Current surgery of retinal detachment recurrence. Review

Directory of Open Access Journals (Sweden)

V. D. Zakharov

2012-01-01

Full Text Available this review presents a detailed analysis and an experience of surgical treatment of retinal detachment recurrence associated with light silicone oil tamponade of vitreous cavity. Approaches and variants of treatment were described in the historical aspect and till now. there are considered general and particular issues in case of retinal detachment recurrence appearance, expediency and volume of intraoperative manipulations, time of operation and choice of temporary substitute of vitreous body for a purpose of postoperative tamponade of vitreous cavity.

Paediatric retinal detachment: aetiology, characteristics and outcomes.

Science.gov (United States)

McElnea, Elizabeth; Stephenson, Kirk; Gilmore, Sarah; O'Keefe, Michael; Keegan, David

2018-01-01

To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. Twenty-eight eyes of 24 patients, 15 (62.5%) of whom were male and 9 (37.5%) of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0%) cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3%) cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6%) cases which underwent surgical repair the retina was attached at last follow-up. Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

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

Science.gov (United States)

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

Paediatric retinal detachment: aetiology, characteristics and outcomes

Directory of Open Access Journals (Sweden)

Elizabeth McElnea

2018-02-01

Full Text Available AIM: To provide contemporary data on the aetiology, clinical features and outcomes of paediatric retinal detachment. METHODS: A retrospective review of all those under 16y who underwent surgical repair for retinal detachment at a single centre between the years 2008 and 2015 inclusive was performed. In each case the cause of retinal detachment, the type of detachment, the presence or absence of macular involvement, the number and form of reparative surgeries undertaken, and the surgical outcome achieved was recorded. RESULTS: Twenty-eight eyes of 24 patients, 15 (62.5% of whom were male and 9 (37.5% of whom were female, their mean age being 11.6y and range 2-16y developed retinal detachment over the eight year period studied. Trauma featured in the development of retinal detachment in 14 (50.0% cases. Retinal detachment was associated with other ocular and/or systemic conditions in 11 (39.3% cases. A mean of 3.0 procedures with a range of 1-9 procedures per patient were undertaken in the management of retinal detachment. Complex vitrectomy combined with scleral buckling or complex vitrectomy alone were those most frequently performed. Mean postoperative visual acuity was 1.2 logMAR with range 0.0-3.0 logMAR. In 22 of 26 (84.6% cases which underwent surgical repair the retina was attached at last follow-up. CONCLUSION: Aggressive management of paediatric retinal detachment including re-operation increases the likelihood of anatomical success. In cases where the retinal detachment can be repaired by an external approach alone there is a more favourable visual outcome.

Retinal Layers Measurements following Silicone Oil Tamponade for Retinal Detachment Surgery.

Science.gov (United States)

Jurišić, Darija; Geber, Mia Zorić; Ćavar, Ivan; Utrobičić, Dobrila Karlica

2017-12-19

This study aimed to investigate the influence of silicone oil on the retinal nerve fiber layer (RNFL) thickness in patients with primary rhegmatogenous retinal detachment who underwent vitreoretinal surgery. The study included 47 patients (eyes), who underwent a pars plana vitrectomy with the silicone oil tamponade. The control group included unoperated eye of all participants. Spectral-domain optical coherence tomography (SD-OCT) was used for the measurements of peripapilar and macular RNFL thickness. The average peripapillary RNFL thickness was significantly higher in the silicone oil filled eyes during endotamponade and after its removal. The eyes with elevated IOP had less thickening of the RNFL in comparison to the eyes with normal IOP. Central macular thickness and macular volume were decreased in the silicone oil filled eyes in comparison to the control eyes. In conclusion, silicone oil caused peripapilar RNFL thickening in the vitrectomized eyes during endotamponade and after silicone oil removal.

Bilateral patching in retinal detachment: fluid mechanics and retinal "settling".

Science.gov (United States)

Foster, William J

2011-07-20

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. 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. 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. 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.

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.

Quality assessment of cataract surgery in Denmark - risk of retinal detachment and postoperative endophthalmitis

DEFF Research Database (Denmark)

Bjerrum, Søren Solborg

2015-01-01

The main purpose of this thesis was to examine whether the Danish National Patient Registry (NPR) could be used to monitor and assess the quality of cataract surgery in Denmark by studying the risks of two serious postoperative complications following cataract surgery - retinal detachment (RD......) and postoperative endophthalmitis (PE). The thesis consists of four retrospective studies. In the first study (paper I), we used data from the NPR in the calendar period 2000-2010 to investigate the risk of pseudophakic retinal detachment (PRD) using the fellow non-operated eyes of the patients as reference....... The study showed that over a 10-year study period, the risk of PRD was increased by a factor of 4.2 irrespective of sex and age. The risk of PRD was highest in the first part of the postoperative period and then gradually decreased but remained statistically significantly higher than the risk of RD in non...

