. Anatomical attachment was seen in 43 eyes (95.6% on the operation table, in 40 eyes (90.9% at first day postoperatively and in 32 eyes (86.5% at 6 weeks after surgery.Conclusion: Outcome of sclera buckle surgery for rhegmatogenous retinal detachment may be improved in developing countries of Sub Sahara Africa if adequate awareness is created to educate the populace on early presentation.Keywords: retinal detachment, scleral buckle surgery, anatomical and visual

  14. [Functional results of cryosurgical procedures in rhegmatogenous retinal detachment including macula region - our experience].

    Science.gov (United States)

    Chrapek, O; Sín, M; Jirková, B; Jarkovský, J; Rehák, J

    2013-10-01

    Aim of this study is to evaluate retrospectively functional results of cryosurgical treatment of uncomplicated, idiopathic rhegmatogenous retinal detachment including macula region in phakic patients operated on at the Department of Ophthalmology, Faculty Hospital, Palacký University, Olomouc, Czech Republic, E.U., during the period 2002 -2013, and to evaluate the significance of the macula detachment duration for the final visual acuity. In the study group were included 56 eyes of 56 patients operated in the years 2003 - 2012 at the Department of Ophthalmology, Faculty Hospital, Palacký University, Olomouc. All patients were phakic and in all of them, the retinal detachment including the macula region was diagnosed. The mean follow-up period of the patients was 8,75 months. The initial and final visual acuity testing were performed. Comparing the initial and final visual acuity we rated the level of the visual acuity change. The result was stated as improved, if the visual acuity improved by 1 or more lines on the ETDRS chart. The result was rated as stabilized, if the visual acuity remained the same or it changed by 1 line of the ETDRS chart only. The result was evaluated as worsened, if the visual acuity decreased by 1 or more lines of the ETDRS chart. In the followed-up group, the authors compared visual acuity levels in patients with the macula detachment duration 10 days and 11 days. For the statistical evaluation of achieved results, the Mann - Whitney U test was used. The visual acuity improved in 49 (87 %), did not changed in 5 (9 %) and worsened in 2 (4 %) patients. The patients with macula detachment duration 10 days achieved statistically significant better visual acuity than patients with macula detachment duration 11 days. Patients with macula detachment duration 10 days have better prognosis for functional result than patients with macula detachment duration 11 days.

  15. Evolving trends in primary retinal detachment repair: microincisional vitrectomy and the role of OCT.

    Science.gov (United States)

    Williams, Patrick D; Hariprasad, Seenu M

    2014-01-01

    Retinal detachment repair continues to evolve toward less invasive techniques that can safely, efficiently, and consistently provide optimal outcomes. In fact, 53% of U.S. respondents to the American Society of Retinal Specialists 2013 Preferences and Trends Survey said they would perform a vitrectomy without scleral buckle to treat a retinal detachment with a superior tear, while 25% would perform pneumatic retinopexy, and 21% would use a scleral buckle with or without vitrectomy.11 Compared to in 2005, many more surgeons prefer vitrectomy-only repair, whereas fewer prefer scleral buckle. Interestingly, preferences toward pneumatic retinopexy have slightly declined, which may reflect increased confidence in vitrectomy surgery to repair a detached retina safely and efficiently as an alternative. Even complex detachments can be treated in a minimally invasive fashion with the improvements in instrumentation, trocars, and oil infusion. While trends will likely continue toward minimal invasiveness, some form of scleral buckle, vitrectomy, and pneumatic retinopexy will all persist as treatment options. OCT advancements may allow for individualized discussions of visual prognosis and surgical decision making without the need for any invasive testing.

  16. Healing effect analysis of rhegmatogenous retinal detachment in 288 myopic cases

    Directory of Open Access Journals (Sweden)

    Fan Yang

    2014-12-01

    Full Text Available AIM: To understand the prognostic factors of myopic rhegmatogenous retinal detachment(RRDsurgery, and provide guidance for clinical treatment.METHODS: This retrospective study included 288 myopic RRD eyes(excluding trauma, aphakia, congenital diseases, tractional and exudative retinal detachmentfrom April 2007 to April 2014 in our department. The surgical anatomic reduction situation was statistically recorded, the effects of hole's size, retinal detachment duration on sight restoration and surgery success rate were analyzedRESULTS:The statistical results showed that 245 eyes(85.1%healed after their first operation, about 95.1% cases finally healed after their second or third operation. The degree of myopia and aging factor influenced the RRD operation: the higher degree and the older age were, the lower success rates were(PPPCONCLUSION: Surgery is an effective means of treating myopic RRD. The older patients have lower success rates. A higher degree of myopia led lower reset rate after retinal detachment surgery and poor postoperative visual acuity. When treat myopic RRD, we should pay attention to the recovery of visual function.

  17. The influence of refractive error and lattice degeneration on the incidence of retinal detachment.

    Science.gov (United States)

    Burton, T C

    1989-01-01

    This study indicates the feasibility of stratifying the general population into various risk pools for retinal detachment depending on a person's age, refractive status, and the presence of lattice degeneration. At first impression the risks seem at variance with the fine clinical studies of Byer, who has shown a very low detachment rate in the population with lattice degeneration. In all likelihood the vast majority of his patients were emmetropic or mildly myopic, so that very few would be expected to develop detachments during their entire lifetimes, let along during intervals of only 10 to 20 years. This study shows the futility of following, or treating prophylactically, young emmetropic individuals with lattice degeneration. Assuming that prophylaxis is actually effective, one would have to treat 1000 emmetropic lattice patients in the 30 to 39 year age group to prevent a single detachment over a 10-year period. Lattice patients with low to moderate degrees of myopia tend to develop detachments between 40 and 60 years of age caused by premature posterior vitreous separation and tractional tears. Clearly prophylaxis for this group is not warranted, since only 5% to 10% of these individuals will experience detachments in their lifetimes. On the other hand this study has verified the previous suspicions that persons with myopia exceeding -5.0 D accompanied by lattice degeneration have an extraordinarily high risk of detachment during their lifetimes. Detachments in this group tend to cluster in the second, third, and fourth decades, are typically caused by atrophic holes, are slowly progressive, and are often simultaneously bilateral. Enhanced vigilance is certainly appropriate during this time and perhaps consideration should be given to prophylactically treating this group. This would be no small task, since within a population of 1 million persons there would be about 1150 aged 10 to 39 years with myopia exceeding -5.0 D and lattice degeneration. Only 4

  18. Clinical characteristics and surgical management of familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment.

    Science.gov (United States)

    Chen, San-Ni; Hwang, Jiunn-Feng; Lin, Chun-Ju

    2012-02-01

    The purpose of this study was to report the clinical characteristics and surgical outcome of familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment. Retrospective interventional case series of patients with familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment. All cases had preoperative and postoperative clinical evaluations. Eyes were divided into three groups: no, moderate, and severe foveal dragging according to the status of fovea. Scleral buckling procedures or vitrectomy was performed to attach the retina. Twenty-four eyes in 22 patients were included in this study. The male to female ratio was 18:4. The average age was 16.42 ± 5.48 years. There were 14, 5, and 5 eyes in the no, moderate, and severe foveal dragging groups, respectively. Proliferative vitreoretinopathy was present in only one eye in the severe foveal dragging group. In the subgroup of eyes without foveal dragging, neither proliferative vitreoretinopathy, posterior located breaks, nor giant tears were noted. All eyes needed only scleral buckle to reattach the retina. In the subgroup with moderate foveal dragging, posterior located break was noted in one eye, which was the only eye in this group that needed vitrectomy besides scleral buckle to attach the retina. In eyes with severe foveal dragging, Stage D proliferative vitreoretinopathy was noted in one eye and posterior located break in one eye. Encircling buckle and vitrectomy were necessary in all eyes. The average number of operation is 1.1, 1.2, and 2.4 for each of the three groups, respectively. Final visual acuity improved in 23 of 24 eyes. Final retinal attachment was obtained in 95.8% of eyes (23 of 24). Male predominance and juvenile onset are the main characteristics in familial exudative vitreoretinopathy-associated rhegmatogenous retinal detachment. Surgical success rates are comparable to rhegmatogenous retinal detachment unassociated with familial exudative

  19. VISUAL AND ANATOMICAL OUTCOMES AFTER DIABETIC TRACTION AND TRACTION-RHEGMATOGENOUS RETINAL DETACHMENT REPAIR.

    Science.gov (United States)

    Storey, Philip P; Ter-Zakarian, Anna; Philander, Shannon A; Olmos de Koo, Lisa; George, Meena; Humayun, Mark S; Rodger, Damien C; Ameri, Hossein

    2017-08-08

    To evaluate visual and anatomical outcomes of diabetic tractional retinal detachment repaired with pars plana vitrectomy. Operative records were used to retrospectively identify all patients with tractional retinal detachments secondary to proliferative diabetic retinopathy surgically repaired with pars plana vitrectomy between November 1, 2009, and January 1, 2015 at the LAC + USC (Los Angeles County + University of Southern California) Medical Center. A total of 403 eyes with diabetic tractional retinal detachment in 359 patients were included. Successful reattachment of the retina was achieved in 87.6% of eyes after one surgery and 92.6% of eyes at the final follow-up. Best-corrected visual acuity at the final follow-up improved two or more lines in 56.3% of eyes, was stable in 23.8% of eyes, and decreased two or more lines in 19.9% of eyes. Eyes repaired with 23-gauge and 25-gauge vitrectomy systems had similar success rates as eyes treated with 20-gauge instrumentation (P = 0.73). Eyes receiving silicone oil tamponade had lower single-surgery reattachment rates (77.6% vs. 87.6%; P = 0.013), lower reattachment rates at the final follow-up (85.7% vs. 92.6%; P = 0.048), and higher rates of vision loss (34.7% vs. 19.9%; P detachment (47.0% vs. 21.3%; P detachment (74.5% vs. 60.0%; P detachment, vitrectomy achieved excellent anatomical outcome and improved or stabilized vision in 80.1% of eyes. Smaller gauge vitrectomy systems were found to have similar outcomes to 20-gauge instrumentation.

  20. The Effects of Transient Retinal Detachment on Cavity Size and Glial and Neural Remodeling in a Mouse Model of X-Linked Retinoschisis

    Science.gov (United States)

    Luna, Gabriel; Kjellstrom, Sten; Verardo, Mark R.; Lewis, Geoffrey P.; Byun, Jiyun; Sieving, Paul A.; Fisher, Steven K.

    2009-01-01

    Purpose To determine the cellular consequences of retinal detachment in retinoschisin knockout (Rs1-KO) mice, a model for retinoschisin in humans. Methods Experimental retinal detachments (RDs) were induced in the right eyes of both Rs1-KO and wild-type (wt) control mice. Immunocytochemistry was performed on retinal tissue at 1, 7, or 28 days after RD with antibodies to anti-GFAP, -neurofilament, and -rod opsin to examine cellular changes after detachment. Images of the immunostained tissue were captured by laser scanning confocal microscopy. Quantitative analysis was performed to measure the number of Hoechst-stained photoreceptor nuclei and their density, number, and size of inner retinal cavities, as well as the number of subretinal glial scars. Results Since detachments were created with balanced salt solution, by examination, all retinas had spontaneously reattached by 1 day. Cellular responses common to many photoreceptor degenerations occurred in the nondetached retinas of Rs1-KO mice, and, of importance, RD did not appear to significantly accentuate these responses. The number of schisis cavities was not changed after detachment, but their size was reduced. Conclusions These data indicate that large short-term RD in Rs1-KO mice, followed by a period of reattachment may cause a slight increase in photoreceptor cell death, but detachments do not accentuate the gliosis and neurite sprouting already present and may in fact reduce the size of existing retinal cavities. This finding suggests that performing subretinal injections to deliver therapeutic agents may be a viable option in the treatment of patients with retinoschisis without causing significant cellular damage to the retina. PMID:19387072

  1. Retinal pigment epithelial atrophy following indocyanine green dye-assisted surgery for serous macular detachment

    Directory of Open Access Journals (Sweden)

    Hussain Nazimul

    2008-01-01

    Full Text Available To report subretinal migration of indocyanine green dye (ICG and subsequent retinal pigment epithelial (RPE atrophy during macular surgery for serous macular detachment. A 65-year-old woman presented with residual epiretinal membrane and serous detachment of the macula following vitreoretinal surgery for epiretinal membrane. She underwent resurgery with ICG-assisted internal limiting membrane peeling and intraocular tamponade. Intraoperatively a large area of subretinal ICG was seen with subsequent RPE mottling and atrophy of the macula in the area involved during follow-up. This case demonstrates that subretinal migration of ICG is possible and can be toxic to RPE.

  2. Pars plana vitrectomy without adjuvant procedures for repair of primary rhegmatogenous retinal detachment.

    Science.gov (United States)

    Schneider, Eric W; Geraets, Ryan L; Johnson, Mark W

    2012-02-01

    To evaluate the anatomical and functional outcomes of pars plana vitrectomy without adjuvant scleral buckling, prophylactic 360° endolaser photocoagulation, or perfluorocarbon liquid use for the treatment of primary uncomplicated rhegmatogenous retinal detachment. Retrospective interventional case series of consecutive patients undergoing vitrectomy for noncomplex rhegmatogenous retinal detachment over a 10-year period. Main outcome measures included primary anatomical success rate, defined as retinal reattachment at final follow-up after a single operation, proportion of eyes achieving a final best-corrected visual acuity ≤ logarithm of the minimum angle of resolution 0.3 (≥ Snellen 20/40), and postoperative complications. With a mean follow-up of 31 months, primary anatomical success was achieved in 95.7% (89 of 93) of eyes. Final anatomical success, defined as retinal attachment at final follow-up without regard to additional procedures, was achieved in 98.9% (92 of 93). Final best-corrected visual acuity of ≤ logarithm of the minimum angle of resolution 0.3 (≥ Snellen 20/40) was achieved in 77.4% of eyes in the cohort. Postoperative proliferative vitreoretinopathy developed in 3.2% of eyes. No new retinal breaks developed postoperatively in the absence of clinically evident proliferative vitreoretinopathy. Thorough pars plana vitrectomy alone, without adjuvant scleral buckling, 360° endolaser photocoagulation, or routine perfluorocarbon liquid use, yields high anatomical and functional success rates and low complication rates in the treatment of primary uncomplicated rhegmatogenous retinal detachment. In the absence of observable proliferative vitreoretinopathy, postoperative vitreous base contraction does not appear to be a clinically relevant phenomenon.

  3. Massive Retinal Pigment Epithelial Detachment Following Acute Hypokalemic Quadriparesis in Dengue Fever.

    Science.gov (United States)

    Goel, Neha; Bhambhwani, Vishaal; Jain, Pooja; Ghosh, Basudeb

    2016-01-01

    To describe an unusual retinal manifestation of dengue fever in an endemic region. A 35 year old male presenting with acute onset decreased vision in his right eye, was found to have a massive retinal pigment epithelial detachment (PED) extending up to the vascular arcades. He had been diagnosed with acute hypokalemic quadriparesis in dengue fever in the preceding week, which had resolved following treatment. The patient was managed conservatively. At three months follow up, there was spontaneous flattening of the PEDs with improvement in visual acuity. Dengue fever complicated by acute hypokalemic quadriparesis can be associated with PED, which can be large. The condition resolves spontaneously and bears a good prognosis.

  4. Elastic stability of silicone ferrofluid internal tamponade (SFIT) in retinal detachment surgery

    International Nuclear Information System (INIS)

    Voltairas, P.A.; Fotiadis, D.I.; Massalas, C.V.

    2001-01-01

    It has been argued that silicone ferrofluid internal tamponade (SFIT) can provide (360 deg.) tamponade of the retina in retinal detachment surgery. Provided that the produced SFIT is biocompatible, exact knowledge is needed of its elastic stability in the magnetic field produced by the semi-solid magnetic silicon band (MSB) used as a scleral buckle. We propose a quantitative, phenomenological model to estimate the critical magnetic field produced by the MSB that 'closes' retinal tears and results in the reattachment of the retina. The magnetic 'deformation' of SFIT is modeled in accordance with the deformation of a ferrofluid droplet in an external magnetic field

  5. Serous retinal detachment accompanied by MEWDS in a myopic patient with dome-shaped macula.

    Science.gov (United States)

    Shin, Min Kyu; Byon, Ik Soo; Park, Sung Who; Lee, Ji Eun

    2014-01-01

    Macular serous retinal detachment (MSRD) is a rare complication in highly myopic patients with an inferior staphyloma, tilted disc, or dome-shaped macula. Multiple evanescent white dot syndrome (MEWDS) presents with sudden visual loss and multiple yellowish dots that resolve spontaneously within several weeks. The authors report the development and spontaneous resolution of subretinal fluid accompanied by MEWDS in a myopic patient with a dome-shaped macula. Dysfunction of the retinal pigment epithelium due to MEWDS likely induced temporary MSRD in this patient. Copyright 2014, SLACK Incorporated.

  6. Elastic stability of silicone ferrofluid internal tamponade (SFIT) in retinal detachment surgery

    Energy Technology Data Exchange (ETDEWEB)

    Voltairas, P.A. E-mail: pvolter@cs.uoi.gr; Fotiadis, D.I.; Massalas, C.V

    2001-07-01

    It has been argued that silicone ferrofluid internal tamponade (SFIT) can provide (360 deg.) tamponade of the retina in retinal detachment surgery. Provided that the produced SFIT is biocompatible, exact knowledge is needed of its elastic stability in the magnetic field produced by the semi-solid magnetic silicon band (MSB) used as a scleral buckle. We propose a quantitative, phenomenological model to estimate the critical magnetic field produced by the MSB that 'closes' retinal tears and results in the reattachment of the retina. The magnetic 'deformation' of SFIT is modeled in accordance with the deformation of a ferrofluid droplet in an external magnetic field.

  7. Analysis of 50 cases of traumatic retinal detachment diagnosed by color Doppler ultrasound and two-dimensional ultrasound

    Directory of Open Access Journals (Sweden)

    Guo-An Liu

    2014-07-01

    Full Text Available AIM: To evaluate the value of color Doppler ultrasound in the diagnosis of traumatic retinal detachment. METHODS:All 50 cases(56 eyesof suspicious traumatic retinal detachment from January to June in 2013 were enrolled in this study. All first received the two-dimensional ultrasound, then the color Doppler ultrasound, finally, these results were compared with the results of surgery. RESULTS:All 56 eyes were observed intravitreal abnormal spots by the two-dimensional ultrasound, and 39 eyes were observed color blood signal by the color Doppler ultrasound. Forty eyes were approved retinal detachment by surgery. CONCLUSION: It is better to display the intravitreal abnormal spots and color blood signal by the color Doppler ultrasound than by the two-dimensional ultrasound, so there is important clinical significance of the color Doppler ultrasound in the diagnosis of traumatic retinal detachment.

  8. Thermofusion of the retina with the RPE to seal tears during retinal detachment repair.

    Science.gov (United States)

    Heriot, Wilson J

    2016-04-01

    To develop an animal model to test the hypothesis that immediate adhesion of the retina to the choroid (retinopexy) can be created by elimination of the water separating the retina from the retinal pigment epithelium (RPE) prior to photocoagulation. The retina and RPE are hydrophobic lipoprotein structures separated intraoperatively by a thin layer of fluid despite surgical drainage. If the RPE and retina are contacting, heating should create a unified local coagulum and achieve instantaneous fusing of the retina and RPE, thus sealing the subretinal space around the retinal tear. The surgical technique and histological findings in a rabbit model of rhegmatogenous retinal detachment (RRD) are reported here. Nine Dutch-belted, pigmented rabbits underwent vitrectomy with lensectomy, creation of localised retinal detachment by subretinal injection of balanced salt solution (BSS), enlargement of the hole and fluid-gas exchange to "re-attach" the retina. Dehydration of the retina surrounding the hole was achieved by an airstream from a flute needle. A laser (810 nm) was applied in long pulses to achieve a mild retinal reaction around the hole in the dehydrated adjacent retina. The BSS irrigation was resumed. Eyes were then enucleated and the treated retina examined histologically. The dehydrated and lasered retinal tear margin demonstrated fusion of the retina with the RPE/choroid. The non-dehydrated adjacent areas showed thermal tissue changes in the retina, RPE/choroid and adjacent sclera but remained separated by persistent subretinal fluid and no fusion or unified coagulum developed. Immediate laser-induced thermal fusion of the retina with the RPE at the margin of a retinal tear can be achieved by removing the subretinal fluid prior to photocoagulation. The integrated coagulum seals the tear margin preventing further fluid entering the subretinal space, thus correcting the cause of RRD. This method may facilitate RRD repair without buckling or internal tamponade.

  9. Clinical outcomes of endoscope-assisted vitrectomy for treatment of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Yokoyama S

    2017-11-01

    Full Text Available Sho Yokoyama,1 Takashi Kojima,2 Toshio Mori,3 Taisuke Matsuda,1 Hiroyuki Sato,3 Norihiko Yoshida,4 Tatsushi Kaga,1 R Theodore Smith,5 Kazuo Ichikawa6 1Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan; 2Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 3Department of Ophthalmology, Iida Municipal Hospital, Iida, Japan; 4Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan; 5Department of Ophthalmology, New York University School of Medicine, New York, NY, USA; 6Chukyo Eye Clinic, Nagoya, Japan Summary: We evaluated the clinical outcomes for ophthalmic endoscope-assisted vitrectomy in consecutive patients with uncomplicated rhegmatogenous retinal detachment (RRD. The primary success rate was 98.4% (125/127 without performing a posterior drainage retinotomy or using perfluorocarbon liquids (PFCL for subretinal fluid drainage.Purpose: To investigate the clinical outcomes of endoscope-assisted vitrectomy in patients with uncomplicated RRD.Methods: We examined 127 eyes from consecutive patients who underwent repair of RRD by 23- or 25-gauge endoscope-assisted vitrectomy, with a minimum follow-up of 3 months. Eyes with the following criteria were excluded: Giant retinal tears, grade C proliferative vitreoretinopathy, dense vitreous hemorrhage, retinal detachment secondary to other ocular diseases, and prior retinal or vitreous surgery. All cases underwent subretinal fluid drainage, endolaser photocoagulation and fundus inspection were performed under ophthalmic endoscopic observation. Success rate, visual acuity, surgery time and complications were evaluated.Results: Primary and final success rate was 98.4% (125/127 and 100% (127/127, respectively, Surgery time was 59.6±26.3 minutes. The best-corrected visual acuity significantly improved from 20/100 to 20/20 (P<0.0001. There were 2 cases (1.6% of creation of a peripheral drainage retinotomy and 4

  10. A case of Alagille syndrome complicated by intraocular lens subluxation and rhegmatogenous retinal detachment

    OpenAIRE

    Fukumoto, Masanori; Ikeda,Tsunehiko; Sugiyama,Tetsuya; Ueki,Mari; Isizaki,Eisuke; Satou,Takaki

    2013-01-01

    Masanori Fukumoto, Tsunehiko Ikeda, Tetsuya Sugiyama, Mari Ueki, Takaki Sato, Eisuke Ishizaki Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan Abstract: This case report describes a case of Alagille syndrome with developing intraocular lens subluxation and rhegmatogenous retinal detachment 4 years after cataract surgery. A 15-year-old female patient with Alagille syndrome-associated cataracts in both eyes underwent phacoemulsification aspiration and intraocular lens ...

  11. Postoperative recovery of visual function after macula-off rhegmatogenous retinal detachment.

    Science.gov (United States)

    van de Put, Mathijs A J; Croonen, Danna; Nolte, Ilja M; Japing, Wouter J; Hooymans, Johanna M M; Los, Leonoor I

    2014-01-01

    To determine which factors affect the recovery of visual function in macula off rhegmatogenous retinal detachment (RRD). In a prospective study of forty-five patients with a primary macula-off RRD of 24 hours to 6 weeks duration, the height of the macular detachment was determined by ultrasonography. At 12 months postoperatively, best corrected visual acuity (BCVA), contrast acuity, and color confusion indexes (CCI) were obtained. Macular detachment was present for 2-32 (median 7) days before repair. A shorter duration of macular detachment was correlated with a better CCI saturé (p = 0.0026) and lower LogMAR BCVA (better Snellen visual acuity) (p = 0.012). Also, a smaller height of macular detachment was correlated with a lower LogMAR BCVA (p = 0.0034). A younger age and lower pre-operative LogMAR BCVA at presentation were both correlated with better postoperative contrast acuity in the total group (age: p = 1.7×10(-4) and pre-operative LogMAR BCVA: p = 0.0034). Functional recovery after macula-off RRD is affected by the duration and the height of the macular detachment. Recovery of contrast acuity is also affected by age and BCVA at presentation. ARVO annual meeting 2013, May 7, Seattle, Washington, United States of America. trialregister.nl NTR839.

  12. Postoperative recovery of visual function after macula-off rhegmatogenous retinal detachment.

    Directory of Open Access Journals (Sweden)

    Mathijs A J van de Put

    Full Text Available PURPOSE: To determine which factors affect the recovery of visual function in macula off rhegmatogenous retinal detachment (RRD. METHODS: In a prospective study of forty-five patients with a primary macula-off RRD of 24 hours to 6 weeks duration, the height of the macular detachment was determined by ultrasonography. At 12 months postoperatively, best corrected visual acuity (BCVA, contrast acuity, and color confusion indexes (CCI were obtained. RESULTS: Macular detachment was present for 2-32 (median 7 days before repair. A shorter duration of macular detachment was correlated with a better CCI saturé (p = 0.0026 and lower LogMAR BCVA (better Snellen visual acuity (p = 0.012. Also, a smaller height of macular detachment was correlated with a lower LogMAR BCVA (p = 0.0034. A younger age and lower pre-operative LogMAR BCVA at presentation were both correlated with better postoperative contrast acuity in the total group (age: p = 1.7×10(-4 and pre-operative LogMAR BCVA: p = 0.0034. CONCLUSION: Functional recovery after macula-off RRD is affected by the duration and the height of the macular detachment. Recovery of contrast acuity is also affected by age and BCVA at presentation. MEETING PRESENTATION: ARVO annual meeting 2013, May 7, Seattle, Washington, United States of America. TRIAL REGISTRATION: trialregister.nl NTR839.

  13. Anatomical and functional results of primary pars plana vitrectomy in rhegmatogenous retinal detachment.

    Science.gov (United States)

    Gerding, H; Hersener, A

    2013-04-01

    It was the aim of this retrospective study to analyse the anatomical success rate and functional outcome of patients with rhegmatogenous retinal detachments treated primarily by pars plana vitrectomy (PPV). 157 of 200 eyes (79%, 89 phakic (57%), 67 pseudophakic (43%), 1 aphakic) with rhegmatogenous retinal detachment were treated by primary pars plana vitrectomy. 132 cases (84%) completed 6 months, 131 (83%) 12 months, and 108 cases (69%) 24 months of follow-up. Selection of surgical methods was guided by recommendations from the SPR study. Different from these recommendations, phakic eyes were treated by primary PPV if the chance of successful scleral buckling was estimated to be detachment presented during silicon removal. A second surgical intervention for the treatment of re-detachment became necessary in 8 eyes during follow-up. The rate of permanent single-intervention (except silicon removal) attachment was 92.4%. Finally the retina was completely attached in all eyes. Visual acuity improved from a preoperative level of logMAR 1.01 to 0.48 at month 6, 0.40 at month 12 and 0.33 at month 24. Mean final visual acuity at month 24 was 0.32 in phakic eyes and 0.35 in pseudophakic eye (difference not significant). Significant differences in visual acuity were found in relation to the preoperative status of the fovea. The results of this case series, together with the previous published outcome of a cohort treated in the identical study period by scleral buckling, indicate that the outcome of retinal detachment surgery in an average cohort of patients can be expected to be much better than suggested by results of the SPR study. Georg Thieme Verlag KG Stuttgart · New York.

  14. The predisposing pathology and clinical characteristics in the Scottish retinal detachment study.

    Science.gov (United States)

    Mitry, Danny; Singh, Jaswinder; Yorston, David; Siddiqui, M A Rehman; Wright, Alan; Fleck, Brian W; Campbell, Harry; Charteris, David G

    2011-07-01

    To describe the predisposing pathology and clinical features of all incident cases of rhegmatogenous retinal detachment (RRD) recruited in Scotland during a 2-year period. Prospective surveillance study of incident cases of RRD. All incident cases of RRD recruited as part of the Scottish Retinal Detachment Study. During a 2-year period, we coordinated a comprehensive system in which every case of primary RRD presenting to 1 of 6 vitreoretinal surgical sites in Scotland was examined and approached for study inclusion. Rhegmatogenous retinal detachment incidence, predisposing features, and clinical characteristics. A total of 1202 cases were recruited. Detailed clinical information was available on 1130 (94%) of cases. By causative break, the proportions of RRD were horseshoe tear (HST) associated with posterior vitreous detachment (PVD) in 86.2%, giant retinal tear (GRT) and PVD in 1.3%, non-PVD round hole (RH) in 4.9%, retinal dialysis in 5.9%, and retinoschisis RRD in 1.6%. One in 10 cases reported significant ocular trauma. One in 5 cases were pseudophakic. Round hole RRD more frequently presented with multiple retinal breaks compared with HST RRD (67.8% vs. 48.7%; P = 0.003). In PVD-associated RRD, 56.1% (95% confidence interval [CI], 53.8-58.3) of breaks were identified in the superotemporal retina. In non-PVD RRD, 54.6% (95% CI, 47.9-61.1) of breaks were inferotemporal, followed by superotemporal in 34.9% (95% CI, 28.7-41.5). Lattice degeneration was present in 18.7% of affected eyes and more common in RH RRD (35.7%) than in HST RRD (19.3%) (P = 0.003). Seven percent reported an affected first-degree relative, and these cases were significantly more myopic than nonfamilial cases. More than 85% of RRD cases are associated with PVD and related tractional tears. Non-PVD RH RRD occurred in younger and more myopic individuals. The majority of cases are caused by more than 1 retinal break, and the macula is affected in more than 50% at presentation. Ocular trauma

  15. Serous retinal detachment following panretinal photocoagulation (PRP) using Pattern Scan Laser (PASCAL) photocoagulator.

    Science.gov (United States)

    Azar, Georges; Wolff, Benjamin; Cornut, Pierre-Loïc; Mauget-Faÿsse, Martine

    2012-01-01

    To report a case of serous retinal detachment after Pattern Scan Laser (PASCAL) treatment in a diabetic woman. A 34-year-old diabetic woman presented with florid diabetic retinopathy after a miscarriage during the 20(th) week of pregnancy. Her Best Corrected Visual Acuity (BCVA) was 20/40 right eye (OD) and 20/30 left eye (OS). Fundus exam showed multiple microaneurysms, large blot hemorrhages and venous dilation both eyes (OU). Fundus fluorescein angiography (FFA) revealed large areas of capillary nonperfusion and panretinal neovascularisation in all quadrants OU. Macular Spectral-Domain Optical Coherence Tomography scan (SD-OCT) did not show any foveal thickening. Panretinal photocoagulation (PRP) was immediately performed OU during the same day. Two days after PASCAL treatment, her BCVA decreased to 20/80 OU and worsened to Count Fingers (CF) during the following days. Fundus exam revealed an extensive serous retinal detachment confirmed on SD-OCT. 2 sub-conjunctival injections of 0.1 ml Betamethasone were done OU. One month later, BCVA improved to 20/30 and SD-OCT confirmed regression of retinal detachment. PASCAL is considered to be a safe treatment, but one has to be aware of its potential side effects. It has to be used with caution in pregnant women.

  16. A case of Alagille syndrome complicated by intraocular lens subluxation and rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Fukumoto M

    2013-07-01

    Full Text Available Masanori Fukumoto, Tsunehiko Ikeda, Tetsuya Sugiyama, Mari Ueki, Takaki Sato, Eisuke Ishizaki Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan Abstract: This case report describes a case of Alagille syndrome with developing intraocular lens subluxation and rhegmatogenous retinal detachment 4 years after cataract surgery. A 15-year-old female patient with Alagille syndrome-associated cataracts in both eyes underwent phacoemulsification aspiration and intraocular lens implantation. Four years postoperative, intraocular lens subluxation developed in her left eye. For treatment, extraction of the dislocated intraocular lens, anterior vitrectomy, and intraocular lens fixation was performed. Three weeks later, the patient developed rhegmatogenous retinal detachment, which was well-treated by pars plana vitrectomy. Cataract surgery needs to be performed carefully in patients with Alagille syndrome due to the weakness of the zonule of Zinn. Careful postoperative observation is necessary for patients with Alagille syndrome who have undergone intraocular surgery in order to facilitate early detection of a possible rhegmatogenous retinal detachment. Keywords: Alagille syndrome, cataract, retina, surgery

  17. Changes in contrast sensitivity after surgery for macula-on rhegmatogenous retinal detachment.

    Science.gov (United States)

    Okamoto, Fumiki; Sugiura, Yoshimi; Okamoto, Yoshifumi; Hiraoka, Takahiro; Oshika, Tetsuro

    2013-10-01

    To evaluate changes in contrast sensitivity after surgery for macula-on rhegmatogenous retinal detachment (RRD). Prospective, interventional, consecutive, case-control study. This study included 84 eyes of 84 patients with unilateral macula-on RRD undergoing primary scleral buckling or vitrectomy without postoperative macular complication. We examined the logarithm of the minimal angle of resolution best-corrected visual acuity (logMAR BCVA) and contrast sensitivity at 4 spatial frequencies (3, 6, 12, and 18 cycles/degree) using the CSV-1000E (Vector Vision) before and after surgery. From the data obtained with the CSV-1000E, the area under the log contrast sensitivity function was calculated. The logMAR BCVA and contrast sensitivity in the contralateral normal eyes also were measured and were used as normal controls. Clinical data were collected, including age, gender, surgical procedures, the number of retinal tears, circumferential dimension of retinal tears, and area of retinal detachment, to determine the clinical factors related to visual function. Preoperative contrast sensitivity was significantly worse in eyes with RRD than in normal controls, but the preoperative logMAR BCVA was not different from that of normal controls. Contrast sensitivity decreased significantly after surgery, but logMAR BCVA did not change by surgery. Multiple regression analysis revealed that postoperative contrast sensitivity had a significant correlation with the circumferential dimension of retinal tears, whereas no clinical parameters were associated significantly with postoperative BCVA. Surgery for macula-on RRD did not change visual acuity, whereas contrast sensitivity was affected significantly in association with the extent of retinal tears. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Optical coherence tomography evaluation of patients with macula-off retinal detachment after different postoperative posturing: a randomized pilot study

    NARCIS (Netherlands)

    Peiretti, Enrico; Nasini, Francesco; Buschini, Elisa; Caminiti, Giulia; Lesnik Oberstein, Sarit Y.; Willig, Alissa; Bijl, Heico M.; Mura, Marco

    2017-01-01

    To assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO). In this

  19. RhoA Inactivation Prevents Photoreceptor Axon Retraction in an In Vitro Model of Acute Retinal Detachment

    Science.gov (United States)

    Fontainhas, Aurora Maria

    2011-01-01

    Purpose. An early injury response to retinal detachment is disruption of synaptic connectivity between photoreceptors and second-order neurons. Most dramatic is the retraction of rod cell axons and their terminals away from the outer synaptic layer and toward their cell bodies. This study tested whether axonal retraction in detached retina was due to the activation of the small GTPase RhoA and was preventable using RhoA antagonists. Methods. Retinal detachments were created in in vitro preparations of porcine eyecups. RhoA activation was determined with a Rhotekin binding assay. To block axon retraction, drugs were applied to neural retinal explants either before or after detachment from the retinal pigment epithelium. Presynaptic movement was quantified by image analysis of double-labeled retinas examined with confocal microscopy. Results. Active RhoA increases transiently after detachment followed by morphologic evidence of axonal retraction over the next 24 hours. Pretreating the retina with a RhoA antagonist, CT-04, or a Rho kinase inhibitor, Y27632, at multiple concentrations significantly inhibited axonal retraction. Reducing calcium influx through L-type calcium channels with nicardipine also blocked retraction. To create a more plausible therapeutic scenario, drug treatments were delayed and applied after retinal detachment. The Rho kinase inhibitor, but not nicardipine, significantly blocked rod axonal retraction when applied up to 6 hours after detachment. Conclusions. Thus, RhoA and downstream Rho kinase activity constitute part of the mechanism that produces rod axonal retraction in retinal explants. Treatments that manipulate RhoA signaling may promote synaptic stability after retinal detachment. PMID:20861490

  20. Posterior vitreous detachment with microplasmin alters the retinal penetration of intravitreal bevacizumab (Avastin) in rabbit eyes.

    Science.gov (United States)

    Goldenberg, David T; Giblin, Frank J; Cheng, Mei; Chintala, Shravan K; Trese, Michael T; Drenser, Kimberly A; Ruby, Alan J

    2011-02-01

    Intravitreal bevacizumab (BV) (Avastin, Genentech Inc., South San Francisco, CA) is frequently used for the treatment of age-related macular degeneration. Previous studies have demonstrated full-thickness retinal penetration. Intravitreal recombinant microplasmin (MP) has been shown to successfully induce a posterior vitreous detachment (PVD) and vitreous liquefaction in animals. It has been suggested that a PVD may alter the retinal penetration of molecules in the vitreous cavity. The aim of this study was to compare BV retinal penetration in rabbit eyes with and without an MP-induced PVD. Twelve adult rabbits were injected with 0.1 mL (0.4 mg) of MP into the vitreous cavity of 1 eye. One week later, the rabbits were injected with 0.05 mL (1.25 mg) of BV into both eyes. Both eyes of 3 rabbits were harvested at 6 hours, 12 hours, 24 hours, and 72 hours after the BV injection. Frozen retinal cross sections were prepared, and BV retinal penetration was evaluated with immunohistochemistry using a fluorescence-labeled antibody against BV. Two eyes from one rabbit were not injected with either agent and used as controls to compare the background autofluorescence. Peripapillary retinal sections were recorded with a digital camera, and intraretinal BV fluorescence-labeled antibody was measured by qualitative photographic interpretation. Two additional rabbits received an intravitreal injection of 0.1 mL of MP in 1 eye. One week later, both eyes from each rabbit were enucleated, and frozen retinal sections were prepared and analyzed with light microscopy to evaluate histologic damage. Full-thickness BV retinal penetration was observed throughout the retina in both eyes of each rabbit. All the MP-injected eyes exhibited increased antibody labeling in retinas evaluated at 6 hours, 12 hours, and 24 hours after BV injection when compared with the contralateral non-MP-injected eyes. By 3 days after BV injection, all eyes demonstrated decreased antibody labeling compared with

  1. BRIDGE ARCH-SHAPED SEROUS RETINAL DETACHMENT IN AGE-RELATED MACULAR DEGENERATION.

    Science.gov (United States)

    Fajnkuchen, Franck; Cohen, Salomon Y; Thay, Nathalie; Ayrault, Sandrine; Delahaye-Mazza, Corinne; Grenet, Typhaine; Nghiem-Buffet, Sylvia; Quentel, Gabriel; Giocanti-Auregan, Audrey

    2016-03-01

    To describe bridge arch-shaped serous retinal detachment (SRD) in exudative age-related macular degeneration and evaluate its functional outcomes. In this monocentric, retrospective, noncomparative case series, patients were included. Patients with exudative age-related macular degeneration and bridge arch-shaped SRD treated with ranibizumab were included. Anatomical patterns of SRD and functional outcomes were assessed. Twenty-two eyes with bridge arch-shaped SRD of 22 patients with age-related macular degeneration were included. Serous retinal detachments were characterized by a steep angle at the junction between the retinal pigment epithelium and the sensory retina (mean, 53.45 ± 12.5°), and characterized by the presence of adhesion areas between the sensory retina and a fibrous complex developed from the choroidal neovascularization. In 15 eyes, the choroidal neovascularization was classic choroidal neovascularization and a fibrotic evolution was observed. Serous retinal detachments were compartmentalized in 14 eyes, leading to a multipocket structure. Visual acuity decreased from 49.9 ± 19.2 letters (20/100) to 40.3 ± 18.6 letters (20/160), corresponding to a mean change of -9.6 ± 19.4 letters. This was the first study to describe the specific morphologic features of bridge arch-shaped SRD, a previously undescribed type of SRD complicating exudative age-related macular degeneration. Patients with bridge arch-shaped SRD responded to intravitreal injections of ranibizumab, but their visual prognosis was unfavorable, compared with the literature. The presence of bridge arch-shaped SRD seemed to be a marker for the fibrotic evolution of the choroidal neovascularization.

  2. Shape change of the vitreous chamber influences retinal detachment and reattachment processes: is mechanical stress during eye rotations a factor?

    Science.gov (United States)

    Meskauskas, Julia; Repetto, Rodolfo; Siggers, Jennifer H

    2012-09-19

    We aim to understand how mechanical causation influences retinal detachment and reattachment processes. In particular, myopes suffer retinal detachment more frequently than emmetropes, and following a retinal detachment, scleral buckling promotes retinal reattachment. We test the hypothesis that stresses arising from saccadic eye rotations are involved in the processes, and that the alteration in the stress due to the change in the vitreous chamber geometry is sufficient to explain the phenomena. The vitreous chamber of the eye has an approximately spherical shape and it is filled with vitreous humor. We developed a mathematical model, treating the vitreous chamber in emmetropic and myopic eyes as a spheroid and in eyes subjected to scleral buckling as a sphere with a circumferential indentation. We assume that the eye performs prescribed small-amplitude, periodic, torsional rotations and we solve semi-analytically for the fluid pressure, velocity, and stress distributions. The shape of the vitreous chamber has a large effect on the retinal stress. The vitreous and the retina of a highly myopic eye continuously experience shear stresses significantly higher than those of an emmetropic eye. An eye fitted with a scleral buckle experiences large stress levels localized around the buckle. Our results provide a mechanical explanation for the more frequent occurrence of posterior vitreous detachment and retinal detachment in myopic eyes. To understand how the stress distribution in a buckled eye facilitates reattachment, an additional model of the details of the reattachment process should be coupled to this model.

  3. Hypoxia inducible factor 1α contributes to regulation of autophagy in retinal detachment

    Science.gov (United States)

    Shelby, Shameka J.; Angadi, Pavan S.; Zheng, Qiong-Duon; Yao, Jingyu; Jia, Lin; Zacks, David N.

    2015-01-01

    Photoreceptor (PR) cells receive oxygen and nutritional support from the underlying retinal pigment epithelium (RPE). Retinal detachment results in PR hypoxia and their time-dependent death. Detachment also activates autophagy within the PR, which serves to reduce the rate of PR apoptosis. In this study, we test the hypothesis that autophagy activation in the PR results, at least in part, from the detachment-induced activation of hypoxia-inducible factors (HIF). Retina-RPE separation was created in Brown-Norway rats and C57BL/6J mice by injection of 1% hyaluronic acid into the subretinal space. Retinas were harvested and assayed for HIF protein levels. Cultured 661W photoreceptor cells were subjected to hypoxic conditions and assayed for induction of HIF and autophagy. The requirement of HIF-1α and HIF-2α in regulating photoreceptor autophagy was tested using siRNA in vitro and in vivo. We observed increased levels of HIF-1α and HIF-2α within 1 day post-detachment, as well as increased levels of BNIP3, a downstream target of HIF-1α that contributes to autophagy activation. Exposing 661W cells to hypoxia resulted in increased HIF-1α and HIF-2α levels and increase in conversion of LC3-I to LC3-II. Silencing of HIF-1α, but not HIF-2α, reduced the hypoxia-induced increase in LC3-II formation and increased cell death in 661W cells. Silencing of HIF-1α in rat retinas prevented the detachment-induced increase in BNIP3 and LC3-II, resulting in increased PR cell death. Our data support the hypothesis that HIF-1α, but not HIF-2α, serves as an early response signal to induce autophagy and reduce photoreceptor cell death. PMID:26093278

  4. Ocular coherence tomographic examination of postoperative foveal architecture after scleral buckling vs vitrectomy for macular off retinal detachment.