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.

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.

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.

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)

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.

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.

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.

[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.

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)

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

Science.gov (United States)

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

[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.

Vitreo-retinal eye surgery robot : sustainable precision

NARCIS (Netherlands)

Meenink, H.C.M.

2011-01-01

Vitreo-retinal eye surgery encompasses the surgical procedures performed on the vitreous humor and the retina. A procedure typically consists of the removal of the vitreous humor, the peeling of a membrane and/or the repair of a retinal detachment. Vitreo-retinal surgery is performed minimal

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

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

A case of traction retinal detachment in a patient with Gaucher disease.

Science.gov (United States)

Watanabe, Akira; Gekka, Tamaki; Arai, Kota; Tsuneoka, Hiroshi

2017-01-01

This is the first report of vitreous surgery for traction retinal detachment in a patient with type III Gaucher disease with multiple vitreous opacities. A 16-year-old boy who was diagnosed with Gaucher disease at age two and was undergoing enzyme replacement therapy presented with numerous white opacities of varying sizes in the vitreous bodies of both eyes. Visual acuity was 20/40 in the right eye and 20/2000 in the left eye. The retina of the left eye was completely detached, and vitreous surgery was performed. Liquefaction of the vitreous body was advanced, and the central part of the vitreous cavity contained almost no vitreous humor. The macular region was successfully aspirated with a vitreous cutter to form a posterior vitreous detachment. From the optic disk to the nasal side, however, posterior vitreous detachment formation was prevented by strong adhesions between the retina and the vitreous body. The traction retinal detachment of the posterior fundus improved after vitreous body resection alone. Traction retinal detachment may occur as a result of severe vitreous liquefaction in cases of Gaucher disease with numerous vitreous opacities.

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

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......Purpose. The pathogenesis of rhegmatogenous retinal detachment (RRD) remains incompletely understood, with no clinically effective treatment for potentially severe complications such as photoreceptor cell death and proliferative vitreoretinopathy. Here we investigate the protein profile...... the eyes were enucleated and the vitreous was removed. The vitreous samples were evaluated with two-dimensional polyacrylamide gel electrophoresis and the differentially expressed proteins were identified with tandem mass spectrometry. Results. Ten protein spots were found to be at least twofold...

Macular Buckling Surgery for Retinal Detachment Associated with Macular Hole in High Myopia Eye

Directory of Open Access Journals (Sweden)

Kenan Sönmez

2017-12-01

Full Text Available A 68-year-old woman presented to our clinic with a 1-month history of central scotoma and visual loss in her right eye. The best corrected visual acuity (BCVA was hand motion in her right eye. Fundus examination showed myopic chorioretinal degeneration in association with posterior staphyloma and the retina was slightly elevated throughout the macula. Optical coherence tomography (OCT revealed retinal detachment involving the posterior pole with a macular hole and staphyloma. The patient underwent pars plana vitrectomy, internal limiting membrane peeling, macular buckling, and perfluoropropane gas tamponade. At 3-month follow-up, her BCVA was improved to counting fingers at 1 meter and flattened retina with closed macular hole was observed by OCT. Myopic macular hole with retinal detachment associated with posterior staphyloma represent a challenge regarding their management and several surgical techniques have been described. Although satisfactory anatomical improvement is achieved in these eyes after surgery, the visual acuity outcomes may be poorer than expected due to the chorioretinal atrophy at the posterior pole.

Spectral domain optical coherence tomography imaging of subretinal bands associated with chronic retinal detachments

OpenAIRE

Kothari, Nikisha; Kuriyan, Ajay E; Flynn, Harry W

2016-01-01

Nikisha Kothari, Ajay E Kuriyan, Harry W Flynn JrDepartment of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAAbstract: We report three patients with subretinal bands associated with retinal detachment in chronic retinal detachments who underwent successful retinal reattachment. Subretinal bands before and after surgery can be identified on clinical examination and spectral domain optical coherence tomography. Removal of subr...

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.

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.

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

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

Directory of Open Access Journals (Sweden)

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.

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.

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

Science.gov (United States)

Zafar, Shakir; Shakir, Munira; Mahmood, Syed Asaad; Amin, Saima; Iqbal, Zafar

2016-01-01

To compare the efficacy and complications of using 1000-centistoke versus 5000-centistoke silicone oil for complex retinal detachment repair. Case series. LRBT Tertiary Eye Hospital, Karachi, from January 2007 to June 2013. 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. 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%); 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 BCVAof 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%) 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. 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.

Clinically undetected retinal breaks causing retinal detachment: A review of options for management.

Science.gov (United States)

Gupta, Deepak; Ching, Jared; Tornambe, Paul E

2017-08-12

The successful detection of retinal breaks is a critical step in rhegmatogenous retinal detachment surgery in order to prevent persistent/recurrent retinal detachments. Not all retinal breaks causing retinal detachments are obvious. Retinal breaks may be obscured by opacities that are either anterior segment related, lens related, or posterior segment related. Rules to identify breaks based on subretinal fluid configuration are more difficult to apply in pseudophakic, aphakic, and scleral buckle encircled eyes-and in eyes with repeat detachments and those with proliferative vitreoretinopathy. Exudative detachments exhibit characteristic features and must be ruled out. A thorough clinical examination preoperatively is important even if a vitrectomy is planned. We review the incidence and causes of undetected breaks, along with preoperative/clinical issues that may hinder break detection. We review the literature with respect to investigative approaches and techniques that are available to the vitreoretinal surgeon when primary breaks remain clinically undetected during the preoperative examination. We broadly divide the surgical approaches into ones where the surgeon utilizes techniques to pursue actively a search for breaks versus adopting a purely speculative approach. Advantages and disadvantages of various techniques are appraised. Intuitively one might argue that an encircling scleral buckle combined with vitrectomy would give higher single operation success than pars plana vitrectomy alone because "undetected" retinal breaks would be addressed by a 360° plombage. We could not confirm this concept. Newer techniques, such as pars plana vitrectomy augmented with dye extrusion or endoscopic-assisted pars plana vitrectomy, show encouraging results. Technological advances such as intraoperative optical coherence tomography will also help to broaden the vitreoretinal surgeon's armamentarium. At this time, there is no gold standard in terms of the recommended

Retinal Detachment

Science.gov (United States)

... to your brain. It provides the sharp, central vision needed for reading, driving, and seeing fine detail. A retinal detachment lifts or pulls the retina from its normal position. It can occur at ...

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)

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

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

Changes in Retinal Function and Cellular Remodeling Following Experimental Retinal Detachment in a Rabbit Model

Directory of Open Access Journals (Sweden)

Tilda Barliya

2017-01-01

Full Text Available Purpose. To explore functional electroretinographic (ERG changes and associated cellular remodeling following experimental retinal detachment in a rabbit model. Methods. Retinal detachment was created in ten rabbits by injecting 0.1 ml balanced salt solution under the retina. Fundus imaging was performed 0, 3, 7, 14, and 21 days postoperatively. ERGs were recorded pre- and 7 and 21 days postoperatively. Eyes were harvested on day 21 and evaluated immunohistochemically (IHC for remodeling of second- and third-order neurons. Results. Retinal reattachment occurred within two weeks following surgery. No attenuation was observed in the photopic or scotopic a- and b-waves. A secondary wavefront on the descending slope of the scotopic b-wave was the only ERG result that was attenuated in detached retinas. IHC demonstrated anatomical changes in both ON and OFF bipolar cells. Bassoon staining was observed in the remodeled dendrites. Amacrine and horizontal cells did not alter, but Muller cells were clearly reactive with marked extension. Conclusion. Retinal detachment and reattachment were associated with functional and anatomical changes. Exploring the significance of the secondary scotopic wavefront and its association with the remodeling of 2nd- and 3rd-order neurons will shade more light on functional changes and recovery of the retina.

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.

Prevention and control of proliferative vitreoretinopathy: primary retinal detachment surgery using silicone oil as a planned two-stage procedure in high-risk cases.

Science.gov (United States)

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.

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.

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.

[Surgical managment of retinal detachment].

Science.gov (United States)

Haritoglou, C; Wolf, A

2015-05-01

The detachment of the neurosensory retina from the underlying retinal pigment epithelium can be related to breaks of the retina allowing vitreous fluid to gain access to the subretinal space, to exudative changes of the choroid such as tumours or inflammatory diseases or to excessive tractional forces exerted by interactions of the collagenous vitreous and the retina. Tractional retinal detachment is usually treated by vitrectomy and exudative detachment can be addressed by treatment of the underlying condition in many cases. In rhegmatogenous retinal detachment two different surgical procedures, vitrectomy and scleral buckling, can be applied for functional and anatomic rehabilitation of our patients. The choice of the surgical procedure is not really standardised and often depends on the experience of the surgeon and other more ocular factors including lens status, the number of retinal breaks, the extent of the detachment and the amount of preexisting PVR. Using both techniques, anatomic success rates of over 90 % can be achieved. Especially in young phakic patients scleral buckling offers the true advantage to prevent the progression of cataract formation requiring cataract extraction and intraocular lens implantation. Therefore, scleral buckling should be considered in selected cases as an alternative surgical option in spite of the very important technical refinements in modern vitrectomy techniques. Georg Thieme Verlag KG Stuttgart · New York.

[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

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.

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).

Measurement of the relative afferent pupillary defect in retinal detachment.