    LENUS (Irish Health Repository)

    Gibran, S K

    2012-02-03

    AIMS: This pilot study uses Optical Coherence Tomography (OCT) imaging to compare the difference in foveal architecture after successful retinal detachment (RD) surgery by scleral buckling or pars plana vitrectomy (PPV). METHODS: Prospective recruitment of patients with macular off RDs. Detachment surgery was undertaken by scleral buckling, external drainage, and air injection (group 1) or by PPV (group 2). Postoperatively patients had clinical examinations and OCT at 1, 3, 6, and 12 months. If abnormalities persisted, a further OCT was obtained at 18 months. RESULTS: Retinal reattachment, including clinical macular reattachment, was achieved in all cases within 24 h postoperatively. In group 1 (n=22), postoperative OCT showed persistent foveal detachment in 63% of cases (n=14) at 1 and 3 months. At 6 and 12 months, 36% (n=8) and 9% (n=2) had a persistent foveal detachment, respectively, and at 18 months, foveal detachment eventually. In group 2 (n=21), postoperative OCT showed an attached fovea in all cases; however, foveal thickening suggesting intraretinal oedema was present in all cases. The oedematous appearance of retina on OCT settled in 1-3 months. No foveal abnormality was seen at 6 and 12 months postoperatively. CONCLUSIONS: A high proportion of patients with successful retinal reattachment surgery by scleral buckling had foveal detachments postoperatively. No cases who had PPV had foveal detachments; however, transient retinal oedema was evident in all cases. The aetiology of these changes is unknown and warrants further investigation, as there is the potential of a long-term effect on vision.

  5. The effect of a preoperative subconjuntival injection of dexamethasone on blood-retinal barrier breakdown following scleral buckling retinal detachment surgery: a prospective randomized placebo-controlled double blind clinical trial

    NARCIS (Netherlands)

    E. Bali (Ernesto); E.J. Feron (Eric); E. Peperkamp (Ed); M.A.H. Veckeneer (Marc); P.G.H. Mulder (Paul); J.C. van Meurs (Jan)

    2010-01-01

    textabstractBackground: Blood-retinal barrier breakdown secondary to retinal detachment and retinal detachment repair is a factor in the pathogenesis of proliferative vitreoretinopathy (PVR). We wished to investigate whether an estimated 700 to 1000 ng/ml subretinal dexamethasone concentration at

  6. Scleral Buckling with and without Retinopexy and Laser Photocoagulation for Treatment of Rhegmatogenous Retinal Detachment

    Directory of Open Access Journals (Sweden)

    A Ghodosi

    2008-10-01

    Full Text Available Introduction: There are different methods to repair retinal detachment. In this trial the retinopexy in repairmen of retinal regmatogenesis RD is compared with other methods in Qazvin Teaching Hospitals during 1993-2003. Methods: This out come study was conducted on 47 patients with S/B and retinal break cryopexy (group I , 30 patients undergoing S/B with barrier laser photocoagulation around retinal breaks (group II and 41 patients with S/B without retinopexy (group III. An encircling or segmental buckle was placed for all eyes. In some patients, subretinal fluid drainage (SRED or anterior chamber paracentesis and intravitreal air dubble injection was performed. The patients were followed for 3 to 48 months. T. test, chi square and fisher exact test were used for data analysis. Results: The groups were similar with respect to age, sex, lens status, visual acuity, type, number and location of break. There were no differences in the surgical procedure performed. The reattachment rate in group I was 91.5% , in group II 86.7% and in group III was 97.6%, a difference that was not significant. Conclusions: With S/B procedure, retinal cryopexy does not seem to increase success rate of operation.

  7. Incidence of retinal detachment associated with atopic dermatitis in Japan: review of cases from 1992 to 2011

    Directory of Open Access Journals (Sweden)

    Sasoh M

    2015-06-01

    Full Text Available Mikio Sasoh,1,2 Hitoshi Mizutani,3 Hisashi Matsubara,1 Motoyasu Furuta,4 Yoshitsugu Matsui,1 Kei-ichi Yamanaka,3 Mineo Kondo11Department of Ophthalmology, Graduate School of Medicine, Mie University, Tsu, 2Local Independent Administrative Institution, Mie Prefectural General Medical Center, Yokkaichi, 3Department of Dermatology, Graduate School of Medicine, Mie University, Tsu, 4Japanese Red Cross Ise Hospital, Ise, Mie, JapanPurpose: The present study aims to investigate the number and characteristics of retinal detachment with atopic dermatitis (AD in these 20 years, and the number of the first visit AD outpatients in almost the same period.Methods: A retrospective review of 101 consecutive surgically treated retinal detachments with AD patients from 1992 to 2011 was conducted. Retinal detachments were divided into two groups: eyes operated on from 1992 to 2001 (former AD group, n=63 and eyes operated on from 2002 to 2011 (recent AD group, n=38. We also reviewed the records of the first visit AD outpatients from 1993 to 2011 except 1998.Results: The percentage of bilateral detachment was significantly higher in the former AD group (14/63 than that in the recent AD group (0/38 (P=0.0002. In addition, patients in the recent AD group were significantly older than those in the former AD group (P=0.0084. The annual cases with non-AD retinal detachment remained invariant for 20 years. The ratio of the retinal detachment with AD for the total retinal detachment was significantly lower in the recent (38/847 AD group than that in the former (63/796 AD group (P=0.0038. The number of the first visit AD outpatients linearly decreased in these 19 years (153 cases in 1993 and 65 cases in 2011.Conclusion: Our study indicates an apparent decrease in retinal detachment with AD in the recent 10 years, and might suggest the importance of dermatitis control for prevention of retinal detachment with AD.Keywords: atopic dermatitis, incidence, ocular

  8. Comparison of clinical characteristics of rhegmatogenous retinal detachment in pseudophakic and phakic Eyes

    International Nuclear Information System (INIS)

    Mukhtar, M. A.; Ishaq, M.; Mehboob, M. A.; Islam, Q. U.

    2017-01-01

    Objective: To compare the clinical profile, systemic risk factors, and characteristics of rhegmatogenous retinal detachment (RRD) in pseudophakic and phakic eyes. Study Design: Cross-sectional comparative study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi from August 2013 to August 2015. Methodology: A total of 164 eyes (96 pseudophakic patients and 68 phakic patients) with RRD were analyzed. Demographic data and associated known risk factors of study population were acquired. Retinal examination was done by single experienced retinal surgeon using indirect ophthalmoscopy for type of retinal break, location and number of retinal breaks, status of macula, morphological extent of RRD and retinal degenerations. All the findings were endorsed on a pre-devised proforma. Results: Mean age of patients in pseudophakic and phakic groups was 61.18+-10.39 and 59.27+-9.57 years, respectively. Frequency of male patients in pseudophakic and phakic groups was 74% and 57.4%, respectively. Mean axial length in pseudophakic and phakic groups was 23.13+-2.18 mm and 21.9+-2.01 mm, respectively. Difference in axial length and gender distribution between two groups was statistically significant (p < 0.05). Difference in frequency of patients with history of hypertension and myopia between two groups was statistically significant (p < 0.05). Characteristics of RRD (type, location and number of retinal breaks, macula status, and extent of RRD) between groups were not statistically significant. Conclusion: RRD is more common in pseudophakic patients with male gender, increased axial length, myopia, and hypertension. (author)

  9. Drainage of subretinal fluidduring scleral buckling surgery for rhegmatogenous retinal detachment

    Science.gov (United States)

    MALAGOLA, R.; PANNARALE, L.; TORTORELLA, P.; ARRICO, L.

    2015-01-01

    Background and objective The purpose of the study is to compare the drainage of subretinal fluid (SRF) in a scleral pocket (SP) with incision parallel to the limbus to drainage through a simple radial scleral thinning (ST), during scleral buckling surgery for rhegmatogenous retinal detachment (RRD). Patients and methods Retrospective cohort study of one hundred sixty-nine consecutive buckling surgery for RRD, where a drainage puncture was performed through SP in eighty-five cases and through previous radial ST in eighty-four cases. Results PT shows significant lower complication rate. The incidence of retinal incarceration or formation of a retinal hole at the first drainage site is lower in PT group (p=0.0285). During surgery choroidal detachment have been observed in a higher percentage of cases in the SP group (p=0.0379). At the end of the surgery a certain amount of SRF behind the buckling was significant in ST group (p=0.0026). Conclusion The SP drainage technique appears to be a useful, effective and safe method to drain SRF. PMID:26188754

  10. Anatomical and functional outcomes of retinectomies in retinal detachments complicated by proliferative vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Mohammad Idrees Adhi

    2017-10-01

    Full Text Available Purpose: To study anatomical and functional outcomes of retinectomies in rhegmatogenous retinal detachments complicated by proliferative vitreoretinopathy. Methods: This is a retrospective interventional consecutive case series of eyes with rhegmatogenous retinal detachments complicated by advanced proliferative vitreoretinopathy and managed by relaxing retinectomy over a period of seventeen years. Three-port pars plana vitrectomy included core vitrectomy and removal of all epi-retinal membranes. On failure to flatten, retina was cut and excised. Basal vitrectomy and removal of anterior flap of retina then followed. Silicone oil was used as temponade in majority of cases. The dependent variables were anatomical and functional outcomes. The statistical analysis was performed on SPSS 21. Results: Series included 370 eyes of 337 patients. Mean follow up was 39 months. Scleral explant was used in 90(24.39% cases. Two hundred and nine (56.49% eyes were operated with trans conjunctival sutureless vitrectomy technique. Procedure was bilateral in 33 patients (09.79%. Retina attached in 311(84.05% eyes after initial surgery. Final re-attachment after one or more surgeries was achieved in 344(92.97% eyes. Two hundred and eleven (57.02% cases achieved visual acuity of 6/60 or better. Conclusion: Relaxing retinectomies have good and encouraging anatomical and functional outcomes. This surgery can be effectively carried out with trans conjunctival sutureless vitrectomy technique. Keywords: Retinotomy and retinectomy, Proliferative vitreoretinopathy, Trans conjunctival sutureless vitrectomy, Silicone oil

  11. [Evaluation of the macula which was not involved in retinal detachment after surgical treatment of retinal detachment using scleral indentation. Summary of a doctoral thesis].

    Science.gov (United States)

    Boduch-Cieślińska, K

    1992-10-01

    The goal of the study was the evaluation of the influence of the nowadays most frequently used surgical methods in cases of retinal detachment on the macula not involved in the detachment. The study takes into account surgical interventions which have the same indications and principles of action. They are based on an extra-scleral indentation--temporary or permanent one--by means of a Lincoff-Kreissig balloon and a meridional silicone sponge implant. The examinations comprised 54 patients. They were divided into 2 groups: 1st group (24 patients) was treated by cryopexy and a Lincoff-Kreissig balloon, the 2nd group (30 patients) by cryopexy and a meridional silicone sponge implant. In all the patients of both groups the retina reattached. During the 5-years observation of patients of the 1st group no macular changes were detected; one did not observe metamorphopsia or disturbances of the color vision. In the 2nd group instead 17 patients claimed metamorphopsia, 20 patients showed disturbances of the color vision and angiography changes involving the macular region (13 patients).

  12. Incidence and Factors Influencing Retinal Displacement in Eyes Treated for Rhegmatogenous Retinal Detachment With Vitrectomy and Gas or Silicone Oil.

    Science.gov (United States)

    dell'Omo, Roberto; Scupola, Andrea; Viggiano, Davide; Sammarco, Maria Grazia; De Turris, Serena; Romano, Mario R; Grimaldi, Gabriela; dell'Omo, Ermanno; Costagliola, Ciro

    2017-05-01

    The purpose of this study was to study the incidence and factors influencing retinal displacement in eyes treated for rhegmatogenous retinal detachment (RRD) with pars plana vitrectomy (PPV) and gas or silicone oil. This was a prospective observational case series. One hundred twenty-five eyes with macula-off RRD from 125 patients underwent 25-gauge PPV at two vitreoretinal institutional practices. Eyes without proliferative vitreoretinopathy (PVR) or PVR grade A were tamponated with sulfur hexafluoride (SF6) gas, whereas eyes with PVR grade B received 1000 centistokes silicone oil (SO). The patients postured face-down immediately after surgery. Blue-fundus autofluorescence (B-FAF) pictures were obtained at each follow-up examination. Main outcome measures were incidence and direction of retinal displacement. Ninety-seven eyes (77.6%) were tamponated with SF6 and 28 eyes (22.4%) with SO. After retinal reattachment, displacement was observed in 44 of 125 (35.2%) eyes (40 eyes in the SF6 group and 4 eyes in the SO group, respectively). The type of tamponade, specifically gas, was the only significant predictor of retinal displacement (P = 0.007). The displacement was downward in 39 (88.6%) eyes (36 tamponated with SF6 and 3 with SO) and upward in 5 (11.4%) eyes (4 tamponated with SF6 and 1 with SO). Displacement of the retina after repair of macula-off RRD with PPV is observed using either SF6 gas or SO. Downward and upward displacements may occur with both tamponades, but downward dislocation is more common. Of the factors potentially implicated in favoring displacement that were studied, only the type of tamponade, specifically the gas, was significant.

  13. METAMORPHOPSIA AND OUTER RETINAL MORPHOLOGIC CHANGES AFTER SUCCESSFUL VITRECTOMY SURGERY FOR MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT.

    Science.gov (United States)

    Okuda, Tetsuhiko; Higashide, Tomomi; Sugiyama, Kazuhisa

    2018-01-01

    To evaluate the correlation between metamorphopsia and outer retinal morphologic changes after successful vitrectomy for rhegmatogenous retinal detachment (RRD). Forty eyes from 40 patients with macula-off (26 eyes) or macula-on (14 eyes) RRDs that underwent pars plana vitrectomy were included. Metamorphopsia was quantified with M-CHARTS. The relationship between the integrity of the outer retinal layers examined by spectral domain optical coherence tomography and metamorphopsia at 6 and 12 months postoperatively was evaluated. Metamorphopsia was significantly more frequent in eyes with macula-off RRD (88%) than in eyes with macula-on RRD (21%) at 6 months postoperatively (P macula-off RRD eyes from 6 months to 12 months (64%) postoperatively (P = 0.041). Horizontal metamorphopsia scores in eyes with continuous interdigitation zone and ellipsoid zone bands were significantly smaller than in eyes with a disrupted interdigitation zone band and a continuous ellipsoid zone band or in eyes with disrupted ellipsoid zone and interdigitation zone bands (P = 0.003 and P macula-off RRD.

  14. Reoperation for rhegmatogenous retinal detachment as quality indicator for disease management

    DEFF Research Database (Denmark)

    Hajari, Javad N; Christensen, Ulrik; Kiilgaard, Jens F

    2015-01-01

    PURPOSE: To establish a quality indicator that could be used in optimizing treatment for rhegmatogenous retinal detachment (RRD). METHODS: The Danish National Patient Registry was used to identify surgery conducted in Denmark for RRD in the period 01 January 2001-31 December 2009. Cases were...... identified by diagnosis and surgical codes. RESULTS: A total of 6522 cases were operated for a primary RRD in the study period, and 22% (1434 patients) were reoperated for a redetachment. A Cox regression analysis showed that the risk of redetachment was equal to or less than detachment on the fellow eye 1...... year after primary surgery with techniques not using silicone oil. The same was true 1.5 years after surgery for techniques using silicone oil. Based on this, we established a quality indicator defining failure as the need for operation for redetachment within 1 year from initial surgery when using...

  15. LONGITUDINAL QUANTITATIVE EVALUATION OF PHOTORECEPTOR VOLUME FOLLOWING REPAIR OF MACULA-OFF RETINAL DETACHMENT.

    Science.gov (United States)

    Narala, Ramsudha; Scarinci, Fabio; Shaarawy, Amr; Simonett, Joseph M; Flaxel, Christina J; Fawzi, Amani A

    2016-08-01

    To quantify photoreceptor volume changes after successful surgical repair of macula-off retinal detachment and to correlate these volumetric changes to postoperative best-corrected visual acuity (BCVA). Retrospective study of 15 eyes of 15 patients with macula-off retinal detachment who underwent successful surgical repair. A minimum of 4 optical coherence tomography scans that straddled the foveal center was used to quantify the central photoreceptor volume (central 1 mm). Mean photoreceptor volume at the first postoperative visit was 0.451 mm, increasing to 0.523 mm at the final postoperative visit (P = 0.004). Mean BCVA improved from 1.13 ± 0.59 logarithm of the minimum angle of resolution units (∼20/270) preoperatively to 0.52 ± 0.42 logarithm of the minimum angle of resolution units (∼20/66) at the final postoperative visit (P = 0.001). Mean photoreceptor volume at either the initial or final visit demonstrated significant correlations with final postoperative BCVA (r = -0.670, P = 0.017 and r = -0.753, P = 0.005, respectively). Shorter time interval from diagnosis to surgery was significantly associated with greater mean final postoperative photoreceptor volume (r = -0.588, P = 0.021) and better mean final postoperative BCVA (r = 0.709, P = 0.003). We observed a significant increase in photoreceptor volume after successful retinal detachment repair; photoreceptor volume was positively associated with BCVA and time to surgery. Our series emphasizes the importance of prompt surgical repair and shows that photoreceptor recovery and volumetric improvement correlate significantly with BCVA.

  16. Demarcation laser photocoagulation of selected macula-sparing rhegmatogenous retinal detachments.

    Science.gov (United States)

    Vrabec, T R; Baumal, C R

    2000-06-01

    To report a series of macula-sparing rhegmatogenous retinal detachments (MSRRDs) treated with demarcation laser photocoagulation (DLP). Retrospective, noncomparative case series. Thirty-one patients (34 eyes) with primary or recurrent MSRRDs without associated visual field loss, necrotizing retinitis, or proliferative vitreoretinopathy (PVR), managed with DLP from November 1992 through May 1999. Demarcation laser photocoagulation consisting of a triple row of confluent laser burns. Best corrected postoperative visual acuity and MSRRD progression or recurrence. Thirty-four primary and recurrent MSRRDs were treated by DLP, which consisted of a triple row of confluent laser burns. Macula-sparing rhegmatogenous retinal detachments were located in all quadrants and affected 10% to 45% of the retina. Findings associated with MSRRDs included lattice degeneration (12 eyes), vitreous hemorrhage (4 eyes), and demarcation line (9 eyes). Symptoms (photopsias or floaters) were associated with 14 MSRRDs. Eight eyes were myopic and 11 were pseudophakic. Thirty-two MSRRDs were shallow, two were dome shaped, and all were smooth without corrugations. Follow-up ranged from 1.5 to 80 months (mean, 15.8 months; median, 17 months). Thirty-three of 34 detachments remained stable after DLP. Three flattened spontaneously. One eye was managed with scleral buckle 6 weeks after DLP. Progression was attributed to incomplete laser treatment. Best corrected postoperative visual acuity was the same or improved in all but one eye, in which a cataract developed. Demarcation laser photocoagulation is an effective method to manage acute or chronic, primary or recurrent MSRRDs without associated PVR that are shallow and smooth without corrugations. Demarcation laser photocoagulation is an alternative to both observation and surgical repair for these select MSRRDs.

  17. Perfluorocarbon-perfused 23 gauge three-dimensional vitrectomy for complicated diabetic tractional retinal detachment

    Science.gov (United States)

    Velez-Montoya, Raul; Guerrero-Naranjo, Jose Luis; Garcia-Aguirre, Gerardo; Morales-Cantón, Virgilio; Fromow-Guerra, Jans; Quiroz-Mercado, Hugo

    2011-01-01

    Background Perfluorocarbon liquid (PCL)-perfused vitrectomy has been shown in previous studies to be feasible, safe, and to have advantages in managing complicated cases of tractional retinal detachment. The present study had the objectives of describing the anatomical results and measuring surgical time and PCL consumption when combining PCL-perfused techniques with modern vitrectomy equipment. Methods A prospective, interventional consecutive case series was investigated. We enrolled patients with diabetic tractional retinal detachment, complicated by proliferative vitreoretinopathy and poor vision. A 23 gauge PCL-perfused vitrectomy was done with three-dimensional settings. During the procedure, we assessed the degree of surgical bleeding, visualization quality, and difficulty of membrane dissections. Visual acuity, intraocular pressure, and anatomical success were assessed at one and 3 months of follow-up. Results Twelve patients were enrolled in this study. There were no statistical significant changes in intraocular pressure and visual acuity throughout the follow-up period. Surgery was performed in a hemorrhage-free environment in almost all cases, with good visualization and low technical difficulty. The mean complete surgical time was 94.92 ± 25.03 minutes. The mean effective vitrectomy time was 22.50 ± 19.04 minutes and the mean PCL consumption was 25.08 ± 9.76 mL, with a speed of 1.11 mL/minute. Anatomical success was 67% at 3 months. Conclusion Although the technique proved to have some advantages in managing complicated cases of diabetic tractional retinal detachment, there was a high consumption of PCL. A redesign of the entire system is needed in order to decrease the amount of PCL needed for the technique. PMID:22267907

  18. Comparison of scleral buckling using wide-angle viewing systems and indirect ophthalmoscope for rhegmatogenous retinal detachment.

    Science.gov (United States)

    Li, Xiu-Juan; Yang, Xiao-Peng; Lyu, Xiao-Bei

    2016-01-01

    To compare the effects of scleral buckling using wide-angle viewing systems (WAVS) with that using indirect ophthalmoscope for the treatment of rhegmatogenous retinal detachment. The study was a retrospective analyses of the medical records of 94 eyes (94 patients) with rhegmatogenous retinal detachment. Among them, 47 eyes underwent scleral buckling using WAVS with endoilluminator (Group W), and 47 eyes underwent scleral buckling using indirect ophthalmoscope (Group I). Surgical durations, primary success rate, best-corrected visual acuities (BCVA), delayed subretinal fluid absorptions and surgical complications were compared between the two groups. At baseline, there were no statistical differences between the two groups in patient's age (P=0.997), gender (P=0.853), symptom duration (P=0.216), BCVA (P=0.389), refractive error (P=0.167), intraocular pressure (P=0.595), the number of retinal breaks (P=0.832), the extent of retinal detachment (P=0.246), subretinal demarcation line (P=0.801), and macular detachment (P=0.811). The follow-up period was 12mo. The surgical durations in Group W (with or without encircling buckling) were significant shorter than those in Group I (Pbuckling using WAVS can be an alternative choose for rhegmatogenous retinal detachment.

  19. Bilateral exudative retinal detachment associated with central serous chorioretinopathy in a patient treated with corticosteroids.

    Science.gov (United States)

    Rueda-Rueda, T; Sánchez-Vicente, J L; Llerena-Manzorro, L; Medina-Tapia, A; González-García, L; Alfaro-Juárez, A; Vital-Berral, C; López-Herrero, F; Muñoz-Morales, A; Ortega, L S; Herrador-Montiel, Á

    2017-10-01

    The case is presented on a 54-year-old woman with a central serous chorioretinopathy, misdiagnosed as Vogt-Koyanagi-Harada disease, and treated with systemic corticosteroids. The patient presented with a bilateral bullous exudative retinal detachment. Discontinuation of corticosteroid therapy, surgical drainage of subretinal fluid, and photodynamic therapy, led to anatomical and functional improvement. The recognition of an atypical presentation of central serous chorioretinopathy may avoid complications of the inappropriate treatment with corticosteroids. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Supplemental scleral buckling for inferior retinal detachment in silicone oil-filled eyes.

    Science.gov (United States)

    Solaiman, Kamal A M; Dabour, Sherif A

    2014-06-01

    To evaluate the efficiency of treating selected cases of inferior retinal detachment in silicone oil-filled eyes using a supplemental scleral buckling with external drainage of subretinal fluid, versus performing a second vitreoretinal surgery and silicone oil endotamponade. A prospective interventional pilot study that was performed on silicone oil-filled eyes with inferior retinal detachment. Twenty-three eyes of 23 consecutive patients were alternatively distributed between 2 groups: Group A included 12 eyes treated with supplemental scleral buckling with drainage of subretinal fluid and without the removal of silicone oil, and Group B included 11 eyes treated with silicone oil removal, vitreoretinal surgery, and reinjection of silicone oil. The preoperative data included indications and details of primary vitreoretinal surgery, cause of retinal redetachment, subretinal fluid, grade of proliferative vitreoretinopathy, lens status, and the duration between primary vitreoretinal surgery and reoperation. The postoperative examination included the best-corrected visual acuity, retina status, proliferative vitreoretinopathy, silicone oil, and any reported complication. Follow-up examinations were scheduled at Day 1, weekly for 1 month, and monthly thereafter till the end of the follow-up period which extended for at least 2 months after silicone oil removal. The average number of detached clock hours per eye was 2.7 in Group A and 2.4 in Group B, caused by a mean of 1.58 ± 0.80 break per eye in Group A and 1.48 ± 0.66 break per eye in Group B. The mean interval between the primary vitreoretinal surgery and the scleral buckling procedure in Group A patients was 2.83 ± 1.22 months (range, 1-5 months), while in Group B, the mean interval between the primary and the secondary vitreoretinal surgeries was 3.00 ± 1.61 months (range, 1-6 months). The mean operative time was statistically significantly (P 0.05) and from 1.93 ± 0.74 to 1.55 ± 0.63 in Group B patients (P

  1. Risk of retinal tear or detachment with oral fluoroquinolone use: a cohort study.

    Science.gov (United States)

    Eftekhari, Kian; Ghodasra, Devon H; Haynes, Kevin; Chen, Jinbo; Kempen, John H; VanderBeek, Brian L

    2014-07-01

    The aim of this study is to determine if oral fluoroquinolone exposure is associated with an increased hazard for having a retinal tear or detachment. A retrospective cohort study was performed using individuals who met inclusion criteria from The Health Improvement Network database. Cohorts were created for individuals who had a prescription written for either an oral fluoroquinolone or an oral β-lactam antibiotic (comparison group). Subjects were excluded if they had a previous diagnosis of a retinal tear or detachment (hereafter retinal break (RB)), or a procedure code to treat an RB, where in the practice for less than 365 days, had a previous prescription for either antibiotic within 365 days of the index date or had intraocular surgery or a diagnosis of endophthalmitis within 90 days prior to the antibiotic prescription. Covariates of interest were age, gender, diabetes, and year of index. The primary outcome measure of interest was the hazard ratio (HR) of undergoing a procedure to treat an RB within 7, 30, 90, or 365 days after exposure to an oral fluoroquinolone prescription versus an oral β-lactam prescription. After exclusions, 6,604,423 prescriptions (290,393 fluoroquinolone; 6,314,030 β-lactam) from 3,413,498 patients (247,073 fluoroquinolone; 3,303,641 β-lactam) and 2685 RB procedures were eligible for analysis (661 retinal tears and 2024 retinal detachments). For fluoroquinolones, 0, 1, 5, and 23 RBs occurred at the 7-, 30-, 90-, and 365-day time points, respectively. For β-lactam prescriptions, 7, 28, 87, and 373 RBs occurred at the 7-, 30-, 90-, and 365-day time points, respectively. Because of zero events occurring in the fluoroquinolone cohort during the 7-day observation period, an unadjusted or an adjusted HR (and subsequent p-value or confidence intervals) was unable to be calculated. Univariate and multivariate analyses demonstrated that fluoroquinolones were not significantly associated with RB in the 30-, 90-, or 365-day

  2. Early simultaneous fundus autofluorescence and optical coherence tomography features after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

    Science.gov (United States)

    Dell'Omo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y; Bijl, Heico; Tan, H Stevie

    2012-04-01

    To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the involvement of the macula were prospectively investigated with simultaneous fundus autofluorescence and OCT imaging using the Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) within a few weeks after the operation. Fundus autofluorescence imaging of the macula showed lines of increased and decreased autofluorescence in 19 cases (57.6%). On OCT, these lines corresponded to the following abnormalities: outer retinal folds, inner retinal folds, and skip reflectivity abnormalities of the photoreceptor inner segment/outer segment band. Other OCT findings, not related to abnormal lines on fundus autofluorescence, consisted of disruption of photoreceptor inner segment/outer segment band and collection of intraretinal or subretinal fluid. The presence of outer retinal folds significantly related to metamorphopsia but did not relate to poor postoperative visual acuity. Partial-thickness retinal folds occur commonly after vitrectomy for rhegmatogenous retinal detachment repair and may represent an important anatomical substrate for postoperative metamorphopsia. Fundus autofluorescence and OCT are both sensitive techniques for the detection of these abnormalities.

  3. Surgical Management of a Patient with Anterior Megalophthalmos, Lens Subluxation, and a High Risk of Retinal Detachment

    Directory of Open Access Journals (Sweden)

    María Carmen Guixeres Esteve

    2017-01-01

    Full Text Available The early development of lens opacities and lens subluxation are the most common causes of vision loss in patients with anterior megalophthalmos (AM. Cataract surgery in such patients is challenging, however, because of anatomical abnormalities. Intraocular lens dislocation is the most common postoperative complication. Patients with AM also seem to be affected by a type of vitreoretinopathy that predisposes them to retinal detachment. We here present the case of a 36-year-old man with bilateral AM misdiagnosed as simple megalocornea. He had a history of amaurosis in the right eye due to retinal detachment. He presented with vision loss in the left eye due to lens subluxation. Following the removal of the subluxated lens, it was deemed necessary to perform a vitrectomy in order to prevent retinal detachment. Seven months after surgery, an Artisan® Aphakia iris-claw lens was implanted in the anterior chamber. Fifteen months of follow-up data are provided.

  4. What made you wait so long? Delays in presentation of retinal detachment: knowledge is related to an attached macula.

    Science.gov (United States)

    Eijk, Eva S V; Busschbach, Jan J V; Timman, Reinier; Monteban, Helma C; Vissers, Jan M H; van Meurs, Jan C

    2016-08-01

    In rhegmatogenous retinal detachment, the time between first symptoms and reattachment surgery is critical to prevent macular detachment. We explored which determinants discriminate between 'macula-ON' and 'macula-OFF' retinal detachments to improve timely treatment. Eight-hundred patients with rhegmatogenous retinal detachment admitted for surgery at the Rotterdam Eye Hospital in the Netherlands were eligible to complete a questionnaire to explore the following determinants: (i) patient's delay and doctor's delay; (ii) patient-reported causes for delay; (iii) symptoms as early warning signals; (iv) patient's prior knowledge about retinal detachment; and (v) trait anxiety. Five hundred and twenty-one questionnaires (65%) were analysed. Median interval between first symptoms and surgery was 14 days. Macula-ON/OFF ratio was 46/54. Patient's delay in macula-ON patients (median 3 days) was shorter than in macula-OFF (5 days, p = 0.026). No difference was found in doctor's delay except for 'waiting time for surgery': macula-ON patients were operated on faster (median 1 day) than macula-OFF (median 5 days, p Macula-ON patients more often attributed symptoms to retinal problems. Except floaters, no symptoms were determined as early warning signals for macula-ON. Macula-ON patients more often reported knowing that prognosis would be worse when treated later, even when controlled for previous experience with retinal detachment. Macula-ON patients seem to self-refer faster to a healthcare provider, seem more sensitive to floaters and seem more informed. This suggests that increasing awareness, especially about floaters, might increase the proportion of patients with macula still on at the moment of referral to the ophthalmologist. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. [Preventive treatment of retinal detachment of the contralateral eye. Results of 5 years follow-up of 109 eyes].

    Science.gov (United States)

    Haut, J; Ladjimi, A; Van Effenterre, G; Monin, C; Moulin, F; Le Mer, Y

    1991-01-01

    In 1987, we presented a study of 141 eyes treated prophylactically following retinal detachment in the fellow eye. A hundred and nine of these patients are reviewed with a minimum follow-up of five years. Only the evolution was studied, whether a peripheral retinal lesion was present or not at the time of prophylactic treatment. The examiner noted if new lesions had occurred, or if lesions present at the time of the first examination had developed: lattice degeneration or snail track developing into a retinal tear, hole or tear causing a retinal detachment, contained or not by laser treatment. Our study contained sixty two myopes. Fifty eyes had visible, dangerous lesions, and fifty nine a normal retina. Forty five circular barrages with four anterior radial rows returning to the ora serrata were performed, and sixty four barrages with tight anterior grids and a localised barrage of visible lesions. The results were judged on one criterion only: retinal detachment requiring emergency surgery. Only one retinal detachment occurred behind the barrage, caused by proliferative vitreoretinopathy due to multiple tears, and surgical results were good. Eight tears appeared in front of the barrage, five of these in healthy retina. Two very posterior tears behind the barrage were blocked with no problem by laser treatment. Four localised detachments occurred in front of the barrage, three of these without anterior grid treatment. The advantage of this is undeniable since out of sixty three cases treated in this way, only three tears were seen to be blocked by the laser shots, and one anterior localised detachment where the anterior grid was insufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. GoPro HERO 4 Black recording of scleral buckle placement during retinal detachment repair.

    Science.gov (United States)

    Ho, Vincent Y; Shah, Vaishali G; Yates, David M; Shah, Gaurav K

    2017-08-01

    GoPro and Google Glass technology have previously been used to record procedures in ophthalmology and other medical fields. In this manuscript, GoPro's latest HERO 4 Black edition camera (GoPro Inc, San Mateo, Calif.) will be used to record the placement of a scleral buckle during retinal detachment surgery. GoPro HERO 4 Black edition camera, which records 4K-quality video with a resolution of 3840 (pixels) x 2160 (lines), was mounted on a head strap to record placement of a scleral buckle for a retinal detachment. Excellent video quality was achieved with the 4K SuperView setting. Bluetooth connection with an Apple iPad (Apple Inc, Cupertino, Calif.) provided live streaming and use of the GoPro App. Zoom, horizontal/vertical alignment, exposure, and contrast adjustments were made with postproduction editing on GoPro Studio software. Video recording with the GoPro HERO 4 Black edition camera is an excellent way to document extraocular procedures to improve medical education, self-training, or medicolegal documentation. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  7. Scleral depressed vitreous shaving, 360 laser, and perfluoropropane (C3 F8) for retinal detachment

    Science.gov (United States)

    Chaturvedi, Vivek; Basham, Ryan P; Rezaei, Kourous A

    2014-01-01

    Purpose: To review the characteristics and outcomes of patients who underwent pars plana vitrectomy (PPV) with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 gas for rhegmatogenous retinal detachment (RRD). Materials and Methods: A retrospective review of a consecutive series of patients who underwent primary repair of RRD by PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% perfluoropropane (C3F8) was conducted. Patients with less than 3 months follow-up, previous retinal surgery, and higher than grade B proliferative vitreoretinopathy were excluded. Results: Ninety-one eyes were included in the study. The mean age was 60.1 years. The mean follow-up was 13.7 months. The macula was detached in 63% (58/91) of the eyes. The reattachment rate after one surgical procedure was 95% (86/91) while overall reattachment rate was 100%. There was no statistically significant difference between reattachment rates of superior, nasal/temporal, or inferior RRDs. The mean final best corrected visual acuity (BCVA) was 20/40. Of all the patients, 66% of patients with macula-off RRDs had a final BCVA of 20/40 or better. Conclusions: PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 leads to successful anatomical reattachment with visual improvement in patients with primary RRD. PMID:25116775

  8. Scleral depressed vitreous shaving, 360 laser, and perfluoropropane (C 3 F 8 for retinal detachment

    Directory of Open Access Journals (Sweden)

    Vivek Chaturvedi

    2014-01-01

    Full Text Available Purpose : To review the characteristics and outcomes of patients who underwent pars plana vitrectomy (PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C3F8 gas for rhegmatogenous retinal detachment (RRD. Materials and Methods : A retrospective review of a consecutive series of patients who underwent primary repair of RRD by PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% perfluoropropane (C 3 F 8 was conducted. Patients with less than 3 months follow-up, previous retinal surgery, and higher than grade B proliferative vitreoretinopathy were excluded. Results : Ninety-one eyes were included in the study. The mean age was 60.1 years. The mean follow-up was 13.7 months. The macula was detached in 63% (58/91 of the eyes. The reattachment rate after one surgical procedure was 95% (86/91 while overall reattachment rate was 100%. There was no statistically significant difference between reattachment rates of superior, nasal/temporal, or inferior RRDs. The mean final best corrected visual acuity (BCVA was 20/40. Of all the patients, 66% of patients with macula-off RRDs had a final BCVA of 20/40 or better. Conclusions: PPV with scleral depressed vitreous shaving, 360 degree peripheral endolaser, and 14% C 3 F 8 leads to successful anatomical reattachment with visual improvement in patients with primary RRD.

  9. Dashed line relaxing retinotomy in the management of retinal detachment with anterior proliferative vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Tsen CL

    2015-04-01

    Full Text Available Chui-Lien Tsen,1 Yu-Harn Horng,1 Shwu-Jiuan Sheu1,2 1Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; 2School of Medicine, National Yang-Ming University, Taipei, Taiwan Background: We describe the anatomical and functional outcomes of eyes that underwent a modified technique of relaxing retinotomy, dashed line relaxing retinotomy, in the management of retinal detachment with anterior proliferative vitreoretinopathy.Methods: We retrospectively reviewed 54 consecutive eyes in 52 patients who received pars plana vitrectomy with relaxing retinotomy during retinal detachment repair. Perfluorocarbon liquid (PFCL was used as a standard procedure to stabilize the retina during retinotomy to prevent slippage or inversion of the posterior flap. If PFCL was not available due to economic reasons, dashed line relaxing retinotomy was performed instead. Best-corrected visual acuity, slit-lamp biomicroscopy, intraocular pressure measurement, lens status, and fundus examination were analyzed. We excluded patients who were followed up <4 months.Results: Regarding anatomical success rates and visual outcomes, we found no significant differences between patients treated with intraoperative PFCL and those treated with dashed line relaxing retinotomy without PFCL.Conclusion: Compared to the simple and efficient PFCL-assisted relaxing retinotomy, dashed relaxing retinotomy is not the first choice when PFCL is available. Based on our results, this modified technique may offer an alternative in patients with anterior proliferative vitreoretinopathy for whom PFCL is not available. Keywords: perfluorocarbon liquid, PFCL 

  10. Restoration of foveal thickness and architecture after macula-off retinal detachment repair.

    Science.gov (United States)

    dell'Omo, Roberto; Viggiano, Davide; Giorgio, Dario; Filippelli, Mariaelena; Di Iorio, Roberto; Calo', Rocco; Cardone, Michele; Rinaldi, Michele; dell'Omo, Ermanno; Costagliola, Ciro

    2015-01-22

    To investigate the foveal changes after repair of macula-off rhegmatogenous retinal detachment (RRD). Prospective comparative case series. Twenty-four eyes of 24 patients with macula-off/fovea-on detachment (n = 9) and fovea-off detachment (n = 15) were studied. Serial optical coherence tomography (OCT) images taken at the same location were recorded at months 1, 3, 6, and 12 after operation. Fellow eyes were used as controls. No significant changes of the central foveal thickness (CFT) were recorded in the fovea-on group over the follow-up. From month 1 to month 12, CFT increased significantly in the fovea-off group (P < 0.00001). In this group, a significant increase of the Henle fiber and outer nuclear layer (HFL + ONL, P = 0.007), external limiting membrane (ELM)-ellipsoid zone (EZ; P = 0.03), and EZ-retinal pigment epithelium (RPE) thicknesses (P < 0.00001) was recorded. Significant restoration of the integrity of the ELM in the fovea-off group (P < 0.001) and of the EZ and cone interdigitation zone in the fovea-on group and the fovea-off group was observed (P = 0.02 and P < 0.001, and P = 0.002 and P < 0.001, respectively). Twelve months after operation the foveal bulge restored in 8 of 15 eyes of the fovea-off group. Multiple regression analysis showed that in the fovea-off group BCVA correlated with EZ-RPE thickness at months 1 and 12, whereas the improvement of BCVA during the 12 months follow-up correlated with the increase of ELM-RPE thickness. Optical coherence tomography scans taken serially at the same location showed a progressive increase of HNL+ONL, ELM-EZ, and EZ-RPE thicknesses and restoration of the integrity of outer retinal bands after repair of fovea-off RRD. The use of software able to rescan at exactly the same area is crucial to correctly follow and interpret the reconstitution of the retinal bands and to correlate them to BCVA recovery. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  11. Utility of microscope-integrated optical coherence tomography (MIOCT) in the treatment of myopic macular hole retinal detachment.

    Science.gov (United States)

    Kumar, Atul; Kakkar, Prateek; Ravani, Raghav Dinesh; Markan, Ashish

    2017-07-14

    Macular hole-associated retinal detachment in high myopia is described as a final stage in progression of myopic traction maculopathy (MTM). 1â€"3 Shimada et al 4 described the progressive stages of MTM from macular retinoschisis to serous retinal detachment in high myopia. Stage 4 MTM is characterised as disappearance of retinoschisis with progression to retinal detachment due to macular hole formation. It is hypothesised that vitreoschisis and abnormal vitreo-retinal interface create the premacular tangential traction. 5 6 Intraoperative triamcinolone acetonide is used to visualise the residual posterior vitreous cortex (PVC). We hereby describe the utility of microscope-integrated optical coherence tomography (MIOCT) in assisting complete removal of PVC and internal limiting membrane (ILM) peeling with multilayered inverted ILM flap in the treatment of myopic macular hole retinal detachment. MIOCT helped identify vitreoschisis and confirm the position of ILM flaps over the macular hole intraoperatively. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. The accuracy of axial length measurements in cases of macula-off retinal detachment.

    Science.gov (United States)

    Abou-Shousha, Mohsen; Helaly, Hany Ahmed; Osman, Ihab Mohamed

    2016-04-01

    To assess the accuracy of axial length measurements in cases of macula-off retinal detachment using different methods (optical biometry, A-scan ultrasound, and combined applanation vector-A/B-scan biometry). This prospective clinical study included 100 eyes of 100 patients who underwent vitrectomy alone or phacovitrectomy for macula-off retinal detachment. All patients included signed an informed consent. Preoperative examination of the patients included recording the axial length measurements using optical biometry, A-scan ultrasound, and combined applanation vector-A/B-scan biometry. The mean postoperative IOLMaster axial length after macular reattachment was 26.11 ± 2.91 mm. The mean preoperative IOLMaster axial length with macula-off was 25.32 ± 2.72 mm. The mean preoperative A-scan axial length with macula-off was 25.29 ± 2.80 mm. The mean preoperative vector-A/B-scan axial length with macula-off was 26.03 ± 2.90 mm. The preoperative vector-A/B-scan mean absolute error was 0.59 ± 0.48 D (range, 0.10-2.25 D). Regular methods (optical biometry and A-scan biometry) of measuring the axial length in cases with a detached macula proved to be variable and less accurate. The vector-A/B-scan offered good measurements of the actual axial length in the patients. This was reflected on more accurate postoperative refractive outcome. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  13. Pediatric retinal detachment in the Eastern Province of Saudi Arabia: Experience of a tertiary care hospital

    International Nuclear Information System (INIS)

    Cheema Rizwan A; AlKhars Wajeeha; AlAskar, Essam; Amin, Yasir M

    2009-01-01

    Because no previous studies have addressed the issue, we describe clinical characteristics and surgical outcome of patients with rhegmatogenous retinal detachment (RRD) in a pediatric population of the Eastern province of Saudi Arabia. We conducted a retrospective review of all consecutive cases of pediatric RRD (0-18 years) patients presenting at Dhahran Eye Specialist Hospital, a tertiary care hospital, in the Eastern Province of Saudi Arabia over a period of 3 years. Twenty patients were included in the study, accounting for 9.4% of all retinal detachment surgery cases performed over a period of 3 years (January 2006 to December 2008). The median age was 11.0 years, (range, birth to 18 years). Trauma, (45%) myopia/vitreoretinal degeneration (10%) and prior ocular surgery (25%) were significant risk factors for RRD. Proliferative vitreoretinopathy (PVR) more than grade C was present in 14/20 (70%) of cases. Most patients (15/20, 75%) were treated with pars plana vitrectomy and placement of an encircling buckle, while silicone oil or gas was used as tamponade in 13/20 (65%) patients. Surgery was successful in 17/20 (85%) cases in achieving retinal re-attachment. Visual acuity improved significantly following surgery (Mean preop 2.146 LogMAR, Mean postop 1.497 LogMAR) ( P= .014). Longer duration of RRD ( P =.007) and macular involvement ( P =.05) were associated with worse anatomical outcomes following surgery. Pediatric RRD in the Eastern province is often associated with predisposing pathology. Surgery is successful in achieving anatomical reattachment of the retina in a majority of cases with improvement of visual acuity. (author)

  14. Comparison of 1000-Centistoke versus 5000-Centistoke Silicone Oil in Complex Retinal Detachment Surgery

    International Nuclear Information System (INIS)

    Zafar, S.; Shakir, M.; Mahmood, S. A.; Amin, S.; Iqbal, Z.