Science.gov (United States)

Bovino, J A; Burton, T C

1980-07-01

A swinging flashlight test and calibrated neutral density filters were used to quantitate the depth of relative afferent pupillary defects in ten patients with retinal detachment. Postoperatively, the pupillary responses returned to normal in seven of nine patients with anatomically successful surgery.

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%.

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.

Retinal detachment and retinal holes in retinitis pigmentosa sine pigmento.

Science.gov (United States)

Csaky, K; Olk, R J; Mahl, C F; Bloom, S M

1991-01-01

Retinal detachment and retinal holes in two family members with retinitis pigmentosa sine pigmento are reported. We believe these are the first such cases reported in the literature. We describe the presenting symptoms and management, including cryotherapy, scleral buckling procedure, and sulfur hexafluoride injection (SF6), resulting in stable visual acuity in one case and retinal reattachment and improved visual acuity in the other case.

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

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.

Scleral buckling procedure with chandelier illumination for pediatric rhegmatogenous retinal detachment

Directory of Open Access Journals (Sweden)

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

Primary Repair of Moderate Severity Rhegmatogenous Retinal Detachment: A Critical Decision-Making Algorithm.

Science.gov (United States)

Velez-Montoya, Raul; Jacobo-Oceguera, Paola; Flores-Preciado, Javier; Dalma-Weiszhausz, Jose; Guerrero-Naranjo, Jose; Salcedo-Villanueva, Guillermo; Garcia-Aguirre, Gerardo; Fromow-Guerra, Jans; Morales-Canton, Virgilio

2016-01-01

We reviewed all the available data regarding the current management of non-complex rhegmatogenous retinal detachment and aimed to propose a new decision-making algorithm aimed to improve the single surgery success rate for mid-severity rhegmatogenous retinal detachment. An online review of the Pubmed database was performed. We searched for all available manuscripts about the anatomical and functional outcomes after the surgical management, by either scleral buckle or primary pars plana vitrectomy, of retinal detachment. The search was limited to articles published from January 1995 to December 2015. All articles obtained from the search were carefully screened and their references were manually reviewed for additional relevant data. Our search specifically focused on preoperative clinical data that were associated with the surgical outcomes. After categorizing the available data according to their level of evidence, with randomized-controlled clinical trials as the highest possible level of evidence, followed by retrospective studies, and retrospective case series as the lowest level of evidence, we proceeded to design a logical decision-making algorithm, enhanced by our experiences as retinal surgeons. A total of 7 randomized-controlled clinical trials, 19 retrospective studies, and 9 case series were considered. Additional articles were also included in order to support the observations further. Rhegmatogenous retinal detachment is a potentially blinding disorder. Its surgical management seems to depend more on a surgeon´s preference than solid scientific data or is based on a good clinical history and examination. The algorithms proposed herein strive to offer a more rational approach to improve both anatomical and functional outcomes after the first surgery.

[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.

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.

Optical coherence tomography can be used in evaluation of morphological and functional results after successful rhegmatogenous retinal detachment surgery with different tamponade agents

Directory of Open Access Journals (Sweden)

Tat'yana Andreevna Avanesova

2015-03-01

Full Text Available Background: Optical coherence tomography (OCT findings are helpful in assessing the cause of reduced visual acuity (VA after successful rhegmatogenous retinal detachment (RRD surgery. Objective: To study anatomical and functional results after successful RRD surgery with gas-air mixture or silicone oil (SO tamponade using OCT. Materials and methods. 70 patients were divided into 2 groups: group I (n = 34 - gas-air mixture tamponade; group II (n = 36 - SO tamponade. At baseline, were no significant differences by gender, age and VA between the groups. Follow-up was 12 months after the surgery. OCT was performed with the Cirrus HD-OCT 4000, CARL ZEISS MEDITEC, USA. Results: VA increased significantly in both groups. Regression analysis showed lower VA in group II and statistically significant association between VA and IS/OS and ELM defects. Сonclusions. There is a strong association of disruption of the IS/OS and ELM with reduced vision after successful retinal detachment surgery. Gas-air mixture tamponade showed some benefits in comparison with SO tamponade.

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.