    2016-01-01

    Objective: To compare the efficacy and complications of using 1000-centistoke versus 5000-centistoke silicone oil for complex retinal detachment repair. Study Design: Case series. Place and Duration of Study: LRBT Tertiary Eye Hospital, Karachi, from January 2007 to Jun 2013. Methodology: Eighty-five eyes (85 patients) presenting with superior rhegmatogenous retinal detachments associated with PVR grades B and C (involving not more than 3 clock hours) were randomized to either 1000 centistokes (n=44) or 5000 centistokes (n=41) silicone oil group. All patients underwent 23-gauge pars plana vitrectomy surgery with silicone oil intraocular tamponade. Patient data was analysed at 18 months post-operatively. IBM SPSS 21 was used for data analysis. Results: There were 52 male and 33 female patients aged between 22 and 70 years (45.2 ±16.2). After the first surgery, successful reattachment of the retina was achieved in 67 eyes (78.8 percentage); of which 35 eyes were in 1000-centistoke and 32 eyes in 5000-centistoke groups. Mean pre-operative Best Corrected Visual Acuity (BCVA) was 1.63 ±0.54 which was improved to a mean post-operative BCVA of 1.46 ±0.78 (1.42 ±0.74 in 1000-centistoke group; 1.49 ±0.78 in 5000 centistoke group). The 1000-centistoke group had a significantly higher frequency of oil emulsification which necessitated early removal of silicone oil. There were 66 eyes (77 percentage) with at least one complication (34 eyes in 1000-centistoke group; 32 eyes in 5000-centistoke group) including cataract, corneal abnormalities, raised IOP, hypotony, vitreous haemorrhage and retinal redetachment. Conclusion: Although visual and anatomical outcomes were comparable between the two groups, the 1000-centistoke silicone oil group developed early oil emulsification necessitating its early removal. (author)

  15. Anatomical and Gene Expression Changes in the Retinal Pigmented Epithelium Atrophy 1 (rpea1) Mouse: A Potential Model of Serous Retinal Detachment

    Science.gov (United States)

    Luna, Gabriel; Lewis, Geoffrey P.; Linberg, Kenneth A.; Chang, Bo; Hu, Quiri; Munson, Peter J.; Maminishkis, Arvydas; Miller, Sheldon S.; Fisher, Steven K.

    2016-01-01

    Purpose The purpose of this study was to examine the rpea1 mouse whose retina spontaneously detaches from the underlying RPE as a potential model for studying the cellular effects of serous retinal detachment (SRD). Methods Optical coherence tomography (OCT) was performed immediately prior to euthanasia; retinal tissue was subsequently prepared for Western blotting, microarray analysis, immunocytochemistry, and light and electron microscopy (LM, EM). Results By postnatal day (P) 30, OCT, LM, and EM revealed the presence of small shallow detachments that increased in number and size over time. By P60 in regions of detachment, there was a dramatic loss of PNA binding around cones in the interphotoreceptor matrix and a concomitant increase in labeling of the outer nuclear layer and rod synaptic terminals. Retinal pigment epithelium wholemounts revealed a patchy loss in immunolabeling for both ezrin and aquaporin 1. Anti-ezrin labeling was lost from small regions of the RPE apical surface underlying detachments at P30. Labeling for tight-junction proteins provided a regular array of profiles outlining the periphery of RPE cells in wild-type tissue, however, this pattern was disrupted in the mutant as early as P30. Microarray analysis revealed a broad range of changes in genes involved in metabolism, signaling, cell polarity, and tight-junction organization. Conclusions These data indicate changes in this mutant mouse that may provide clues to the underlying mechanisms of SRD in humans. Importantly, these changes include the production of multiple spontaneous detachments without the presence of a retinal tear or significant degeneration of outer segments, changes in the expression of proteins involved in adhesion and fluid transport, and a disrupted organization of RPE tight junctions that may contribute to the formation of focal detachments. PMID:27603725

  16. Risk Factors for Endophthalmitis and Retinal Detachment with Retained Intraocular Foreign Bodies

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    D. Wilkin Parke

    2012-01-01

    Full Text Available Purpose. To analyze risk factors for endophthalmitis and retinal detachment (RD in patients with retained intraocular foreign bodies (IOFBs. Design. A retrospective, interventional, consecutive case series. Participants. All patients treated at Bascom Palmer Eye Institute for traumatic IOFBs between 1999 and 2008. Methods. Analysis of visual outcome, mechanism of injury, management, and postoperative course. Results. 108 eyes with IOFBs were identified. Endophthalmitis occurred in 7 eyes (6.4% at presentation, and risk was higher with vegetable matter exposure (P=0.003. All eyes with posterior segment IOFBs received intravitreal antibiotics and there were no cases of endophthalmitis after initial management. RD was identified in 6 of 108 eyes (5.5% at presentation. Risk factors were entry more than 5 mm behind the limbus (P<0.001 and posterior segment IOFB (P=0.028. Postoperative RD occurred in 11 of 102 eyes (10.7%. Risk factors for postoperative RD were preoperative endophthalmitis (P=0.001, posterior segment IOFB (P=0.008, and retinal impact sites (P=0.028. Conclusions. Risk factors for endophthalmitis included vegetable matter exposure and delay to initial management. Risk factors for RD were posterior entry site, posterior segment IOFB, endophthalmitis, and retinal impact sites. No eyes developed endophthalmitis after presentation.

  17. RHEGMATOGENOUS RETINAL DETACHMENT AFTER INTRAARTERIAL CHEMOTHERAPY FOR RETINOBLASTOMA: The 2016 Founders Award Lecture.

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    Shields, Carol L; Say, Emil A T; Pefkianaki, Maria; Regillo, Carl D; Caywood, Emi H; Jabbour, Pascal M; Shields, Jerry A

    2017-08-01

    To evaluate rhegmatogenous retinal detachment (RRD) in eyes with retinoblastoma after intraarterial chemotherapy (IAC). Retrospective case series. Chart review. Development of RRD in the IAC era. Of 167 eyes in 157 consecutive patients, mean patient age at diagnosis of retinoblastoma was 19 months. Intraarterial chemotherapy was primary (75/167, 45%) or secondary (92/167, 55%). There were 10 eyes (10/167, 6%) that developed RRD after IAC. The RRD was mostly related to rapid tumor regression with atrophic retinal hole, occurring within one month (n = 8) or 12 months (n = 2) of IAC. Rhegmatogenous retinal detachment was found after primary (6/75, 8%) or secondary (4/92, 4%) IAC. Of primary cases, RRD was found in Group D (1/38 [3%], P = 0.1075) or Group E (5/30 [17%], P = 0.0348). For primary IAC (n = 75 eyes), RRD was found in endophytic (5/22 [23%], P = 0.0073), exophytic (0/29 [0%], P = 0.0760), or combined endophytic/exophytic pattern (1/24 [4%], P = 0.6575). A comparison of eyes with RRD (n = 10) versus without RRD (n = 157) found significant differences including greater mean age at presentation (38 vs. 18 months, P = 0.0522), greater 4-quadrant vitreous seeding (5/10, 50% vs. 27/157, 17%, P = 0.0236), and absence of subretinal fluid (3/10, 30% vs. 102/157, 65%, P = 0.0236). The cause of RRD was tumor regression-related atrophic retinal hole(s) in 7 (7/10, 70%) (unifocal [1/10, 10%] or multifocal [6/10, 60%] holes), cryotherapy-induced single atrophic hole in 2 (2/10, 20%), and single flap-tear from posterior vitreous detachment in one (1/10, 10%). In 4 (4/10, 40%) eyes with RRD, proliferative vitreoretinopathy was noted. The RRD was not related to intravitreal injection in any case, as in primary IAC no case had previous injection and in secondary IAC the injections were performed many months previously. Primary RRD repair involved pars plana vitrectomy in three, scleral buckle without drainage in one, laser barricade in one, and observation in five eyes

  18. RhoA Signaling and Synaptic Damage Occur Within Hours in a Live Pig Model of CNS Injury, Retinal Detachment

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    Wang, Jianfeng; Zarbin, Marco; Sugino, Ilene; Whitehead, Ian; Townes-Anderson, Ellen

    2016-01-01

    Purpose The RhoA pathway is activated after retinal injury. However, the time of onset and consequences of activation are unknown in vivo. Based on in vitro studies we focused on a period 2 hours after retinal detachment, in pig, an animal whose retina is holangiotic and contains cones. Methods Under anesthesia, retinal detachments were created by subretinal injection of a balanced salt solution. Two hours later, animals were sacrificed and enucleated for GTPase activity assays and quantitative Western blot and confocal microscopy analyses. Results RhoA activity with detachment was increased 1.5-fold compared to that in normal eyes or in eyes that had undergone vitrectomy only. Increased phosphorylation of myosin light chain, a RhoA effector, also occurred. By 2 hours, rod cells had retracted their terminals toward their cell bodies, disrupting the photoreceptor-to-bipolar synapse and producing significant numbers of spherules with SV2 immunolabel in the outer nuclear layer of the retina. In eyes with detachment, distant retina that remained attached also showed significant increases in RhoA activity and synaptic disjunction. Increases in RAC1 activity and glial fibrillary acidic protein (GFAP) were not specific for detachment, and sprouting of bipolar dendrites, reported for longer detachments, was not seen. The RhoA kinase inhibitor Y27632 significantly reduced axonal retraction by rod cells. Conclusions Activation of the RhoA pathway occurs quickly after injury and promotes synaptic damage that can be controlled by RhoA kinase inhibition. We suggest that retinal detachment joins the list of central nervous system injuries, such as stroke and spinal cord injury, that should be considered for rapid therapeutic intervention. PMID:27472075

  19. Optical coherence tomography predicts visual outcome in macula-involving rhegmatogenous retinal detachment

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    Cho, Minhee; Witmer, Matthew T; Favarone, Guilleherme; Chan, RV Paul; D’Amico, Donald J; Kiss, Szilárd

    2012-01-01

    Purpose Visual recovery after rhegmatogenous retinal detachment (RRD) repair depends upon various anatomical factors. We investigated spectral-domain optical coherence tomography (SD-OCT) abnormalities, pre- and postoperatively, in patients with nontraumatic RRD and correlated these findings with visual outcome. Methods The medical records of all patients presenting to Weill Cornell Medical College with nontraumatic macula-involving RRD from August 2010 to September 2011 were retrospectively reviewed in this single-center, consecutive case series. All patients underwent pre- and postoperative visual acuity (VA) testing, slit-lamp biomicroscopy, and dilated fundus examination. Spectral domain optical coherence tomography was obtained preoperatively in twelve patients and postoperatively in ten patients. Results Twelve patients (12 eyes) were included in the final analysis. Preoperative optical coherence tomography revealed that the inner segment/outer segment (IS/OS) junction was disrupted in 10/12 eyes (83%), the external limiting membrane (ELM) was disrupted in 9/12 (75%) eyes, cystoid macular edema (CME) was present in 10/12 (83%) eyes, an epiretinal membrane (ERM) was present in 2/12 eyes (17%) and outer retinal corrugation was present in 7/12 (58%) eyes. In postoperative imaging of 10 eyes, the IS/OS junction was disrupted in 4/10 (40%), the ELM was disrupted in 3/10 (30%) eyes, CME was present in 2/10 (20%), and an ERM in 1/10 (10%). All retinas were attached postoperatively. Outer retinal corrugation was the most predictive of worse preoperative (P = 0.0016) and 1-month postoperative visual acuity (P = 0.05). Conclusion Preoperative SD-OCT demonstrating outer retinal corrugation in macula involving RRD predicts poor visual acuity outcome in nontraumatic RRD. Such findings may have implications for the urgency for these eyes to undergo surgical repair. PMID:22275812

  20. Persistent submacular fluid diagnosed with Optical Coherence Tomography after successful scleral buckle surgery for macula-off retinal detachment

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    Kovačević, Igor; Radosavljević, Aleksandra; Kalezić, Bojan; Potić, Jelena; Damjanović, Goran; Stefanović, Ivan

    2012-01-01

    The objective of our study was to analyze the presence of persistent submacular fluid after apparently successful scleral buckle surgery for macula-off retinal detachment, using Optical Coherence Tomography (OCT), and to correlate these findings to postoperative visual acuity. Prospective study of consecutive patients hospitalized for macula-off retinal detachment, between February 2008 and April 2010, was carried out at the single referral centre for vitreoretinal surgery in Serbia. Outcomes were evaluated 1, 3, 6 and 12 months postoperatively, using OCT and best corrected visual acuity (BCVA). All 48 patients with macula-off retinal detachment had undergone clinically successful scleral buckle surgery, 3 to 30 days (mean 14.2 ± 6.9) after the onset of symptoms. Reattachment was achieved and one month later, patients were divided in two groups, according to the presence of submacular fluid assessed by OCT group A with detectable residual submacular fluid (40%) and group B without (60%). The mean BCVA one month postoperatively was significantly lower (pmacula-off retinal detachment who had undergone successful scleral buckle surgery could be explained with presence of submacular fluid, diagnosed by OCT. However, final visual outcome was favourable, due to the gradual resorption of submacular fluid in a 12-month-period. PMID:22938546

  1. Intraoperative optical coherence tomography in macula involving rhegmatogenous retinal detachment repair with pars plana vitrectomy and perfluoron.

    Science.gov (United States)

    Toygar, O; Riemann, C D

    2016-01-01

    PurposeTo investigate microanatomical relationships during surgical repair of macula involving retinal detachment with pars plana vitrectomy (PPV) and perfluoron (PFO) with a microscope-integrated intraoperative optical coherence tomography (iOCT) device.Patients and methodsThis consecutive case series included nine eyes of nine patients with macula involving retinal detachment operated by a single surgeon at the Cincinnati Eye Institute. All patients underwent PPV, PFO injection, endolaser, and air-fluid exchange. The macula was imaged with iOCT before PFO injection, after PFO injection, and after air-fluid exchange in all eyes.ResultsiOCT imaging was ergonomically easy to obtain in all eyes. iOCT clearly demonstrated submacular fluid (SMF) at the beginning of the surgery, macular flattening under PFO in all eyes, small residual SMF under PFO in six of nine eyes, and increased occult SMF following air-fluid exchange in all eyes.ConclusionMicroscope-integrated iOCT is a versatile and powerful imaging modality that holds a great deal of promise in the future. Its confirmation of persistent occult SMF in this small series of macular involving retinal detachment repair with PFO, may inform surgical decision making, and demonstrates a pathophysiological rationale for initial face-down positioning after retinal detachment repair.

  2. Communications between intraretinal and subretinal space on optical coherence tomography of neurosensory retinal detachment in diabetic macular edema

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    Aditi Gupta

    2013-01-01

    Conclusions: Outer retinal communications between intra and subretinal space were noted in eyes having NSD associated with DME. The size of communications correlated positively with the size of NSD and subretinal detachment space hyper-reflective dots, and inversely with BCVA.

  3. Clinical report of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment

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    Chun-Yang Zhao

    2014-04-01

    Full Text Available AIM: To conclude the clinical situation of the key techniques used in the external-route microsurgery for rhegmatogenous retinal detachment. METHODS: A total of 152 patients with rhegmatogenous retinal detachment who underwent drainage of sub-retinal fluids, cryotherapy, localization of the retinal break, silicone scleral buckling by surgical microscope.RESULTS: Retinal reattachment were achieved in 89.5% of patients after the primary surgery and the final reattachment rate was 96.7%, and 89.8% of the eyes achieved the corrected visual acuity high above 0.05, 35.2% above 0.3 at 1mo postoperatively. In 83.6% of eyes had a succeed drainage of sub-retinal fluids by the first acupuncture, and 13.1% of eyes achieved it by the second try after silicone buckling and circling; in 82.9% of cases, the retinal tear localization directly under microscope was accurate, in 90.0% of eyes were achieved it after check and adjustment by the end of operation; in 6.6% of cases,the scleral buckling had to be adjusted to more correct position in the first operation, and 10.6% of eyes had to be adjusted in the next operation; in 95.4% of eyes, the posterior edge of silicone buckling were within 20mm behind corneal limbus, 4.6% of eyes were behind 20mm.CONCLUSION: The external-route microsurgery can bring us expected clinical results for rhegmatogenous retinal detachment. Its key microsurgical techniques are applied in convenient, reliable, and can be adjusted timely when some deviations occurred. The observable retina under microscope range from ora serrata to 20mm behind corneal limbus, and even to 20-24mm in some high myopia eye with large axial length.

  4. Toxic effects of extracellular histones and their neutralization by vitreous in retinal detachment.

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    Kawano, Hiroki; Ito, Takashi; Yamada, Shingo; Hashiguchi, Teruto; Maruyama, Ikuro; Hisatomi, Toshio; Nakamura, Makoto; Sakamoto, Taiji

    2014-05-01

    Histones are DNA-binding proteins and are involved in chromatin remodeling and regulation of gene expression. Histones can be released after tissue injuries, and the extracellular histones cause cellular damage and organ dysfunction. Regardless of their clinical significance, the role and relevance of histones in ocular diseases are unknown. We studied the role of histones in eyes with retinal detachment (RD). Vitreous samples were collected during vitrectomy, and the concentration of histone H3 was measured by enzyme-linked immunosorbent assay. The location of the histones and related molecules was examined in a rat RD model. The release of histones and their effects on rat retinal progenitor cells R28 and ARPE-19 were evaluated in vitro. In addition, the protective role of the vitreous body against histones was tested. The intravitreal concentration of histones was higher in eyes with RD (mean, 30.9 ± 9.8 ng/ml) than in control eyes (below the limit of detection, Phistone H3 was observed on the outer side of the detached retina and was associated with photoreceptor death. Histone H3 was released from cultured R28 by oxidative stress. Histones at a concentration 10 μg/ml induced the production of interleukin-8 in ARPE-19 cells (2.5-fold increase, PHistones were toxic to cells at concentrations of ≥ 20 μg/ml. Vitreous body or hyaluronan decreased toxicity of histones by inhibiting diffusion of histones. These results indicate that histones are released from retinas with RD and may modulate the subretinal microenvironment by functioning as damage-associated molecular pattern molecules, thereby inducing proinflammatory cytokines or cell toxicity. In addition, the important role of the vitreous body and hyaluronan in protecting the retina from these toxic effects is suggested.

  5. Mammalian STE20-like kinase 2, not kinase 1, mediates photoreceptor cell death during retinal detachment

    Science.gov (United States)

    Matsumoto, H; Murakami, Y; Kataoka, K; Lin, H; Connor, K M; Miller, J W; Zhou, D; Avruch, J; Vavvas, D G

    2014-01-01

    Photoreceptor cell death is the definitive cause of vision loss in retinal detachment (RD). Mammalian STE20-like kinase (MST) is a master regulator of both cell death and proliferation and a critical factor in development and tumorigenesis. However, to date the role of MST in neurodegeneration has not been fully explored. Utilizing MST1−/− and MST2−/− mice we identified MST2, but not MST1, as a regulator of photoreceptor cell death in a mouse model of RD. MST2−/− mice demonstrated significantly decreased photoreceptor cell death and outer nuclear layer (ONL) thinning after RD. Additionally, caspase-3 activation was attenuated in MST2−/− mice compared to control mice after RD. The transcription of p53 upregulated modulator of apoptosis (PUMA) and Fas was also reduced in MST2−/− mice post-RD. Retinas of MST2−/− mice displayed suppressed nuclear relocalization of phosphorylated YAP after RD. Consistent with the reduction of photoreceptor cell death, MST2−/− mice showed decreased levels of proinflammatory cytokines such as monocyte chemoattractant protein 1 and interleukin 6 as well as attenuated inflammatory CD11b cell infiltration during the early phase of RD. These results identify MST2, not MST1, as a critical regulator of caspase-mediated photoreceptor cell death in the detached retina and indicate its potential as a future neuroprotection target. PMID:24874741

  6. Impact of Age on Scleral Buckling Surgery for Rhegmatogenous Retinal Detachment.

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    Park, Sung Who; Kwon, Han Jo; Byon, Ik Soo; Lee, Ji Eun; Oum, Boo Sup

    2017-08-01

    The purpose of this study is to investigate new prognostic factors in associated with primary anatomical failure after scleral buckling (SB) for uncomplicated rhegmatogenous retinal detachment (RRD). The medical records of patients with uncomplicated RRD treated with SB were retrospectively reviewed. Eyes with known prognostic factors for RRD, such as fovea-on, proliferative vitreoretinopathy, pseudophakia, aphakia, multiple breaks, or media opacity, were excluded. Analysis was performed to find correlations between anatomical success and various parameters, including age. This study analyzed 127 eyes. Binary logistic regression analysis revealed that older age (≥35) was the sole independent prognostic factor (odds ratio, 3.5; p = 0.022). Older age was correlated with worse preoperative visual acuity (p < 0.001), shorter symptom duration (p < 0.001), presence of a large tear (p < 0.001), subretinal fluid drainage (p < 0.001), postoperative macular complications (p = 0.048), and greater visual improvement (p = 0.003). Older age (≥35) was an independent prognostic factor for primary anatomical failure in SB for uncomplicated RRD. The distinguished features of RRD between older and younger patients suggest that vitreous liquefaction and posterior vitreous detachment are important features associated with variation in surgical outcomes. © 2017 The Korean Ophthalmological Society

  7. Factors having implications on re-retinal detachments after silicone oil removal

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    Manish P Nagpal

    2012-01-01

    Full Text Available Aim: To investigate factors having implications on re-retinal detachments (reRD after silicone oil removal (SOR. Materials and Methods: A retroprospective study of 412 eyes (with attached retina after vitrectomy with silicone oil for rhegmatogenous RD which underwent SOR was conducted and were followed up for six months after SOR. They were studied for various factors like encirclage, 360° retinopexy, oil emulsification at the time of SOR, duration of oil tamponade and previous retinal surgeries prior to SOR with their implications on reRD after SOR. Results: Encirclage, 360 laser barrage, both, emulsification of oil (P=0.021, P=0.001, P=0.001, P=0.001, respectively were associated with lower risks of reRD after SOR whereas duration of tamponade (P=0.980 was not. Conclusion: Factors like encirclage, 360 retinopexy, their combination, oil emulsification reduced the incidence of re RD after SOR whereas duration of tamponade does not have statistical significant correlation with re RD after SOR.

  8. Effect of scleral buckle removal on strabismus surgery outcomes after retinal detachment repair

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    Chang, Jee Ho; Hutchinson, Amy; Zhang, Monica; Lambert, Scott R.

    2015-01-01

    Background/Aims To investigate the effect of scleral buckle removal on the outcomes of strabismus surgery in patients with a prior history of retinal detachment surgery. Methods We reviewed the medical records of 18 patients who underwent strabismus surgery following a scleral buckling procedure at one institution. We investigated the effect of multiple variables on outcome, including: gender, age, surgeon, number of strabismus surgeries, adjustable suture use, previous pars plana vitrectomy, preoperative best-corrected visual acuity and time of surgery. Outcomes were considered successful if there was ≤ 10 prism diopter (PD) residual horizontal and/or ≤ 4 PD residual vertical deviation. Outcomes were analyzed statistically using Fisher's exact test and Mann-Whitney test. Results Strabismus surgery coupled with scleral buckle removal was associated with a higher rate of success (success with buckle removal, 62.5%; success without buckle removal, 10.0%; p=0.04). There were no significant difference in preoperative findings between the scleral buckle removal and non- removal groups. No retinal redetachments occurred after scleral buckle removal. Conclusion In our series, scleral buckle removal was associated with improved surgical outcome in patients with strabismus following a scleral buckling procedure. PMID:24299332

  9. [Surgical treatment with dacryocystitis and retinal detachment in a patient with Wegener granulomatosis].

    Science.gov (United States)

    Metoki, Tomomi; Kubo, Masabumi; Takano, Yoshiko; Nakamura, Hideo; Nakazawa, Mitsuru

    2003-06-01

    We report surgical treatment of a patient with dacryocystitis and retinal detachment (RD), which are rare ophthalmic involvements of Wegener granulomatosis (WG). The patient was a 26-year-old man with WG. He was diagnosed as having WG 4 years ago and he has been treated by maintenance doses of predonisolone and cyclophosphamide. Rheumatoid factor and serum antinuclear antibody were negative. Cytoplasmic pattern-antineutrophil cytoplasmic antibody (C-ANCA) and renal function were normal. He was found to have nasolacrimal duct obstruction and lattice degeneration bilaterally, retinal tear with RD in the left eye and tear without RD in the right eye. No sign of vasculitis was found in fluorescein angiography. Bilateral dacryocystorhinostomy was performed without any sign of postoperative necrosis of the wound. After the surgery, epiphora and eye discharge disappeared and lacrimal passage has been maintained without obstruction. The pathological findings of his nasal mucosa and lacrimal sac showed chronic inflammation and no typical changes of WG. There was no abnormal change in the conjunctiva and sclera after an uncomplicated scleral buckling surgery. We conclude that operations such as dacryocystorhinostomy and scleral buckling surgery may be performed successfully when WG is controlled within the normal limits of C-ANCA.

  10. Outcome of surgery after macula-off retinal detachment - results from MUSTARD, one of the largest databases on buckling surgery in Europe.

    Science.gov (United States)

    Thelen, Ulrich; Amler, Susanne; Osada, Nani; Gerding, Heinrich

    2012-08-01

    To evaluate the anatomical success rate of scleral buckling surgery in the treatment of rhegmatogenous retinal detachment and to evaluate the differences in outcome between patients suffering macula-off retinal detachment and those without a macular involvement. As a retrospective interventional case series, Munster Study on Therapy Achievements in Retinal Detachment (MUSTARD) is one of the largest ever established of retinal detachment patients and their outcome after buckling surgery, with 4325 patients who underwent surgery between 1980 and 2001. In 53.94% (n = 2134) of 3956 patients with nontraumatic retinal detachment, the macula was involved. The main outcome measure was the achievement of dry anatomical attachment of the retina. The success rate in patients with macula-off retinal detachment is 80.46% and thus 7.78% lower (p macula intact whose success rate amounted to 88.24%. The overall success rate of all 4325 MUSTARD patients was 83.98%. Scleral buckling is an established and mostly successful method for the treatment of retinal detachment. As our case series has demonstrated, even eyes with macula-off can be treated successfully by this procedure, thereby avoiding the complications of primary vitrectomy. © 2010 The Authors. Journal compilation © 2010 Acta Ophthalmol.

  11. [Macula analysis by spectral domain OCT in rhegmatogenous retinal detachment surgery].

    Science.gov (United States)

    Zghal, I; Zgolli, H; Fekih, O; Chebbi, A; Bouguila, H; Nacef, L

    2015-03-01

    Despite surgical reattachment of retinal layers, postoperative functional outcomes after rhegmatogenous retinal detachment (RRD) may be limited. This can be explained by microstructural changes in the macula inherent to the pathology itself as well as the surgery. To evaluate the various changes in the macula by OCT pre- and postoperatively, and correlate them with functional and clinical outcomes in patients with RRD. To establish pre- and postoperative prognostic factors. This was a prospective study of 50 eyes of 50 patients operated for RDD. Each patient underwent a complete clinical examination and macular OCT using the Heidelberg Spectralis; preoperatively and then successively at 7 days, 1 month, 3 months and 6 months after RRD surgery. Preoperative tomographic results revealed an average height of submacular fluid of 742 ± 345 μm. Ninety-six percent of patients exhibited thickening of photoreceptor outer segments (PROS), 62% an outer layer undulation, 60% cystic cavities in the outer and/or inner nuclear layers (ONL, INL), 36% disruptions of the external limiting membrane (ELM) and 64% disruption of the IS/OS junction. Postoperatively, 24% of patients had persistent submacular fluid. The average thickness of the central fovea, the ONL, the IS/OS junction and the PROS were 172 ± 51.3 μm, 88.4 ± 30.9 μm, 11.36 ± 5.4 μm and 19.54 ± 13.1 μm respectively. Postoperative disruptions of the ELM, the IS/OS junction and Verhoeff's membrane (VM) were present in 24%, 60% and 82% of patients respectively. The preoperative tomographic risk factors for poor visual outcome were: submacular fluid height > 800 μm (P<0.001), disruptions of the MLE and/or IS/OS junction (P<0.001), as well as cystic cavities in the ENL and/or INL (P=0.002). Postoperative risk factors were: thinning of the fovea (≤ 250 μm), central fovea (≤ 160 μm), ONL (≤ 90 μm), IS/OS junction (≤ 10 μm) and PROS (≤ 18 μm) layers (P<0.001), as well as a discontinuous or absent

  12. Thinning of Inner Retinal Layers after Vitrectomy with Silicone Oil versus Gas Endotamponade in Eyes with Macula-Off Retinal Detachment.

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    Purtskhvanidze, Konstantine; Hillenkamp, Jost; Tode, Jan; Junge, Olaf; Hedderich, Jürgen; Roider, Johann; Treumer, Felix

    2017-01-01

    To evaluate retinal layer thickness with optical coherence tomography (OCT) in eyes with macula-off retinal detachment after silicone oil (SiO) or gas endotamponade. Cross-sectional study of 40 eyes with macula-off rhegmatogenous retinal detachment that underwent vitrectomy. 20 eyes received SiO tamponade and 20 matched eyes received gas. 33 healthy fellow eyes served as controls. Macular spectral domain OCT was performed with automated layer detection in the 5 inner subfields of the Early Treatment Diabetic Retinopathy Study (ETDRS) map. Comparing the SiO group with the gas group, the ganglion cell layer showed a significant thinning in all fields of the inner ring of the ETDRS map, the inner plexiform layer in the nasal, superior and temporal quadrants, and the outer plexiform layer in the nasal quadrant. Inner retinal layers in the fovea/parafovea were significantly thinner in the SiO group. Prospective studies are warranted to further elucidate possible retinal adverse effects of SiO tamponade. © 2017 S. Karger AG, Basel.

  13. Prophylactic treatment to the fellow eye of patients with phakic lattice retinal detachment: analysis of failures and risks of treatment.

    Science.gov (United States)

    Folk, J C; Bennett, S R; Klugman, M R; Arrindell, E L; Boldt, H C

    1990-01-01

    The authors performed a retrospective analysis on 296 phakic patients who had bilateral lattice degeneration and a retinal detachment in one eye. The analysis was done to determine the complications of full prophylactic treatment to lattice and breaks in the fellow eye and to explain the reasons that this treatment sometimes did not prevent new retinal breaks or detachments. The patients were followed for a mean +/- SD of 7.415 +/- 5.422 years after their first detachment. Twenty-four new tears occurred in the fellow eyes during this time, seven (29.2%) of which were away from areas of visible lattice. Prophylactic treatment did not appear to cause new tears or increase the risk of detachment if a new tear occurred. It also did not compromise the surgical repair in those patients who had eyes in which new breaks or detachments developed. The risk of visual loss was similar in those patients receiving prophylactic treatment compared with those not receiving treatment.

  14. Influence of intravitreal triamcinolone acetonide injection in scleral buckling surgery for macula-off retinal detachment.

    Science.gov (United States)

    Mirshahi, Ahmad; Karkhaneh, Reza; Zamani Amir, Javad; Movassat, Morteza; Azadi, Pejvak

    2014-01-01

    To investigate the effect of intravitreal triamcinolone acetonide injection on the resolution of subretinal fluid (SRF), and its correlation with visual outcome after scleral buckle (SB) surgery. A prospective consecutive case series was conducted in patients who underwent SB surgery for macula-off rhegmatogenous retinal detachment (RRD) at Farabi Eye Hospital from February 1, 2012 to August 30, 2013. Exclusion criteria included previous ocular surgery (e.g. primary surgical failure) except cataract surgery, recurrent retinal detachment, macular hole, epiretinal membrane, proliferative vitreoretinopathy grade C, history of trauma, other retinal diseases, and diabetes mellitus. Patients were assigned to two groups. In group 1, patients received 2 mg of intravitreal triamcinolone acetonide injection at the end of surgery while patients in group 2 received intravitreal balanced saline solution for balancing the intraocular pressure (IOP). Patients were followed up at 1 day, 1 week, 1 month, 2 months and 3 months after the surgery by best-corrected visual acuity (BCVA), slitlamp examination, indirect ophthalmoscopy and optical coherence tomography (OCT). OCT (Heidelberg Engineering, Heidelberg, Germany) was used at all visits except day 1 after the surgery. Student's t test and χ(2) tests were used for comparisons; p value ≤ 0.05 was considered significant. Sixty-two eyes of 62 patients were enrolled in the study. There were 33 male patients (53%) and 29 female patients (47%). The average age was 43.8 years (18-72 years). The mean duration of symptoms was 34.7 ± 46.8 days. There were 29 eyes in group 1 and 33 eyes in group 2. Twelve weeks after the operation, 25 patients (40%) had SRF beneath the macula, but there was no significant difference (p = 0.24, χ(2) test) between the two groups. Improvement in BCVA in both groups was statistically significant (p ≤ 0.001) but did not differ between the two groups (p = 0.09) apart from week 12, in which the improvement

  15. Microinvasive surgery in the treatment of retinal detachment associated with an optic disk pit: 2 cases report

    Directory of Open Access Journals (Sweden)

    S. V. Sdobnokova

    2014-07-01

    Full Text Available We report two cases of an 18-year-old boy with a left optic disc pit and associated retinal edema of the macula and 47-year-old woman with an optic disk pit and associated retinal detachment of the macula. First was treated by intravitreal injection of Lucentis. Woman was treated by gas tamponade as a primary procedure. Both procedures resulted in complete resolution of subretinal fluid andincrease of visual acuity. We conclude that microinvasive surgery can be effective treatment of this disease.

  16. Reoperation for rhegmatogenous retinal detachment as quality indicator for disease management: a register study.

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    Hajari, Javad N; Christensen, Ulrik; Kiilgaard, Jens F; Bek, Toke; la Cour, Morten

    2015-09-01

    To establish a quality indicator that could be used in optimizing treatment for rhegmatogenous retinal detachment (RRD). The Danish National Patient Registry was used to identify surgery conducted in Denmark for RRD in the period 01 January 2001-31 December 2009. Cases were identified by diagnosis and surgical codes. A total of 6522 cases were operated for a primary RRD in the study period, and 22% (1434 patients) were reoperated for a redetachment. A Cox regression analysis showed that the risk of redetachment was equal to or less than detachment on the fellow eye 1 year after primary surgery with techniques not using silicone oil. The same was true 1.5 years after surgery for techniques using silicone oil. Based on this, we established a quality indicator defining failure as the need for operation for redetachment within 1 year from initial surgery when using techniques without oil and after 1.5 years for techniques using oil. Also the lack of oil removal within 1 year from initial surgery should be noted as an operational failure. We applied the quality indicators on the cohort of 6522 RRDs and found that in Denmark the need for redetachment surgery has decreased over time and also that high-volume departments have better outcome compared to smaller ones. The risk of reoperation for redetachment after initial surgery fulfils the criteria for a good quality indicator and can be used in RRD surgery. This indicator could aid in optimizing the management of RRD patients to minimize morbidity. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Corneal topographic changes after 20-gauge pars plana vitrectomy associated with scleral buckling for the treatment of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Alexandre Achille Grandinetti

    2013-04-01

    Full Text Available PURPOSE: To evaluate the changes in corneal topography after 20-gauge pars plana vitrectomy associated with scleral buckling for the repair of rhegmatogenous retinal detachment. METHODS: Twenty-five eyes of 25 patients with rhegmatogenous retinal detachment were included in this study. 20-gauge pars plana vitrectomy associated with scleral buckling was performed in all patients. The corneal topography of each was measured before surgery and one week, one month, and three months after surgery by computer-assisted videokeratoscopy. RESULTS: A statistically significant central corneal steepening (average, 0,9 D , p<0,001 was noted one week after surgery. The total corneal astigmatism had a significant increase in the first postoperative month (p=0,007. All these topographic changes persisted for the first month but returned to preoperative values three months after the surgery. CONCLUSION: Pars plana vitrectomy with scleral buckling was found to induce transient changes in corneal topography.

  18. Tonic Pupil and Corneal Anesthesia after Vitrectomy and Encircling Band for Retinal Detachment in an Ex-Premature Child

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    Xavier Valldeperas

    2010-09-01

    Full Text Available An 11-year-old boy presented with a total retinal detachment in his right eye. He had a bilateral 360° argon laser treatment for an active retinopathy of prematurity performed after his birth. He underwent an uneventful pars plana vitrectomy, encircling band, 810-nm diode endolaser and heavy silicone oil (Densiron® endotamponade. A tonic pupil and abolition of corneal sensitivity, with a large epithelial defect, were observed during the postoperative period. We discuss the possible etiopathogenic mechanisms of the long and short ciliary nerves damage, and the role that retinopathy of prematurity and retinal detachment laser treatment and the encircling band placement might have played in the development of the tonic pupil and the corneal anesthesia.

  19. Scleral infolding combined with vitrectomy and gas tamponade for retinal detachment with macular holes in highly myopic eyes.

    Science.gov (United States)

    Matsuo, T; Shiraga, F; Takasu, I; Okanouchi, T

    2001-01-01

    To describe the effectiveness of a surgical procedure, scleral infolding combined with vitrectomy and gas tamponade, for retinal detachment caused by macular holes in highly myopic eyes. In a pilot study, scleral infolding was performed in 5 patients with macular holes, who were selected from 10 consecutive highly myopic patients with retinal detachment caused by macular holes (8 patients) or extramacular posterior-pole holes (2 patients), treated during 1 year at Okayama University Hospital. The patients were all women, 48-77 years of age (mean = 63.4 years), who had been followed-up for 1-2 years. Selection criteria for scleral infolding were either second surgeries for reopening of macular holes (2 patients) or residual retinal detachment around macular holes after complete fluid-air exchange with drainage of subretinal fluid at the initial surgery (3 patients). Following vitrectomy and complete epiretinal membrane removal in the posterior pole, the sclera was shortened by infolding on the temporal side. Three mattress sutures with 5-0 Dacron in each quadrant, 6 sutures in total, were placed at a 7-mm anteroposterior interval with posterior sutures located as deep as possible, near vortex veins. Fluid-gas exchange was then done, with or without endophotocoagulation applied around macular holes. After scleral infolding, macular holes were closed, and the retina was totally attached in all 5 patients. The final visual acuity ranged from 20/2000 to 20/70. Scleral infolding is a simple and effective procedure for treating retinal detachment with macular holes in highly myopic eyes and could be used as an optional procedure of reoperation for a failed initial vitrectomy.

  20. Ophthalmic complications including retinal detachment in hyperimmunoglobulinemia E (Job′s syndrome: Case report and review of literature

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    Arora Vipul

    2009-01-01

    Full Text Available Hyperimmunoglobulinemia E (Job′s syndrome is characterized by markedly increased levels of immunoglobulin E, recurrent cutaneous and systemic pyogenic infections, atopic dermatitis, and peripheral eosinophilia. Although ocular involvement in Job′s syndrome is rare, there are reports of keratoconus, staphylococcal chalazia with blepharitis, and endophthalmitis by various authors. We present the first case report of retinal detachment with complicated cataract in Job′s syndrome.

  1. RISK FACTORS FOR DEVELOPMENT OF MACULAR HOLE RETINAL DETACHMENT AFTER PARS PLANA VITRECTOMY FOR PATHOLOGIC MYOPIC FOVEOSCHISIS.

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    Huang, Yao; Huang, Weilin; Ng, Danny S C; Duan, Anli

    2017-06-01

    To identify the risk factors for the development of macular hole retinal detachment (MHRD) after vitrectomy without internal limiting membrane peeling for pathologic MF. We retrospectively reviewed the records of 131 eyes (115 patients) treated with vitrectomy for pathologic MF from 2009 to 2014. The best-corrected visual acuity (BCVA), refractive error, axial length, and spectral-domain optical coherence tomography findings were analyzed. Postoperative MHRD developed in 7 eyes (5.3%). Between patients with or without secondary MHRD after vitrectomy, there were no significant differences in age, sex, axial length, preoperative BCVA, refractive error, lens status, and presence of posterior staphyloma. Spectral-domain optical coherence tomography showed all 7 eyes (100%) had foveal detachment, while only 47 patients (37.9%) of 124 eyes had foveal detachment (P = 0.004). There was no significant difference between preoperative and postoperative BCVA in the 7 eyes with MHRD. The postoperative BCVA in the 124 eyes without MHRD was significantly improved (P detachment was worse than the eyes without foveal detachment (P detachment is a risk factor for the development of MHRD after vitrectomy for pathologic MF.

  2. SCLERAL BUCKLING VERSUS VITRECTOMY IN THE MANAGEMENT OF MACULA-OFF PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT: A COMPARISON OF VISUAL OUTCOMES.

    Science.gov (United States)

    Wong, Chee Wai; Yeo, Ian Yew San; Loh, Boon Kwang; Wong, Edmund Yick Mun; Wong, Doric Wen Kuan; Ong, Sze Guan; Ang, Chong Lye; Lee, Shu Yen

    2015-12-01

    To compare visual outcomes between pars plana vitrectomy (PPV) with or without scleral buckling (SB) and SB alone in the management of uncomplicated macula-off primary rhegmatogenous retinal detachment. Case-control study of 723 patients with uncomplicated macula-off primary rhegmatogenous retinal detachment seen at the Singapore National Eye Centre from 2005 to 2011. The primary outcome measure was the proportion of eyes achieving functional success, defined as logMAR best-corrected visual acuity of ≤0.3 logMAR at 6 months postoperatively. Multivariable logistic regression analysis was performed adjusting for the following preoperative covariates: age, gender, race, lens status, number of tears found, presence of proliferative vitreoretinopathy, operative procedure, logMAR best-corrected visual acuity, and duration of symptoms. Three hundred and eight eyes underwent SB alone, and 415 eyes underwent PPV ± SB. In the SB group, 133 eyes (43.2%) achieved functional success compared with 116 eyes (28.0%) in the PPV ± SB group. This difference was statistically significant on both univariate (P macula-off primary rhegmatogenous retinal detachment.

  3. SHORT-TERM OUTCOMES OF HYBRID 23-, 25-, AND 27-GAUGE VITRECTOMY FOR COMPLEX DIABETIC TRACTIONAL RETINAL DETACHMENT REPAIR.

    Science.gov (United States)

    Khan, M Ali; Samara, Wasim A; Hsu, Jason; Garg, Sunir

    2017-03-29

    To describe the short-term outcomes of complex diabetic retinal detachment repair using hybrid 23-gauge or 25-gauge vitrectomy instruments with a 27-gauge vitrectomy system. Retrospective, interventional, consecutive case series. Ten eyes of 10 patients undergoing hybrid pars plana vitrectomy for diabetic tractional retinal detachment were reviewed. Combined use of 25-gauge and 27-gauge instrumentation was used in 8 of 10 eyes and combined use of 23-gauge and 27-gauge instrumentation in 2 of 10 eyes. In all cases, a 27-gauge vitreous cutter was used for membrane dissection and delamination. All eyes had successful anatomical reattachment at a mean follow-up of 207 ± 55 days. Snellen visual acuity improved from a mean of 20/822 preoperatively to 20/566 at the final follow-up (P = 0.55). Mean intraocular pressure remained stable at 13 ± 3.4 mmHg preoperatively to 13.6 ± 5.4 mmHg at the final follow-up (P = 0.76). No intraoperative or postoperative complications were encountered. Concurrent use of the 27-gauge vitreous cutter with 23-gauge or 25-gauge instrumentation was effective during diabetic tractional retinal detachment repair. This hybrid technique was not associated with any significant intraoperative or short-term postoperative complications.

  4. OUTCOMES OF VITRECTOMY WITH SILICONE OIL TAMPONADE FOR MANAGEMENT OF RETINAL DETACHMENT IN EYES WITH CHORIORETINAL COLOBOMA.