Primary 25-gauge transconjunctival sutureless vitrectomy in pseudophakic retinal detachment

Directory of Open Access Journals (Sweden)

Horozoglu Fatih

2007-01-01

Full Text Available Aims: There are few reports on 25-gauge transconjunctival sutureless vitrectomy (TSV in cases of pseudophakic retinal detachment. We conducted this study to report the anatomic and functional outcomes of 25-gauge TSV in the treatment of primary pseudophakic retinal detachment (RD. Design: Prospective, interventional case series. Materials and Methods: Fifteen eyes of 15 patients with RD after cataract surgery with phacoemulsification were evaluated. Primary pseudophakic RDs with macular detachment and proliferative vitreoretinopathy Stage B or less were included in the study. Pars plana vitrectomy with the 25-gauge TSV system, perfluorocarbon liquid injection followed by air exchange, endolaser photocoagulation and sulfur hexafluoride gas (20% injection were applied to all eyes. Results: Mean follow-up time was 9.2 months (range, six to 12 months. Retinal reattachment with a single operation was achieved in 93% of eyes and with additional surgery, the retina was reattached in 100% of eyes. Preoperative visual acuity was less than 20/200 in all eyes (range, hand motions to 20/400. Postoperative visual acuity was 20/40 or better in eight eyes (53% and between 20/50 and 20/200 in seven eyes (47%. No severe hypotony was encountered and no sutures were required to close the scleral and conjunctival openings. Postoperative complications were macular pucker in one eye (7% and cystoid macular edema in another eye (7%. Conclusions: Primary 25-gauge TSV system appears to be an effective and safe procedure in the treatment of uncomplicated pseudophakic RD.

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

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.

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.

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

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

[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.

[Paediatric retinal detachment and hereditary vitreoretinal disorders].

Science.gov (United States)

Meier, P

2013-09-01

The number of retinal detachments in children is very low in comparison to the number in adults. One predisposing factor for development of paediatric retinal detachment is suffering from hereditary vitreoretinal degeneration (e.g., Stickler syndrome, Wagner syndrome, Kniest dysplasia, familial exudative vitreoretinopathy, congenital X-linked retinoschisis, Knobloch syndrome, incontinentia pigmenti, Norrie disease). Hereditary vitreoretinopathies are characterised by an abnormal-appearing vitreous gel with associated retinal changes. In most of these eyes further ocular abnormalities can be diagnosed. A group of hereditary disorders is associated with characteristic systemic abnormalities. Allied conditions should be considered in the clinical diagnosis. Vitreoretinopathies are the most common cause of inherited retinal detachment. In most eyes primary vitrectomy is necessary, and disease-specific surgical treatment is discussed. Georg Thieme Verlag KG Stuttgart · New York.

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

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.

Repair of Total Tractional Retinal Detachment in Norrie Disease: Report of Technique and Successful Surgical Outcome.

Science.gov (United States)

Todorich, Bozho; Thanos, Aristomenis; Yonekawa, Yoshihiro; Capone, Antonio

2017-03-01

Norrie disease is a rare, but devastating cause of pediatric retinal detachment, universally portending a poor visual prognosis. This paper describes successful surgical management of an infant with total retinal detachment associated with Norrie disease mutation. The infant was a full-term white male who presented with bilateral total funnel retinal detachments (RDs). He underwent genetic testing, which demonstrated single-point mutation 133 G>A transition in exon 2 of the NDP gene. The retinal detachment was managed with translimbal iridectomy, lensectomy, capsulectomy, and vitrectomy. Careful dissection of the retrolental membranes resulted in opening of the funnel. Single-stage surgery in this child's eye achieved re-attachment of the posterior pole with progressive reabsorption of subretinal fluid and cholesterol without the need for external drainage. Fluorescein angiography, performed at 2 months postoperatively, demonstrated perfusion of major vascular arcades, but with significant abnormalities and aneurysmal changes of higher-order vessels, suggestive of retinal and vascular dysplasia. The child has maintained brisk light perception vision. Early surgical intervention with careful dissection of tractional tissues can potentially result in good anatomic outcomes in some patients with Norrie disease-associated retinal detachment. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:260-262.]. Copyright 2017, SLACK Incorporated.

Retinal detachment in black South Africans

African Journals Online (AJOL)

low incidence of retinal detachment in black patients is not known. ... a retinal break. Predisposing factors include peripheral retinal degenerations, myopia, aphakia and trauma. Delay in presentation increases the difficulty in achieving adequate surgical ... On examination, note was taken of the visual acuity in both eyes, the ...

Rhegmatogenous Retinal Detachment Associated with Choroidal Detachment

Directory of Open Access Journals (Sweden)

L. Sh. Bilandarli

2017-01-01

Full Text Available Review describes the theme of rhegmatogenous retinal dеtаchment associated with choroidal separation. It is rare, but quite severe eye pathology. In most cases it has a very poor prognosis. Most authors consider the retinal detachment as a primary pathogenetic part, which decompensates the production of aqueous humor by increasing the absorptive surface of the retinal pigment epithelium. Dilatation of choroidal arterioles occurs in hypotension, it leads to extravasation of protein-rich fluid in the choroidal and the suprachoroidal space. This helps to further swelling and separation of the ciliary body and the choroid with reduced production of aqueous humor and progressive hypotension. There is a high risk of developing “retino-choroidal” separation in patients with macular rupture due to localization of retinal separation and rupture rear hyaloid membrane. The protein level in aqueous humor can be increased to 70 times. It may be a result of reflux of suprachoroidal proteins through uveoscleral route and / or venous proteins through the trabecular network. In addition, the diffusion of proteins from the posterior camera and vitreous cavity is possible. This creates favorable conditions for cell proliferation that can lead to postoperative proliferative vitreoretinopathy. Typically patients have a pronounced signs of inflammation, pain, and “red eye”, which is accompanied with vision decrement. Rhegmatogenous retinal reparationcan be associated with such clinical symptoms as severe panuveit, deepening of the anterior camera and the inflammatory response in the moisture, concentric wrinkles and sagging back of the iris, posterior synechia, iridofakodenez, blurred vitreous detachment of the ciliary body, hypotension, and choroidal and retinal detachment in addition. Debatableness of etiopathogenesis and a clinical picture, which is similar to other eye diseases create significant difficulties in early diagnosis and proper treatment of

Perfluorocarbon in vitreoretinal surgery and preoperative bevacizumab in diabetic tractional retinal detachment

Institute of Scientific and Technical Information of China (English)

J; Fernando; Arevalo; Martin; A; Serrano; Juan; D; Arias

2014-01-01

AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival sutureless vitrectomy) in eyes with advancedproliferative diabetic retinopathy(PDR) with tractionalretinal detachment(TRD).METHODS: This is a prospective, interventional caseseries. Participants included 114(eyes) with advancedproliferative diabetic retinopathy and TRD. EBPD wasperformed in 114 eyes(consecutive patients) during23-gauge vitrectomy with the utilization of preoperativebevacizumab(1.25 mg/-0.05 mL). Patients mean age was 45 years(range, 21-85 years). Surgical time had a mean of 55 min(Range, 25-85 min). Mean follow up of this group of patients was 24 mo(range, 12-32 mo). Main outcome measures included best-corrected visual acuity(BCVA), retinal reattachment, and complications.RESULTS: Anatomic success occurred in 100%(114/-114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study(ETDRS) lines] was obtained in 69.2%(79/-114), in 26 eyes(22.8%) BCVA remained stable, and in 8 eyes(7%) BCVA decreased(≥ 2 ETDRS lines). Final BCVA was 20/-50 or better in 24% of eyes, between 20/-60 and 20/-400 in 46% of eyes, and worse than 20/-400 in 30% of eyes. Complications included cataract in 32(28%) eyes, iatrogenic retinal breaks in 9(7.8%) eyes, vitreous hemorrhage requiring another procedure in 7(6.1%) eyes, and phthisis bulbi in 1(0.9%) eye.CONCLUSION: This study demonstrates the usefulne-ss of using preoperative intravitreal bevacizumab and EBPD during smallgauge vitreoretinal surgery in eyes with TRD in PDR.

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

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.

Exudative Retinal Detachment Treatment in a Patient with Thrombotic Thrombocytopenic Purpura

Directory of Open Access Journals (Sweden)

Magali Sampo

2016-02-01

Full Text Available Purpose: We report a case of unilateral exudative retinal detachment in a patient with thrombotic thrombocytopenic purpura (TTP, without associated hypertension, successfully treated with plasmapheresis. Case Report: A 46-year-old woman with a medical history of TTP presented with unilateral exudative retinal detachment. Biological and radiological assessment eliminated other causes of exudative retinal detachment, including hypertension. Plasma exchange was performed, followed by a rapid improvement in visual acuity and total disappearance of serous detachment. Conclusion: Exudative unilateral retinal detachment is a rare complication of TTP and can be successfully treated by plasma exchange.

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.

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.

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.

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.

Reoperation for rhegmatogenous retinal detachment as quality indicator for disease management:

DEFF Research Database (Denmark)

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

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...

Outcomes in bullous retinal detachment

Directory of Open Access Journals (Sweden)

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.

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...

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%).

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

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.

Posterior vitreous detachment - prevalence of and risk factors for retinal tears

Directory of Open Access Journals (Sweden)