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    Hocaoglu, Mumin; Karacorlu, Murat; Ersoz, Mehmet G; Sayman Muslubas, Isil; Arf, Serra

    2017-12-26

    To estimate the outcomes of retinal detachment in eyes with chorioretinal coloboma managed by pars plana vitrectomy and silicone oil tamponade. A retrospective chart review of 10 eyes (10 patients) who underwent pars plana vitrectomy for retinal detachment with chorioretinal coloboma. The average age at the time of the surgery was 29.8 ± 19.7 years. The mean follow-up period was 28.8 ± 28.4 months. The mean silicone oil tamponade duration was 9.8 ± 3.5 weeks. Of 10 eyes, 4 (40%) had retinal breaks outside the coloboma, 4 (40%) had breaks inside the coloboma, 1 (10%) had breaks inside and outside the coloboma, and in 1 eye (10%); the causative retinal break was not localized. Preoperatively, the mean visual acuity was 20/2,500 (n = 9), and 1 (10%) was recorded as "Not CSM." At the final examination, the mean visual acuity for the patients with measurable visual acuity was 20/200 (P = 0.06), and in the remaining eye was recorded as light perception. The retina was finally reattached in nine eyes (90%). Postoperative complications included cataract in three (30%), persistent elevated intraocular pressure in one (10%), band keratopathy in one (10%), and proliferative vitreoretinopathy in one (10%). Complete pars plana vitrectomy with or without lensectomy, laser photocoagulation around the peripheral retina, around all the peripheral breaks and around the colobomatous area, and silicone oil tamponade is effective for retinal detachment in eyes with chorioretinal coloboma. Silicone oil removal as early as possible did not increase the risk of redetachment and seems to reduce the incidence of oil-related complications in such cases.

  5. Diagnosis of retinal detachments by a tele-ophthalmology screening program.

    Science.gov (United States)

    McCord, Sarah A; Lynch, Mary G; Maa, April Y

    2018-01-01

    In 2015, a tele-ophthalmology program was undertaken at the Atlanta Veterans Affairs Medical Center to provide screening eye care for veterans in their primary care clinics. Though this program was developed as a screening tool, the availability of these services in primary care clinics has enabled triage of certain acute eye complaints. These case reports describe two patients who were diagnosed with retinal detachments through this program, although their primary care providers had triaged them as requiring non-urgent referrals to the eye clinic. Although many patients are seen for acute ocular complaints in primary care clinics and emergency departments, providers in such settings may lack the ability to adequately examine eyes and thus triage ocular complaints. These cases demonstrate the ability of tele-ophthalmology to assist in diagnosing urgent ocular conditions in primary care clinics. Though tele-ophthalmology has been accepted in some parts of the world, in the United States of America it remains widely underutilized. These cases highlight the ability of tele-ophthalmology to close the gap in acute eye care coverage that exists in the USA, most prominently in rural regions.

  6. [Choroidal thickness after scleral buckling surgery in macula-off rhegmatogenous retinal detachment].

    Science.gov (United States)

    Akkoyun, I; Pınarcı, E Y; Yesilirmak, N; Yılmaz, G

    2014-10-01

    Enhanced depth imaging (EDI) optical coherence tomography (OCT) provides high-definition cross-sectional images of the choroid. Information on alterations in choroidal thickness (CT) after scleral buckling surgery (SBS) is rare. The medical charts of 122 patients (122 eyes) who underwent SBS for macula-off rhegmatogenous retinal detachment (RRD) were retrospectively analyzed. Patients with a follow-up ≥ 6 months were included. Postoperative EDI-OCT images concerning CT were evaluated 1 week, 1 month and 6 months postoperatively in 4 groups: group 1 cerclage + cryopexy (n = 39 eyes), group 2 cerclage + cryopexy + sponge (n = 28 eyes), group 3 SBS + subretinal fluid drainage (SRD) (n = 25 eyes) and group 4 SBS + sponge + SRD (n = 30 eyes). Subfoveal CT was compared between the groups and with the non-operated fellow eye. Subfoveal CT in groups 1, 2, 3 and 4 was thicker 1 week postoperatively. There were no significant differences between the groups or when comparing the operated eye with the fellow eye 1 and 6 months postoperatively. There were no differences in subfoveal CT 1 and 6 months after SBS between the eye with macula-off RRD and the fellow eye. The use of a sponge or SRD induced no differences concerning subfoveal CT.

  7. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification for rhegmatogenous retinal detachment repair

    Directory of Open Access Journals (Sweden)

    Hoseok Moon

    2015-02-01

    Full Text Available AIM: To assess the outcomes of combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for rhegmatogenous retinal detachment (RRD repair. METHODS: This was a retrospective, consecutive, non-comparative, interventional case series of 30 eyes of 30 patients who underwent combined sutureless vitrectomy and clear corneal cataract surgery for the repair of RRD. The principal outcome measures were primary anatomical success rate, reasons for redetachment, final visual acuity, and surgical complications. RESULTS: Primary reattachment was achieved in 27 eyes (90.0%. The reasons for redetachment (3 eyes, 10% were incomplete laser retinopexy, persistent chronic subretinal fluid, and proliferative vitreoretinopathy, respectively. The logarithm of the minimum angle of resolution visual acuity (mean±SD improved from 0.76±0.74 preoperatively to 0.21±0.37 6 months’ postoperatively (PCONCLUSION: Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification with intraocular lens implantation for RRD repair was proven safe and effective. It may provide not only the known advantages of conventional combined surgery, but also additional advantages such as less conjunctival fibrosis and the maintenance of stable intraocular pressure with low risks of postoperative hypotony and intraocular pressure elevation.

  8. Rapid macular hole formation and closure in a vitrectomized eye following rhegmatogenous retinal detachment repair

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    Ratnesh Ranjan

    2018-01-01

    Full Text Available The development of a full-thickness macular hole (FTMH after pars plana vitrectomy (PPV for rhegmatogenous retinal detachment (RRD repair is a rare occurrence. We report the first case of rapid MH formation with internal limiting membrane (ILM-like hyper-reflective bridging membrane under silicone oil (SO meniscus, noted on the first postoperative day (POD postvitrectomy for RRD. A 57-year-old man presented with best-corrected visual acuity (BCVA of perception of light with immature cataract and total RRD in the left eye. He underwent cataract extraction with intraocular lens implantation with uneventful PPV, endolaser to primary break, and 360° periphery followed by injection of 1000 Cst SO. On the first POD, retina was attached in all quadrants with SO in situ. However, a dark red spot was noted at macula which was confirmed as FTMH with a bridging linear hyper-reflectivity under SO meniscus on optical coherence tomography (OCT. Repeat OCT, at 2 weeks and 3 months, revealed closed MH under the SO meniscus with BCVA improving to 6/60. This is the first reported case of very rapid FTMH formation with an ILM-like linear hyper-reflectivity following vitrectomy for RRD and highlights the possible contributory role of multiple nonconventional factors for rapid FTMH development and fibrinous membrane-assisted closure under SO tamponade.

  9. Ocular torsion as a complication of scleral buckle procedures for retinal detachments.

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    Cooper, L L; Harrison, S; Rosenbaum, A L

    1998-10-01

    Strabismus can occur in as many as 30% of patients after scleral buckle procedures for retinal detachments. Most previous case series have reported on horizontal and vertical deviations. This study examines the frequency of torsion after scleral buckle procedures, the abnormalities of extraocular muscles seen during strabismus surgery, and the surgical procedures effective in improving torsion. A chart review examined the records of all patients coming to a strabismus referral practice with diplopia reported > or =6 months after scleral buckle procedures. Forty-six percent of patients with diplopia after scleral buckle operations had torsion (88% extorsion, 12% intorsion). The 2 mechanisms that caused extorsion most frequently were inadvertent production of a superior oblique muscle palsy and tightening of the inferior rectus muscle from the underlying scleral buckle. Other mechanisms of extorsion were also seen. The mechanism for production of intorsion was scarring of the superior oblique muscle to the nasal border of the insertion of the superior rectus muscle. Surgical procedures were successful in reducing torsion 4 degrees or more in 59% of cases. In patients undergoing surgery for torsion after a scleral buckle procedure, exploration of the superior oblique muscle and the inferior rectus muscle may yield information about the mechanism involved in the production of the torsion.

  10. [OCT Angiography in Exudative AMD with Detachment of Vascularised Retinal Pigment Epithelium].

    Science.gov (United States)

    Gunnemann, Frederic; Rothaus, Kai; Farecki, Marie-Louise; Faatz, Henrik; Book, Benedikt; Lommatzsch, Albrecht; Pauleikoff, Daniel

    2017-09-01

    Background The aim of the following extended case study was to analyse whether choroidal neovascularisation (CNV) in vascularised epithelial detachments (PED) in OCT angiography (OCT-A) can be better visualised in OCT-A than in the established angiographic methods during the course of anti-VEGF therapy and if possible used to quantify the CNV size and flow area. These findings were compared with other SD-OCT characteristics of the lesion (PED height, retinal thickness). Patients and Methods 8 patients with PED and associated CNV were diagnosed with multimodal imaging and additionally OCT angiography was performed. The CNV region in the B-scan of the OCT-A was detected with a fine segmentation setting (20 µm) parallel and just below the retinal pigment epithelium (RPE). The CNV area was manually marked, and the size of the CNV and the vessel section (flow area) were analysed with the evaluation tool of the device. This measurement was performed both initially and after anti-VEGF therapy (3 injections). At the same time, the visual acuity (logMAR) and the SD-OCT parameters of PED height and retinal thickness were determined before and after therapy and also statistically compared. Results Initially, the size of CNV in OCT-A showed a large phenotypic range of variation (0.33 - 1.35 mm 2 , mean 0.71 mm 2 ). This decreased significantly under therapy (after therapy 0.44 - 0.84 mm 2 , mean 0.57 mm 2 , p = 0.02). The proportion of the vessels analysed within the CNV (flow area) varied as well (0.21 - 0.88 mm 2 , mean 0.45) and decreased under therapy (0.08 - 0.44 mm 2 after therapy), mean 0.27 mm 2 , p = 0.07). The height of PED in SD-OCT was initially different (initially 274 - 1459 µm, mean 607 µm), but showed only small changes (132 - 1317 µm, mean 524 µm, p = 0.09) under therapy. This also applied to the mean retinal thickness (before therapy 315 µm, after therapy 294 µm, p = 0.5). Mean visual

  11. Short-time prone posturing is well-tolerated and reduces the rate of unintentional retinal displacement in elderly patients operated on for retinal detachment.

    Science.gov (United States)

    dell'Omo, Roberto; Semeraro, Francesco; Guerra, Germano; Verolino, Marco; Cinelli, Mariapia; Montagnani, Stefania; Costagliola, Ciro

    2013-01-01

    To evaluate the feasibility, efficacy and safety of strict prone posturing taken for 2 hours after operation in preventing the occurrence of unintentional retinal displacement in elderly patients operated on for retinal detachment (RD). Twenty patients aged 60 or more with diagnosis of macula-off RD were asked to keep a strict face-down posturing for 2 hours after vitrectomy and 20% sulfur hexafluoride tamponade. IOP was measured immediately before and after surgery and after the 2-hour posturing. A questionnaire was administered to each patient to evaluate the rate of discomfort experienced because of the face-down posturing. Unintentional displacement of the retina was assessed by evaluating the presence of retinal vessel printings on fundus autofluorescence images taken 4 weeks after operation. The 2-hour posturing was generally well-tolerated. A mild neck pain was the most common reported symptom. Only a few patients experienced moderate breath shortness while posturing and none had to break the posturing because of respiratory problems. Intraocular pressure (IOP) measured before operation (11.7 ± 2.6 mmHg) was significantly different from IOP recorded at the end of surgery (18.9 ± 4.9 mmHg) and from IOP measured 2 hours after surgery (16.8 ± 4.7 mmHg, P<0.05, Friedman test). IOPs measured immediately and 2 hours after surgery did not differ significantly. Fundus autofluorescence imaging showed RVPs in 7 eyes. This study shows that a 2-hour face-down posturing is effective in reducing the rate of retinal displacement in patients operated on for rhegmatogenous retinal detachment using vitrectomy and SF6 20%. A 2-hour face-down posturing is feasible for elderly patients and does not appear to cause unwanted, post-operative IOP raises.

  12. Effect of internal limiting membrane peeling on the development of epiretinal membrane after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

    Science.gov (United States)

    Nam, Ki Yup; Kim, Jung Yeul

    2015-05-01

    To investigate the difference in the occurrence of postoperative epiretinal membranes (ERMs) in vitrectomy for rhegmatogenous retinal detachment with and without peeling of the internal limiting membrane (ILM). The medical records of the 135 patients, who underwent vitrectomy for primary rhegmatogenous retinal detachment from November 2007 to August 2011, were analyzed retrospectively. Of the subjects, 70 patients underwent ILM peeling during the surgery and 65 did not. The best-corrected visual acuity, fundus photograph, and optical coherence tomography were collected 3, 6, and 12 months postoperatively. The relationship between ILM peeling and the preoperative findings of rhegmatogenous retinal detachment and development of a postoperative ERM was analyzed. No ERM occurred in the ILM peeling group, whereas an ERM occurred in 14 of 65 patients who underwent vitrectomy without ILM peeling (21.5%). This difference was significant (P detachment.

  13. Vitrectomy with or without encircling band for pseudophakic retinal detachment: a multi-centre, three-arm, randomised clinical trial. VIPER Study Report No. 1--design and enrolment.

    Science.gov (United States)

    Mazinani, B; Baumgarten, S; Schiller, P; Agostini, H; Helbig, H; Limburg, E; Hellmich, M; Walter, P

    2016-03-01

    Scleral buckling is currently used in addition to vitrectomy for the treatment of pseudophakic retinal detachment (PRD) to better support the vitreous base and better visualisation of the periphery. The aims of this study are to evaluate (1) whether the combination of 20 G vitrectomy and scleral buckling is superior to 20 G vitrectomy alone (control) (confirmatory), and (2) whether transconjunctival 23/25 G vitrectomy is non-inferior to 20 G vitrectomy (both without scleral buckling) regarding operation success (exploratory). The VIPER (Vitrectomy Plus Encircling Band Vs. Vitrectomy Alone For The Treatment Of Pseudophakic Retinal Detachment) study is an unmasked, multi-centre, three-arm randomised trial. Patients with PRD were eligible, excluding complicated retinal detachment or otherwise severe ophthalmologic impairment. Patients were randomised to one of three interventions: 20 G vitrectomy alone (control C), combination of 20 G vitrectomy and circumferential scleral buckling (experimental treatment E1) or 23/25 G vitrectomy alone (experimental treatment E2). The primary endpoint is the absence of any indication for a retina re-attaching procedure during 6 months of follow-up. Secondary endpoints include best corrected visual acuity, retina re-attaching procedures, complications and adverse events. From June 2011 to August 2013, 257 patients were enrolled in the study. The internet randomisation service assigned 100 patients each to the treatment arms C and E1, and 57 patients to treatment E2. The imbalance is due to the fact that several retinal surgeons did not qualify for performing E2. The random assignment was stratified and balanced (ie, 1:1 or 1:1:1 ratio) by surgeon. The described study represents a methodologically rigorous protocol evaluating the benefits of three different vitrectomy approaches to PRD. The projected results will help to establish their overall efficacy and will permit conclusions regarding their relative value. DRKS

  14. Using optical coherence tomography to evaluate macular changes after surgical management for rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Kai-Chun Cheng

    2016-05-01

    Full Text Available Incomplete visual recovery, color vision defects, or persistent metamorphopsia may persist even after successful surgery for rhegmatogenous retinal detachment (RRD, especially in cases of RD with macula off, suggesting microstructural macular damage that standard fundus biomicroscopy could not detect. We compared spectral-domain optical coherence tomography imaging with preoperative and postoperative visual acuity to evaluate the relationship between morphological changes in the outer retina and visual outcome after successful repair of RRD with macula on or off. We enrolled 43 patients (43 eyes with successful repair of RRD and a minimum 6-month follow up after surgery in this retrospective research. Patients accepted spectral-domain optical coherence tomography postoperatively and visual acuity examination preoperatively and postoperatively. The mean age of the patients was 48.74 ± 12.68 years (range: 16–77 years. The mean visual acuity (logarithm of minimal angle of resolution before surgery was 0.87 ± 0.70. Disrupted ellipsoid zone was noted in one of 11 eyes in the macula-on group (9.1% and 19 of 32 eyes in the macula-off group (59.4%. Disrupted external limiting membrane (ELM was noted in no eye in the macula-on group (0% and 11 of 32 eyes in the macula-off group (34.4%. The macula-off group was associated with better postoperative visual gains than the macula-on group (p = 0.013. Patients with integrity of the ellipsoid zone and ELM were associated with significant visual improvement than patients with disruption of the ellipsoid zone or ELM.

  15. MORPHOLOGY SCORE AS A MARKER OF RETINAL FUNCTION IN DRUSENOID PIGMENT EPITHELIAL DETACHMENT.

    Science.gov (United States)

    Clemens, Christoph R; Alten, Florian; Heiduschka, Peter; Eter, Nicole

    2015-07-01

    To evaluate a morphology score for drusenoid pigment epithelial detachment (dPED) regarding predictability of a decline in retinal function beyond best-corrected visual acuity. Thirteen eyes of 10 patients with dPED due to age-related macular degeneration (AMD) were included (age 72.8 ± 4.2 years). All underwent volume spectral domain optical coherence tomography, fluorescence angiography, and confocal scanning laser ophthalmoscopy infrared imaging as well as multifocal electroretinography and microperimetry. The dPED morphology score suggested consists of five parameters: hyperreflective spots in infrared, lesion diameter, lesion height, presence of vitelliform-like material in the subretinal space or subretinal fluid, and integrity of the ellipsoid zone in spectral domain optical coherence tomography. Subsequently, a score value between 0 and 1 according to the extent of morphologic changes was correlated to foveal multifocal electroretinography and microperimetry measurements. The mean best-corrected visual acuity was 20/40. The mean height and mean diameter of dPED were 312.2 ± 111 μm and 2,535 ± 805 μm. Two dPED showed no hyperreflective spots in confocal scanning laser ophthalmoscopy infrared images, three displayed a moderate stage of hyperreflective spots, and eight had severe hyperreflective spots. Two eyes showed subretinal fluid, and five patients showed vitelliform-like material in the subretinal space. Eight eyes revealed a severe disruption of the ellipsoid zone. Although no correlation was found between dPED morphology score and best-corrected visual acuity, eyes with a dPED morphology score >0.5 revealed distinctly decreased values in functional measurements compared with those with a score ≤0.5. The dPED morphology score aggregates all currently known morphologic changes in dPED and represents a valuable tool for clinical lesion evaluation. Furthermore, it allows for assessing an estimate of functional decline beyond best-corrected visual

  16. Pneumatic retinopexy versus scleral buckle for repairing simple rhegmatogenous retinal detachments.

    Science.gov (United States)

    Hatef, Elham; Sena, Dayse F; Fallano, Katherine A; Crews, Jonathan; Do, Diana V

    2015-05-07

    Rhegmatogenous retinal detachment (RRD) is a full-thickness break in the sensory retina, caused by vitreous traction on the retina. While pneumatic retinopexy, scleral buckle, and vitrectomy are the accepted surgical interventions for eyes with RRD, their relative effectiveness has remained controversial.  The objectives of this review were to assess the effectiveness and safety of pneumatic retinopexy versus scleral buckle or pneumatic retinopexy versus a combination treatment of scleral buckle and vitrectomy for people with RRD. The secondary objectives were to summarize any data on economic measures and quality of life. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2015), EMBASE (January 1980 to January 2015), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to January 2015), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 January 2015. We included all randomized or quasi-randomized controlled trials comparing the effectiveness of pneumatic retinopexy versus scleral buckle (with or without vitrectomy) for eyes with RRD. After screening for eligibility, two review authors independently extracted study characteristics, methods, and outcomes. We followed systematic review standards as set forth by The Cochrane Collaboration. We included two randomized controlled trials (218 eyes of 216 participants) comparing the effectiveness of pneumatic retinopexy versus scleral buckle for eyes with RRD. We identified no studies

  17. Association between oral fluoroquinolone use and the development of retinal detachment: a systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Chui, Celine S L; Wong, Ian C K; Wong, Lisa Y L; Chan, Esther W

    2015-04-01

    Several observational studies have been published investigating the association between oral fluoroquinolone use and the development of retinal detachment; however, the findings are not concordant. This study is a meta-analysis of the existing literature and estimates the overall absolute risk of such an event. Electronic databases were searched for observational studies on the association between oral fluoroquinolone and retinal detachment up to August 2014. Studies that did not meet the criteria for meta-analysis were narratively reviewed. Cases of retinal detachment during current fluoroquinolone use were also extracted for absolute risk calculation. Seven observational studies were included. Three (case-control and self-controlled case series studies) were eligible for meta-analysis and four (cohort studies) were narratively reviewed. The rate ratio of the case-control studies was 1.82 (95% CI 0.67-4.93), I(2) =96% and the incidence rate ratio of the self-controlled case series was 1.03 (95% CI 0.84-1.27), I(2) =36%. Three of the four cohort studies found no significant association between oral fluoroquinolone use and the development of retinal detachment. The pooled absolute risk of retinal detachment whilst on current oral fluoroquinolone treatment is estimated to be 4.85 per 1000000 prescriptions (95% CI 0.78-8.91). The findings of this systematic review and meta-analysis do not support an association between oral fluoroquinolone use and the development of retinal detachment. Given the low absolute risk, such an event would be rare if there were an association. The current prescribing practice for fluoroquinolones should not be altered because of a previously suggested potential risk of retinal detachment. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. Rate and risk factors for the conversion of fovea-on to fovea-off rhegmatogenous retinal detachment while awaiting surgery.

    Science.gov (United States)

    Kontos, Andreas; Williamson, Tom H

    2017-08-01

    Progression of a fovea-on to a fovea-off rhegmatogenous retinal detachment (RRD) while awaiting surgery is rare. A retrospective review of patient records to identify patients in whom a fovea-on retinal detachment at presentation was found to be fovea off at surgery. We identified 10 cases over 14 years which converted from fovea-on to fovea-off RRD while awaiting surgery. This represented 1.1% of RRDs that were fovea on at presentation (n=930). Nine out of 10 patients had superotemporal RRDs extending to at least the vascular arcade at presentation and all had superotemporal breaks within detached retina, which was significantly higher than the rate for other retinal detachments (100% vs 63%, p=0.02). There were 2.4 breaks per eye, similar to other retinal detachments. Six of the 10 patients converted to a fovea-off retinal detachment within a few hours and the rest by the following day. Visual outcomes were good, with eight patients maintaining their presenting visual acuity and two losing one Snellen line. Offering same-day surgery to high-risk fovea-on RRDs may not significantly influence visual outcomes and would only prevent about half of the conversions to fovea off. Superotemporal retinal detachments extending to near the arcades are most at risk and might warrant posturing to limit spread of the detachment in the preoperative period. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Changing Concepts in the Surgical Repair of Primary Retinal Detachment (Part 2: Comparison of Four Current Surgical Techniques for Repair of Primary Retinal Detachments

    Directory of Open Access Journals (Sweden)

    Ingrid Kreissig

    2008-12-01

    Full Text Available

    The second part of this literature review deals with the comparison of two intraocular (pneumatic retinopexy and primary vitrectomy and two extraocular (segmental sponge buckle without drainage, i.e. minimal extraocular surgery and the temporary balloon operation procedures used to seal off the leaking break in primary retinal detachments. The outcomes, rate of complications and reoperations will be compared among these procedures.

  1. Failed Pneumatic Retinopexy for Rhegmatogenous Retinal Detachment Repair in Ocular Albinism: Clues to the Role of Melanin in Retinal Pigment Epithelium Pump Function.

    Science.gov (United States)

    Felfeli, Tina; Mandelcorn, Mark S; Yan, Peng; Jeffery, Glen; Mandelcorn, Efrem D

    2017-12-01

    The authors report the first case, to their knowledge, of failed pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RRD) repair in a patient with ocular albinism (OA). The failure of PR to spontaneously resolve the subretinal fluid and reattach the retina in this case is suggestive of a deficiency in subretinal fluid reabsorption by the retinal pigment epithelium (RPE). These findings suggest that in cases of RRD in OA, primary PR should be avoided since this procedure relies on an adequately functioning RPE pump to reabsorb subretinal fluid prior to laser retinopexy. The use of primary vitrectomy or scleral buckling with cryopexy may constitute a more effective strategy for RRD in OA. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:1016-1020.]. Copyright 2017, SLACK Incorporated.

  2. A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland

    Directory of Open Access Journals (Sweden)

    Sahanne S

    2017-03-01

    Full Text Available Sari Sahanne,1 Raimo Tuuminen,2 Jari Haukka,3 Sirpa Loukovaara4 1Department of Anesthesiology, Helsinki University Central Hospital, Helsinki, 2Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, 3Hjelt Institute, Faculty of Medicine, University of Helsinki, 4Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland Background: Rhegmatogenous retinal detachment (RRD is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV. Methods: This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50 and PPV (n=269. Changes in intraocular pressure (IOP and best-corrected visual acuity (BCVA were recorded at 30 days and reoperation rates within 180 days postoperatively. Results: Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes (P=0.001, log-rank test; however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; P=0.006. Changes in BCVA did not differ between the surgical procedures. Conclusion: PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD. Keywords: rhegmatogenous retinal detachment, vitrectomy, scleral buckling

  3. A Retinal Detachment Case with a Delay in Diagnosis Due to Unilateral Lens Coloboma and Bilateral Ectopic Pupil

    Directory of Open Access Journals (Sweden)

    Hüseyin Mayalı

    2015-12-01

    Full Text Available A 29-year-old female patient was admitted with the complaint of decreased vision in the left eye for the last 9 months. The visual acuity was 0.4 in the right eye and hand movements in the left eye. Biomicroscopic examination revealed ectopic pupils in both eyes and lens coloboma in the left eye; her right lens was normal. There was total retinal detachment in the left fundus. Optic disc, macula, and peripheral retina were normal in the right eye at her fundus examination. In our case, reduction of vision in the left eye was associated with ectopic pupil at various centers and this situation has led to delay in the diagnosis. Therefore, the importance of careful retinal examination should be kept in mind in cases in which the reduction of vision does not correlate with clinical picture. (Turk J Ophthalmol 2014; 44: 75-7

  4. SURGICAL OUTCOMES AND COMPLICATIONS OF RHEGMATOGENOUS RETINAL DETACHMENT IN EYES WITH CHORIORETINAL COLOBOMA: The Results of the KKESH International Collaborative Retina Study Group.

    Science.gov (United States)

    Abouammoh, Marwan A; Alsulaiman, Sulaiman M; Gupta, Vishali S; Younis, Afnan; Chhablani, Jay; Hussein, Abdullah; Casella, Antonio M; Banker, Alay S; Arevalo, J Fernando

    2017-10-01

    To study the outcomes of management of rhegmatogenous retinal detachment in eyes with chorioretinal colobomas. A retrospective review of 119 patients (119 eyes) with chorioretinal colobomas who underwent surgical repair for rhegmatogenous retinal detachment was performed. Data were collected on the site of the retinal break, type of surgery, anatomical success, and complications. The most common location of the primary retinal break was the intercalary membrane in 58.8% of eyes. The most common surgical intervention was vitrectomy with endolaser and silicone oil tamponade (77.3% of eyes). Final anatomical success was achieved in 87.4% of eyes. Anatomical success was significantly higher in eyes that received long-acting tamponade (P = 0.006). Cryotherapy was significantly associated with failure of primary vitrectomy (P = 0.028). Placement of an encircling band did not affect anatomical outcomes (P = 0.75). Most of the eyes (60%) with recurrent retinal detachment after primary vitrectomy had a primary break within the normal retina. The optimal option for managing retinal detachment in eyes with chorioretinal colobomas is pars plana vitrectomy with long-acting tamponade (silicone oil or octafluoropropane) and retinopexy to the edge of the coloboma and the primary breaks. Cryotherapy is associated with poor anatomical outcomes. An encircling band does not seem to affect the final anatomical outcome.

  5. Intraoperative optical coherence tomography assisted analysis of pars Plana vitrectomy for retinal detachment in morning glory syndrome: a case report.

    Science.gov (United States)

    Lytvynchuk, Lyubomyr M; Glittenberg, Carl G; Ansari-Shahrezaei, Siamak; Binder, Susanne

    2017-08-01

    The pathogenesis of non-rhegmatogenous retinal detachment (non-RRD) associated with morning glory syndrome (MGS) is not established, as well as best surgical approach to treat RD. Our purpose was to analyse intraoperative optical coherence tomography data (iOCT) in all steps of pars plana vitrectomy (PPV) for non-RRD in MGS, in order to follow pathophysiological aspects of the disease and to understand the tissues behaviour during surgical workflow. Intraoperative spectral domain optical coherent tomography (iSD-OCT) assisted PPV using Rescan 700 (Carl Zeiss Meditech, Jena, Germany) with epiretinal membrane (ERM) and internal retinal membrane (ILM) peeling, and air endotamponade was performed on the only eye of a 21 years old female with non-RRD associated with MGS. BCVA, pre-, intra- and postoperative OCT were performed along with standard ocular examination. iOCT video and snapshots were analysed intra- and postoperatively using post-processing approach using graphic software. The progression of non-RRD resulted in best corrected visual acuity (BCVA) decrease from 0.8 to 0.2. Triamcinolone enhanced iOCT imaging revealed strong vitreous traction and adhesion above the macula and optic disc. Internal limiting membrane was peeled under iOCT control to prevent the peeling of inner layers of the retinal schisis. No retinal break was detected, and only air endotamponade was performed. The retina reattached during first 4 weeks of follow-up with gradual resolution of intraretinal- and subretinal fluid, and remained stable in 12 months. BCVA improved to 0.8. Based on iSD-OCT findings we assume that non-RRD in this case of MGS is caused primarily by the vitreous traction with further possible formation of the retinal breaks. Retinal reattachment reached only with air endotamponade strongly advocates the tractional component of non-RRD and retinal schisis assotiated with MGS. Early PPV for central non-RRD and retinal schisis with the use of iOCT can be performed in more

  6. Activated retinal glia mediated axon regeneration in experimental glaucoma.

    Science.gov (United States)

    Lorber, Barbara; Guidi, Alessandra; Fawcett, James W; Martin, Keith R

    2012-01-01

    Glaucoma, a leading cause of blindness, is a neurodegenerative disease characterized by progressive loss of retinal ganglion cell axons in the optic nerve and their cell bodies in the retina. Reactive retinal glial changes have been observed in glaucoma but the role of such glial changes in the pathogenesis of the condition remains unclear. In the present study we found that retinal ganglion cells in an experimental animal model of glaucoma have an increased axon regenerative potential. Regeneration of adult rat retinal ganglion cell axons after optic nerve crush was significantly increased in vivo when combined with intraocular pressure-induced experimental glaucoma. This enhanced axon regeneration response was correlated with a significant increase in activation of glial fibrillary acidic protein+retinal glia. Using a dissociated retinal ganglion cell culture model we showed that reducing the number of activated retinal glia with a glial specific toxin, α-Aminoadipic acid, significantly reduced the growth potential of retinal ganglion cells from glaucomatous rat eyes, suggesting that activated retinal glia mediate, at least in part, the growth promoting effect. This was shown to be mediated by both membrane-bound and soluble glial-derived factors. Neurotrophin and ciliary neurotrophic/leukemia inhibitory factor blockers did not affect the regenerative potential, excluding these growth factors as principal mediators of the enhanced growth response occurring in glaucomatous retinal cultures. These observations are the first to reveal that retinal ganglion cells from glaucomatous rat eyes have an enhanced regenerative capacity. Furthermore, our results suggest that activated retinal glia mediate at least part of this response. Further work to understand and enhance the regeneration-promoting effect of activated retinal glia is required to determine if this approach could be useful as part of a therapeutic strategy to encourage optic nerve regeneration in glaucoma

  7. Retained subretinal perfluorocarbon liquid in microincision 23-gauge versus traditional 20-gauge vitrectomy for retinal detachment repair.

    Science.gov (United States)

    Garg, Sunir J; Theventhiran, Alex B

    2012-01-01

    To assess the rate of retained subretinal perfluorocarbon liquid (PFCL) in patients undergoing rhegmatogenous retinal detachment (RRD) repair with sutureless 23-gauge vitrectomy versus traditional 20-gauge vitrectomy. A retrospective, consecutive, interventional comparative case series. All patients with a diagnosis of RRD who underwent pars plana vitrectomy with PFCL for RRD repair from November 1, 2005 through October 31, 2008 were included. A total of 234 RRD repairs were performed during the study period by one surgeon. Subretinal PFCL occurred in 4 of 176 eyes (2.3%) who underwent sutured 20-gauge pars plana vitrectomy and in 6 of 58 eyes (10.3%) who underwent sutureless 23-gauge pars plana vitrectomy for repair of retinal detachment (P = 0.0167, Fisher exact test, 2-tailed). There is a statistically significant 4.5-fold increased incidence of retained subretinal PFCL in patients undergoing RRD repair with sutureless 23-gauge vitrectomy versus traditional 20-gauge vitrectomy. This may be because of higher fluid flow through open 23-gauge cannulas, which causes disruption of the PFCL surface tension resulting in formation of small PFCL bubbles that can enter the subretinal space. Reduction of fluid flow may help prevent this complication.

  8. A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland.

    Science.gov (United States)

    Sahanne, Sari; Tuuminen, Raimo; Haukka, Jari; Loukovaara, Sirpa

    2017-01-01

    Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB) with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV). This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50) and PPV (n=269). Changes in intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded at 30 days and reoperation rates within 180 days postoperatively. Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes ( P =0.001, log-rank test); however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; P =0.006). Changes in BCVA did not differ between the surgical procedures. PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD.

  9. A review of direct experimental measurements of detachment

    Science.gov (United States)

    Boedo, J.; McLean, A. G.; Rudakov, D. L.; Watkins, J. G.

    2018-04-01

    Detached divertor plasmas feature strong radial and parallel gradients of density, temperature, electric fields and flow over the divertor volume and therefore, sampling the divertor plasma directly provides crucial knowledge to the interpretation and modeling efforts. We review the contribution of diagnostics that directly sample the plasma to the advancement of knowledge of the physics of detachment and detached divertors, such as the characteristics of the various regimes, discovery and quantification of drifts and identification of convection of heat and particles. We focus on wall probes, scanning probes, retarding field analyzers and Thomson scattering in the divertor region and also include the contribution of measurements away from the divertor that provide insight on how divertor detachment affects core, edge or pedestal conditions. Wall probes are critical as they can be installed in closed volumes of difficult access to other diagnostics and measure plasma parameters at the divertor structures, which define the plasma boundary conditions and where detachment effects are more likely to be strongest.

  10. Analysis of the results detected by ultrasound biomicroscopy before patients with rhegmatogenous retinal detachment perform pars plana vitrectomy

    Directory of Open Access Journals (Sweden)

    Juan Chen

    2015-05-01

    Full Text Available AIM: To analyze the result of ultrasound biomicroscopy(UBMof patients with rhegmatogenous retinal detachment(RRDwho need to perform pars plana vitrectomy(PPVto explore the value of clinical application of UBM at preoperation.METHODS: Patients who underwent PPV for RRD in our hospital from January to December 2014 were selected. The preoperative results of UBM were recorded and the positive findings of UBM were analyzed, the value of preoperative application of UBM was investigated.RESULTS:Totally 356 cases(357 eyesof patients with RRD were received PPV. All patients were examined by UBM, 122 eyes(34.17%were positive, 56 eyes were ciliochoroidal detachment, 28 eyes were narrow anterior chamber angle, 6 eyes were chamber angle-closure, 28 eyes were ciliary body cyst, 4 eyes were iris cyst, 11 eyes were anterior proliferative vitreoretinopathy, 1 eye was retinal cyst. There were 12 eyes existing two lesions at the same times. In this study, patients with choroidal detachment was detected by UBM in 56 eyes, the positive rate was 15.7%, while 25 eyes was detected by B-ultrasonography, the positive was 7.0%. The difference was statistical significant(χ2=13.382, PCONCLUSION: The patients with RRD have underwent PPV for the condition of illness, preoperative UBM can be examined to detect the condition of anterior chamber angle, iris, ciliary and anterior choroid, which is significant for comprehensively understanding the preoperative condition of patients, estimating the difficulty of the operation, and guiding operation and the postoperative follow-up.

  11. Simulation of experimentally achieved detached plasmas using the UEDGE code

    International Nuclear Information System (INIS)

    Porter, G.D.; Allen, S.; Fenstermacher, M.

    1995-01-01

    The introduction of a divertor Thomson scattering system in DIII-D has enabled accurate determination of the plasma properties in the divertor region. We identify two plasma regimes; detached and attached. The electron temperature in the detached regime is about 2 eV, much lower than 5 to 10 eV determined earlier. We show that fluid models of the DIII-D scrape-off layer plasma are able to reproduce many of the features of these two plasma regimes, including the boundaries for transition between them. Detailed comparison between the results obtained from the fluid models and experiment suggest the models underestimate the spatial extent of the low temperature region associated the detached plasma mode. We suggest that atomic physics processes at the low electron temperatures reported here may account for this discrepancy

  12. Neovascularization associated with large retinal pigment epithelial detachment in elderly Korean patients. Subdivision according to indocyanine green angiographic features

    International Nuclear Information System (INIS)

    Lee, Won-Ki; Lee, Phil-Young; Park, Young-Hoon

    2007-01-01

    In Korean patients, to subdivide the neovascular forms of age-related macular degeneration (AMD) associated with large retinal pigment epithelial detachment (PED), according to the indocyanine green angiographic features. Indocyanine green angiograms (ICGA) of 67 elderly patients (72 eyes) who presented with a PED of at least 1 disc diameter were evaluated retrospectively. Polypoidal choroidal vasculopathy (PCV) and typical choroidal neovascularization (CNV)-associated PEDs were identified in 18 eyes (25%) and 19 eyes (26%), respectively. In ten eyes (13.9%), the exact type of neovascularization, whether PCV or CNV, could not be determined. Pure serous PEDs were identified in seven eyes (10%). The remaining 18 eyes (25%) were classified as having retinal angiomatous proliferation (RAP)-associated PED based upon the angiographic findings of vascular connections between the retinal vasculature and the neovascular complex. Three subset groups of PCV, CNV, and RAP were present with similar frequency in neovascularized AMD with a large PED in these Korean patients. In particular, RAP, previously thought to be rare in Asian patients, was found to be present with considerable frequency. (author)

  13. Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system

    NARCIS (Netherlands)

    Dell'Omo, Roberto; Barca, Francesco; Tan, H. Stevie; Bijl, Heico M.; Oberstein, Sarit Y. Lesnik; Mura, Marco

    2013-01-01

    To compare anatomical, functional outcomes and complications of high-speed 25-gauge (G) pars plana vitrectomy (PPV) versus 20-G PPV for the management of primary inferior rhegmatogenous retinal detachment (RRD) associated to inferior breaks/holes. Eighty-five eyes from 85 patients with a minimum

  14. [Traumatic macular hole with central retinal detachment and choroidal rupture with ora serrata dialysis].

    Science.gov (United States)

    Fiorentzis, M; Seitz, B; Viestenz, A

    2015-08-01

    Closed ocular trauma is associated with various retinal complications, such as Berlin's edema, peripheral retinal tears, retinal hemorrhage, choroidal rupture, subretinal bleeding and macular holes. Traumatic macular holes (TMH) are rare and surgical intervention is controversial due to possible spontaneous closure. The positive development in the patient described here indicates that a pars plana vitrectomy with drainage of subretinal hemorrage combined with peeling of the internal limiting membrane (ILM) for a penetrating traumatic macular hole with choroidal rupture can lead to the restoration of visual acuity. The anti-vascular endothelial growth factor (VEGF) therapy (under silicone oil with avastin 0.02 ml) can successfully lead to limitation of posttraumatic choroidal neovascularization (CNV). Patients with ocular contusion require extensive long-term ophthalmological follow-up. Furthermore, prevention, education and information is essential to prevent serious injuries.

  15. Serous Retinal Detachment in Dome-shaped Macula with 7 Years Follow-up.

    Science.gov (United States)

    Alakeely, Adel G; Alrashaed, Saba

    2016-01-01

    Dome-shaped macula (DSM) was first described by Gaucher et al . as a convex protrusion of macula within a staphyloma in highly myopic eyes that cause visual impairment associated with serous foveal detachment (SFD). We describe a patient with persistent SFD in DSM documented by serial spectral domain optical coherence tomography for 7 years with stable vision.

  16. Morphological and functional outcome of scleral buckling surgery compared to primary vitrectomy in patients with retinal detachment.

    Science.gov (United States)

    Stamenković, Miroslav; Stefanović, Ivan; Senćanić, Ivan; Jakšić, Vesna; Mavija, Milka; Babović, Siniša

    2014-10-01

    Among the proposed operative techniques for retinal detachment (RD) the most commonly applied are classical method with scleral buckling and pars plana vitrectomy (PPV). The aim of this paper was to determine which surgical intervention of these two leads to better morphological results in terms of the applied retina and better functional outcomes in terms of visual acuity (VA) of the operated eye in patients with RD. A retrospective study on the comparative section of the effects of scleral buckling surgery and PPV in uncomplicated rhegmatogenous RD was performed. In a 2-year period 97 patients, i.e. 98 eyes with RD were operated on (68 eyes with scleral buckling surgery vs 30 by PPV). In the group with classically operated detachment, the retina was applied in 52 (76.5%) cases vs 30 (100%) patients in PPV group (p buckling surgery. VA was significantly improved in both observed groups, while its mean value was postoperatively better in the group that was operated with the classical method. The reason for this could be due to better VA in baseline in the scleral buckling surgery group.

  17. PERIPAPILLARY RETINAL NERVE FIBER THICKNESS CHANGES AFTER VITRECTOMY FOR EPIRETINAL MEMBRANE IN EYES WITH AND WITHOUT VITREOUS DETACHMENT.

    Science.gov (United States)

    Mariotti, Cesare; Nicolai, Michele; Longo, Antonio; Viti, Francesca; Bambini, Elisa; Saitta, Andrea; Pirani, Vittorio; Orsini, Emanuele; Baruffa, Daniela; Reibaldi, Michele

    2017-12-01

    To compare the changes in postoperative peripapillary retinal nerve fiber layer (p-RNFL) thickness after vitrectomy for epiretinal membrane in eyes with preexisting posterior vitreous detachment (PVD) and eyes with surgically induced PVD. This study included consecutive patients who underwent 25-gauge vitrectomy for epiretinal membrane. Eyes were divided, according to intraoperative PVD status, into a preexisting PVD group and surgically induced PVD group. Best-corrected visual acuity, p-RNFL thickness, and central retinal thickness were performed before and at 1, 3, and 6 months after surgery. One hundred and twenty eyes of 120 patients were enrolled: 64 eyes in the preexisting PVD group and 56 eyes in the surgically induced PVD group. In the preexisting PVD group at 6 months, the mean global p-RNFL thickness did not change, whereas it was reduced in the temporal sector (P = 0.034). In the surgically induced PVD group at 6 months, significant decreases were observed in global p-RNFL thickness (P = 0.027), temporal (P = 0.021), temporal inferior (P = 0.030), and nasal inferior sectors (P = 0.010). At 6 months, the two groups differed significantly in temporal (P PVD.

  18. Morphometric analysis of fovea with spectral-domain optical coherence tomography and visual outcome postsurgery for retinal detachment

    Directory of Open Access Journals (Sweden)

    Manish Nagpal

    2014-01-01

    Full Text Available Purpose: The purpose of this study was to correlate the postoperative best-corrected visual acuity (BCVA with spectral-domain optical coherence tomography (SD-OCT findings in fovea involving rhegmatogenous retinal detachment (RRD surgery. Materials and Methods: Thirty eyes with preoperative fovea-involving RRD, who underwent scleral buckling (SB (6 eyes and pars plana vitrectomy (PPV (19 eyes and combined SB and PPV (5 eyes were recruited. Patients underwent clinical examination and SD-OCT scan of fovea preoperatively and at 30 days and 90 days postoperatively. The correlations between SD-OCT findings and BCVA were analyzed. Results: Inner segment/outer segment (IS/OS junction integrity was the indicator of better BCVA at 30 days and 90 days (P = 0.0002 and P = 0.0003, respectively whereas outer retinal corrugation (ORC was related to worse BCVA at 30 days and 90 days (P = 0.001. External limiting membrane did not have a co-relation with visual outcome, but cystoid macular edema showed co-relation at 90 days (P = 0.047. All eyes of SB and 3 eyes of PPV had a minimal subfoveal fluid at 30 days follow-up that had no effect on visual acuity. All retinas were attached at final follow-up. Conclusion: IS/OS junction integrity and ORC may be important predictors of postoperative visual outcome after anatomically successful RRD surgery.

  19. Silicone Oil Reinjection without Macular Buckling for Treatment of Recurrent Myopic Macular Hole Retinal Detachment after Silicone Oil Removal

    Directory of Open Access Journals (Sweden)

    Hammouda Hamdy Ghoraba

    2014-01-01

    Full Text Available Purpose. To evaluate the efficacy of silicone oil (S.O reinjection without macular buckling for treatment of recurrent myopic macular hole retinal detachment (MHRD after silicone oil removal. Methods. A retrospective consecutive interventional study from medical reports on cases of myopic MHRD. Fifty-three eyes of 51 patients underwent silicone oil removal after successful repair of MHRD were reviewed. The main outcomes were the retinal status after silicone oil removal and management of recurrent cases. Results. The rate of recurrent RD (Re RD after silicone oil removal was 11.3% (6 out of 53 eyes. One case refused any other interference. In the remaining 5 eyes, 4 eyes (80% could be reattached by S.O re-injection and one eye (20% developed Re RD after S.O re-injection. Range of followup after management of recurrence was 5–53 months (mean 18.7 months. Conclusions. This case series concluded that the risk factors for recurrent RD after silicone oil removal from cases of myopic MHRD were high myopia, open flat MH, and large posterior staphyloma. Revision of vitrectomy and S.O re-injection can reattach most of recurrent cases.

  20. Scleral buckling with a noncontact wide-angle viewing system in the management of rhegmatogenous retinal detachment.

    Science.gov (United States)

    Yan, Hua

    2017-01-19

    To introduce a modified scleral buckling surgery using noncontact wide-angle viewing system and intraocular illumination in the treatment of rhegmatogenous retinal detachment (RRD) without proliferative retinopathy. A modified scleral buckling surgery using noncontact wide-angle viewing system with a 25-G optic fiber through sclerotomy site was performed in 22 eyes of 22 patients with RRD. Twelve women and 10 men were included. The mean age was 49.23 ± 15.19 years. The mean refraction of myopia was -4 D (range -3 to -7 D). The mean duration of RRD was 6.64 ± 3.14 days. The preoperative best-corrected visual acuity (BCVA) ranged from 0.02 to 0.8. Mean follow-up was 9.59 ± 2.24 months. Proliferative retinopathy was grade A in 8 eyes and grade B in 14 eyes. This surgery was performed successfully and retinal attachment was achieved in all eyes at the final follow-up. The postoperative BCVA increased in all eyes. No complication was encountered related to this technique. This modified scleral buckling surgery brings a panoramic and upright view and easy surgical maneuvers. It may be an additional approach for the management of RRD.

  1. Ten years follow-up after surgery for a foveal detachment due to optic disc pit: a case report of outer retinal layer healing.

    Science.gov (United States)

    Giocanti-Aurégan, Audrey; Chbat, Elige A; Morel, Christophe G H; Morin, Bruno R; Conrath, John G; Devin, François C

    2017-12-04

    To report a case of complete progressive visual recovery and healing of outer retinal layers after vitrectomy for foveal detachment associated with optic disc pit. Optical coherence tomography (OCT) follow-up was performed on a 15-year-old boy with deep optic disc pit and foveal detachment, before and for 10 years after vitrectomy with gas. The foveal detachment was successfully reattached with complete reapplication of the retina. OCT scans showed a progressive long-term retinal healing with reappearance of the ellipsoid line and visual acuity improved from 20/100 before surgery to 20/25, 10 years after surgery. Photoreceptor regeneration after foveal detachment surgery has been already described only in zebrafish but never humans. However, we highlight with this case that in humans, a healing process of the outer retinal layers can occur with reappearance of the ellipsoid zone on OCT. This healing process may take several years and allow a complete functional restoration.

  2. COMPLETE SUBRETINAL FLUID DRAINAGE IS NOT NECESSARY DURING VITRECTOMY SURGERY FOR MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT WITH PERIPHERAL BREAKS: A Prospective, Nonrandomized Comparative Interventional Study.

    Science.gov (United States)

    Chen, Xiao; Zhang, Yong; Yan, Ying; Hong, Ling; Zhu, Li; Deng, Jun; Din, Qin; Huang, Zhijian; Zhou, Hezhen

    2017-03-01

    To compare clinical outcomes in eyes with macula-off rhegmatogenous retinal detachments managed by surgical protocols, the result in either complete (CSFD) or partial subretinal fluid drainage (PSFD). Fifty-four eyes with macula-off rhegmatogenous retinal detachments with peripheral retinal breaks of 54 patients were assigned prospectively to one of the two surgical designs (PSFD or CSFD, 2:1) in a sequence. Patients were treated with 25-gauge plus vitrectomy, either CSFD (n = 18) or PSFD (n = 36), and 14% C3F8 was used for intraocular tamponade. Anatomical and visual outcomes as well as intraoperative and postoperative complications of the two groups were compared. The single-operation success rates were 16/18 (88.9%) and 33/36 (91.6%), respectively, for the CSFD and the PSFD groups (P = 1.00). The mean BCVA improvement (Early Treatment Diabetic Retinopathy Study letters) at the 6-month postoperative was not significantly different between the two groups (26.50 ± 15.43 in CSFD group vs. 22.64 ± 15.43 in PSFD group, P = 0.43). Partial subretinal fluid drainage procedure during vitrectomy for the repair of macula-off rhegmatogenous retinal detachments revealed comparable results with CSFD in terms of anatomical and visual outcomes. Complete subretinal fluid drainage during vitrectomy seems to be unnecessary for all RRD reattachment surgical procedures.

  3. MACULAR HOLE CLOSURE OVER RESIDUAL SUBRETINAL FLUID BY AN INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE IN PATIENTS WITH MACULAR HOLE RETINAL DETACHMENT IN HIGH MYOPIA.

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    Okuda, Tetsuhiko; Higashide, Tomomi; Kobayashi, Koh; Ikuno, Yasushi; Sugiyama, Kazuhisa

    2016-01-01

    To describe the closure of a macular hole over residual subretinal fluid in patients with macular hole retinal detachment in high myopia who had been treated using an inverted internal limiting membrane flap technique. Three patients with macular hole retinal detachment in high myopia underwent pars plana vitrectomy using the inverted internal limiting membrane flap technique. One patient received a silicone oil injection, and the other two patients received a long-acting gas injection at the end of the surgery. After surgery, spectral domain ocular coherence tomography examination was performed. In the patient with the silicone oil injection, spectral domain optical coherence tomography revealed that the macular hole was sealed with an inverted internal limiting membrane flap in the presence of subretinal fluid 1 day after surgery. The inner retinal layers gradually regained a more physiologic configuration over the residual subretinal fluid. In all patients, macular holes were completely closed over the subretinal fluid, which was gradually absorbed. Using the inverted internal limiting membrane flap technique, macular holes were closed over residual subretinal fluid in patients with macular hole retinal detachment. The results indicate that reattachment of the retina may not be necessary for closure of macular holes.

  4. 23-gauge vitrectomy assisted by combined endoscopy and a wide-angle viewing system for retinal detachment with severe penetrating corneal injury: a case report

    Directory of Open Access Journals (Sweden)

    Morishita S

    2011-12-01

    Full Text Available Seita Morishita, Mihori Kita, Shin Yoshitake, Miou Hirose, Hideyasu OhDepartment of Ophthalmology, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, JapanBackground: We report a case of traumatic retinal detachment in an eye with severe corneal opacity that was successfully treated using 23 gauge (G transconjunctival vitrectomy assisted by endoscope and a wide-angle viewing system.Case presentation: A 22-year-old Japanese man was referred to our hospital with the suspicion of traumatic retinal detachment of the right eye, 1 month after an open globe eye injury due to fireworks. At the time of his first visit, his best-corrected visual acuity was hand motion in the right eye. A 23 G three port pars plana vitrectomy was conducted in combination with ophthalmic endoscope and a wide-angle viewing system. Endoscopy revealed a retinal detachment in the inferior quadrant with tiny retinal breaks. Primary reattachment of the retina was achieved by tamponade of SF6 gas. Five months after the vitrectomy, penetrating keratoplasty was performed and visual acuity recovered to 0.02. Optical coherent tomography revealed thinning of the retina, which might be the cause of the remaining poor vision.Conclusion: 23 G vitrectomy assisted by combined endoscopy and a wide-angle viewing system could be advantageous in managing visualization constraints due to penetrating trauma.Keywords: penetrating injury, vitrectomy, endoscope, wide angle viewing system, 23 gauge vitrectomy

  5. Visual recovery in a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision: a case report

    Directory of Open Access Journals (Sweden)

    Liebmann Jeffrey M

    2011-06-01

    Full Text Available Abstract Introduction We report the case of a patient with total hyphema, neovascular glaucoma, long-standing retinal detachment and no light perception vision, who regained counting fingers vision with complete regression of neovascularization following anterior chamber washout, intravitreal bevacizumab, pars plana vitrectomy, and silicone oil placement. This represents a rare case in which a patient with no light perception vision was able to regain functional vision. Case presentation A 63-year-old Caucasian man with a 55-year history of long-standing retinal detachment after trauma presented to our facility with pain and redness, a total hyphema, no light perception vision and an intraocular pressure of 60 mmHg (right eye. He had a history of diabetes mellitus and coronary artery disease. Following anterior chamber washout, he was found to have neovascular glaucoma, for which intravitreal bevacizumab was administered. After washout and intraocular pressure control, his visual acuity improved to light perception. He subsequently underwent vitrectomy, membrane peeling, endolaser and silicone oil placement to reattach his retina, and then a second retinal reattachment procedure. Following these procedures, he had visual recovery to counting fingers vision in his right eye at five metres, complete regression of neovascularization, and intraocular pressure of 10 to 12 mmHg on one antiglaucoma medication. Conclusion Functional vision can be regained despite long-standing retinal detachment.

  6. Prevention and control of proliferative vitreoretinopathy: primary retinal detachment surgery using silicone oil as a planned two-stage procedure in high-risk cases.

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    Alexander, P; Prasad, R; Ang, A; Poulson, A V; Scott, J D; Snead, M P

    2008-06-01

    For rhegmatogenous retinal detachment, reattachment with a single procedure is associated with better visual outcomes. In the past, silicone oil has been used mostly as a last resort following failed primary surgery. This study evaluates a novel approach to patients at high risk of primary failure, using silicone tamponade as the primary stage of a planned two-stage procedure. We report a series of 140 eyes that underwent primary surgery for rhegmatogenous retinal detachment. Patients at higher risk of surgical failure (eg giant retinal tear, inability to posture, poor view, uncertainty of location of primary break, primary proliferative vitreoretinopathy (PVR), multiple tears with rolled posterior edges, retinoschisis/detachment, staphyloma with macular hole) were managed by a planned staged procedure using primary silicone oil tamponade. This was followed by silicone removal at a later date. Fifty-four eyes underwent scleral buckling alone, with primary success in 52/54 (96%). Fifty-three eyes underwent vitrectomy and gas, achieving primary success in 50/53 (94%). Thirty-three eyes were classified high risk and managed with primary silicone. Silicone was safely removed in 22/25. In eight eyes, silicone was retained without attempt at removal. In total, primary retinal reattachment was achieved in 128 of 140 eyes (91.4%). Of these, 124 (97%) did not require long-term tamponade. Only four eyes (2.9%) developed PVR. A planned two-stage approach to highrisk cases of retinal detachment using primary silicone oil tamponade followed by silicone removal can achieve a high primary reattachment rate with less than 3% incidence of PVR.

  7. Establishing an experimental rat model of photodynamically-induced retinal vein occlusion using erythrosin B

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    Wei Chen

    2014-04-01

    Full Text Available AIM:To develop a reliable, reproducible rat model of retinal vein occlusion (RVO with a novel photosensitizer (erythrosin B and study the cellular responses in the retina.METHODS:Central and branch RVOs were created in adult male rats via photochemically-induced ischemia. Retinal changes were monitored via color fundus photography and fluorescein angiography at 1 and 3h, and 1, 4, 7, 14, and 21d after irradiation. Tissue slices were evaluated histopathologically. Retinal ganglion cell survival at different times after RVO induction was quantified by nuclear density count. Retinal thickness was also observed.RESULTS:For all rats in both the central and branch RVO groups, blood flow ceased immediately after laser irradiation and retinal edema was evident at one hour. The retinal detachment rate was 100% at 3h and developed into bullous retinal detachment within 24h. Retinal hemorrhages were not observed until 24h. Clearance of the occluded veins at 7d was observed by fluorescein angiography. Disease manifestation in the central RVO eyes was more severe than in the branch RVO group. A remarkable reduction in the ganglion cell count and retinal thickness was observed in the central RVO group by 21d, whereas moderate changes occurred in the branch RVO group.CONCLUSION: Rat RVO created by photochemically-induced ischemia using erythrosin B is a reproducible and reliable animal model for mimicking the key features of human RVO. However, considering the 100% rate of retinal detachment, this animal model is more suitable for studying RVO with chronic retinal detachment.

  8. Abnormal regional spontaneous neural activity in visual pathway in retinal detachment patients: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Huang X

    2017-11-01

    Full Text Available Xin Huang,1,2,* Dan Li,3,* Hai-Jun Li,3 Yu-Lin Zhong,1 Shelby Freeberg,4 Jing Bao,1 Xian-Jun Zeng,3 Yi Shao1 1Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, People’s Republic of China; 2Department of Ophthalmology, Eye Center, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, People’s Republic of China; 3Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 4Department of Ophthalmology, University of Florida, Gainesville, FL, USA *These authors contributed equally to this work Objective: The aim of the study was to investigate changes of brain neural homogeneity in retinal detachment (RD patients using the regional homogeneity (ReHo method to understand their relationships with clinical features. Materials and methods: A total of 30 patients with RD (16 men and 14 women, and 30 healthy controls (HCs (16 men and 14 women closely matched in age and sex were recruited. Resting-state functional magnetic resonance imaging scans were performed for all subjects. The ReHo method was used to investigate the brain regional neural homogeneity. Patients with RD were distinguished from HCs by receiver operating characteristic curve. The relationships between the mean ReHo signal values in many brain regions and clinical features in RD patients were calculated by Pearson correlation analysis. Results: Compared with HCs, RD patients had significantly decreased ReHo values in the right occipital lobe, right superior temporal gyrus, bilateral cuneus and left middle frontal gyrus. Moreover, we found that the mean ReHo signal of the bilateral cuneus showed positive relationships with the duration of the RD (r=0.392, P=0.032. Conclusion: The RD patients showed brain neural homogeneity dysfunction in the visual pathway, which may underline the pathological mechanism

  9. Macula-On Versus Macula-Off Pseudophakic Rhegmatogenous Retinal Detachment Following Primary 23-Gauge Vitrectomy Plus Endotamponade.

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    Rezar, Sandra; Sacu, Stefan; Blum, Robert; Eibenberger, Katharina; Schmidt-Erfurth, Ursula; Georgopoulos, Michael

    2016-04-01

    To evaluate anatomical and functional outcomes of macula-on and macula-off rhegmatogenous retinal detachment (RRD) after 23-gauge vitrectomy and gas endotamponade, in eyes after successful cataract surgery. Forty-six pseudophakic eyes of 46 consecutive patients who underwent surgery for RRD repair were included. Based on the severity degree and extension of the RRD, diluted C3F8, SF6 or C2F6 gases were used for endotamponade. Patients were followed 1 month, 3 months, 6 months and 12 months after surgery. Main outcome variables were functional and anatomic outcomes till 12 months after surgery. Proliferative vitreoretinopathy of grade B or C was observed in 43%. C3F8 was used in 59%, SF6 in 28% and C2F6 in 13%. Reattachment after the first intervention was achieved in 89%. Preoperatively, 63% of patients presented with fovea-off retinal detachment. No intraoperative complications were registered. Preoperatively, eyes with macula-on RRD had a logMar BCVA of 0.3 ± 0.6 compared with 1.2 ± 0.7 in the macula-off group (p = 0.01). The mean visual acuity significantly improved to 0.06 ± 0.1 logMar in macula-on eyes and to 0.2 ± 0.3 logMar in macula-off eyes at 12 months (p = 0.01 compared to baseline and p = 0.04 between both the groups). The mean final postoperative CRT was 318 ± 48 µm in the macula-on group compared with 305 ± 71 µm in the macula-off group (p = 0.5). Even morphological improvement after 23-gauge vitrectomy and gas endotamponade was comparable between macula-on and macula-off eyes, macula-off RRDs showed delayed visual rehabilitation. Both groups showed significant visual acuity improvement until 12 months, however, macula-on RRDs showed significantly more improvement than macula-off RRDs.

  10. Optical coherence tomography evaluation of patients with macula-off retinal detachment after different postoperative posturing: a randomized pilot study.

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    Peiretti, Enrico; Nasini, Francesco; Buschini, Elisa; Caminiti, Giulia; Lesnik Oberstein, Sarit Y; Willig, Alissa; Bijl, Heico M; Mura, Marco

    2017-08-01

    To assess the presence of outer and inner retinal folds (RFs) and drop-out of the ellipsoid zone (EZ) occurring after surgical repair of macula-off rhegmatogenous retinal detachment (RRD) with different postoperative posture and preoperative use of adjuvant perfluorocarbon liquid (PFCO). In this prospective study, 56 eyes of 56 consecutive patients affected by RRD were subjected to 23- or 25-gauge pars plana vitrectomy (PPV). The patients were randomized in four groups (14 prone 5 hr without PFCO, 14 supine 5 hr without PFCO, 14 prone 5 hr with PFCO and 14 supine 5 hr with PFCO) and followed up with spectral domain optical coherence tomography (SD-OCT). Spectral domain optical coherence tomography (SD-OCT) was recorded before surgery, at days 30 and 90 to detect the presence of outer RFs, inner RFs and drop-out of EZ and to follow their variation over time. No statistical significance was found in our groups for outer RFs, inner RFs, drop-out of EZ formation and evolution. The postoperative best-corrected visual acuity (BCVA) improved in all groups (mean preoperative BCVA 1.47 logMar ± 0.19, mean postoperative BCVA 0.27 logMar ± 0.11, p < 0.01), without statistical variations between the four groups in BCVA after surgery. The use of adjuvant and variation in postoperative position did not change the risk of presenting outer RFs, inner RFs and drop-out of EZ after RRD. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  11. [Observation of single-layered inverted internal limiting membrane flap technique for macular hole with retinal detachment in high myopia].

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    Xu, C Z; Wu, J H; He, J W; Feng, C

    2017-05-11

    Objective: To compare the outcome of pars plana vitrectomy (PPV) with a single-layered inverted internal limiting membrane (ILM) flap versus PPV with ILM peeling for the treatment of macular hole associated retinal detachment (MHRD) in high myopia. Methods: In a retrospective cohort study, PPV with 2 kinds of adjuvant surgical procedures were used in 35 moderately high myopia eyes with MHRD. These eyes were divided into 2 groups: group 1 (17 eyes) receiving PPV and ILM peeling and group 2 (18 eyes) receiving PPV with a single-layered inverted ILM flap. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity (BCVA) were measured at 6 months after surgery. Results: The retina was successfully reattached in all cases. The difference of the retinal reattachment rate between the two groups was not statistically significant (Fisher's exact test, P= 1.000). The rate of macular hole closure was 47.1% in group 1 (8 eyes) and 88.9% in group 2 (16 eyes). The difference of the macular hole closure rate between the two groups was statistically significant (Fisher's exact test, P= 0.012). Significant improvement in logarithm of minimal angle of resolution (logMAR) BCVA was achieved in both groups. There was no difference in the initial, final, or improved logMAR BCVA in the 2 groups. Conclusion: Single-layered inverted ILM flap technique effectively helps close the macular hole in moderately high myopia with MHRD. This may prevent the possible redetachment from the macular hole. (Chin J Ophthalmol, 2017, 53: 338 - 343) .

  12. Anatomic and functional outcomes of 25-gauge vitrectomy for repair of eyes with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy.

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    Iwahashi-Shima, Chiharu; Sato, Tatsuhiko; Bando, Hajime; Ikeda, Toshihide; Emi, Kazuyuki

    2013-01-01

    The purpose of this study was to evaluate the outcome of 25-gauge vitrectomy for repair of rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR). Twenty-seven eyes of 27 patients who had undergone 25-gauge vitrectomy for grade C PVR were investigated retrospectively. The surgical procedures, anatomic success, and best-corrected visual acuity were assessed. The mean number of operations was 1.4 (range 1-4). During the 25-gauge vitrectomy, 20-gauge instruments were needed in eleven eyes (40.7%) to remove resilient fibrous preretinal membranes, to extract subretinal proliferations, or to remove or infuse silicone oil. The retina was reattached in 21 eyes (77.8%) after the initial vitrectomy and in 25 eyes (92.6%) at the final examination. The mean best-corrected visual acuity in logarithm of the minimal angle of resolution units was 1.36 ± 0.81 before vitrectomy and 0.79 ± 0.71 at one month, 0.73 ± 0.72 at 3 months, 0.73 ± 0.75 at 6 months, and 0.75 ± 0.78 at 12 months after vitrectomy. The best-corrected visual acuities were significantly improved compared with the preoperative ones at all postoperative assessments (Pgauge vitrectomy is a relatively safe and efficacious method of treating RRD with PVR, although combined use of 20-gauge instruments may be needed for certain surgical procedures.

  13. Combined 23-Gauge PPV and Scleral Buckle Versus 23-Gauge PPV Alone for Primary Repair of Pseudophakic Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Setlur, Vikram J; Rayess, Nadim; Garg, Sunir J; Hsu, Jason; Luo, Caesar K; Regillo, Carl D; Fineman, Mitchell S; Sivalingam, Arunan

    2015-01-01

    This review compares 23-gauge pars plana vitrectomy (PPV) alone versus combined 23-gauge pars plana vitrectomy and scleral buckle (PPV/SB) for primary repair of pseudophakic rhegmatogenous retinal detachment (RRD). A retrospective review of 70 eyes that underwent 23-gauge PPV and 43 eyes that received 23-gauge PPV/SB for pseudophakic RRD. Minimum follow-up was 3 months. Outcome measures included anatomical success, visual acuity, and complication rates. The 23-gauge PPV group achieved primary anatomical success in 58 of 70 cases (83%). Primary success in the PPV/SB group occurred in 36 of 43 cases (84%). Final anatomical success was achieved in all 113 cases (100%). The difference in primary success rates was not statistically significant (P = 1.000, Fisher exact test). Average visual acuity for macula-on RRDs in the PPV group showed a +0.07 logMAR improvement (P = .580) versus a +1.34 improvement (P gauge PPV and PPV/SB are effective procedures for repairing pseudophakic RRD and exhibit similar rates of success. Copyright 2015, SLACK Incorporated.

  14. Contrast Sensitivity after Pars Plana Vitrectomy: Comparison between Macula-On and Macula-Off Rhegmatogenous Retinal Detachment.

    Science.gov (United States)

    Kawamura, Hajime; Fujikawa, Masato; Sawada, Osamu; Sawada, Tomoko; Saishin, Yoshitsugu; Ohji, Masahito

    2016-07-01

    To evaluate the contrast sensitivity (CS) of eyes successfully repaired by vitrectomy for rhegmatogenous retinal detachment (RRD) with or without preoperative macular involvement. In this retrospective, consecutive, interventional case series, 109 eyes received primary vitrectomy for RRD, of which 36 with at least 12 months of follow-up and a best-corrected visual acuity (BCVA) ≥1 at 12 months postoperatively were investigated. The main outcome measurements were BCVA and CS at 12 months postoperatively. Patients with macula-on RRD preoperatively were included in the macula-on group, and patients with macula-off RRD preoperatively were included in the macula-off group. The between-group difference in CS under evening vision conditions was measured with a Takagi glare tester CGT-2000 at 6 visual angles and 13 contrast levels with and without glare. CS was significantly lower in the macula-off group for targets with visual angles of 1.6, 1.0, and 0.64° with glare (p macula-off RRD patients with good postoperative BCVA compared to macula-on RRD patients with good postoperative BCVA. © 2016 S. Karger AG, Basel.

  15. The use of contrast-enhanced color doppler ultrasound in the differentiation of retinal detachment from vitreous membrane

    International Nuclear Information System (INIS)

    Han, Sang Suk; Chang, Seung Kook; Yoon, Jung Hee; Lee, Young Joon

    2001-01-01

    To compare the clinical utility of contrast-enhanced color Doppler US in the differentiation of retinal detachment (RD) from vitreous membrane (VM) with that of various conventional US modalities, and to analyze the enhancement patterns in cases showing an enhancement effect. In 32 eyes examined over a recent two-year period, RD (n=14) and VM (n=18) were confirmed by surgery (n=28) or clinical follow-up (n=4). In all cases, gray-scale, color Doppler, and power Doppler US were performed prior to contrast injection, and after the intravenous injection of Levovist (Schering, Berlin) by hand for 30 seconds at a dose of 2.5 g and a concentration of 300 mg/mL via an antecubital vein, contrast-enhanced color Doppler US was performed. At Doppler US, the diagnostic criterion for RD and VM was whether or not color signals were visualized in membranous structures. Diagnostic accuracy was 78% at gray-scale US, 81% at color Doppler US, 59% at power Doppler US, and 97% at contrast-enhanced color Doppler US. The sensitivity of color Doppler US to color signals in RD increased from 57% to 93% after contrast enhancement. The enhancement patterns observed were signal accentuation (n=3), signal extension (n=2), signal addition (n=3), and new signal visualization (n=5). Contrast-enhanced color Doppler US was the most accurate US modality for differentiating RD from VM, showing a significantly increased signal detection rate in RD

  16. Pars plana vitrectomy compared with pars plana vitrectomy combined with scleral buckle in the primary management of noncomplex rhegmatogenous retinal detachment.

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    Orlin, Anton; Hewing, Nina J; Nissen, Michael; Lee, Sangwoo; Kiss, Szilard; DʼAmico, Donald J; Chan, R V Paul

    2014-06-01

    To compare pars plana vitrectomy (PPV) with PPV combined with scleral buckle (PPV/SB) in the treatment of primary, noncomplex rhegmatogenous retinal detachment in an academic setting. Retrospective review of 74 consecutive cases that underwent either PPV or PPV/SB for primary rhegmatogenous retinal detachment at New York Presbyterian Hospital, Weill Cornell Medical College. Fifty-two eyes underwent PPV alone while 22 eyes had PPV combined with SB. All eyes had a minimum of 2 months of follow-up. The main outcome measure was single surgery anatomical success. Patients in the PPV/SB group were less likely to be phakic (P = 0.05) and more likely to have an inferior retinal break (P = 0.001) when compared with the PPV group. Between groups, there was no difference in eyes with peripheral retinal lattice degeneration (P = 0.929), multiple breaks (P = 0.801), breaks seen preoperatively (P = 0.095), or those presenting with the macula off retinal detachment (P = 0.548). The majority of patients in both groups underwent small-gauge surgery (23 G or 25 G) (P = 0.65). Attachment of the retina was obtained in 100% of the patients in both groups at most recent follow-up. Single surgery anatomical success was similar between groups (83% PPV vs. 86% PPV/SB; P = 0.695). Mean best-corrected Snellen visual acuity improved in both groups (P = 0.75), with a final best-corrected Snellen visual acuity of 0.418 logMAR in the PPV group and 0.479 logMAR in the PPV/SB group (P = 0.61). When comparing PPV with PPV/SB, no difference in single surgery anatomical success existed after evaluating eyes with inferior breaks (P = 0.68), pseudophakia (P = 0.75), or when small-gauge surgery was performed (P = 0.76). We did not find significant differences in single surgery anatomical success, final anatomical success, or change in visual acuity when comparing PPV with PPV/SB in the repair of primary noncomplex rhegmatogenous retinal detachment in an academic setting where vitreoretinal fellows

  17. Twenty-three-gauge pars plana vitrectomy, Densiron-68, and 360° endolaser versus combined 20-gauge pars plana vitrectomy, scleral buckle, and SF6 for pseudophakic retinal detachment with inferior retinal breaks.

    Science.gov (United States)

    Romano, Mario R; Angi, Martina; Valldeperas, Xavier; Costagliola, Ciro; Vinciguerra, Paolo

    2011-04-01

    To compare the anatomical and functional outcomes of 23-gauge pars plana vitrectomy (PPV) with Densiron-68 tamponade and 360° endolaser versus 20-gauge PPV with encircling scleral buckling (ESB) and an SF6 gas tamponade for the repair of primary pseudophakic retinal detachment with inferior retinal breaks. Prospective, randomized, comparative, interventional study. Eighty-two eyes of 82 consecutive patients were randomly assigned to 1 of the 2 treatment groups: 23-gauge PPV/Densiron-68 (44 eyes, 54%) or 20-gauge PPV/ESB/SF6 (20%) (38 eyes, 46%). The inclusion criterion was the presence of primary pseudophakic retinal detachment with at least 1 retinal break between the 4- and 8-o'clock positions. The study protocol involved a minimum of 7 visits: baseline, day of surgery, 1 week, and 1, 3, 6, and 9 months postoperation. Densiron-68 removal was performed within 12 weeks of the initial surgery. Two surgical procedures were required in the Densiron group to remove the oil. After the primary procedure, the retina was reattached in 90% (40 of 44) of cases in the 23-gauge PPV/Densiron group and in 92% (35 of 38) of cases in the 20-gauge PPV/ESB/SF6 group (P = 0.2, Fisher's exact test). After resolution of redetachments, final anatomical success rate rose to 97% (43 of 44) in the 23-gauge PPV/Densiron group and 94% (36 of 38) in the 20-gauge PPV/SB/SF6 group (P = 0.32, Fisher's exact test). Mean final best-corrected visual acuity (logarithm of the minimum angle of resolution) was 0.40 in the 23-gauge PPV/Densiron group and 0.48 in the 20-gauge PPV/ESB/SF6 group (P = 0.31, t-test). Operative time was significantly less in the 23-gauge PPV/Densiron group (P = 0.002, t-test). No statistically significant difference in the complication rate between the two groups was recorded. Twenty-three-gauge PPV combined with Densiron-68 and 360° endolaser and 20-gauge PPV combined with ESB/SF6 seemed to have similar efficacy in the repair of primary pseudophakic retinal detachment

  18. Optimizing visualization in enhanced depth imaging OCT in healthy subjects and patients with retinal pigment epithelial detachment

    Directory of Open Access Journals (Sweden)

    Kampik A

    2012-11-01

    Full Text Available Lukas Reznicek, Efstathios Vounotrypidis, Florian Seidensticker, Karsten Kortuem, Anselm Kampik, Aljoscha S Neubauer, Armin WolfDepartment of Ophthalmology, Ludwig Maximilians University Muenchen, Munich, GermanyBackground: This study’s objective was to optimize the visualization of three different spectral-domain optical coherence tomography (SD-OCT display modalities and evaluate enhanced depth imaging (EDI by comparing the maximum depth of assessment in conventional versus inverted cross-sectional OCT images in healthy subjects and in patients with retinal pigment epithelial detachment (PED.Methods: Cross-sectional SD-OCT conventional and inverted images were obtained with the HRA2 (Heidelberg Retina Angiograph II, Heidelberg Engineering, Heidelberg, Germany. Horizontal as well as vertical sections in three different display modes were blinded for evaluation by three independent, experienced graders for maximal imaging depth of the deep ocular fundus layers.Results: The mean imaging depth as measured from the inner segment/outer segment (IS/OS to the outer choroid of all 14 healthy subjects was 197 ± 44 µm vs 263 ± 56 µm for conventional vs EDI scans: in black/white mode, it was significantly lower (P < 0.001 than in white/black mode (249 ± 42 µm vs 337 ± 71 µm and color/heat mode (254 ± 48 µm vs 354 ± 73 µm. The mean imaging depth of all 14 study eyes with PED was 240 ± 78 µm vs 345 ± 100 µm for conventional vs EDI scans in black/white mode, and was significantly lower (P < 0.001 than in white/black mode (393 ± 104 µm vs 464 ± 126 µm and in color/heat mode (373 ± 106 µm vs 453 ± 114 µm. In each display modality of healthy subjects and of patients with PED, EDI scans showed a significantly higher imaging depth than the corresponding conventional scans.Conclusion: White/black and color/heat modes allow increased imaging depth, compared to black/white mode using both conventional or EDI OCT scans in healthy subjects or

  19. Impact of duration of macula-off retinal detachment on visual outcome: a systematic review and meta-analysis of literature.

    Science.gov (United States)

    van Bussel, Erik M; van der Valk, Rikkert; Bijlsma, Ward R; La Heij, Ellen C

    2014-10-01

    To systematically review the influence of the lag time between macula-off retinal detachment and surgical intervention on postoperative visual acuity as main outcome measure. Systematic review and meta-analysis of articles published from 1995 to October 2013 of patients with macula-off retinal detachment and treated with scleral buckling or pars plana vitrectomy. Eligible data were pooled in a meta-analysis, analyzing the odds ratio between different durations of ≤ 3, ≤ 4, ≤ 7, and ≤ 10 days, comparing a final visual acuity of ≤ 0.4 logMAR with >0.4 logMAR, using a random-effects model. Last, the number needed to treat was calculated. Fourteen articles were eligible, of which 9 studies contained data that were suitable for meta-analysis. Patients who were operated with scleral buckling (n = 602) within 3 days since macular detachment had a statistically significant better chance of reaching a final visual acuity of 0.4 logMAR or better compared with a longer duration of macular detachment, with an odds ratio for ≤ 3 days versus 4 days to 7 days of 2.86 (95% confidence interval, 1.37-5.99) and an odds ratio for ≤ 3 days versus >3 days of 3.09 (95% confidence interval, 1.56-6.12), and with a number needed to treat of 4. For pars plana vitrectomy, the limited amount of data precluded a meta-analysis with substantial results. This meta-analysis suggests that scleral buckling for macular detachment must preferably be performed within 3 days to optimize visual outcome.

  20. Heavy lifting at work and risk of retinal detachment: a population-based register study in Denmark.

    Science.gov (United States)

    Curti, Stefania; Coggon, David; Hannerz, Harald; Mattioli, Stefano

    2016-01-01

    To investigate the relationship between rhegmatogenous retinal detachment (RRD) and frequent heavy lifting in a Danish working population through national register data. A dynamic cohort of all men aged 20-59 years in Denmark was followed through the Danish Occupational Hospitalisation Register from 1995 to 2010 for diagnosed RRD. Occupational categories were classified according to their potential for heavy lifting in 4 main groups: heavy lifters, manual workers unlikely to be heavy lifters, other manual workers and non-manual workers unlikely to be heavy lifters. The age-standardised rate of diagnosed RRD for heavy lifting occupations was compared with that experienced by the other 3 occupational categories. Rate ratios (RRs) and 95% CIs were estimated through a Poisson regression model adjusted for calendar period and age group. The highest age-standardised rate of diagnosed RRD was recorded among non-manual workers performing occupational activities unlikely to be associated with heavy lifting (18.0 cases per 100,000 person-years). The RR for workers in jobs expected to entail a high frequency of heavy lifting compared with manual workers whose occupation was unlikely to be associated with heavy lifting was 0.91 (95% CI 0.73 to 1.14), while in comparison with other manual workers, it was 0.93 (95% CI 0.78 to 1.11). The RR compared with non-manual workers in occupations unlikely to entail heavy lifting was 0.51 (95% CI 0.43 to 0.60). These findings do not support an association of occupational heavy lifting with diagnosed RRD. The epidemiological evidence for this association is still inconclusive. Future studies should use a more specific measure of exposure to resolve the outstanding uncertainties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Twenty-seven-gauge vitrectomy for combined tractional and rhegmatogenous retinal detachment involving the macula associated with proliferative diabetic retinopathy.

    Science.gov (United States)

    Cruz-Iñigo, Yousef J; Berrocal, María H

    2017-01-01

    To report our experience using 27-gauge pars plana vitrectomy (PPV) system for treating patients with combined tractional and rhegmatogenous retinal detachments (CTRRD) involving the macula associated with proliferative diabetic retinopathy (PDR). Retrospective noncomparative interventional cases series of 12 patients with CTRRD associated with PDR who underwent 3-port, transconjunctival 27-gauge PPV by a single surgeon. Main outcome measures were change in Snellen best corrected visual acuity (BCVA) and occurrence of intra- and post-operative complications. Twelve eyes from 12 patients (9 men and 3 women) underwent 27-gauge PPV. Mean follow-up was 17 months (range 8-26 months). Preoperatively, BCVA of 20/400 or better was recorded in only 2 of 12 (16.7%) eyes. Postoperatively, BCVA improved to 20/400 or better in 11 of 12 (91.7%) eyes at 6 months ( P  = 0.001). At last follow-up, BCVA of 20/400 or better was recorded in 10 of 12 (83.3%), in comparison to 2 (16.7%) eyes at baseline ( P  = 0.004). The only intraoperative complication was an iatrogenic break in 1 eye (8.3%). Postoperative complications included vitreous hemorrhage in 4 eyes (33.3%) and transient ocular hypertension in 3 eyes (25.0%). At final follow-up anatomic success was confirmed in all eyes. The current study findings suggest that 27-gauge PPV is a safe and promising surgical technology for treating patients with CTRRD involving the macula associated with PDR. Smaller gauge instruments and higher cutting rates may facilitate the dissection and shaving of fibrovascular membranes, while minimizing intra- and post-operative complications.

  2. High-resolution Fourier-Domain Optical Coherence Tomography and Microperimetric Findings After Macula-off Retinal Detachment Repair

    Science.gov (United States)

    Smith, Allison J.; Telander, David G.; Zawadzki, Robert J.; Choi, Stacey S.; Morse, Lawrence S.; Werner, John S.; Park, Susanna S.

    2009-01-01

    Objective To evaluate the morphologic changes in the macula of subjects with repaired macula-off retinal detachment (RD) using high-resolution Fourier-domain optical coherence tomography (FD OCT) and to perform functional correlation in a subset of patients using microperimetry (MP-1). Design Prospective observational case series. Participants Seventeen eyes from 17 subjects who had undergone anatomically successful repair for macula-off, rhegmatogenous RD at least 3 months earlier and without visually significant maculopathy on funduscopy. Methods FD OCT with axial and transverse resolution of 4.5 μm and 10 to 15 μm, respectively, was used to obtain rapid serial B-scans of the macula, which were compared with that from Stratus OCT. The FD OCT B-scans were used to create a 3-dimensional volume, from which en face C-scans were created. Among 11 patients, MP-1 was performed to correlate morphologic changes with visual function. Main Outcome Measures Stratus OCT scans, FD OCT scans, and MP-1 data. Results Stratus OCT and FD OCT images of the macula were obtained 3 to 30 months (mean 7 months) postoperatively in all eyes. Although Stratus OCT revealed photoreceptor disruption in 2 eyes (12%), FD OCT showed photoreceptor disruption in 13 eyes (76%). This difference was statistically significant (Pmacula-off RD repair is a common abnormality in the macula that is detected better with FD OCT than Stratus OCT. A good correlation between MP-1 abnormality and presence of photoreceptor disruption or subretinal fluid on FD OCT demonstrates that these anatomic abnormalities contribute to decreased visual function after successful repair. PMID:18672289

  3. Interleukin and growth factor levels in subretinal fluid in rhegmatogenous retinal detachment: a case-control study.

    Directory of Open Access Journals (Sweden)

    Lukas J A G Ricker

    Full Text Available BACKGROUND: Rhegmatogenous retinal detachment (RRD is a major cause of visual loss in developed countries. Proliferative vitreoretinopathy (PVR, an eye-sight threatening complication of RRD surgery, resembles a wound-healing process with inflammation, scar tissue formation, and membrane contraction. This study was performed to determine the possible involvement of a wide range of cytokines in the future development of PVR, and to identify predictors of PVR and visual outcome. METHODOLOGY: A multiplex immunoassay was used for the simultaneous detection of 29 different cytokines in subretinal fluid samples from patients with primary RRD. Of 306 samples that were collected and stored in our BioBank between 2001 and 2008, 21 samples from patients who developed postoperative PVR were compared with 54 age-, sex-, and storage-time-matched RRD control patients who had an uncomplicated postoperative course during the overall follow-up period. FINDINGS: Levels of IL-1α, IL-2, IL-3, IL-6, VEGF, and ICAM-1 were significantly higher (P0.05. Multivariate logistic regression analysis revealed that IL-3 (P = 0.001, IL-6 (P = 0.047, ICAM-1 (P = 0.010, and preoperative visual acuity (P = 0.026 were independent predictors of postoperative PVR. Linear regression analysis showed that ICAM-1 (P = 0.005 and preoperative logMAR visual acuity (P = 0.001 were predictive of final visual outcome after primary RRD repair. CONCLUSIONS/SIGNIFICANCE: Our findings indicate that after RRD onset an exaggerated response of certain cytokines may predispose to PVR. Sampling at a time close to the onset of primary RRD may thus provide clues as to which biological events may initiate the development of PVR and, most importantly, may provide a means for therapeutic control.

  4. BAX and BCL-2 polymorphisms, as predictors of proliferative vitreoretinopathy development in patients suffering retinal detachment: the Retina 4 project.

    Science.gov (United States)

    Pastor-Idoate, Salvador; Rodríguez-Hernández, Irene; Rojas, Jimena; Fernández, Itziar; García-Gutierrez, María-Teresa; Ruiz-Moreno, Jose M; Rocha-Sousa, Amandio; Ramkissoon, Yashin D; Harsum, Steven; MacLaren, Robert E; Charteris, David G; Van Meurs, Jan C; González-Sarmiento, Rogelio; Pastor, Jose C

    2015-11-01

    To compare the distribution of BCL-2 -938C>A (rs2279115) and BAX -248G>A (rs4645878) genotypes among European subjects undergoing rhegmatogenous retinal detachment (RRD) surgery in relation to the further development of proliferative vitreoretinopathy (PVR). A case-control gene association study, as a part of Retina 4 project, was designed. rs2279115 and rs4645878 polymorphisms were analysed in 555 samples from patients with RRD (134 with PVR secondary to surgery). Proportions of genotypes and AA homozygous groups of BCL-2 and BAX polymorphisms between subsamples were analysed in two phases. Genotypic and allelic frequencies were compared in global sample and in subsamples. BAX: Differences were observed in the genotype frequencies and in AA carriers between controls and cases in the global series. The odds ratio (OR) of A carriers in the global sample was 1.7 (95% CI: 1.23-2.51). Proportions of genotypes in Spain + Portugal were significant different. The OR of A carriers from Spain and Portugal was 1.8 (95% CI: 1.11-2.95). BCL-2: No significant differences were observed in genotype frequencies. However, proportions of genotypes in Spain + Portugal were significant. A protective effect (OR: 0.6 95% CI: 0.43-0.96) was found in A carriers from Spain and Portugal. Results suggest that A allele of rs4645878 could be a biomarker of high risk of developing PVR in patients undergoing RD surgery. The possible role of BCL-2 (inhibitor of necroptosis pathway) as a possible new target in PVR prophylaxis should be investigated. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy

    Directory of Open Access Journals (Sweden)

    Oellers P

    2016-05-01

    Full Text Available Patrick Oellers, Sandra Stinnett, Paul Hahn Duke Eye Center, Duke University School of Medicine, Durham, NC, USA Purpose: Valved cannulas are a recent addition to small-gauge pars plana vitrectomy (PPV and provide stable intraocular fluidics. The goal of this study was to compare outcomes and postoperative complication rates of valved vs nonvalved cannula small-gauge PPV for repair of retinal detachments (RDs complicated by Grade C proliferative vitreoretinopathy (PVR.Methods: A retrospective chart review of 364 consecutive eyes with either valved or nonvalved cannula PPV for RD repair was performed. The primary outcomes were single surgery and final anatomic success and change in best-corrected visual acuity for repair of RDs complicated by Grade C PVR.Results: We identified 36 eyes in the valved group and 31 eyes in the nonvalved group with Grade C PVR RD. The single surgery success was 83% vs 77% (P=0.555 and the final anatomic success was 94% vs 87% (P=0.404 in the valved vs nonvalved eyes, respectively. The mean final visual acuity gain was −0.36 logarithm of the minimum angle of resolution (logMAR; approximate Early Treatment Diabetes Retinopathy Study [ETDRS] score =17 letters in valved eyes vs −0.33 logMAR (approximate ETDRS score =16 letters in nonvalved eyes (P=0.81. Postoperative complication rates including postoperative day 1 hypotony, hypertony, and anterior chamber fibrin formation; postoperative retention of intraocular or subretinal perfluorocarbon liquid; and subsequent epiretinal membrane peel were not statistically different between groups.Conclusion: Valved cannula PPV yields equivalent visual acuity and anatomic outcomes without increased postoperative complication rates compared to traditional nonvalved cannula PPV for Grade C PVR-associated RD repair. Keywords: 23 gauge, 25 gauge, PVR, RD, chronic, single surgery success, final anatomic success

  6. Subretinal Fluid Levels of Signal-Transduction Proteins and Apoptosis Molecules in Macula-Off Retinal Detachment Undergoing Scleral Buckle Surgery.