Bond-Taylor M

2017-09-01

Full Text Available Martin Bond-Taylor,1 Gunnar Jakobsson,1,2 Madeleine Zetterberg1,2 1Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, 2Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden Purpose: The present study aimed to describe clinical characteristics of patients with posterior vitreous detachment (PVD, to determine the prevalence of retinal tears in PVD patients, and to find predictors for retinal tears in this patient group. Methods: Retrospective analysis of medical records on patients diagnosed with PVD, retinal tears, or vitreous hemorrhage at the Department of Ophthalmology at Sahlgrenska University Hospital, a tertiary eye center. Results: Between February and July 2009, 365 patients consulted the Department of Ophthalmology for PVD-related symptoms. The incidence of retinal tears was 14.5% (n=53 and that of vitreous and/or retinal hemorrhage was 22.7% (n=83. For analysis of possible predictors for complications to PVD, patients diagnosed with retinal tears or vitreous hemorrhage between May and July 2009 were also included in the study, resulting in a total of 426 patients. Predictors of a retinal tear were symptoms of visual impairment (P=0.024, the presence of vitreous or retinal hemorrhage at examination (P<0.001, and a duration of symptoms for <24 hours (P=0.004. Symptoms of flashes did not constitute an extra risk of retinal tears (P=0.135. Subsequent retinal pathology (follow-up time 4.5 years, including vitreous detachment/hemorrhage or retinal tears/detachment, occurred more often in patients presenting with a retinal tear. For patients with a retinal tear, the relative risk of having a retinal detachment in the same eye during the follow-up time was 17.7 when compared to patients without a retinal tear (risk ratio 17.7, 95% confidence interval 2.2–145. Conclusion: Patients seeking care on the first day have a

Pars plana vitrectomy compared with pars plana vitrectomy combined with scleral buckle in the primary management of noncomplex rhegmatogenous retinal detachment.

Science.gov (United States)

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

Long-term effects of short-term retinal bleb detachments in rabbits.

Science.gov (United States)

Ivert, Lena; Kjeldbye, Hild; Gouras, Peter

2002-03-01

To examine the effects of saline-induced bleb detachments in rabbit retina. Retinal bleb detachments were produced by the injection of 50 microl of balanced salt solution (BSS) into the subretinal space of one eye of each of six rabbits using a glass pipette with a flat tip, 50 microm in diameter. The retina was examined by biomicroscopy, scanning laser ophthalmoscopy (SLO), auto-fluorescence and simultaneous fluorescein and indocyanine green (ICG) angiography. Histological examination was carried out at 1, 2, 3 and 4 months after surgery. All rabbits showed leakage of fluorescein for at least a day after detachment, but within 1 month the leakage ceased. ICG staining developed gradually at the level of the RPE or Bruch's membrane near sites of previous staining. Lipofuscin fluorescence also developed gradually around areas of staining. Histology revealed the source of the excessive lipofuscin to be in the RPE layer, especially in cells migrating away from Bruch's membrane. Short-term bleb detachments cause a transient breakdown in the blood-retinal barrier, long-term ICG staining at or deep to the RPE layer, hyperlipofuscinosis and migration of the RPE. The abnormal lipofuscin accumulation is apparent on fluorescence ophthalmoscopy and can be confused with markers such as green fluorescent protein.

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.

A chick model of retinal detachment: cone rich and novel.

Directory of Open Access Journals (Sweden)

Colleen M Cebulla

Full Text Available 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.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.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.

INTERNAL LIMITING MEMBRANE PEELING-DEPENDENT RETINAL STRUCTURAL CHANGES AFTER VITRECTOMY IN RHEGMATOGENOUS RETINAL DETACHMENT.

Science.gov (United States)

Hisatomi, Toshio; Tachibana, Takashi; Notomi, Shoji; Koyanagi, Yoshito; Murakami, Yusuke; Takeda, Atsunobu; Ikeda, Yasuhiro; Yoshida, Shigeo; Enaida, Hiroshi; Murata, Toshinori; Sakamoto, Taiji; Sonoda, Koh-Hei; Ishibashi, Tatsuro

2018-03-01

To examine retinal changes after vitrectomy with internal limiting membrane (ILM) peeling, we used 3-dimensional optical coherence tomography (3D-OCT) in rhegmatogenous retinal detachment cases. The 68 eyes from 67 patients with rhegmatogenous retinal detachment were studied, including 35 detached macula cases (51%) and 33 attached macula cases. Internal limiting membrane peeling was performed with fine forceps after brilliant blue G staining. The 3D-OCT images were obtained with volume-rendering technologies from cross-sectional OCT images. The 3D-OCT detected 45 eyes (66%) with ILM peeling-dependent retinal changes, including dissociated optic nerve fiber layer appearance, dimple sign, temporal macular thinning, ILM peeling area thinning, or forceps-related retinal thinning. The ILM peeled area was detectable in only 9 eyes with 3D-OCT, whereas it was undetectable in other 59 eyes. The dissociated optic nerve fiber layer appearance was detected in 8 of the total cases (12%), and dimple signs were observed in 14 cases (21%). Forceps-related thinning was also noted in eight cases (24%) of attached macula cases and in four cases (11%) of detached macula cases. No postoperative macular pucker was noted in the observational period. The 3D-OCT clearly revealed spatial and time-dependent retinal changes after ILM peeling. The changes occurred in 2 months and remained thereafter.

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.

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

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.

Pseudophakic retinal detachment in young-aged patients.