    Science.gov (United States)

    Carpineto, Paolo; Aharrh-Gnama, Agbeanda; Ciciarelli, Vincenzo; Borrelli, Enrico; Petti, Francesco; Aloia, Raffaella; Lamolinara, Alessia; Di Nicola, Marta; Mastropasqua, Leonardo

    2016-12-01

    To evaluate signal transduction and early apoptosis protein levels in subretinal fluid collected during scleral buckling surgery for macula-off rhegmatogenous retinal detachment (RRD). Our aim was to assess both their relation with RRD features and their influence on the posttreatment outcome. Thirty-three eyes of 33 RRD patients scheduled for scleral buckle surgery were enrolled in the study. Undiluted subretinal fluid samples were collected during surgery and analyzed via magnetic bead-based immunoassay. All patients underwent a complete ophthalmologic evaluation at baseline and at each follow-up visit (months 1, 3, and 6). Moreover, both at baseline and at the postsurgery month 6 visit, the patients were tested by means of spectral-domain optical coherence tomography (SD-OCT) in order to evaluate the average ganglion cell-inner plexiform complex thickness, as well as the photoreceptor inner segment/outer segment junction status. Patients' clinical features (retinal detachment size, detachment duration, and occurrence of proliferative vitreoretinopathy) were associated with several early apoptotic factors (caspase-8, caspase-9, and B-cell lymphoma 2 [Bcl-2]-associated death promoter [BAD]). Furthermore, both early apoptosis factors (caspase-8, Bcl-2, and p53) and signal-transduction proteins (ERK 1/2) were found to influence the postsurgery month 3 OCT characteristics. Signal-transduction proteins and early apoptosis proteins are associated with different clinical features and postsurgery outcomes.

  7. Hybrid microincision vitrectomy surgery combined with 20-gauge silicone cannulas for use with 20-gauge horizontal scissors in diabetic tractional retinal detachment.

    Science.gov (United States)

    Yamada, Keiko; Maeno, Takatoshi; Yamada, Mitsunori

    2013-01-01

    To verify the utility and preliminary safety of a 20-gauge silicone cannula for use with 20-gauge horizontal scissors delamination during microincision vitrectomy surgery (MIVS). Thirty-eight eyes in 35 consecutive patients with diabetic tractional retinal detachment, who underwent MIVS between April 2010 and March 2012 and were followed for 3-24 months, were retrospectively assessed using a chart review. Twenty-gauge scissors delamination through a silicone cannula, with an additional 20-gauge port as a hybrid, was primarily selected when treating thick and rigid fibrovascular membranes, including fluctuating vessels over the detached retina near the macula. The main outcome measures included the proportion of patients treated with this hybrid method, the postoperative visual acuity, and the incidence of complications. Compared with the 26 eyes treated with MIVS only, 12 eyes (32%) required a hybrid technique with the use of 20-gauge instruments through a silicone cannula in addition to MIVS. Two patients underwent additional surgery. Temporary silicone oil tamponade was performed in one case of retinotomy and one case of schizophrenia. The mean visual acuity (logarithm of the minimum angle of resolution [logMAR]) improved from 1.43 ± 0.85 to 0.72 ± 0.47 at the last follow-up visit. No patients exhibited worsening of their visual acuity postoperatively. No sclerotomy-related complications were recorded during the intraoperative or postoperative periods. Hybrid MIVS combined with a 20-gauge silicone cannula for use with 20-gauge horizontal scissors in diabetic tractional retinal detachment eyes is useful and safe due to the reduced risk of sclerotomy-related retinal breaks. This procedure is a reasonable option when performing complex surgery for diabetic vitrectomy.

  8. MACULAR BUCKLING WITH ANDO PLOMBE MAY INCREASE CHOROIDAL THICKNESS AND MIMIC SEROUS RETINAL DETACHMENT SEEN IN THE TILTED DISK SYNDROME.

    Science.gov (United States)

    Mateo, Carlos; Burés-Jelstrup, Anniken

    2016-01-01

    Serous subfoveal detachment has been described in the literature as a complication that appears at the border of the staphyloma. Macular buckling induces a postoperative inward bulge that resembles the ridge of a staphyloma. We describe three patients who developed a serous subfoveal detachment after uneventful macular buckling. To our knowledge, this complication, that shares similarities with the staphyloma ridge detachment, has not been previously reported. The clinical records of all cases that underwent macular buckling at our clinic were reviewed. Three patients developed a serous subfoveal detachment that could not be explained by choroidal neovascularization or polypoidal vascular choroidopathy. Along with the development of the subfoveal detachment, we observed an increase of the choroidal thickness beneath the fovea. This thickening, that tended to progress during the follow-up, resolved spontaneously after explantation of the buckle. The decrease in foveal thickness did also lead to resolution of the subfoveal detachment. The development of the subfoveal detachment in our patients was closely associated with a focal increase of the choroidal thickness after the macular buckling. After the buckle was removed, the choroidal thickness went back to the normal prebuckling values and the detachment resolved in all three patients. This leads us to think that there is a close association between choroidal thickness and the serous subfoveal detachment.

  9. [A study of the localization and accumulation of S-phase cells in the retina of newt Pleurodeles waltl after experimental pigment epithelial detachment].

    Science.gov (United States)

    Novikova, Iu P; Poplinskaia, V A; Aleĭnikova, K S; Grigorian, E N

    2008-01-01

    This work continues the studies of the proliferative ability of cells in the adult newt retina. The model of experimental detachment of the retina from pigment epithelium and two techniques to saturate the ocular tissues in vivo with precursors of DNA synthesis were used: (1) the method of repeated [3H]-thymidine labeling and subsequent autoradiographic analysis of semithin sections and (2) an original method for continuous labeling of thymidine analog bromodeoxyuridine and subsequent immunochemical detection. The data obtained confirm and extend our previous data on the localization of DNA-synthesizing cells in the neural retina and expose the pattern of S-phase cell accumulation after retinal detachment for each proliferation-competent cell population. In addition to cells in the growth zone of the retina, Muller glia, microglia, and minor cell population in the vitreal part of interneurons, DNA-synthesizing cells included astrocytes of the optic nerve and cells of its vascular network. Four weeks after detachment, the number of S-phase cells in the growth zone could reach 15-20%, while the above-mentioned DNA-synthesizing cells in the differentiated retina have low reproductive rate and could produce only one generation within the same period.

  10. RhoA Inactivation Prevents Photoreceptor Axon Retraction in an In Vitro Model of Acute Retinal Detachment

    OpenAIRE

    Fontainhas, Aurora Maria; Townes-Anderson, Ellen

    2011-01-01

    Axon retraction by rod cells is an early response to detachment that likely contributes to poor outcomes after reattachment. In mammalian retina, blocking RhoA signaling prevents axon retraction. Effective treatment can occur as much as 6 hours after the detachment.

  11. Proliferative vitreo-retinal disorders: experimental models in vivo and in vitro.

    Science.gov (United States)

    Martini, B

    1992-01-01

    The aim of the present thesis was to develop, refine, and assess experimental models for the study of proliferative vitreo-retinal disorders. An intravitreal injection of a colloidal solution of microparticles was used in the primate eye to produce pathologic changes including intraocular cell invasion, cell proliferation, neovascularization, collagen synthesis, and tractional retinal detachment. In a separate primate model for laser-induced subretinal neovascularization, the origin and the occurrence of macrophages was evaluated. Examinations were performed using ophthalmoscopy, slit-lamp microscopy, light microscopy, and transmission electron microscopy. Cell cultures were employed to study the effects of vitreous humor and macrophages on the proliferation of cultured retinal pigment epithelial (RPE) cells and cultured fibroblasts using a Coulter counter. Morphologic changes were documented by phase micrography. A quantitative estimation of the extracellular matrix deposition of fibrous proteins by macrophage-modulated RPE cells as well as by vitreous-modulated RPE cells was done using enzymatic digestion and radioactive labeling techniques. A qualitative analysis of the types of collagen that was deposited in the extracellular matrices by vitreous modulated cultures was also made using indirect immunofluorescence. Using a newly developed RPE cell specific monoclonal antibody, the avidin-biotin-peroxidase labeling technique was finally employed to test the phenotypic epitope expression of macrophage-modulated and non-modulated RPE cells. A new experimental in vivo model for pathologic changes that characterize proliferative vitreo-retinal disorders was developed in the primate eye. In the model for laser-induced subretinal neovascularization, macrophages were shown to be principally recruited from the systemic circulation. Using cell cultures, it was found that both macrophage-conditioned medium and vitreous humor, separately or combined, exert mitogenic effects

  12. Resolution of bilateral cystoid macular edema and subfoveal serous retinal detachments after treatment with bortezomib in a patient with "smoldering" multiple myeloma.

    Science.gov (United States)

    Grannis, Charity H; Dewan, Vinay N; Wang, Robert C

    2014-01-01

    To describe a case of a patient with multiple myeloma without extraocular end-organ damage but with cystoid macular edema and macular detachments who was treated with bortezomib and dexamethasone. There was a complete resolution of retinal and subretinal fluid and significant improvement of vision. The patient's ocular disease was monitored with visual acuity, dilated fundus examinations, and optical coherence tomography before, during, and after treatment. The patient in this case report was a 43-year-old African American man with a medical history of untreated, "smoldering" multiple myeloma, hypertension, hyperlipidemia who presented to our clinic with progressive painless loss of vision in both eyes over 6 weeks. Before treatment with bortezomib and dexamethasone, the patient had complaints of confusion, muscle stiffness, joint pain, and 20-lb unintentional weight loss; however, he did not have hypercalcemia, renal insufficiency, anemia, or bone lesions typical of active multiple myeloma. The bilateral cystoid macular edema and subfoveal neurosensory retinal detachments, noted on presentation and confirmed by optical coherence tomography, completely resolved over the course of treatment with bortezomib and dexamethasone. This case of bilateral cystoid macular edema and subfoveal neurosensory retinal detachments is remarkable for both its presentation and response to therapy. The macular edema and macular detachments along with nonspecific complaints of confusion, muscle stiffness, joint pain, and weight loss were the presenting signs and symptoms; signs typically used as guides to initiate treatment for multiple myeloma were not present. Macular edema in the context of paraproteinemia is usually associated with Waldenstrom's macroglobulinemia and has classically been reported as "silent" with respect to fluorescein angiography. Our patient has multiple myeloma and demonstrated leakage on fluorescein angiography. The case is also notable in that there was

  13. Experimental and Modeling Study on Detachment of Silver Nanoparticles in Saturated Granular Media

    Science.gov (United States)

    Kim, I.; Jeon, C. H.; Lawler, D. F.

    2017-12-01

    The detachment of citrate-capped silver nanoparticles (AgNPs) previously captured in a column packed with 350-μm glass beads was investigated either by increasing the hydrodynamic force (filtration velocity) or by reducing electrosteric attraction. Overall, the physical enforcement showed negligible (0.4 0.7%) release of attached AgNPs while the chemically-driven force resulted in the noticeable release up to 25.5% of attached AgNPs. Among the chemical parameters tested in this study, Na ionic strength reduction clearly demonstrated the reversible deposition in the secondary energy minimum of classical DLVO theory, yielding the most significant release of the attached AgNPs. The immediate and transient AgNP release after the ionic strength reduction further corroborated the weak deposition. However, an insignificant release was observed with Ca ionic strength reduction due to the strong Ca-citrate complexation and the subsequent deposition in the primary energy minimum; calculations indicated that the depth of the secondary energy minimum was only 1/10 that of the Na ion case. The natural organic matter (NOM) coating on both AgNPs and granular media resulted in approximately 6.1% greater AgNP release compared to the case without NOM coating, indicating additional weak deposition due to the reduced steric attraction between AgNPs and granular media. A modified filtration model in agreement with the experimental data provided the estimated detachment coefficient as a transient AgNP releasing capacity independent of the amount of attached AgNPs. The marginal difference between the detachment coefficients from Na ionic strength reduction and NOM coating indicates the release potential by NOM coating was possibly underestimated in the experimental study due to a lesser amount of the initially attached AgNPs. The findings provide insights into chemical factors on possible reentrainment behavior of the engineered nanoparticles in soil and groundwater contamination.

  14. Serous Retinal Detachment Associated with Dome-Shaped Macula and Staphyloma Edge in Myopic Patients before and after Treatment with Spironolactone

    Directory of Open Access Journals (Sweden)

    Álvaro Fernández-Vega Sanz

    2016-01-01

    Full Text Available Objective. Serous retinal detachment (SRD is a common anatomical complication associated with dome-shaped macula (DSM and staphyloma margin in myopic patients. Here we described the anatomical and functional outcomes obtained with the use of oral spironolactone, a mineralocorticoid antagonist, in the management of myopic patients with SRD associated with DSM and staphyloma margin. Methods. We evaluated both eyes of twelve myopic patients with long-standing SRD associated with DSM or staphyloma margin. The patients were treated daily for six months with oral spironolactone 50 mg. Best-corrected visual acuity (BCVA and central retinal thickness (CRT, determined by optical coherence tomography, were evaluated on the first day and on monthly follow-up visits. Results. Pretreatment BCVA (mean ± standard deviation was 0.406 ± 0.324 LogMAR, and posttreatment BCVA was 0.421 ± 0.354 LogMAR (P=0.489. Pretreatment CRT was 323.9 ± 78.6 μm, and after six months of treatment it was significantly lower, 291.2 ± 74.5 μm (P=0.010. There were no treatment-related complications. Conclusions. We evaluated a novel treatment for SRD associated with DSM and staphyloma margin in myopic patients. After six months of treatment with the mineralocorticoid antagonist spironolactone, the subretinal fluid and CRT were significantly reduced; however, there was no improvement in BCVA.

  15. Induced chorioretinal venous anastomosis in experimental retinal branch vein occlusion.

    OpenAIRE

    McAllister, I L; Yu, D Y; Vijayasekaran, S; Barry, C; Constable, I

    1992-01-01

    Iatrogenic retinal vein to choroidal vein anastomoses were created using laser photocoagulation in six of seven dog eyes in which a partial branch retinal vein occlusion had previously been created photochemically. A similar attempt to create an anastomosis was made in six control eyes in which no branch vein occlusion was present. In the eyes in which a branch retinal vein had been created, a venous chorioretinal anastomosis appeared to be present by 3 to 6 weeks. In three control eyes simil...

  16. F6H8 as an Intraoperative Tool and F6H8/Silicone Oil as a Postoperative Tamponade in Inferior Retinal Detachment with Inferior PVR

    Directory of Open Access Journals (Sweden)

    Gian Marco Tosi

    2014-01-01

    Full Text Available Purpose. To evaluate the effectiveness and safety of perfluorohexyloctane (F6H8 for intraoperative flattening of the retina and of F6H8/silicone oil (SO 1000 cSt as a postoperative tamponade for inferior retinal detachment with inferior proliferative vitreoretinopathy. Methods. This is a retrospective review of 22 patients who underwent pars plana vitrectomy using F6H8 as an intraoperative tool to flatten the retina. At the end of the surgery a direct partial exchange between F6H8 and SO 1000 cSt was performed, tamponing the eye with different ratios of F6H8/SO (70/30, 60/40, 50/50, 40/30, and 30/70. Anatomical and functional results and complications were evaluated over the follow-up period (mean 22.63 months. Results. F6H8 was efficacious for intraoperative flattening of the retina. Twenty-one of the 22 patients achieved a complete retinal reattachment. Postoperative visual acuity (VA ranged from light perception to 20/70, with 72% of patients obtaining VA better than 20/400. No emulsification/inflammation was observed whatever the ratio of F6H8/SO used. With higher ratios of F6H8/SO (70/30 and 60/40 cloudiness of the tamponade was observed. A transparent mixture was present with all the other ratios. Conclusions. The surgical technique adopted is very simple and safe. The optimal F6H8/SO ratio seems to be between 50/50 and 30/70.

  17. Effect of PKCbeta on retinal oxygenation response in experimental diabetes.

    OpenAIRE

    Luan, H.; Leitges, M.; Gupta, R.; Pacheco, D.; Seidner, A.; Liggett, J.; Ito, Y.; Kowluru, R.; Berkowitz, B.

    2004-01-01

    PURPOSE: To test the hypotheses that, in mice, breathing carbogen (95% O(2)-5% CO(2)) oxygenates the retina better than breathing 100% oxygen, the superior hemiretinal oxygenation response to carbogen inhalation is subnormal early in diabetes, and diabetes-induced elevation of retinal protein kinase C (PKC)-beta contributes to this pathophysiology. METHODS: Retinal oxygenation response (DeltaPO(2)) was measured using functional magnetic resonance imaging (MRI) and either carbogen or 100% oxyg...

  18. Effect of lens status in the surgical success of 23-gauge primary vitrectomy for the management of rhegmatogenous retinal detachment: the Pan American Collaborative Retina Study (PACORES) group results.

    Science.gov (United States)

    Caiado, Rafael R; Magalhães, Octaviano; Badaró, Emmerson; Maia, Andre; Novais, Eduardo A; Stefanini, Francisco Rosa; Navarro, Rodrigo Milan; Arevalo, J Fernando; Wu, Lihteh; Moraes, Nilva; Farah, Michel Eid; Maia, Maurício

    2015-02-01

    To determine the effects of lens status on the success rate of primary pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment using either perfluoropropane gas (C3F8) or silicone oil (SO) tamponade. A retrospective chart analysis was made of 97 eyes from 92 patients with rhegmatogenous retinal detachment with no proliferative vitreoretinopathy that were treated with primary 23-gauge PPV. Eyes included in this were phakic (n = 28), pseudophakic (n = 41), or phakic eyes subject to simultaneous phacoemulsification, intraocular lens implantation, and PPV during primary rhegmatogenous retinal detachment repair (n = 28). Tamponade at the end of PPV was with either C3F8 (n = 65) or SO (n = 32). Success was defined as retinal reattachment at 1 year follow-up after a single procedure in eyes submitted to C3F8 injection; in eyes treated with SO injection, the success rate was defined as retina reattached 1 year after oil removal. Statistical comparisons were made between groups using chi-square, Fisher's exact test, Kruskal-Wallis, Mann-Whitney, and multivariate analysis. All eyes were operated by 2 experienced retina surgeons and had a minimum follow-up of 12 months. The vitreoretinal redetachment rate in eyes subjected to C3F8 tamponade was significantly higher (28.6%) for phakic eyes (P = 0.011) compared with pseudophakic or phakic eyes that underwent to phacoemulsification and intraocular lens implantation (4.5%). Eyes in which SO was used at the end of the surgical procedure demonstrated a similar trend of higher reoperation rates in phakic eyes (28.6%) compared with pseudophakic or phakic eyes (8%) subjected to phacoemulsification and intraocular lens implantation; however, no statistically significant difference was observed (P = 0.201). No statistically significant differences were found between groups in relation to the number of tears (P = 0.863) and their location (inferior: P = 0.189, superior: P = 0.708, nasal: P = 0.756, and temporal: P = 0.08). The

  19. Pigment epithelial detachment followed by retinal cystoid degeneration leads to vision loss in treatment of neovascular age-related macular degeneration.

    Science.gov (United States)

    Schmidt-Erfurth, Ursula; Waldstein, Sebastian M; Deak, Gabor-Gyoergy; Kundi, Michael; Simader, Christian

    2015-04-01

    Intravitreal antiangiogenic therapy is the major therapeutic breakthrough in neovascular age-related macular degeneration (AMD). Optical coherence tomography (OCT) is the leading diagnostic tool, but solid criteria for optimal therapeutic outcomes are lacking. A comprehensive analysis of structure/function correlations using Food and Drug Administration- and European Medicines Agency-approved substances and fixed and flexible regimens was performed. Post hoc analysis of a prospective, randomized multicenter clinical trial including 189 study sites. A total of 1240 patients with active neovascular AMD. Participants received intravitreal ranibizumab or aflibercept. A fixed regimen was used for 48 weeks followed by a flexible regimen until week 96. At monthly intervals, best-corrected visual acuity (BCVA) was measured and retinal morphology was assessed by standardized OCT, including intraretinal cysts (IRCs), subretinal fluid (SRF), and pigment epithelial detachment (PED), presenting with a width ≥400 μm or a height of ≥200 μm. Results were correlated for each regimen, feature, and time. The BCVA outcomes in relation to retinal pathomorphology based on noninferiority for all treatment arms. In neovascular AMD, only IRC at baseline and persistent through week 12 had a negative impact on BCVA. With therapeutic intervention, exudative features such as IRC and SRF resolved rapidly in 74% of eyes, whereas PED responded only slowly with 38%. Independent of the type of regimen, fixed or flexible, retinal morphology correlated tightly with visual function. Intraretinal cysts consistently showed the lowest BCVA gains with either regimen or substance. With the switch from a fixed to a flexible pro re nata (PRN) regimen, progressive visual loss occurred exclusively in the group with primary PED presenting as the hallmark of neovascular activity and was induced by secondary formation of IRC in the neurosensory retina. The efficacy of antiangiogenic therapy in neovascular

  20. Spectral-domain optical coherence tomography analysis of persistent subretinal fluid after scleral buckling surgery for macula-off retinal detachment

    Science.gov (United States)

    Gharbiya, M; Malagola, R; Mariotti, C; Parisi, F; De Vico, U; Ganino, C; Grandinetti, F

    2015-01-01

    Purpose To determine the predictive value of markers for persistent subretinal fluid (SRF) absorption and the influence of subfoveal fluid on visual outcome after scleral buckle (SB) surgery for rhegmatogenous retinal detachment (RRD). Patients and methods This was a retrospective, observational study. We reviewed the medical records of 64 eyes of 64 patients who underwent SB surgery for macula-off RRD. Patients underwent clinical examination and spectral-domain optical coherence tomography before surgery, at 1 month and every 3 months postoperatively. The height and width of SRF bleb(s) were measured over time. Results Persistent SRF at 1 month was observed in 40 eyes (62.5%). SRF blebs were first detected 1.7±2.2 months postoperatively. In 29 cases that could be fully followed up, SRF blebs were completely absorbed 7.8±4.4 months postoperatively. Resolution of fluid was associated with an improvement of VA (P=0.003). Serial measurements of SRF bleb size showed that bleb width decreased significantly at all time points during the 12-month follow-up period (P0.05). The cut-off value of the bleb width-to-height ratio level for predicting bleb absorption at 6 months was 7, with 89% sensitivity and 83% specificity. Conclusions Visual improvement may occur with late resolution of residual subfoveal fluid. A bleb width-to-height ratio >7 indicates a higher risk of SRF to persist beyond 6 months after surgery. PMID:26139048

  1. Considering photodynamic therapy as a therapeutic modality in selected cases of dome-shaped macula complicated by foveal serous retinal detachment.

    Science.gov (United States)

    Arapi, Ilir; Neri, Piergiorgio; Mariotti, Cesare; Gesuita, Rosaria; Pirani, Vittorio; Freddo, Francesco; Lutaj, Pajtim; Giovannini, Alfonso

    2015-02-01

    To study the role of photodynamic therapy (PDT) as a therapeutic modality in myopic patients with dome-shaped macula (DSM) associated with foveal serous retinal detachment (SRD). Retrospective interventional case series. The medical records of 10 consecutive myopic patients (10 eyes) with DSM associated with subfoveal SRD and treated with PDT were reviewed. Visual gain and loss were considered as increasing or decreasing of two or more lines of best corrected visual acuity (BCVA), respectively, and eyes with fluid resolution were deemed responsive to PDT. All eyes underwent several PDT treatments, with a median of three and a median follow-up time of 15.5 months. At final follow-up, six eyes (60%) showed complete resolution of the foveal SRD. The baseline hypocyanescent macular area observed during late indocyanine green angiography (ICGA) frames was significantly lower in the group of patients who responded to PDT and had an increase of at least two Snellen lines in BCVA (P = .01). Data suggest that myopic eyes associated with DSM and foveal SRD may be responsive to PDT, showing total resolution of fluid accumulation and positive BCVA changes if baseline ICGA findings show evidence of a limited hypocyanescent macular area. Copyright 2015, SLACK Incorporated.

  2. A Comparative Study between Vitrectomy with Internal Tamponade and a New Modified Fiber Optic Illuminated Ando Plombe for Cases of Macular Hole Retinal Detachment in Myopic Eyes

    Directory of Open Access Journals (Sweden)

    Ahmed M. Bedda

    2015-01-01

    Full Text Available Aim. To compare pars plana vitrectomy (PPV with silicone tamponade or gas (Groups Ia and Ib and a new modified Ando plombe equipped with a fiber optic light (Group II for cases with macular hole retinal detachment (MHRD in high myopic eyes (axial length > 26 mm. Methods. A prospective interventional randomized case series included 60 eyes (20 in each group. Successful outcome was considered if the retina was completely attached at the end of the follow-up period. Complications were identified for each group. Results. Visual acuity improved by 37.31%, 40.67%, and 49.40% in Groups Ia, Ib, and II, respectively. The success rate was 55%, 60%, and 100% in Groups Ia , Ib, and II, respectively, with a statistically significant difference between Groups Ia, Ib, and II (p < 0.001 in Ia, p: 0.002 in Ib. Complications rates were 60%, 45%, and 20% in Groups Ia, Ib, and II, respectively, with a statistically significant difference between Groups Ia and II (p: 0.01. Conclusion. Fiber optic illuminated Ando plombe allows better positioning under the macula and consequently improves the success rate of epimacular buckling in comparison to PPV with internal tamponade in MMHRD.

  3. Study and development of retinal dopamine nervous system in experimental myopia

    International Nuclear Information System (INIS)

    Zhao Juan; Liu Xingdang

    2007-01-01

    Myopia is the most familiar ametropia. Animal experimental models include form deprivation myopia and defocus myopia. Experimental animals we often use are chicken and mammals. The retinal dopamine system and vision experience have close relations with the regulation of eyeball's growth after birth, while the change of dopamine transporter may reflect the change of dopamine in the synaptic cleft more directly. (authors)

  4. Rhegmatogenous retinal detachment surgery in elderly people over 70 years old: visual acuity, quality of life, and cost-utility values.

    Science.gov (United States)

    Ma, Yingyan; Ying, Xiaohua; Zou, Haidong; Xu, Xiaocheng; Liu, Haiyun; Bai, Lin; Xu, Xun; Zhang, Xi

    2014-01-01

    To evaluate the influence of rhegmatogenous retinal detachment (RRD) surgery on elderly patients in terms of visual acuity, vision-related quality of life and its cost-effectiveness. Elderly patients over 70 years old, who were diagnosed and underwent RRD surgery at Shanghai First People's Hospital, Shanghai Jiao Tong University, China, from January 1, 2009, through January 1, 2013. The participants received scleral buckling surgery and vitreous surgery with or without scleral buckling under retrobulbar anesthesia. We followed the patients for 1 year and collected best-corrected visual acuity (BCVA), vision-related quality of life, and direct medical costs data. Utility values elicited by time-trade-off were analyzed to determine the quality of life. Quality-adjusted life years (QALYs) gained in life expectancy were calculated and discounted at 3% annually. Costs per QALY gained were reported using the bootstrap method. Further analyses were made for two age groups, age 70-79 and age over 80 years. Sensitivity analyses were performed to test stability of the results. 98 patients were included in the study. The BCVA significantly improved by 0.53±0.44 (Logarithm of the Minimum Angle of Resolution (logMAR)) at the 1-year postoperative time point (plife expectancy. Costs per QALY gained from the RRD surgery were 33,186 Chinese Yuan (CNY) (5,276 US dollars (USD))/QALY; 24,535 CNY (3,901 USD)/QALY for the age group of 70-79 years and 71,240 CNY (11,326 USD)/QALY for the age group over 80 years. RRD surgery improved the visual acuity and quality of life in the elderly patients over 70 years old. According to the World Health Organization's recommendation, at a threshold of willingness to pay of 115,062 CNY (18,293 USD)/QALY, RRD surgery is cost effective in the elderly patients.

  5. Pars plana vitrectomy for the repair of primary, inferior rhegmatogenous retinal detachment associated to inferior breaks. A comparison of a 25-gauge versus a 20-gauge system.

    Science.gov (United States)

    Dell'Omo, Roberto; Barca, Francesco; Tan, H Stevie; Bijl, Heico M; Oberstein, Sarit Y Lesnik; Mura, Marco

    2013-02-01

    To compare anatomical, functional outcomes and complications of high-speed 25-gauge (G) pars plana vitrectomy (PPV) versus 20-G PPV for the management of primary inferior rhegmatogenous retinal detachment (RRD) associated to inferior breaks/holes. Eighty-five eyes from 85 patients with a minimum follow-up of 3 months were retrospectively evaluated. Forty-one patients underwent 25-G and 44 patients underwent 20-G PPV. All patients underwent PPV with fluid-air exchange, sulfur hexafluoride (SF6) 20 % gas tamponade and laser or cryo retinopexy. The mean follow-up interval was 6.51(± 2.32) and 6.63 (± 2.58) months in the 25-G and 20-G groups respectively. Single-operation success rate was 92.7 % for the 25-G group and 81.8 % for the 20-G group (P = 0.24). Post-operative hypotony was observed in no case. Redetachment occurred in 3 eyes operated on with 25-G and in 8 eyes operated on with 20-G system. All retinas were attached at final follow-up. Logarithm of the minimum angle of resolution visual acuity significantly improved from 0.69 ± 0.76 to 0.33 ± 0.37 in the 25-G and from 0.47 ± 0.59 to 0.21 ± 0.28 in the 20-G group (P = 0.0007 and P < 0.0001 respectively). High-speed PPV and SF6 gas tamponade using either 25-G or 20-G PPV system, yields similar single operation anatomical success rates for the repair of uncomplicated, primary inferior RRDs associated to inferior breaks.

  6. Clinicopathological correlation of parapapillary atrophy in monkeys with experimental glaucoma and temporary central retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Jost B Jonas

    2014-01-01

    Full Text Available Objective: To investigate the clinicopathological correlation of parapapillary atrophy. Materials and Methods: The study included 16 eyes of rhesus monkeys (Macaca mulatta - 4 eyes with experimental glaucoma, 11 eyes after experimental temporary occlusion of the central retinal artery, and 1 normal eye. On histological sections, we measured zones with different histological characteristics.On fundus photographs, alpha zone and beta zone of parapapillary atrophy were measured and correlated with the histological data. Results: The size of the clinical alpha zone of parapapillary atrophy was significantly correlated with the size of the histological region with irregularities of the retinal pigment epithelium (P = 0.05; correlation coefficient r = 0.49 and with the size of the histological region with a decreased density of retinal photoreceptors (P = 0.01; r = 0.60. The size of clinical beta zone of parapapillary atrophy significantly correlated with the size of the histological region with complete loss of the retinal pigment epithelium (P <0.001; r = 0.91, with the size of the histological zone with a complete loss of photoreceptors (P <0.001; r = 0.81, and with the size of the histological zone with a closed choriocapillaris (P <0.001; r = 0.89. Conclusions: The clinically seen alpha zone of parapapillary atrophy correlates with histological parapapillary irregularities of the retinal pigment epithelium and decreased density of retinal photoreceptors. The clinically seen beta zone of parapapillary atrophy correlates with histological complete loss of the retinal pigment epithelium and of the photoreceptors, and a closure of the choriocapillaris.

  7. Numerical computational of fluid flow through a detached retina

    Science.gov (United States)

    Jiann, Lim Yeou; Ismail, Zuhaila; Shafie, Sharidan; Fitt, Alistair

    2015-02-01

    In this paper, a phenomenon of fluid flow through a detached retina is studied. Rhegmatogeneous retinal detachment happens when vitreous humour flow through a detached retina. The exact mechanism of Rhegmatogeneous retinal detachment is complex and remains incomplete. To understand the fluid flow, a paradigm mathematical model is developed and is approximated by the lubrication theory. The numerical results of the velocity profile and pressure distribution are computed by using Finite Element Method. The effects of fluid mechanical on the retinal detachment is discussed and analyzed. Based on the analysis, it is found that the retinal detachment deformation affects the pressure distribution. It is important to comprehend the development of the retinal detachment so that a new treatment method can be developed.

  8. Statins in rhegmatogenous retinal detachment are associated with low intravitreal angiopoietin-2, VEGF and MMP-2 levels, and improved visual acuity gain in vitrectomized patients.

    Science.gov (United States)

    Tuuminen, Raimo; Haukka, Jari; Loukovaara, Sirpa

    2015-10-01

    In rhegmatogenous retinal detachment (RRD), intravitreal growth factors and cytokines may compromise post-vitrectomy outcomes. Here, we analysed perioperative intravitreal protein levels of potent vasoactive, pro-inflammatory, and extracellular matrix-remodelling factors in RRD eyes of patients treated with statins and evaluated post-vitrectomy outcome in the same study eyes. Institutional, retrospective, observational study of 14 patients operated on for RRD while on statins compared to patients without statin medication (n = 82). Vitreous samples were subjected to protein measurements of angiopoietin (ANGPT)-1 and -2, transforming growth factor-β1, and vascular endothelial growth factor (VEGF) by ELISA, and of matrix metalloproteinase (MMP)-2 and -9 by gelatin zymography. A 1-month best-corrected visual acuity (BCVA) gain was modelled by Student's T-test and multivariate linear regression with concomitant perioperative medication. Cumulative 12-month revitrectomy frequency was modelled by Kaplan-Meier log-rank test. Intravitreal levels of ANGPT-2 (49.2 ± 33.1 vs. 112.8 ± 134.1 pg/ml, mean ± SD, p < 0.001), VEGF (2.3 ± 2.4 vs. 17.7 ± 57.8 pg/ml, p = 0.021), and MMP-2 (1107.1 ± 884.6 vs 1976.4 ± 970.1 AU/ml, p = 0.005) in RRD eyes of patients treated with statins were lower than in non-statin-treated controls. Patients on statins had better 1-month BCVA improvement than did those not on statins (p = 0.022), with no difference in 1-year re-vitrectomy rates. Intravitreal levels of ANGPT-2, VEGF, factors involved in vascular permeability and inflammation, and activity of MMP-2, the factor connected with breakdown of basement membrane and fibroproliferation, were lower in RRD eyes of patients with statin treatment. At 1-month, postoperative BCVA gain was improved in statin-treated RRD eyes, suggesting that statin administration may be effective in preventing inflammation-related PVR formation.

  9. Effect of low dose laser on the chorioallantoic culture of retinal pigment cells

    International Nuclear Information System (INIS)

    Yew, D.T.; Lam, S.T.L.; Chan, Y.W.

    1982-01-01

    Low dose laser effects were analysed in chorioallantoic cultures of retinal pigment cells. Decrease in cell sizes and increase in number of mitosis were observed in the experimental cultures. On the other hand, pyknosis did not change significantly following irradiation. Most cells in the control and experimental cultures formed groups. However, 2 types of detached cells were evident. The percentage of detached cells was higher in the experimental culture. (Auth.)

  10. Retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy Cirurgia de descolamento de retina com injeção de óleo de silicone no sistema de vitrectomia transconjuntival sem sutura de 23-gauge

    Directory of Open Access Journals (Sweden)

    Rubens Camargo Siqueira

    2007-12-01

    Full Text Available PURPOSE: To report a surgical technique for retinal detachment surgery using transconjunctival sutureless 23-gauge vitrectomy with silicone oil injection. METHODS: Thirty-one patients with retinal detachment underwent vitreoretinal surgery using a transconjunctival sutureless 23-gauge vitrectomy system. At the end of the procedure silicone oil was injected into all eyes through a microcannula. After removing the microcannula, a bipolar cautery was used in the conjunctiva over the wound to prevent silicone oil reflux. RESULTS: In all patients retinal reattachment and injection of silicone oil through transconjunctival sutureless 23-gauge vitrectomy system was possible. Retinal re-detachment occurred in 8 patients (25.80% who were submitted to a new vitreoretinal surgery by the technique described above, however, more extensive retinotomy was necessary in all cases, specially inferiorly. Three patients (9.67% presented silicone oil leakage in subconjuntival compartment. Another surgical procedure was necessary to remove the subconjuntival silicone oil. CONCLUSIONS: The retinal detachment surgery with silicone oil injection in transconjunctival sutureless 23-gauge vitrectomy is a safe and efficient technique to repair retinal detachment and it has the advantage of being minimally invasive.OBJETIVOS: Relatar técnica cirúrgica para descolamento de retina utilizando sistema de 23-gauge com injeção de óleo de silicone. MÉTODOS: Trinta e um pacientes com descolamento da retina foram submetidos a cirurgia vitreorretiniana usando o sistema 23-gauge de vitrectomia transconjuntival sem sutura. Ao final do procedimento o óleo de silicone foi injetado em todos os olhos através de uma microcânula. Após a retirada da microcânula, foi utilizado cautério bipolar na incisão conjuntival para prevenir o vazamento do óleo de silicone. RESULTADOS: Em todos os pacientes foi possível reaplicar a retina e injetar o óleo de silicone através do sistema 23

  11. Divertor detachment

    Science.gov (United States)

    Krasheninnikov, Sergei

    2015-11-01

    The heat exhaust is one of the main conceptual issues of magnetic fusion reactor. In a standard operational regime the large heat flux onto divertor target reaches unacceptable level in any foreseeable reactor design. However, about two decades ago so-called ``detached divertor'' regimes were found. They are characterized by reduced power and plasma flux on divertor targets and look as a promising solution for heat exhaust in future reactors. In particular, it is envisioned that ITER will operate in a partly detached divertor regime. However, even though divertor detachment was studied extensively for two decades, still there are some issues requiring a new look. Among them is the compatibility of detached divertor regime with a good core confinement. For example, ELMy H-mode exhibits a very good core confinement, but large ELMs can ``burn through'' detached divertor and release large amounts of energy on the targets. In addition, detached divertor regimes can be subject to thermal instabilities resulting in the MARFE formation, which, potentially, can cause disruption of the discharge. Finally, often inner and outer divertors detach at different plasma conditions, which can lead to core confinement degradation. Here we discuss basic physics of divertor detachment including different mechanisms of power and momentum loss (ionization, impurity and hydrogen radiation loss, ion-neutral collisions, recombination, and their synergistic effects) and evaluate the roles of different plasma processes in the reduction of the plasma flux; detachment stability; and an impact of ELMs on detachment. We also evaluate an impact of different magnetic and divertor geometries on detachment onset, stability, in- out- asymmetry, and tolerance to the ELMs. Supported by the U.S. Department of Energy Office of Science, Office of Fusion Energy Sciences under Award Number DE-DE-FG02-04ER54739 at UCSD.

  12. Effect of glial cell line-derived neurotrophic factor on retinal function after experimental branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Ejstrup, Rasmus; Dornonville de la Cour, Morten; Kyhn, Maria Voss

    2012-01-01

    The objective of the study was to investigate the effect of glial cell line-derived neurotrophic factor (GDNF) on the multifocal electroretinogram (mfERG) following an induced branch retinal vein occlusion (BRVO) in pigs.......The objective of the study was to investigate the effect of glial cell line-derived neurotrophic factor (GDNF) on the multifocal electroretinogram (mfERG) following an induced branch retinal vein occlusion (BRVO) in pigs....

  13. Posterior hyaloid detachment and internal limiting membrane peeling assisted by anthocyanins from acai fruit (Euterpe oleracea) and 10 other natural vital dyes: experimental study in cadaveric eyes.

    Science.gov (United States)

    Chen, Jane; Ferreira, Magno Antonio; Farah, Michel Eid; de Carvalho, André Maia; Alves Ferreira, Raquel Eustaquio; de Moraes Filho, Milton Nunes; Souza Lima-Filho, Acácio Alves; Lago, João Henrique G; Sartorelli, Patricia; Rodrigues, Eduardo Buchele; Ferreira, Eber; Peris, Cristiane; Maia, Maurício

    2013-01-01

    The purpose of this study was to determine whether natural dyes facilitate posterior hyaloid detachment (posterior vitreous detachment [PVD]) and retinal internal limiting membrane (ILM) peeling in human eyes. Open-sky vitrectomy with posterior hyaloid and ILM removal was performed in 86 human cadaveric eyes. After core vitrectomy, 11 different dyes were injected into the vitreous cavity to aid hyaloid detachment and ILM removal. The dyes were allowed to settle on the macula for 5 minutes after PVD and were removed by mechanical aspiration. Intraocular forceps were used for ILM peeling, which was confirmed by light microscopy of the peeled tissue. Acai fruit (Euterpe oleracea) extract and 10 additional dyes from plants or animal sources were tested: pomegranate (Punica granatum), logwood (Haematoxylum campechianum), chlorophyll extract from alfalfa (Medicago sativa), cochineal (Dactylopius coccus), hibiscus (Hibiscus rosa-sinensis), indigo (Indigofera tinctoria), paprika (Capiscum annuum), turmeric (Curcuma longa), old fustic (Maclura tinctoria), and grape (Vitis vinifera). The dyes facilitated PVD and ILM peeling. Acai fruit (E. oleracea) extract, logwood (H. campechianum), cochineal (D. coccus), and old fustic (M. tinctoria) facilitated PVD in all cases; dye-assisted PVD was compared with triamcinolone-assisted PVD performed previously in a comparative model. Acai fruit (E. oleracea) extract, cochineal (D. coccus), and chlorophyll extract from alfalfa (M. sativa) showed the best capability for ILM staining; dye-assisted ILM removal was compared with the ILM peeling guided by indocyanine green staining performed previously in a comparative model. Light microscopy confirmed the ILM removal in all cases. Anthocyanin dye of the acai fruit (E. oleracea) and the dyes from cochineal (D. coccus) and chlorophyll extract from alfalfa (M. sativa) resulted in the best capability for posterior hyaloid and ILM staining in human cadaveric eyes and may be a useful tool for

  14. Considerations in Management of Rhegmatogenous Retinal ...

    African Journals Online (AJOL)

    Retinal detachment (RD) occurs when subretinal fluid accumulates in the potential space between the neurosensory retina and the underlying retinal pigment epithelium. Exudative detachments as a complication of eclampsia are seen in pregnancy, but rhegmatogenous RD (RRD) in pregnancy is co-incidental and very ...

  15. Losartan Treatment Protects Retinal Ganglion Cells and Alters Scleral Remodeling in Experimental Glaucoma

    Science.gov (United States)

    Pitha, Ian F.; Nguyen, Cathy; Steinhart, Matthew R.; Nguyen, Thao D.; Pease, Mary Ellen; Oglesby, Ericka N.; Berlinicke, Cynthia A.; Mitchell, Katherine L.; Kim, Jessica; Jefferys, Joan J.

    2015-01-01

    Purpose To determine if oral losartan treatment decreases the retinal ganglion cell (RGC) death caused by experimental intraocular pressure (IOP) elevation in mice. Methods We produced IOP increase in CD1 mice and performed unilateral optic nerve crush. Mice received oral losartan, spironolactone, enalapril, or no drug to test effects of inhibiting angiotensin receptors. IOP was monitored by Tonolab, and blood pressure was monitored by tail cuff device. RGC loss was measured in masked axon counts and RGC bodies by β-tubulin labeling. Scleral changes that could modulate RGC injury were measured including axial length, scleral thickness, and retinal layer thicknesses, pressure-strain behavior in inflation testing, and study of angiotensin receptors and pathways by reverse transcription polymerase chain reaction, Western blot, and immunohistochemistry. Results Losartan treatment prevented significant RGC loss (median loss = 2.5%, p = 0.13), while median loss with water, spironolactone, and enalapril treatments were 26%, 28% and 43%; p glaucoma eyes (p = 0.007). Losartan inhibited effects of glaucoma, including reduction in extracellular signal-related kinase activity and modification of glaucoma-related changes in scleral thickness and creep under controlled IOP. Conclusions The neuroprotective effect of losartan in mouse glaucoma is associated with adaptive changes in the sclera expressed at the optic nerve head. PMID:26505191

  16. Estudo experimental da aplicação retiniana do laser infravermelho via transescleral sob condições de baixa visibilidade Transscleral infrared laser retinal photocoagulation experimental study under low visibility conditions

    Directory of Open Access Journals (Sweden)

    Dario Grechi Goulart

    2008-06-01

    power of 300 mW (63.14% was found to be higher than that encountered before its enhancement up to 500 mW (59.11%, (P<0.05. CONCLUSIONS: Setting parameters showed dose-response effect. No retinal hole or retinal detachment was noticed in any rabbit. Transscleral infrared photocoagulation appeared to be a reproducible and secure method in the experimental model.

  17. Experimental Branch Retinal Vein Occlusion Induces Upstream Pericyte Loss and Vascular Destabilization.

    Directory of Open Access Journals (Sweden)

    Elisa Dominguez

    Full Text Available Branch retinal vein occlusion (BRVO leads to extensive vascular remodeling and is important cause of visual impairment. Although the vascular morphological changes following experimental vein occlusion have been described in a variety of models using angiography, the underlying cellular events are ill defined.We here show that laser-induced experimental BRVO in mice leads to a wave of TUNEL-positive endothelial cell (EC apoptosis in the upstream vascular network associated with a transient edema and hemorrhages. Subsequently, we observe an induction of EC proliferation within the dilated vein and capillaries, detected by EdU incorporation, and the edema resolves. However, the pericytes of the upstream capillaries are severely reduced, which was associated with continuing EC apoptosis and proliferation. The vascular remodeling was associated with increased expression of TGFβ, TSP-1, but also FGF2 expression. Exposure of the experimental animals to hypoxia, when pericyte (PC dropout had occurred, led to a dramatic increase in endothelial cell proliferation, confirming the vascular instability induced by the experimental BRVO.Experimental BRVO leads to acute endothelial cells apoptosis and increased permeability. Subsequently the upstream vascular network remains destabilized, characterized by pericyte dropout, un-physiologically high endothelial cells turnover and sensitivity to hypoxia. These early changes might pave the way for capillary loss and subsequent chronic ischemia and edema that characterize the late stage disease.

  18. Mutation in type II procollagen (COL2Al) that substitutes aspartate for glycine [alpha]l-67 and that causes cataracts and retinal detachment: Evidence for molecular heterogeneity in the Wagner Syndrome and the stickler syndrome (Arthro-Ophthalmopathy)

    Energy Technology Data Exchange (ETDEWEB)

    Koerkkoe, J.; Ritvaniemi, P.; Kiviirikko, K.I.; Ala-Kokko, L. (Univ. of Oulu (Finland)); Haataja, L. (Univ. of Turku (Finland)); Kaeaeriaeinen, H. (Univ. of Helsinki (Finland)); Prockop, D.J. (Jefferson Thomas Jefferson Univ., Philadelphia PA (United States))

    1993-07-01

    A search for mutations in the gene for type II procollagen (COL2A1) was carried out in affected members of a family with early-onset cataracts, lattice degeneration of the retina, and retinal detachment. They had no symptoms suggestive of involvement of nonocular tissues, as is typically found in the Stickler syndrome. The COL2A1 gene was amplified with PCR, and the products were analyzed by denaturing gradient gel electrophoresis. The results suggested a mutation in one allele for exon 10. Sequencing of the fragment demonstrated a single-base mutation that converted the codon for glycine at position [alpha]1-67 to aspartate. The mutation was found in three affected members of the family available for study but not in unaffected members or 100 unrelated individuals. Comparison with previously reported mutations suggested that mutations introducing premature termination codons in the COL2A1 gene are a frequent cause of the Stickler syndrome, but mutations in the COL2A1 gene that replace glycine codons with codons for bulkier amino acid can produce a broad spectrum of disorders that range from lethal chondrodysplasias to a syndrome involving only ocular tissues, similar to the syndrome in the family originally described by Wagner in 1938. 38 refs., 4 figs., 3 tabs.

  19. Retinal arterial but not venous tortuosity correlates with facioscapulohumeral muscular dystrophy severity

    NARCIS (Netherlands)

    Longmuir, Susannah Q.; Mathews, Katherine D.; Longmuir, Reid A.; Joshi, Vinayak; Olson, Richard J.; Abramoff, M.D.

    2010-01-01

    Background Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal-dominant disease beginning with facial and shoulder girdle weakness with variable progression. Exudative retinal detachment, retinal vessel irregularities on fluorescein angiography, and retinal vessel tortuosity have been

  20. Descolamento regmatogênico de retina: avaliação pós-operatória da mácula Rhegmatogenous retinal detachment: a postoperative study of the macula

    Directory of Open Access Journals (Sweden)

    Otacílio de Oliveira Maia Júnior

    2007-12-01

    Full Text Available OBJETIVO: Avaliar função e estrutura macular de pacientes submetidos a cirurgia de descolamento regmatogênico da retina. MÉTODOS: Estudo prospectivo de pacientes submetidos a retinopexia pneumática ou introflexão escleral com seguimento feito por meio de exame oftalmológico completo e tomografia de coerência óptica. RESULTADOS: A amostra foi composta por 14 olhos (14 pacientes, sendo 10 (71,4% submetidos a introflexão escleral e 4 (28,6%, a retinopexia pneumática. A idade variou entre 24 e 59 anos, média de 39,3 anos. Houve correlações negativas entre a acuidade visual final e a idade (r= -0,64 e p= 0,0127 e entre a acuidade visual final e o tempo de descolamento (r= -0,54 e p= 0,0447. Houve correlação positiva entre as acuidades visual do seguimento inicial e final (r= 0,69 e p= 0,0059. Na tomografia de coerência óptica, quatro olhos (28,6% apresentaram descolamento residual na fóvea, com resolução espontânea e melhora na acuidade visual (p= 0,031; não houve relação entre tempo de resolução e acuidade final (p= 0,5546. CONCLUSÃO: Os resultados mostram que quanto mais jovem o paciente e mais precoce a intervenção cirúrgica, melhor acuidade visual final. Adicionalmente, quanto maior acuidade no início do pós-operatório, melhor acuidade final. Todos os casos de descolamento foveal evidenciados por meio da tomografia de coerência óptica, no pós-operatório, cursaram com reabsorção do líquido subfoveal e melhora da visão.PURPOSE: To evaluate the structure and function of the macula following rhegmatogenous retinal detachment surgery. METHODS: Prospective study of patients submitted to scleral buckle surgery or pneumatic retinopexy. The follow-up comprised a complete ophthalmologic exam and optical coherence tomography. RESULTS: The sample was composed of 14 eyes (14 patients, 71.4% operated with the scleral buckle technique, and 28.6% with the pneumatic retinopexy. The age range was from 24 to 59 years (mean

  1. Losartan Treatment Protects Retinal Ganglion Cells and Alters Scleral Remodeling in Experimental Glaucoma.

    Directory of Open Access Journals (Sweden)

    Harry A Quigley

    Full Text Available To determine if oral losartan treatment decreases the retinal ganglion cell (RGC death caused by experimental intraocular pressure (IOP elevation in mice.We produced IOP increase in CD1 mice and performed unilateral optic nerve crush. Mice received oral losartan, spironolactone, enalapril, or no drug to test effects of inhibiting angiotensin receptors. IOP was monitored by Tonolab, and blood pressure was monitored by tail cuff device. RGC loss was measured in masked axon counts and RGC bodies by β-tubulin labeling. Scleral changes that could modulate RGC injury were measured including axial length, scleral thickness, and retinal layer thicknesses, pressure-strain behavior in inflation testing, and study of angiotensin receptors and pathways by reverse transcription polymerase chain reaction, Western blot, and immunohistochemistry.Losartan treatment prevented significant RGC loss (median loss = 2.5%, p = 0.13, while median loss with water, spironolactone, and enalapril treatments were 26%, 28% and 43%; p < 0.0001. The lower RGC loss with losartan was significantly less than the loss with spironolactone or enalapril (regression model p = 0.001; drug treatment group term p = 0.01. Both losartan and enalapril significantly lowered blood pressure (p< 0.001, but losartan was protective, while enalapril led to worse than water-treated RGC loss. RGC loss after crush injury was unaffected by losartan treatment (difference from control p = 0.9. Survival of RGC in cell culture was not prolonged by sartan treatment. Axonal transport blockade after 3 day IOP elevations was less in losartan-treated than in control glaucoma eyes (p = 0.007. Losartan inhibited effects of glaucoma, including reduction in extracellular signal-related kinase activity and modification of glaucoma-related changes in scleral thickness and creep under controlled IOP.The neuroprotective effect of losartan in mouse glaucoma is associated with adaptive changes in the sclera expressed at

  2. Transcorneal Electrical Stimulation Therapy for Retinal Disease

    Science.gov (United States)

    2012-05-03

    Retinitis Pigmentosa; Macula Off; Primary Open Angle Glaucoma; Hereditary Macular Degeneration; Treated Retina Detachment; Retinal Artery Occlusion; Retinal Vein Occlusion; Non-Arthritic-Anterior-Ischemic Optic-Neuropathy; Hereditary Autosomal Dominant Optic Atrophy; Dry Age Related Macular Degeneration; Ischemic Macula Edema

  3. Role of Bedside Ultrasound in CMV Retinitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Lauren Westafer

    2012-01-01

    Full Text Available We present a case of retinal detachment diagnosed by emergency department bedside ultrasonography in a patient with CMV retinitis. The indications and findings of ocular ultrasonography are discussed.

  4. Rasagiline-induced delay of retinal ganglion cell death in experimental glaucoma in rats.

    Science.gov (United States)

    Levkovitch-Verbin, Hani; Vander, Shelly; Melamed, Shlomo

    2011-01-01

    To evaluate the neuroprotective effect of rasagiline (N-propargyl-1 (R)-aminoindan), a selective monoamine oxidase inhibitor, on the survival of retinal ganglion cells (RGCs) in glaucomatous rat eyes. Rasagiline is an FDA approved anti-Parkinson disease drug with neuroprotective capabilities that were shown in many models of brain damage. The neuroprotective effect of daily intraperitoneal (IP) injections of rasagiline (0.5 mg/kg and 3 mg/kg) was evaluated and compared with saline injections using the translimbal photocoagulation model of experimental glaucoma in Wistar rats. Intraocular pressure (IOP) was measured before and immediately after the laser treatment, and then weekly. Seven weeks after the induction of glaucoma, the animals were killed, the eyes were enucleated and the retinas were prepared as whole mounts. Fluoro-gold had been injected into the superior colliculus 10 days before enucleation, and RGC survival was evaluated by counting the surviving labeled RGCs in a masked way. All rats (n=29) displayed significant IOP elevation and RGC damage. Seven weeks after the induction of glaucoma, the mean RGC survival was 43±8% in the rasagiline 3 mg/kg-treated group and 43±9% in the rasagiline 0.5 mg/kg-treated group compared with 23%±4% in the saline-treated (control) group (P=0.01 and P=0.02, respectively). Systemic treatment with rasagiline significantly enhances the survival of RGCs in experimental glaucoma.

  5. Progressive outer retinal necrosis-like retinitis in immunocompetent hosts.

    Science.gov (United States)

    Chawla, Rohan; Tripathy, Koushik; Gogia, Varun; Venkatesh, Pradeep

    2016-08-10

    We describe two young immunocompetent women presenting with bilateral retinitis with outer retinal necrosis involving posterior pole with centrifugal spread and multifocal lesions simulating progressive outer retinal necrosis (PORN) like retinitis. Serology was negative for HIV and CD4 counts were normal; however, both women were on oral steroids at presentation for suspected autoimmune chorioretinitis. The retinitis in both eyes responded well to oral valaciclovir therapy. However, the eye with the more fulminant involvement developed retinal detachment with a loss of vision. Retinal atrophy was seen in the less involved eye with preservation of vision. Through these cases, we aim to describe a unique evolution of PORN-like retinitis in immunocompetent women, which was probably aggravated by a short-term immunosuppression secondary to oral steroids. 2016 BMJ Publishing Group Ltd.

  6. Retinal glutamate transporter changes in experimental glaucoma and after optic nerve transection in the rat.

    Science.gov (United States)

    Martin, Keith R G; Levkovitch-Verbin, Hana; Valenta, Danielle; Baumrind, Lisa; Pease, Mary Ellen; Quigley, Harry A

    2002-07-01

    High levels of glutamate can be toxic to retinal ganglion cells. Effective buffering of extracellular glutamate by retinal glutamate transporters is therefore important. This study was conducted to investigate whether glutamate transporter changes occur with two models of optic nerve injury in the rat. Glaucoma was induced in one eye of 35 adult Wistar rats by translimbal diode laser treatment to the trabecular meshwork. Twenty-five more rats underwent unilateral optic nerve transection. Two glutamate transporters, GLAST (EAAT-1) and GLT-1 (EAAT-2), were studied by immunohistochemistry and quantitative Western blot analysis. Treated and control eyes were compared 3 days and 1, 4, and 6 weeks after injury. Optic nerve damage was assessed semiquantitatively in epoxy-embedded optic nerve cross sections. Trabecular laser treatment resulted in moderate intraocular pressure (IOP) elevation in all animals. After 1 to 6 weeks of experimental glaucoma, all treated eyes had significant optic nerve damage. Glutamate transporter changes were not detected by immunohistochemistry. Western blot analysis demonstrated significantly reduced GLT-1 in glaucomatous eyes compared with control eyes at 3 days (29.3% +/- 6.7%, P = 0.01), 1 week (55.5% +/- 13.6%, P = 0.02), 4 weeks (27.2% +/- 10.1%, P = 0.05), and 6 weeks (38.1% +/- 7.9%, P = 0.01; mean reduction +/- SEM, paired t-tests, n = 5 animals per group, four duplicate Western blot analyses per eye). The magnitude of the reduction in GLT-1 correlated significantly with mean IOP in the glaucomatous eye (r(2) = 0.31, P = 0.01, linear regression). GLAST was significantly reduced (33.8% +/- 8.1%, mean +/- SEM) after 4 weeks of elevated IOP (P = 0.01, paired t-test, n = 5 animals per group). In contrast to glaucoma, optic nerve transection resulted in an increase in GLT-1 compared with the control eye (P = 0.01, paired t-test, n = 15 animals). There was no significant change in GLAST after transection. GLT-1 and GLAST were significantly

  7. [Peripheral retinal degenerations--treatment recommendations].

    Science.gov (United States)

    Joussen, A M; Kirchhof, B

    2004-10-01

    This report reviews the clinical appearance of degenerative diseases of the peripheral retina in relationship to the risk of developing a rhegmatogenous retinal detachment. We present recommendations for preventive treatment in eyes at increased risk of developing retinal detachment. Retinal degenerations are common lesions involving the peripheral retina but most of them are clinically insignificant. Lattice degeneration, degenerative retinoschisis, cystic retinal tufts, and very rarely zonular traction tufts can result in rhegmatogenous retinal detachment. Therefore, these lesions have been considered for prophylactic treatment; however, adequate studies have not been performed to date. Most of the peripheral retinal degenerations may not require treatment except in rare, high-risk situations. According to current knowledge there is no higher incidence of secondary pucker or other side effects after laser coagulation. Therefore, generous laser indication is recommended if risk factors apply.

  8. [Juxta-basal retinal dialysis near the ora serrata].

    Science.gov (United States)

    Slezak, H; Arocker-Mettinger, E

    1989-09-01

    Retinal dialyses near the ora are large, crescent-shaped retinal defects immediately behind the ora serrata. It is assumed that they practically always occur without posterior vitreous detachment and spread within the vitreous base (intrabasal retinal dialysis). However, there are evidently exceptions to this rule: there may be posterior vitreous detachment with the posterior hyaloid membrane which encroach on the anterior margin of the retinal defect; the defect then spreads along the posterior margin of the vitreous base and is hence a juxtabasal retinal dialysis. While the ophthalmoscopic features of intrabasal and juxtabasal retinal dialysis near the ora serrata are always identical, there are distinct biomicroscopic differences between the two forms.

  9. The effects of rutin on cisplatin induced oxidative retinal and optic nerve injury: an experimental study.

    Science.gov (United States)

    Taşlı, Nurdan Gamze; Uçak, Turgay; Karakurt, Yücel; Keskin Çimen, Ferda; Özbek Bilgin, Aslı; Kurt, Nezahat; Süleyman, Halis

    2018-03-22

    To determine the role of rutin in prevention of cisplatin induced retinal and optic nerve injury in an experimental study. Totally 18 albino Wistar male rats were assigned into three groups, as follows: healthy controls (HC group), only cisplatin administered group for 14 days (CIS group), and rutin + cisplatin administered group for 14 days (RC group). Blood samples were obtained from animals just before the scarification. Serum malondialdehyde (MDA), myeloperoxidase (MPO), total glutathione (tGSH), superoxide dismutase (SOD), interleukin 1 beta (IL-1β) and tumour necrosis factor alpha (TNF-α) levels were investigated. The eyes were enucleated for histopathological evaluations of retina and optic nerve. MDA, MPO, IL-1β and TNF-α levels were statistically significantly higher (p < 0.001) in CIS group compared with other two groups while tGSH and SOD levels were statistically significantly lower (p < 0.001). Regarding these parameters, in CIS group MDA, MPO, IL1β and TNF-α levels were statistically significantly increased with cisplatin administration and giving rutin concomitantly with cisplatin prevented this increase. On the other hand, tGSH and SOD levels were statistically significantly decreased with cisplatin administration and giving rutin concomitantly with cisplatin prevented this decrease. In qualitative analyses of histopathological findings of retina and optic nerve; the results of RC group were similar with the results of healthy controls; but there was statistically significant differences between CIS group and other two groups (p < 0.001). Concomitant rutin administration may prevent the detrimental effects of cisplatin on lipid peroxidation, oxidative stress and inflammation markers and may also avert the histopathological damage on retina and optic nerve. Further studies are warranted to determine the effects of cisplatin and rutin on eye.

  10. Factors Influencing Visual Outcome after Surgery for Retinal ...

    African Journals Online (AJOL)

    Aim: To identify the prognostic factors associated with good visual outcome after surgery for retinal detachment in a series of 103 eyes. Materials and methods: Data were obtained from the case files of patients who had retina re-attachment surgery for rhegmatogenous retinal detachment between June 2006 and December ...

  11. Optimizing the treatment of rhegmatogenous retinal detachment

    DEFF Research Database (Denmark)

    Hajari, Javad Nouri

    2016-01-01

    be performed to attain the most optimal result? In the third paper, we evaluated the progression of posterior RRD with an optical coherence tomography to make an objective assessment of the movement. We found that the risk of a macula on RRD progressing to affect the fovea is small if the patient is postured...

  12. Factors predisposing to rhegmatogenous retinal detachment among ...

    African Journals Online (AJOL)

    10.5%] patients. Conclusion: The study showed that myopia, ocular trauma, pseudophakia and aphakia in decreasing frequency were the main risk factors associated with RRD among Ethiopians attending a tertiary eye care centre.

  13. Persistent hyperplastic primary vitreous versus retinal detachment ...

    African Journals Online (AJOL)

    The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs.

  14. Perfluoroctano líquido como tamponante vitreorretiniano de curta duração no pós-operatório de portadores de descolamento de retina por ruptura gigante Perfluoroctane liquid as a short-term vitreous-retinal tamponade in the postoperative period in patients with retinal detachment due to giant tears

    Directory of Open Access Journals (Sweden)

    Marcelo Carvalho Ventura

    2007-06-01

    Full Text Available OBJETIVOS: Relatar os resultados de vitrectomia via pars plana com utilização de perfluocarbono líquido (Perfluoroctano-Ophtalmos®, como tamponante vítreo-retiniano de curta duração, no pós-operatório de portadores de descolamento de retina, por ruptura gigante. MÉTODOS: Estudaram-se dez desses pacientes. Todos os casos eram complicados por vitreorretinopatia proliferativa grau B ou pior com rupturas que variavam em extensão de 90º a 210º. O perfluorocarbono líquido foi introduzido, por via pars plana, com o volume necessário para ultrapassar o limite posterior da ruptura, permanecendo no pós-operatório por cinco dias, estando os pacientes em decúbito dorsal. Após esse período submetiam-se a segunda intervenção para troca do perfluorocarbono líquido para gás ou óleo de silicone. RESULTADOS: Após período de acompanhamento médio de 16,2 ± 12,4 meses (2 a 43 meses, 80% das retinas estavam aplicadas, sendo necessária a repetição desta técnica em 1 caso (10% caso e em 2 casos (20% não houve reaplicação da retina por vitreorretinopatia avançada. Houve melhora da acuidade visual em 5 casos (50%. CONCLUSÃO: Observaram-se bons resultados quanto à aplicação da retina (80% e melhora da acuidade visual (50% quando do uso do perfluorocarbono líquido como tamponante vitreorretiniano de curta duração no pós-operatório de cirurgias de descolamento de retina por rupturas gigantes.PURPOSE: To report pars plana vitrectomy results of intravitreous use of liquid perfluorocarbon as a short-term postoperative tamponade in retinal detachment due to giant tears in a series of patients. METHODS: Ten of those patients, all of them complicated by proliferative vitreoretinopathy grade B or worse, with tear extension varying from 90º to 210º were studied. Perfluorocarbon liquid was injected via pars plana until the posterior tear limit, remaining in the postoperative period during five days, with the patients in supine position

  15. Ghrelin Attenuates Retinal Neuronal Autophagy and Apoptosis in an Experimental Rat Glaucoma Model.

    Science.gov (United States)

    Zhu, Ke; Zhang, Meng-Lu; Liu, Shu-Ting; Li, Xue-Yan; Zhong, Shu-Min; Li, Fang; Xu, Ge-Zhi; Wang, Zhongfeng; Miao, Yanying

    2017-12-01

    Ghrelin, a natural ligand for the growth hormone secretagogue receptor type 1a (GHSR-1a), may protect retinal neurons against glaucomatous injury. We therefore characterized the underlying mechanism of the ghrelin/GHSR-1a-mediated neuroprotection with a rat chronic intraocular hypertension (COH) model. The rat COH model was produced by blocking episcleral veins. A combination of immunohistochemistry, Western blot, TUNEL assay, and retrograde labeling of retinal ganglion cells (RGCs) was used. Elevation of intraocular pressure induced a significant increase in ghrelin and GHSR-1a expression in retinal cells, including RGCs and Müller cells. Western blot confirmed that the protein levels of ghrelin exhibited a transient upregulation at week 2 after surgery (G2w), while the GHSR-1a protein levels were maintained at high levels from G2w to G4w. In COH retinas, the ratio of LC3-II/LC-I and beclin1, two autophagy-related proteins, were increased from G1w to G4w, and the cleavage product of caspase3, an apoptotic executioner, was detected from G2w to G4w. Intraperitoneal injection of ghrelin significantly increased the number of surviving RGCs; inhibited the changes of LC3-II/LC-I, beclin1, and the cleavage products of caspase3; and reduced the number of TUNEL-positive cells in COH retinas. Ghrelin treatment also reversed the decreased levels of p-Akt and p-mTOR, upregulated GHSR-1a protein levels, and attenuated glial fibrillary acidic protein levels in COH retinas. All these results suggest that ghrelin may provide neuroprotective effect in COH retinas through activating ghrelin/GHSR-1a system, which was mediated by inhibiting retinal autophagy, ganglion cell apoptosis, and Müller cell gliosis.

  16. An analysis of the mechanical behaviour of a detaching retina.

    Science.gov (United States)

    Lakawicz, Joseph M; Bottega, William J; Prenner, Jonathan L; Fine, Howard F

    2015-06-01

    An improved solution to the mechanics-based mathematical model for retinal detachment developed by Bottega et al. (2013, Math. Med. Biol., 30, 287-310) is found by removing the simplifying assumption of negligible meridian displacement employed in that study. The model considers retinas with and without central tears and takes contraction of the vitreous and extension of its fibrils, along with a pressure difference across the retina, as the impetus for detachment propagation. Exact analytical solutions are established for the meridian and radial displacements of detaching retinas with and without tears, and numerical simulations are performed based on these solutions. Inclusion of the meridian displacements is seen to result in substantially larger radial displacements without affecting the 'dimpling' behaviour of the detaching retina observed previously. However, the critical stress for detachment propagation is substantially decreased by the inclusion of the meridian displacement. The effects of changes in material and geometric parameters, as well as the influence of the presence and size of the retinal tear on detachment propagation are also studied. The model predicts that retinal detachment propagates catastrophically, which is in agreement with the results found by Bottega et al. (2013, Math. Med. Biol., 30, 287-310) and also with clinical observations. Results show that the inclusion of the meridian displacements enhances the previously seen stabilizing effect a retinal tear can have with regard to detachment propagation. The meridian displacement is similarly seen to enhance the influence that the size of the tear has on this effect. © The Authors 2014. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

  17. Movement of retinal vessels toward the optic nerve head after increasing intraocular pressure in monkey eyes with experimental glaucoma.

    Science.gov (United States)

    Kuroda, Atsumi; Enomoto, Nobuko; Ishida, Kyoko; Shimazawa, Masamitsu; Noguchi, Tetsuro; Horai, Naoto; Onoe, Hirotaka; Hara, Hideaki; Tomita, Goji

    2017-09-01

    A shift or displacement of the retinal blood vessels (RBVs) with neuroretinal rim thinning indicates the progression of glaucomatous optic neuropathy. In chronic open angle glaucoma, individuals with RBV positional shifts exhibit more rapid visual field loss than those without RBV shifts. The retinal vessels reportedly move onto the optic nerve head (ONH) in response to glaucoma damage, suggesting that RBVs are pulled toward the ONH in response to increased cupping. Whether this phenomenon only applies to RVBs located in the vicinity or inside the ONH or, more generally, to RBVs also located far from the ONH, however, is unclear. The aim of this study was to evaluate the movement of RBVs located relatively far from the ONH edge after increasing intraocular pressure (IOP) in an experimental monkey model of glaucoma. Fundus photographs were obtained in 17 monkeys. High IOP was induced in the monkeys by laser photocoagulation burns applied uniformly with 360° irradiation around the trabecular meshwork of the left eye. The right eye was left intact and used as a non-treated control. Considering the circadian rhythm of IOP, it was measured in both eyes of each animal at around the same time-points. Then, fundus photographs were obtained. Using Image J image analysis software, an examiner (N.E.) measured the fundus photographs at two time-points, i.e. before laser treatment (time 1) and the last fundus photography after IOP elevation (time 2). The following parameters were measured (in pixels): 1) vertical diameter of the ONH (DD), 2) distance from the ONH edge to the first bifurcation point of the superior branch of the central retinal vein (UV), 3) distance from the ONH edge to the first bifurcation point of the inferior branch of the central retinal vein (LV), 4) ONH area, and 5) surface area of the cup of the ONH. We calculated the ratios of UV to DD (UV/DD), LV to DD (LV/DD), and the cup area to disc area ratio (C/D). The mean UV/DD at time 1 (0.656 ± 0.233) was

  18. Barriers to Setting up a Vitreo‑retinal Unit of Ophthalmology in ...

    African Journals Online (AJOL)

    incurable have become manageable by vitreo‑retinal surgical techniques.[1,2]. Diagnosis of diabetic retinopathy, age‑related macular degeneration, retinal detachment, and other vitreo‑retinal diseases have improved, hence the need for vitreo‑retinal units in the hospitals. Treatment of posterior segment disorders, such as ...

  19. Methylene blue prevents retinal damage in an experimental model of ischemic proliferative retinopathy.

    Science.gov (United States)

    Rey-Funes, Manuel; Larrayoz, Ignacio M; Fernández, Juan C; Contartese, Daniela S; Rolón, Federico; Inserra, Pablo I F; Martínez-Murillo, Ricardo; López-Costa, Juan J; Dorfman, Verónica B; Martínez, Alfredo; Loidl, César F

    2016-06-01

    Perinatal asphyxia induces retinal lesions, generating ischemic proliferative retinopathy, which may result in blindness. Previously, we showed that the nitrergic system was involved in the physiopathology of perinatal asphyxia. Here we analyze the application of methylene blue, a well-known soluble guanylate cyclase inhibitor, as a therapeutic strategy to prevent retinopathy. Male rats (n = 28 per group) were treated in different ways: 1) control group comprised born-to-term animals; 2) methylene blue group comprised animals born from pregnant rats treated with methylene blue (2 mg/kg) 30 and 5 min before delivery; 3) perinatal asphyxia (PA) group comprised rats exposed to perinatal asphyxia (20 min at 37°C); and 4) methylene blue-PA group comprised animals born from pregnant rats treated with methylene blue (2 mg/kg) 30 and 5 min before delivery, and then the pups were subjected to PA as above. For molecular studies, mRNA was obtained at different times after asphyxia, and tissue was collected at 30 days for morphological and biochemical analysis. Perinatal asphyxia produced significant gliosis, angiogenesis, and thickening of the inner retina. Methylene blue treatment reduced these parameters. Perinatal asphyxia resulted in a significant elevation of the nitrergic system as shown by NO synthase (NOS) activity assays, Western blotting, and (immuno)histochemistry for the neuronal isoform of NOS and NADPH-diaphorase activity. All these parameters were also normalized by the treatment. In addition, methylene blue induced the upregulation of the anti-angiogenic peptide, pigment epithelium-derived factor. Application of methylene blue reduced morphological and biochemical parameters of retinopathy. This finding suggests the use of methylene blue as a new treatment to prevent or decrease retinal damage in the context of ischemic proliferative retinopathy. Copyright © 2016 the American Physiological Society.

  20. Retinitis Pigmentosa

    Science.gov (United States)

    ... is RP inherited? What testing is available? What treatment is available? What is retinitis pigmentosa? Retinitis pigmentosa, also known as RP, refers to a group of inherited diseases causing retinal degeneration. The retina is a thin piece of tissue ...

  1. Cytomegalovirus retinitis

    Science.gov (United States)

    ... sharing features on this page, please enable JavaScript. Cytomegalovirus (CMV) retinitis is a viral infection of the ... need treatment to prevent its return. Alternative Names Cytomegalovirus retinitis Images Eye CMV retinitis CMV (cytomegalovirus) References ...

  2. Studies of Scleral Biomechanical Behavior Related to Susceptibility for Retinal Ganglion Cell Loss in Experimental Mouse Glaucoma

    Science.gov (United States)

    Nguyen, Cathy; Cone, Frances E.; Nguyen, Thao D.; Coudrillier, Baptiste; Pease, Mary E.; Steinhart, Matthew R.; Oglesby, Ericka N.; Jefferys, Joan L.; Quigley, Harry A.

    2013-01-01

    Purpose. To study anatomical changes and mechanical behavior of the sclera in mice with experimental glaucoma by comparing CD1 to B6 mice. Methods. Chronic experimental glaucoma for 6 weeks was produced in 2- to 4-month-old CD1 (43 eyes) and B6 mice (42 eyes) using polystyrene bead injection into the anterior chamber with 126 control CD1 and 128 control B6 eyes. Intraocular pressure (IOP) measurements were made with the TonoLab at baseline and after bead injection. Axial length and scleral thickness were measured after sacrifice in the CD1 and B6 animals and compared to length data from 78 eyes of DBA/2J mice. Inflation testing of posterior sclera was conducted, and circumferential and meridional strain components were determined from the displacement response. Results. Experimental glaucoma led to increases in axial length and width by comparison to fellow eyes (6% in CD1 and 10% in B6; all P glaucoma, the remainder of the sclera uniformly thinned in CD1, but thickened in B6. Peripapillary sclera in CD1 controls had significantly greater temporal meridional strain than B6 and had differences in the ratios of meridional to effective circumferential strain from B6 mice. In both CD1 and B6 mice, exposure to chronic IOP elevation resulted in stiffer pressure–strain responses for both the effective circumferential and meridional strains (multivariable regression model, P = 0.01–0.03). Conclusions. Longer eyes, greater scleral strain in some directions at baseline, and generalized scleral thinning after glaucoma were characteristic of CD1 mice that have greater tendency to retinal ganglion cell damage than B6 mice. Increased scleral stiffness after glaucoma exposure in mice mimics findings in monkey and human glaucoma eyes. PMID:23404116

  3. Prophylactic treatment of retinal breaks

    DEFF Research Database (Denmark)

    Blindbæk, Søren Leer; Grauslund, Jakob

    2015-01-01

    Prophylactic treatment of retinal breaks has been examined in several studies and reviews, but so far, no studies have successfully applied a systematic approach. In the present systematic review, we examined the need of follow-up after posterior vitreous detachment (PVD) - diagnosed by slit...... published before 2012. Four levels of screening identified 13 studies suitable for inclusion in this systematic review. No meta-analysis was conducted as no data suitable for statistical analysis were identified. In total, the initial examination after symptomatic PVD identified 85-95% of subsequent retinal......-47% of cases, respectively. The cumulated incidence of RRD despite prophylactic treatment was 2.1-8.8%. The findings in this review suggest that follow-up after symptomatic PVD is only necessary in cases of incomplete retinal examination at presentation. Prophylactic treatment of symptomatic retinal breaks...

  4. The effect of EGb 761 on retinal lipid peroxidation and glutathione peroxidase level in experimental lens induced uveitis.

    Science.gov (United States)

    Bilgihan, A; Aricioğlu, A; Bilgihan, K; Onol, M; Hasanreisoğlu, B; Türközkan, N

    1994-01-01

    An acute lens-induced necrotizing intraocular inflammation was produced in pigmented guinea pigs. Treatment of these animals by 100 mg/kg/day EGb 761 a free oxygen radical scavenger for 10 days, reduced retinal lipid peroxidation (p > 0.05) and increased the retinal glutathione peroxidase level (p > 0.05). Although not significantly, these findings suggest that EGb 761 could be combined with other antiinflammatory drugs and may be beneficial in the treatment of uveitis.

  5. Plasma detachment in divertor tokamaks

    Science.gov (United States)

    Leonard, A. W.

    2018-04-01

    Observations of divertor plasma detachment in tokamaks are reviewed. Plasma detachment is characterized in terms of transport and dissipation of power, momentum and particle flux along the open field lines from the midplane to the divertor. Asymmetries in detachment onset and other characteristics between the inboard and outboard divertor plasmas is found to be primarily driven by plasma E× B drifts. The effect of divertor plate geometry and magnetic configuration on divertor detachment is summarized. Control of divertor detachment has progressed with a development of a number of diagnostics to characterize the detached state in real-time. Finally the compatibility of detached divertor operation with high performance core plasmas is examined.

  6. Long-term Evaluation of Laser Retinopexy in Retinal Breaks: A ...

    African Journals Online (AJOL)

    tulyasys

    membrane due to its liquefaction.[1,2]. Although generally it is not dangerous, it can be complicated by tractional retinal breaks and retinal detachment. The most common symptoms of PVD are floaters and flashing. Nonetheless, multiple floaters, retinal hemorrhage, bridging vessels and pigment cells in the anterior vitreous ...

  7. Clinical analysis of 532nm frequency-doubled laser in treating retinal holes of 78 eyes

    Directory of Open Access Journals (Sweden)

    Heng Li

    2013-09-01

    Full Text Available AIM: To evaluate the clinical effect of photocoagulation with 532nm frequency-doubled laser in patients with retinal hole.METHODS: Seventy-two cases(78 eyeswith retinal holes were treated with 532nm frequency-doubled laser. All the eyes were divided according to the quadrants of location of retinal holes and the size of retinal hole and existence of local retinal detachment accompanying retinal holes. Statistical analysis was made on these data.RESULTS: 1The retinal holes were located in the upper quadrants of retina in 44 eyes and there were also retinal holes located in the lower quadrants of retina in 31 eyes(there were 3 eyes with retinal holes both located in the upper and lower quadrants of retina, which were not included in control group. The difference of photocoagulation effect between the two groups was statistically significant. 2The retinal holes diameter ≤2 papilla diameter(PDwere present in 37 eyes, the holes diameter of retina >2PD were seen in 41 eyes, the difference of photocoagulation effect between the two groups was statistically significant. 3Retinal holes without local retinal detachment were observed in 45 eyes, retinal holes with local retinal detachment were seen in 33 eyes, the difference of photocoagulation effect between the two groups was statistically significant.CONCLUSION:Photocoagulation with 532nm frequency-doubled laser is effective and safe to treat retinal holes. The effect is better in patients with retinal holes in the upper quadrants and with the retinal holes diameter ≤2PD and without local retinal detachment.

  8. Avascular Retinal Findings in a Child With Achondroplasia.

    Science.gov (United States)

    Hua, Hong-Uyen T; Tran, Kimberly D; Medina, Carlos A; Fallas, Brenda; Negron, Cathy; Berrocal, Audina M

    2017-03-01

    The authors present clinical and angiographic findings in a 12-year-old girl with achondroplasia who presented with bilateral retinal peripheral nonperfusion and unilateral rhegmatogenous retinal detachment, which has not been previously described in achondroplasia. This report contributes incremental knowledge regarding aberrant retinal vascular phenomena observed in pediatric disease states and implicates the possible role of mutations in the FGFR3 gene in peripheral vascular abnormalities. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:272-274.]. Copyright 2017, SLACK Incorporated.

  9. Spontaneous resorption of sub-retinal cortical lens material

    Directory of Open Access Journals (Sweden)

    Salil S Gadkari

    2014-01-01

    Full Text Available We report a rare case of retained sub-retinal cortical material, which underwent spontaneous resorption. Patient presented with a left eye traumatic retinal detachment with a large retinal tear and posteriorly dislocated cataractous lens. Vitrectomy, lensectomy, silicone oil injection, and endolaser were performed. A good visual result was achieved. The report draws attention to this condition and highlights possible technique for minimizing risk of this complication in similar cases.

  10. Safety detaching hook specification.

    CSIR Research Space (South Africa)

    Roux, JD

    1999-05-01

    Full Text Available Single-sided Impact Tests 14 Appendix C Record of Amendments 15 5. REFERENCES 17 4 1. INTRODUCTION 1.1 Subiect The subject of this specification is safety detaching hooks for mine shaft conveyances. According to South African Law1 it is a legal... after a full detachment in the catch plate or bell. Engineer The Mine Engineer, or his authorised sub-ordinate, legally appointed in terms of an Act to be responsible for shaft equipment. NDE Non-Destructive Examination. OEM Original Equipment...

  11. The dark phase intraocular pressure elevation and retinal ganglion cell degeneration in a rat model of experimental glaucoma☆

    Science.gov (United States)

    Kwong, Jacky M.K.; Vo, Nancy; Quan, Ann; Nam, Michael; Kyung, Haksu; Yu, Fei; Piri, Natik; Caprioli, Joseph

    2013-01-01

    Intraocular pressure (IOP) elevation is considered as a major risk factor causing the progression of vision deterioration in glaucoma. Although it is known that the IOP level changes widely throughout the day and night, how the dark or light phase IOP elevation contributes to retinal ganglion cell (RGC) degeneration is still largely unclear. To examine the profile of IOP, modified laser photocoagulation was applied to the trabecular meshwork of Brown Norway rats and both light and dark phase IOPs were monitored approximately 1–2 times a week. The relationship between IOP elevation and RGC degeneration was investigated while RGC body loss was analyzed with Rbpms immunolabeling on retinal wholemount and axonal injury in the optic nerve was semi-quantified. The baseline awake dark and light IOPs were 30.4 ± 2.7 and 20.2 ± 2.1 mmHg respectively. The average dark IOP was increased to 38.2 ± 3.2 mmHg for five weeks after the laser treatment on 270° trabecular meshwork. However, there was no significant loss of RGC body and axonal injury. After laser treatment on 330° trabecular meshwork, the dark and light IOPs were significantly increased to 43.8 ± 4.6 and 23 ± 3.7 mmHg respectively for 5 weeks. The cumulative dark and light IOP elevations were 277 ± 86 and 113 ± 50 mmHg days respectively while the cumulative total (light and dark) IOP elevation was 213 ± 114 mmHg days. After 5 weeks, regional RGC body loss of 29.5 ± 15.5% and moderate axonal injury were observed. Axonal injury and loss of RGC body had a high correlation with the cumulative total IOP elevation (R2 = 0.60 and 0.65 respectively). There was an association between the cumulative dark IOP elevation and RGC body loss (R2 = 0.37) and axonal injury (R2 = 0.51) whereas the associations between neuronal damages and the cumulative light IOP elevation were weak (for RGC body loss, R2 = 0.01; for axonal injury, R2 = 0.26). Simple linear regression model analysis showed statistical significance for the

  12. Bilateral acute retinal necrosis after herpetic meningitis

    Directory of Open Access Journals (Sweden)

    Katsura T

    2012-04-01

    Full Text Available Keisho Hirota1,2, Masayuki Akimoto1,3, Toshiaki Katsura21Department of Ophthalmology, Kyoto Medical Center, National Hospital Organization, 2Internal Medicine, Kyoto Medical Center, 3Clinical Research Center, Kyoto Medical Center, Kyoto, JapanPurpose: The report of a case of bilateral acute retinal necrosis after herpetic meningitis.Case report: A 47-year-old man was admitted with the chief complaint of persistent high fever and transient loss of consciousness. Although his general condition improved after intravenous acyclovir administration, the patient presented with visual loss in both eyes 4 days after admission. Visual acuity in his right eye was 20/200 and his left eye had light perception alone. Both eyes showed panretinal arteritis diagnosed as acute retinal necrosis. Panretinal photocoagulation was performed for both eyes. Progression of retinal detachment was prevented in both eyes; however, visual acuity of the left eye was totally lost because of neovascular glaucoma. Visual acuity of the right eye recovered to 20/20.Conclusion: Although cases of bilateral acute retinal necrosis have been reported after herpetic encephalitis, this condition is rare after herpetic meningitis. Prophylactic acyclovir therapy and early panretinal photocoagulation may prevent retinal detachment and improve the prognosis. Neurologists and ophthalmologists should be aware that not only herpetic encephalitis but also herpetic meningitis can lead to acute retinal necrosis within a very short interval.Keywords: acute retinal necrosis, herpetic meningitis, herpes simplex, varicella zoster virus

  13. Detachable caster adapter

    Science.gov (United States)

    Mohr, R. J.

    1969-01-01

    Detachable caster adapter moves heavy welding tables when fork lift trucks are not practical. A support saddle on the adapter, connected to the caster platform by means of a hinge, fits the leg of the welding table, but can be modified to fit other leg configurations.

  14. Retinal Vasculitis

    Science.gov (United States)

    Rosenbaum, James T.; Sibley, Cailin H.; Lin, Phoebe

    2016-01-01

    Purpose of review Ophthalmologists and rheumatologists frequently miscommunicate in consulting on patients with retinal vasculitis. This report seeks to establish a common understanding of the term, retinal vasculitis, and to review recent papers on this diagnosis. Recent findings 1) The genetic basis of some rare forms of retinal vascular disease have recently been described. Identified genes include CAPN5, TREX1, and TNFAIP3; 2) Behçet’s disease is a systemic illness that is very commonly associated with occlusive retinal vasculitis; 3) retinal imaging including fluorescein angiography and other newer imaging modalities has proven crucial to the identification and characterization of retinal vasculitis and its complications; 4) although monoclonal antibodies to IL-17A or IL-1 beta failed in trials for Behçet’s disease, antibodies to TNF alpha, either infliximab or adalimumab, have demonstrated consistent benefit in managing this disease. Interferon treatment and B cell depletion therapy via rituximab may be beneficial in certain types of retinal vasculitis. Summary Retinal vasculitis is an important entity for rheumatologists to understand. Retinal vasculitis associated with Behçet’s disease responds to monoclonal antibodies that neutralize TNF, but the many other forms of non-infectious retinal vasculitis may require alternate therapeutic management. PMID:26945335

  15. Socioeconomic Barriers to Rhegmatogenous Detachment Surgery in Brazil

    Directory of Open Access Journals (Sweden)

    Pedro Carlos Carricondo

    2014-01-01

    Full Text Available Purpose. To verify access barriers patients with retinal detachment face to arrive at a reference center and to evaluate patients’ knowledge about the disease. Methods. Transversal study that applied a questioner to 65 patients of the Clinical Hospital of the University of Sao Paulo with retinal detachment between February and August of 2010. Results. Reasons for not performing the surgery in other services were as follows: 47% were referred because there was not vitreoretinal surgeon at original service; 27% could not afford the surgery, had no health insurance, or had no coverage at health insurance plan for the procedure. Time between the first symptom and the arrival at our service was as follows: 18 patients arrived in up to 7 days; 35 between 8 and 30 days; 8 between 31 and 90 days; 5 in more than 90 days. Reasons for delay were as follows: 70% did not know how serious the pathology was; 56% thought that it had spontaneous cure; 16% did not have money to pay for ophthalmic evaluation, 10% did not know where to go and 24% for other reasons. Conclusion. Educational programs about disease and measures to optimize the referral to specialized services are needed to accelerate the treatment of patients with rhegmatogenous retinal detachment.

  16. Retinal Macroglial Responses in Health and Disease

    Directory of Open Access Journals (Sweden)

    Rosa de Hoz

    2016-01-01

    Full Text Available Due to their permanent and close proximity to neurons, glial cells perform essential tasks for the normal physiology of the retina. Astrocytes and Müller cells (retinal macroglia provide physical support to neurons and supplement them with several metabolites and growth factors. Macroglia are involved in maintaining the homeostasis of extracellular ions and neurotransmitters, are essential for information processing in neural circuits, participate in retinal glucose metabolism and in removing metabolic waste products, regulate local blood flow, induce the blood-retinal barrier (BRB, play fundamental roles in local immune response, and protect neurons from oxidative damage. In response to polyetiological insults, glia cells react with a process called reactive gliosis, seeking to maintain retinal homeostasis. When malfunctioning, macroglial cells can become primary pathogenic elements. A reactive gliosis has been described in different retinal pathologies, including age-related macular degeneration (AMD, diabetes, glaucoma, retinal detachment, or retinitis pigmentosa. A better understanding of the dual, neuroprotective, or cytotoxic effect of macroglial involvement in retinal pathologies would help in treating the physiopathology of these diseases. The extensive participation of the macroglia in retinal diseases points to these cells as innovative targets for new drug therapies.

  17. Retinal vasculitis.

    Science.gov (United States)

    Abu El-Asrar, Ahmed M; Herbort, Carl P; Tabbara, Khalid F

    2005-12-01

    Retinal vasculitis is a sight-threatening intraocular inflammation affecting the retinal vessels. It may occur as an isolated ocular condition, as a manifestation of infectious or neoplastic disorders, or in association with a systemic inflammatory disease. The search for an underlying etiology should be approached in a multidisciplinary fashion based on a thorough history, review of systems, physical examination, and laboratory evaluation. Discrimination between infectious and noninfectious etiologies of retinal vasculitis is important because their treatment is different. This review is based on recently published articles on retinal vasculitis and deals with its clinical diagnosis, its link with systemic diseases, and its laboratory investigation.

  18. Bilateral acute retinal necrosis-A case report

    Directory of Open Access Journals (Sweden)

    Prasad Palimar

    1992-01-01

    Full Text Available A 42 year old man presented with acute bilateral uveitis and necrotizing retinitis. Systemic investigations including test for AIDS and CMV retinitis were negative. Despite oral Acyclovir, both eyes progressed rapidly to retinal detachment with loss of vision. Early recognition is necessary to diagnose the bilateral acute retinal necrosis syndrome and initiate treatment. Bilateral acute retinal necrosis (BARN is a term first coined by Young and Bird in 1978 although the syndrome had been originally described by Urayama et al as an unilateral condition. This syndrome is characterized by the triad of acute confluent peripheral necrotizing retinitis, moderate to severe vasculitis and vitritis in an otherwise healthy individual. Rhegmatogenous retinal detachment occurs within two to three months of the onset of the disease and the second eye is involved in 36% of patients, usually within 6 weeks. We herein report a patient who presented with simultaneous BARN leading to retinal detachment in a matter of days. Also, to our knowledge this is the first report of this condition in India.

  19. Retinal meteor.

    Science.gov (United States)

    Venkatesh, Ramesh; Gurav, Prachi; Dave, Prachi Abhishek; Roy, Sankhadeep

    2017-09-01

    We describe a case of a 65-year old man diagnosed with retinal vasoproliferative tumour secondary to posterior uveitis. The fluorescein angiography shows an interesting meteor-like leak emanating from the tumour and rising towards the superior retina in the later frames of the angiogram. Pictorially, we call it the "Retinal Meteor" and also describe the possible mechanism for this pattern of leakage.

  20. Between Involvement and Detachment

    DEFF Research Database (Denmark)

    Thomasen, Gry

    stood between the current ‘balanced’ Western Europe and the Europe of the pre-War period. In addition the administration held the opinion that the German problem and the Western European détente tampered with the US unilateralism in its relations with the Soviet Union, and its position as the leader....... Thus the US proposed the Harmel formula before Harmel. In general, the developments in Western Europe put the Johnson administration in a state of alarm, and the European allies therefore had a larger impact on America’s policies, except in the essentially detached nuclear policy, which...

  1. Chaetomium retinitis.

    Science.gov (United States)

    Tabbara, Khalid F; Wedin, Keith; Al Haddab, Saad

    2010-01-01

    To report a case of Chaetomium atrobrunneum retinitis in a patient with Hodgkin lymphoma. We studied the ocular manifestations of an 11-year-old boy with retinitis. Biomicroscopy, ophthalmoscopy, and fundus photography were done. Magnetic resonance imaging of the brain was performed. A vitreous biopsy was subjected to viral, bacterial, and fungal cultures. Vitreous culture grew C. atrobrunneum. Magnetic resonance imaging showed multiple cerebral lesions consistent with an infectious process. The patient was given intravenous voriconazole and showed improvement of the ocular and central nervous system lesions. We report a case of central nervous system and ocular lesions by C. atrobrunneum. The retinitis was initially misdiagnosed as cytomegaloviral retinitis. Vitreous biopsy helped in the early diagnosis and prompt treatment of a life- and vision-threatening infection.

  2. Bilateral detachment of the macular neuroepithelium in a patient with Klinefelter syndrome.

    NARCIS (Netherlands)

    Haarlem, J. van; Cruysberg, J.R.M.; Deutman, A.F.

    2003-01-01

    PURPOSE: To describe the occurrence of atypical, bilateral detachment of the macular neuroepithelium and Klinefelter syndrome in a young patient. METHODS: Case report. RESULTS: A 20-year-old male of Chinese origin with karyotype 47,XXY presented with bilateral central neurosensory retinal

  3. RETINAL NEOVASCULARIZATION FROM A PATIENT WITH CUTIS MARMORATA TELANGIECTATICA CONGENITA.

    Science.gov (United States)

    Sassalos, Thérèse M; Fields, Taylor S; Levine, Robert; Gao, Hua

    2018-03-14

    To report a rare case of peripheral retinal neovascularization in a patient diagnosed with cutis marmorata telangiectatica congenita (CMTC). Observational case report. A 16-year-old girl was referred to clinic for retinal evaluation. The patient had a clinical diagnosis of CMTC later confirmed by skin biopsy. Examination revealed temporal peripheral retinal sheathing, as well as lattice degeneration in both eyes. Wide-field fluorescein angiogram showed substantive peripheral retinal nonperfusion with evidence of vascular leakage from areas of presumed retinal neovascularization. The patient subsequently had pan retinal photocoagulation laser treatment to each eye without complication. Cutis marmorata telangiectatica congenita is a rare vascular condition known to affect multiple organ systems including the eyes. Although ocular manifestations of CMTC are rare, instances of congenital glaucoma, suprachoroidal hemorrhage, and bilateral total retinal detachments resulting in secondary neovascular glaucoma have been reported. Our patient demonstrates the first reported findings of peripheral nonperfusion and retinal neovascularization related to CMTC in a 16-year-old girl. We propose early retinal examination, wide-field fluorescein angiogram, and early pan retinal photocoagulation laser treatment in patients with peripheral nonperfusion and retinal neovascularization from CMTC.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  4. [Serous macular detachment associated with circumscribed choroidal hemangioma: a case report].

    Science.gov (United States)

    Munteanu, M; Giuri, Stela; Rosca, C; Boruga, O; Chercota, V; Stanca, H T

    2013-01-01

    Choroidal hemangiomas are benign vascular hamartomas that typically present from second to fourth decade of life, when they can cause visual disturbance due to exudative retinal detachment. They represent uncommon benign choroidal vascular tumors, usually occuring sporadically in the absence of systemic disease. We report the case of a young female patient, presenting a juxtapapillary circumscribed choroidal haemangioma complicated with serous macular detachment. The patient underwent photodynamic therapy with verteporfin (PDT). Systematic follow-up using ophthalmoscopy, ultrasonography, Fluorescein angiography and Indocyanine green angiography was performed. The patient presented regression with flattening of tumour, resolution of the subretinal fluid, and significant improvement of vision. Mostly asymptomatic, the choroidal hemangiomas can be associated with serous retinal detachment, leading to reduced vision and metamorphopsia; in those cases, the long term visual prognosis is poor, even in adequately treated patients. PDT is effective in eliminating the subretinal fluid and improving vision in patients with circumscribed choroidal hemangioma.

  5. Management of Ocular Diseases Using Lutein and Zeaxanthin: What Have We Learned from Experimental Animal Studies?

    Directory of Open Access Journals (Sweden)

    Chunyan Xue

    2015-01-01

    Full Text Available Zeaxanthin and lutein are two carotenoid pigments that concentrated in the retina, especially in the macula. The effects of lutein and zeaxanthin on the prevention and treatment of various eye diseases, including age-related macular degeneration, diabetic retinopathy and cataract, ischemic/hypoxia induced retinopathy, light damage of the retina, retinitis pigmentosa, retinal detachment, and uveitis, have been studied in different experimental animal models. In these animal models, lutein and zeaxanthin have been reported to have beneficial effects in protecting ocular tissues and cells (especially the retinal neurons against damage caused by different etiological factors. The mechanisms responsible for these effects of lutein and zeaxanthin include prevention of phototoxic damage by absorption of blue light, reduction of oxidative stress through antioxidant activity and free radical scavenging, and their anti-inflammatory and antiangiogenic properties. The results of these experimental animal studies may provide new preventive and therapeutic procedures for clinical management of various vision-threatening diseases.

  6. Novel Serum Proteomic Signatures in a Non-Human Primate Model of Retinal Injury

    Science.gov (United States)

    2011-01-01

    retinal detachment and diabetic retinopathy [1,2]. However, the identification of acute-phase biomarkers following retinal injury has not been...neuronal and RPE cell damage or death [3-7]. It also leads to altered protein expression in the retina and disruption of the outer blood-retinal...proteins from the retina into the systemic circulation. Using a proteomics approach, we investigated whether detection of this acute-phase response

  7. The porcine retinal vasculature accessed using an endovascular approach

    DEFF Research Database (Denmark)

    Morén, Håkan; Undrén, Per; Gesslein, Bodil

    2009-01-01

    The aim of this study was to examine whether the retinal circulation in the pig can be accessed using interventional neuroradiology and to explore the possibility of creating occlusions that result in experimental retinal ischemia.......The aim of this study was to examine whether the retinal circulation in the pig can be accessed using interventional neuroradiology and to explore the possibility of creating occlusions that result in experimental retinal ischemia....

  8. Posterior Vitreous Detachment and Retinal Detachment After Implantation of the Visian Phakic Implantable Collamer Lens

    OpenAIRE

    Bamashmus, Mahfouth A.; Al-Salahim, Seddique A.; Tarish, Nabil A.; Saleh, Mahmoud F.; Mahmoud, Hatem A.; Elanwar, Mohamed F.; Awadalla, Mohamed A.

    2013-01-01

    Introduction: To evaluate the vitreoretinal complications in myopes after Visian implantable collamer lenses (ICL) implantation. Materials and Methods: This is a retrospective, observational, non-comparative clinical study that evaluated 617 consecutive myopes who underwent ICL implantation at the Department of Refractive Surgery, Yemen Magrabi Hospital, Sana′a, Yemen between July 2006 and May 2010. Follow up ranged from 6 months to 40 months. Preoperative and postoperative patient evalua...

  9. Shock detachment from curved wedges

    Science.gov (United States)

    Mölder, S.

    2017-09-01

    Curved shock theory is used to show that the flow behind attached shocks on doubly curved wedges can have either positive or negative post-shock pressure gradients depending on the freestream Mach number, the wedge angle and the two wedge curvatures. Given enough wedge length, the flow near the leading edge can choke to force the shock to detach from the wedge. This local choking can preempt both the maximum deflection and the sonic criteria for shock detachment. Analytical predictions for detachment by local choking are supported by CFD results.

  10. ZNF408 is mutated in familial exudative vitreoretinopathy and is crucial for the development of zebrafish retinal vasculature

    NARCIS (Netherlands)

    Collin, R.W.J.; Nikopoulos, K.; Dona, M.A.; Gilissen, C.F.H.A.; Hoischen, A.; Boonstra, F.N.; Poulter, J.A.; Kondo, H.; Berger, W.; Toomes, C.; Tahira, T.; Mohn, L.R.; Blokland, E.A.W.; Hetterschijt, L.; Ali, M.; Groothuismink, J.M.; Duijkers, L.E.M.; Inglehearn, C.F.; Sollfrank, L.; Strom, T.M.; Uchio, E.; Nouhuys, C.E. van; Kremer, H.; Veltman, J.A.; Wijk, E. van; Cremers, F.P.M.

    2013-01-01

    Familial exudative vitreoretinopathy (FEVR) is a genetically heterogeneous disorder characterized by abnormal vascularization of the peripheral retina, which can result in retinal detachment and severe visual impairment. In a large Dutch FEVR family, we performed linkage analysis, exome sequencing,

  11. NOVEL CLASSIFICATION SYSTEM FOR COMBINED HAMARTOMA OF THE RETINA AND RETINAL PIGMENT EPITHELIUM.

    Science.gov (United States)

    Dedania, Vaidehi S; Ozgonul, Cem; Zacks, David N; Besirli, Cagri G

    2018-01-01

    To develop an anatomical classification scheme for combined hamartoma of the retina and retinal pigment epithelium (RPE) and specify recommendations for follow-up interval. Retrospective review of patients with combined hamartoma of the retina and RPE examined during a 7-year period (2008-2015). The clinical presentation, fundus examination, and optical coherence tomography were analyzed. Lesions were classified based on location, fundus features, and optical coherence tomography findings. Lesion location: macular/peripapillary-Zone 1; mid-periphery-Zone 2; and far periphery-Zone 3. Associated fundus findings: no retinal traction-Stage 1; retinal traction and/or retinoschisis-Stage 2; and retinal detachment-Stage 3. Optical coherence tomography findings: epiretinal component only-A; partial retinal involvement-B; and complete retinal and RPE involvement-C. Complete ophthalmologic evaluation is recommended at least every 6 months for patients younger than 12 years, with more frequent follow-up in patients with: lesions in the macula/peripapillary (Zone 1) or with retinal traction, retinoschisis, or retinal detachment (Stage 2 and 3). Surgical intervention is recommended in patients with vision loss secondary to macular traction or retinal detachment. A new clinical classification system is proposed for evaluating and managing patients with combined hamartoma of the retina and RPE. The zone and stage of combined hamartoma of the retina and RPE lesion will assist in determining follow-up interval and surgical intervention. Application of a uniform classification scheme will facilitate assessment and comparison of findings across different studies.

  12. Disappearance of a detached vapor mass in subcooled water

    International Nuclear Information System (INIS)

    Inada, Shigeaki; Miyasaka, Yoshiki; Izumi, Ryotaro.

    1986-01-01

    Experiments on pool transition boiling of water under atmospheric pressure on a heated surface 10 mm in diameter were conducted for subcooling 15 - 50 K. The mass flux of condensation of a detached coalescent vapor bubble was experimentally estimated by a mathematical model based on the mass transfer mechanism of condensation. As a result, it is clarified that the mass flux of condensation of the detached bubble was influenced by the initial growing velocity of a vapor bubble immediately following the detached bubble. The disappearance velocity of the detached bubble defined as a ratio of the bubble diameter at the departure to the time required until the disappearance, is in the range 0.2 to 2.0 m/sec. The disappearance velocity is proportional to the initial growing velocity of the bubble, to the square of the heat flux of the heated surface and to the cube of the wall superheat, separately. (author)

  13. Diabetic retinopathy and complexity of retinal surgery in a general hospital.

    Science.gov (United States)

    Mijangos-Medina, Laura Fanny; Hurtado-Noriega, Blanca Esmeralda; Lima-Gómez, Virgilio

    2012-01-01

    Usual retinal surgery (vitrectomy or surgery for retinal detachment) may require additional procedures to deal with complex cases, which increase time and resource use and delay access to treatment. We undertook this study to identify the proportion of primary retinal surgeries that required complex procedures and the associated causes. We carried out an observational, descriptive, cross-sectional, retrospective study. Patients with primary retinal surgery were evaluated (January 2007-December 2010). The proportion and 95% confidence intervals (CI) of preoperative diagnosis and cause of the disease requiring retinal surgery as well as the causes for complex retinal surgery were identified. Complex retinal surgery was defined as that requiring lens extraction, intraocular lens implantation, heavy perfluorocarbon liquids, silicone oil tamponade or intravitreal drugs, in addition to the usual surgical retinal procedure. The proportion of complex retinal surgeries was compared among preoperative diagnoses and among causes (χ(2), odds ratio [OR]). We studied 338 eyes. Mean age of subjects was 53.7 years, and there were 49% females. The most common diagnoses were vitreous hemorrhage (27.2%) and rhegmatogenous retinal detachment (24.6%). The most common cause was diabetes (50.6%); 273 eyes required complex surgery (80.8%, 95% CI: 76.6-85). The proportion did not differ among diagnoses but was higher in diabetic retinopathy (89%, p diabetic retinopathy increased by 3-fold the probability of requiring these complex procedures. Early treatment of diabetic retinopathy may reduce the proportion of complex retinal surgery by 56%.

  14. Recurrent central serous chorioretinopathy after peripheral retinal laser photocoagulation: a case report.

    Science.gov (United States)

    Semeraro, Francesco; Russo, Andrea; Delcassi, Luisa; Costagliola, Ciro

    2013-01-01

    To report a case of recurrent central serous chorioretinopathy (CSC) after performing peripheral laser photocoagulation for retinal degenerations. A 44-year-old woman with ocular history of CSC presented to the emergency room of our department complaining of heavy photopsia due to retinal tuft and lattice degenerations, and underwent laser photocoagulation to prevent retinal detachment. Two days after laser treatment, the visual acuity dropped, and optical coherence tomography scan showed the onset of CSC. The serous detachment completely resolved in 20 days with no therapy. A new CSC episode occurred in the same eye after another analogous laser treatment and, similarly, quickly resolved spontaneously. We reviewed the literature and discuss the possibility that laser-induced inflammation could rouse an inflammatory cascade mediated by proinflammatory cytokines and PAI-1, leading to the exacerbation of retinal serous detachment in susceptible patients.

  15. Optical Coherence Tomography of Retinal and Choroidal Tumors

    Directory of Open Access Journals (Sweden)

    Emil Anthony T. Say

    2011-01-01

    Full Text Available Optical coherence tomography (OCT has revolutionized the field of ophthalmology since its introduction 20 years ago. Originally intended primarily for retina specialists to image the macula, it has found its role in other subspecialties that include glaucoma, cornea, and ocular oncology. In ocular oncology, OCT provides axial resolution to approximately 7 microns with cross-sectional images of the retina, delivering valuable information on the effects of intraocular tumors on the retinal architecture. Some effects include retinal edema, subretinal fluid, retinal atrophy, photoreceptor loss, outer retinal thinning, and retinal pigment epithelial detachment. With more advanced technology, OCT now provides imaging deeper into the choroid using a technique called enhanced depth imaging. This allows characterization of the thickness and reflective quality of small (<3 mm thick choroidal lesions including choroidal nevus and melanoma. Future improvements in image resolution and depth will allow better understanding of the mechanisms of visual loss, tumor growth, and tumor management.

  16. Dexamethasone intravitreal implant downregulates PDGFR-α and upregulates caveolin-1 in experimental branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Cehofski, Lasse Jørgensen; Kruse, Anders; Magnusdottir, Sigriður Olga

    2018-01-01

    while the left control eye was given an identical injection without an implant. Fifteen days after BRVO and DEX implant intervention the retinas were excised and analyzed with tandem mass tag based mass spectrometry. A total of 26 significantly changed proteins were identified. Dexamethasone...... following an intervention with a dexamethasone (DEX) implant this study combined an experimental model of BRVO with proteomic techniques. In six Danish Landrace pigs experimental BRVO was induced in both eyes using argon laser. After inducing BRVO a DEX implant was injected in the right eye of each animal...

  17. Controlling marginally detached divertor plasmas

    Science.gov (United States)

    Eldon, D.; Kolemen, E.; Barton, J. L.; Briesemeister, A. R.; Humphreys, D. A.; Leonard, A. W.; Maingi, R.; Makowski, M. A.; McLean, A. G.; Moser, A. L.; Stangeby, P. C.

    2017-06-01

    A new control system at DIII-D has stabilized the inter-ELM detached divertor plasma state for H-mode in close proximity to the threshold for reattachment, thus demonstrating the ability to maintain detachment with minimal gas puffing. When the same control system was instead ordered to hold the plasma at the threshold (here defined as T e  =  5 eV near the divertor target plate), the resulting T e profiles separated into two groups with one group consistent with marginal detachment, and the other with marginal attachment. The plasma dithers between the attached and detached states when the control system attempts to hold at the threshold. The control system is upgraded from the one described in Kolemen et al (2015 J. Nucl. Mater. 463 1186) and it handles ELMing plasmas by using real time D α measurements to remove during-ELM slices from real time T e measurements derived from divertor Thomson scattering. The difference between measured and requested inter-ELM T e is passed to a PID (proportional-integral-derivative) controller to determine gas puff commands. While some degree of detachment is essential for the health of ITER’s divertor, more deeply detached plasmas have greater radiative losses and, at the extreme, confinement degradation, making it desirable to limit detachment to the minimum level needed to protect the target plate (Kolemen et al 2015 J. Nucl. Mater. 463 1186). However, the observed bifurcation in plasma conditions at the outer strike point with the ion B   ×  \

  18. Intravitreal bevacizumab combined with plaque brachytherapy reduces melanoma tumor volume and enhances resolution of exudative detachment

    Directory of Open Access Journals (Sweden)

    Houston SK

    2013-01-01

    Full Text Available Samuel K Houston,1 Nisha V Shah,1 Christina Decatur,1 Marcela Lonngi,1 William Feuer,1 Arnold M Markoe,2 Timothy G Murray1–31Department of Ophthalmology, 2Department of Radiation Oncology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, 3Murray Ocular Oncology and Retina, Miami, FL, USABackground: The purpose of this study was to evaluate intravitreal bevacizumab as an adjuvant treatment to plaque brachytherapy in the treatment of choroidal melanoma.Methods: This was a retrospective, consecutive study of 124 patients treated from 2007 to 2009 for choroidal melanoma with plaque brachytherapy. Patients were treated with I-125 plaque brachytherapy with 2 mm margins and 85 Gy to the tumor apex. Consecutive patients were injected intravitreally with 2.5 mg/0.1 mL bevacizumab at a site away from the primary tumor and immediately following plaque removal. Choroidal melanomas were observed using indirect ophthalmoscopy, wide-angle photography, and ultrasound. The main outcome measures were tumor volume, resolution of exudative retinal detachment, and visual acuity.Results: One hundred and twenty-four patients met our inclusion criteria and were included in the analysis. The mean patient age was 65.7 years, and the mean apical tumor height was 4.0 ± 2.7 mm and basal diameter was 12.7 ± 3.0 mm. Mean follow-up was 24 months. Prior to treatment, 100% of tumors had exudative retinal detachment, and pretreatment visual acuity was 20/55 (median 20/40. Tumor control was 100%, metastasis was 0% at last follow-up, and 89.8% had complete resolution of exudative retinal detachment, with a mean time to resolution of 3.36 months. At one month, 43% had complete resolution of exudative retinal detachment, which increased to 73% at 4 months. Visual acuity was 20/62 (median 20/40 at 4 months, with stabilization to 20/57 (median 20/40 at 8 months, 20/56 (median 20/30 at 12 months, and 20/68 (median 20/50 at 24 months. Tumor

  19. Retinitis pigmentosa

    Directory of Open Access Journals (Sweden)

    Hamel Christian

    2006-10-01

    Full Text Available Abstract Retinitis pigmentosa (RP is an inherited retinal dystrophy caused by the loss of photoreceptors and characterized by retinal pigment deposits visible on fundus examination. Prevalence of non syndromic RP is approximately 1/4,000. The most common form of RP is a rod-cone dystrophy, in which the first symptom is night blindness, followed by the progressive loss in the peripheral visual field in daylight, and eventually leading to blindness after several decades. Some extreme cases may have a rapid evolution over two decades or a slow progression that never leads to blindness. In some cases, the clinical presentation is a cone-rod dystrophy, in which the decrease in visual acuity predominates over the visual field loss. RP is usually non syndromic but there are also many syndromic forms, the most frequent being Usher syndrome. To date, 45 causative genes/loci have been identified in non syndromic RP (for the autosomal dominant, autosomal recessive, X-linked, and digenic forms. Clinical diagnosis is based on the presence of night blindness and peripheral visual field defects, lesions in the fundus, hypovolted electroretinogram traces, and progressive worsening of these signs. Molecular diagnosis can be made for some genes, but is not usually performed due to the tremendous genetic heterogeneity of the disease. Genetic counseling is always advised. Currently, there is no therapy that stops the evolution of the disease or restores the vision, so the visual prognosis is poor. The therapeutic approach is restricted to slowing down the degenerative process by sunlight protection and vitaminotherapy, treating the complications (cataract and macular edema, and helping patients to cope with the social and psychological impact of blindness. However, new therapeutic strategies are emerging from intensive research (gene therapy, neuroprotection, retinal prosthesis.

  20. Ruby laser in prevention of post-traumatic retinal separation

    Energy Technology Data Exchange (ETDEWEB)

    Berenov, S.N.

    1984-04-01

    An analysis was conducted of the therapeutic effectiveness in management of post-traumatic retinal detachment, employing a group of 28 subjects (28 eyes) with penetrating wounds of the eyeball. The patients ranged in age from 10 to 46 years, with duration of ocular damage ranging from several days to 1.5 years. Light coagulation was effected with ruby laser OK-2 (0.05-0.1 J). Following treatment, most patients were without serious complications, but in 4 cases preretinal point hemorrhages were observed. In 20 patients, visual function remained unchanged, while in 8 cases visual acuity improved by 0.02-0.4 units. Only one case of retinal detachment (due to hemophthalmus) occurred in 22 cases followed for 6 months to 3 years. On the basis of this study, it appears that laser coagulation can be an effective means of preventing post-traumatic retinal separation. 9 references.

  1. Adhesion mechanism of a gecko-inspired oblique structure with an adhesive tip for asymmetric detachment

    International Nuclear Information System (INIS)

    Sekiguchi, Yu; Sato, Chiaki; Takahashi, Kunio

    2015-01-01

    An adhesion model of an oblique structure with an adhesive tip is proposed by considering a limiting stress for adhesion to describe the detachment mechanism of gecko foot hairs. When a force is applied to the root of the oblique structure, normal and shear stresses are generated at contact and the adhesive tip is detached from the surface when reaching the limiting stress. An adhesion criterion that considers both the normal and shear stresses is introduced, and the asymmetric detachment of the oblique structure is theoretically investigated. In addition, oblique beam array structures are manufactured, and an inclination effect of the structure on the asymmetric detachment is experimentally verified. (paper)

  2. Progressive outer retinal necrosis (PORN) in AIDS patients: a different appearance of varicella-zoster retinitis.

    Science.gov (United States)

    Pavesio, C E; Mitchell, S M; Barton, K; Schwartz, S D; Towler, H M; Lightman, S

    1995-01-01

    Retinal infections caused by the varicella-zoster virus (VZV) have been reported in immunocompetent and immunocompromised individuals. Two cases of a VZV-related retinitis are described with the characteristic features of the recently described progressive outer retinal necrosis (PORN) syndrome. Both patients suffered from the acquired immunodeficiency syndrome (AIDS) with greatly reduced peripheral blood CD4+ T lymphocyte counts, and presented with macular retinitis without vitritis. The disease was bilateral in one case and unilateral in the other. The clinical course was rapidly progressive with widespread retinal involvement and the development of rhegmatogenous retinal detachment with complete loss of vision in the affected eyes despite intensive intravenous antiviral therapy. VZV DNA was identified in vitreous biopsies, by molecular techniques based on the polymerase chain reaction (PCR), in both patients. At present, the use of very high-dose intravenous acyclovir may be the best therapeutic option in these patients for whom the visual prognosis is poor. Intravitreal antiviral drugs could also contribute to the management of these cases.

  3. Evidence-based analysis of prophylactic treatment of asymptomatic retinal breaks and lattice degeneration.

    Science.gov (United States)

    Wilkinson, C P

    2000-01-01

    To assess the quality of information in the literature regarding the benefits of prophylactic treatment of asymptomatic retinal tears and lattice degeneration. Asymptomatic retinal breaks occur in approximately 7% of patients over age 40, and lattice degeneration is present in approximately 8% of the general population. Because retinal breaks cause retinal detachment and lattice degeneration is associated with approximately 30% of retinal detachments, prophylactic treatment of these lesions has sometimes been recommended. A panel of vitreoretinal experts performed a literature review of all publications regarding prevention of retinal detachment that have been published in English. These articles were then used to prepare recommendations for patient care in an American Academy of Ophthalmology Preferred Practice Pattern (PPP). Each recommendation was rated according to: (1) its importance in the care process and (2) the strength of evidence supporting the given recommendation. Most recommendations were rated as A (most important to patient care). Only a single publication was graded as I (providing strong evidence in support of a recommendation), and this was not a prospective trial. Of the few publications rated as II (substantial evidence), most were studies documenting a lack of treatment benefit. Because of an absence of level I and level II studies in the literature, level III (consensus of expert opinion) was the basis for most recommendations in the PPP. The current literature regarding prevention of retinal detachment does not provide sufficient information to support strongly prophylactic treatment of lesions other than symptomatic flap tears. Prospective randomized trials of prophylactic therapy are indicated. Eyes highly predisposed to retinal detachment should be considered for such studies.

  4. Analysis of bacterial detachment from substratum surfaces by the passage of air-liquid interfaces

    NARCIS (Netherlands)

    Gomez-Suarez, C; Busscher, HJ; van der Mei, HC

    A theoretical analysis of the detachment of bacteria adhering to substratum surfaces upon the passage of an air-liquid interface is given, together with experimental results for bacterial detachment in the absence and presence of a conditioning film on different substratum surfaces. Bacteria

  5. Enzymatic detachment of therapeutic mesenchymal stromal cells grown on glass carriers in a bioreactor.

    Science.gov (United States)

    Salzig, Denise; Schmiermund, Alexandra; P Grace, Pablo; Elseberg, Christiane; Weber, Christian; Czermak, Peter

    2013-01-01

    Cell therapies require the in vitro expansion of adherent cells such as mesenchymal stromal cells (hMSCs) in bioreactor systems or other culture environments, followed by cell harvest. As hMSCs are strictly adherent cells, cell harvest requires cell detachment. The use of hMSCs for cell therapy requires GMP production in accordance with the guidelines for advanced therapeutic medical products. Therefore, several GMP-conform available proteolytic enzymes were investigated for their ability to promote hMSC detachment. An allogeneic hMSC cell line (hMSC-TERT) that is used in clinical trials in the form of alginate cell capsules was chosen as a model. This study investigated the influence of several factors on the outcome of proteolytic hMSC-TERT detachment. Therefore, hMSC-TERT detachment was analyzed in different cultivation systems (static, dynamic) and in combination with further cell processing including encapsulation. Only two of the commercially available enzymes (AccutaseTM, TrypZeanTM) that fulfill all process requirements (commercial availability, cost, GMP conditions during manufacturing and non-animal origin) are found to be generally suitable for detaching hMSC-TERT. Combining cell detachment with encapsulation demonstrated a high impact of the experimental set up on cell damage. It was preferable to reduce the temperature during detachment and limit the detachment time to a maximum of 20 minutes. Cell detachment in static systems was not comparable with detachment in dynamic systems. Detachment yields in dynamic systems were lower and cell damage was higher for the same experimental conditions. Finally, only TrypZeanTM seemed to be suitable for the detachment of hMSC-TERT from dynamic reactor systems.

  6. Detached Eddy Simulations of an Airfoil in Turbulent Inflow

    DEFF Research Database (Denmark)

    Gilling, Lasse; Sørensen, Niels; Davidson, Lars

    2009-01-01

    The effect of resolving inflow turbulence in detached eddy simulations of airfoil flows is studied. Synthetic turbulence is used for inflow boundary condition. The generated turbulence fields are shown to decay according to experimental data as they are convected through the domain with the free ...

  7. PERIPHERAL RETINAL FINDINGS IN HIGHLY MYOPIC CHILDREN ≤10 YEARS OF AGE

    Science.gov (United States)

    Bansal, Alok S.; Hubbard, G. Baker

    2011-01-01

    Purpose The purpose of this study was to characterize the peripheral retinal findings in highly myopic young children without other known risk factors for retinal detachment. Methods A retrospective review of all cases of children ≤10 years of age with high myopia (>6.00 diopters) who were evaluated for presumed risk of retinal detachment by either an examination under anesthesia or office examination by a single retina specialist from January 2001 through December 2008. Patients with regressed retinopathy of pre-maturity, retinal detachment in the fellow eye, or known Stickler syndrome were excluded. Results Fifty-four eyes of 30 patients with high myopia were examined. Twenty-six eyes of 14 patients were examined under anesthesia because of the examiner’s inability to adequately visualize the peripheral retina during an office examination. Mean age at examination was 6 ± 3 (range, 1–10) years. Mean spherical equivalent refractive error was −13.88 ± 3.79 (range, −6.00 to −25.00) diopters. Peripheral retinal findings were identified in 33% of eyes, the most common being lattice degeneration (20%), white without pressure (11%), and retinal holes with subretinal fluid (4%). Conclusion Approximately one third of highly myopic children in our study showed peripheral retinal findings. If the peripheral retina is not adequately visualized during an office evaluation, examination under anesthesia should be considered. PMID:20224463

  8. Self-sustained detachment observed in LHD and comparison with detachment and Marfe in W7-AS

    Energy Technology Data Exchange (ETDEWEB)

    Miyazawa, J.; Masuzaki, S.; Yamada, H.; Sakamoto, R.; Peterson, B. J.; Shoji, M.; Ohyabu, N.; Komori, A.; Motojima, O.

    2005-07-01

    One of the crucial issues for a magnetically confined fusion reactor [1-3] is the reduction of the divertor heat load. Edge plasma cooling by increasing the density or introducing impurities such as neon as radiators is effective for reducing the divertor heat load by detaching the plasma from the divertor plates. In high-density tokamak plasmas, the so-called high-recycling regime is predicted by two-point model [4,5], where the divertor temperature (density) nonlinearly decreases (increases) with the main plasma density. Detachment takes place when the density is increased further. Then, the pressure in the flux tube is no longer conserved due to the increased radiation loss, charge exchange loss, and volume recombination. Eventually, the discharge is terminated by disruption often via rapid formation of a radiation condensation Marfe [5,6]. This scenario well explains the experimental results of tokamaks [5,7]. A similar kind of conventional detachment has been also intensively studied in a stellarator, W7-AS, after modification to the island divertor configuration [8,9]. Detachment in W7-AS is achieved by increasing the density beyond the density threshold for the high-density H-mode (HDH) [10]. As the density is increased further to the operational density limit, complete detachment takes place and, in some cases, the Marfe is formed on (or inside of) the last-closed-flux-surface (LCFS) [11-13]. These are reviewed in Section 4. Recently, a new state of self-sustained detachment has been found in LHD and named the Serpens mode (Self-regulated plasma edge neath the last-closed-flux-surface) [15,16]. In the Serpens mode, the hot plasma boundary is shrinking to equal 90 % of the LCFS radius. Large fluctuations appear in the divertor flux, H alpha and Cm signals, together with a rotating radiation belt named the serpent [17]. Detachment in LHD is observed in a significant decrease in the ion saturation current, Isat, measured on the divertor tiles [18,19]. In this

  9. The relationship between fundus fluorescein angiographic findings and serous macular detachment in diabetic macular edema.

    Science.gov (United States)

    Gungel, Hulya; Altan, Cigdem

    2013-10-01

    To investigate whether the serous macular detachment (SMD) shown by optical coherence tomography is associated with types of maculopathy, severity of retinopathy, the effect of macular and retinal photocoagulation, and retinal circulation times in diabetic macular edema. Patients were grouped as SMD+ (Group 1) and SMD- (Group 2). Fundus photography and fluorescein angiography were evaluated regarding the type of maculopathy; severity of retinopathy and also arm-retina time, arteriovenous transit time, and venous filling time; and the applied macular and panretinal laser treatment. Diffuse maculopathy was seen more frequently in eyes with SMD, whereas ischemic maculopathy was more frequent in eyes without SMD. There was no significant difference regarding severity of retinopathy and retinal circulation times between groups. The frequency of patients with complete panretinal photocoagulation and grid laser photocoagulation was found to be higher in Group 2. Serous macular detachment can occur in eyes with increased vascular permeability in macula. Serous macular detachment may be an important finding in terms of the possible existence of diffuse maculopathy and the need of additional panretinal photocoagulation, but absence of SMD may point at ischemic maculopathy.

  10. Kinematic Fitting of Detached Vertices

    Energy Technology Data Exchange (ETDEWEB)

    Mattione, Paul [Rice Univ., Houston, TX (United States)

    2007-05-01

    The eg3 experiment at the Jefferson Lab CLAS detector aims to determine the existence of the $\\Xi_{5}$ pentaquarks and investigate the excited $\\Xi$ states. Specifically, the exotic $\\Xi_{5}^{--}$ pentaquark will be sought by first reconstructing the $\\Xi^{-}$ particle through its weak decays, $\\Xi^{-}\\to\\pi^{-}\\Lambda$ and $\\Lambda\\to\\pi^{-}$. A kinematic fitting routine was developed to reconstruct the detached vertices of these decays, where confidence level cuts on the fits are used to remove background events. Prior to fitting these decays, the exclusive reaction $\\gamma D\\rightarrow pp\\pi^{-}$ was studied in order to correct the track measurements and covariance matrices of the charged particles. The $\\Lambda\\rightarrow p\\pi^{-}$ and $\\Xi^{-}\\to\\pi^{-}\\Lambda$ decays were then investigated to demonstrate that the kinematic fitting routine reconstructs the decaying particles and their detached vertices correctly.

  11. Traction on the retina induced by saccadic eye movements in the presence of posterior vitreous detachment.

    Science.gov (United States)

    Repetto, R; Tatone, A; Testa, A; Colangeli, E

    2011-04-01

    Posterior vitreous detachment is a fairly common condition in elderly people. Tractions exerted by the detached vitreous on the retina may result in retinal tears and detachments. We studied how these tractions can arise from saccadic eye movements. Numerical simulations have been performed on a two-dimensional model of the vitreous chamber within a rigid spherical sclera, subjected to prescribed finite-amplitude rotations about a vertical axis. The vitreous chamber was assumed to be split into two regions: one occupied by the detached vitreous, modeled as an elastic viscous solid, and the other occupied by the separated liquefied vitreous, modeled as a Newtonian fluid. At the interface between the two phases, we also considered the presence of the vitreous cortex, modeled as an elastic membrane. We tested several different configurations of the interface. In all cases, we found that eye rotations generate large tractions on the retina close to the attachment points of the membrane. Comparing them, we identified configurations of the vitreous detachment that exhibit higher tractions. We also investigated how the response to saccadic movements depends on some physical parameters, in particular on the rheological properties of the solid phase and the membrane. The numerical simulations show that the generated tractions may be of the same order of magnitude as the adhesive force between the retina and the pigment epithelium. Therefore, the model provides a sound physical justification for the hypothesis that saccadic movements, in the presence of posterior vitreous detachment, could be responsible for high tractions on the retina, which may trigger retinal tear formation.

  12. Negative ion detachment cross sections

    International Nuclear Information System (INIS)

    Champion, R.L.; Doverspike, L.D.

    1992-10-01

    The authors have measured absolute cross sections for electron detachment and charge exchange for collision of O and S with atomic hydrogen, have investigated the sputtering and photodesorption of negative ions from gas covered surfaces, and have begun an investigation of photon-induced field emission of electrons from exotic structures. Brief descriptions of these activities as well as future plans for these projects are given below

  13. Variations of posterior vitreous detachment

    OpenAIRE

    Kakehashi, A.; Kado, M.; Akiba, J.; Hirokawa, H.

    1997-01-01

    AIMS—To identify variations in posterior vitreous detachment (PVD) and establish a clinical classification system for PVD.
METHODS—400 consecutive eyes were examined using biomicroscopy and vitreous photography and classified the PVD variations—complete PVD with collapse, complete PVD without collapse, partial PVD with thickened posterior vitreous cortex (TPVC), or partial PVD without TPVC.
RESULTS—In each PVD type, the most frequently seen ocular pathologies were as follows: in complete PVD ...

  14. Classification of posterior vitreous detachment

    OpenAIRE

    Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

    2013-01-01

    Akihiro Kakehashi,1 Mikiko Takezawa,1 Jun Akiba21Department of Ophthalmology, Jichi Medical University, Saitama Medical Center, Saitama, 2Kanjodori Eye Clinic, Asahikawa, JapanAbstract: Diagnosing a posterior vitreous detachment (PVD) is important for predicting the prognosis and determining the indication for vitreoretinal surgery in many vitreoretinal diseases. This article presents both classifications of a PVD by slit-lamp biomicroscopy and of a shallow PVD by optical coherence tomography...

  15. Clinical research on the development of posterior vitreous detachments after coaxial microincision phacoemulsification

    Directory of Open Access Journals (Sweden)

    Rong Xu

    2013-09-01

    Full Text Available AIM: To explore the development process of when posterior vitreous detachments(PVDsafter coaxial micro-incision phacoemulsification and aspiration combined with foldable intraocular lens implantation.METHODS: Clinical data of 917 patients with cataract were collected after coaxial microincision phacoemulsification and aspiration combined with foldable intraocular lens implantation. The 917 operating eyes forms observation group and the 917 corresponding normal eyes serve as control group. All patients underwent a comprehensive ocular examination before surgery. The vitreous and retinal condition was tested by B-scan ultrasonography and biomicroscope with a 90-diopter(Dpreset lens after 1 week and 1, 3, 6, and 12 months postoperatively. RESULTS: The incident rate of eyes in the observation group that developed PVD after operation were 8(0.9%, 31(3.4%, 53(5.8%, 78(8.5%, 129(14.1%within 1 week and 1, 3, 6, 12 months, respectively. Ten(7.8%of the 129 eyes in which PVD developed during the one year follow-up period had new retinal breaks with or without a retinal detachment; One(0.1%of the 788 eyes in which a PVD did not developed during the follow-up period had new retinal tear with or without a retinal detachment; these percentages were statistically significant(P=0.009. Eight(14.8%of 54 eyes with lattice degeneration and 2(2.7%of 75 eyes without lattice degeneration had retinal tears associated with a PVD; the difference was statistically significant(P=0.004.CONCLUSION: Development of PVDs seems to accelerate after coaxial microincision phacoemulsification and linearly accumulated for 1 year postoperatively. Approximately 7.8% of eyes with a PVD had retinal tears. Compared with patients having no lattice degeneration, Patients' eyes with lattice degeneration had a 5.5-fold higher risk of developing retinal breaks associated with a PVD. This indicates long-term follow-up is necessary after phacoemulsification is performed.

  16. Bilateral Giant Retinal Tear and Sequential Vitrectomy.

    Science.gov (United States)

    Mustapha, Mushawiahti; Roufail Franzco, Edward

    2017-01-01

    To describe the excellent outcome of surgery for bila