Directory of Open Access Journals (Sweden)

Thomas Laube

Full Text Available To investigate the incidence and risk factors for retinal detachment (RD after cataract surgery or refractive lens exchange (RLE in patients aged below 61 years.Retrospective medical chart review of 7,886 patients (13,925 eyes who underwent cataract surgery or RLE. Patients aged below 61 years were selected. Age, gender, axial length, follow-up times, and the occurrence of RD were recorded. Additional characteristics documented for RD cases were: history of RD, preexisting retinal findings, laser capsulotomy, status of macula at RD, date and details of RD.From a total of 421 patients (677 eyes aged below 61 years 24 cases of RD were identified, resulting in an overall cumulative incidence per eyes of 3.55%. The mean follow-up time was 45 ± 32.8 months. Ninety-two % of all RDs occurred within 3.6 years from surgery. Axial length had a significant effect on the risk of RD after cataract/ RLE surgery (HR = 1.42, P = 0.0001, 95% CI 1.19-1.69. The highest incidence of RD occurred in the subgroup of 25 to 28.9 mm axial length (10.2%. With an increase in age of ten years, the hazard of postoperative RD was not significantly increased by a factor of 1.50 (P = 0.286, 95% CI 0.71-3.15. The highest incidence of RD occurred in patients aged 50-54 years (5.39%. Compared to females, males had an almost twofold not significant risk of postoperative RD (HR = 1.96, P = 0.123, 95% CI 0.83-4.63. None of the RD cases had a history of RD.Axial length is a significant risk factor for pseudophakic RD. The need for cataract surgery or RLE should be carefully considered in patients with axial lengths between 25 and 29 mm, aged 50-54 years, in males, and in case of preexisting retinal findings.

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.

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

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.

The efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment.

Science.gov (United States)

Jang, Ji Hye; Kim, Yu Cheol; Kim, Kwang Soo

2009-12-01

This study was designed to evaluate the efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment. We retrospectively reviewed the records of 33 consecutive patients (35 eyes) who underwent fluid-gas exchange treatment for postvitrectomy retinal detachment using the two-needle pars plana approach technique. The retinal reattachment rate was 80.0% after complete intravitreal gas disappearance following the fluid-gas exchange; the overall success rate was 65.7%. Visual acuity was improved or stable in 80.0% of cases; a two-line or greater vision improvement or a best-corrected visual acuity of 0.4 or better occurred in 62.9% of cases. The success rates for superior retinal detachments and posterior pole retinal detachments were 76.5% and 85.7%, respectively. Fluid-gas exchange represents a simple and cost-effective alternative outpatient procedure for retinal reattachment without reoperation for the treatment of superior and posterior pole retinal detachments.

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

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

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.

Massive Bilateral Serous Retinal Detachment in a Case of Hypertensive Chorioretinopathy

Directory of Open Access Journals (Sweden)

Luis Villalba-Pinto

2014-07-01

Full Text Available Introduction: Systemic high blood pressure is related to a variety of retinal manifestations. We present an atypical case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment. Case Report: A 26-year-old male with a genitourinary malformation and secondary grade IV chronic kidney failure as well as high blood pressure complained of acute vision loss. Dilated fundus examination evidenced a bilateral serous retinal detachment with macular involvement. The patient was unresponsive to oral antihypertensive therapy and dialysis treatment. The serous retinal detachment progressively decreased after the restoration of dialysis and antihypertensive therapy. The final visual acuity was 0.50 in both eyes. Discussion: In cases of serous macular detachment, it is mandatory to rule out different systemic and ocular diseases. The presence of uncontrolled high blood pressure may produce aggressive bilateral retinal changes, thus hypertension must be under early and strict control in order to improve the visual outcomes.

Massive Bilateral Serous Retinal Detachment in a Case of Hypertensive Chorioretinopathy

Science.gov (United States)

Villalba-Pinto, Luis; Hernández-Ortega, M. Ángeles; de los Mozos, F. Javier Lavid; Pascual-Camps, Isabel; Dolz-Marco, Rosa; Arevalo, J. Fernando; Gallego-Pinazo, Roberto

2014-01-01

Introduction Systemic high blood pressure is related to a variety of retinal manifestations. We present an atypical case of hypertensive chorioretinopathy with massive bilateral serous retinal detachment. Case Report A 26-year-old male with a genitourinary malformation and secondary grade IV chronic kidney failure as well as high blood pressure complained of acute vision loss. Dilated fundus examination evidenced a bilateral serous retinal detachment with macular involvement. The patient was unresponsive to oral antihypertensive therapy and dialysis treatment. The serous retinal detachment progressively decreased after the restoration of dialysis and antihypertensive therapy. The final visual acuity was 0.50 in both eyes. Discussion In cases of serous macular detachment, it is mandatory to rule out different systemic and ocular diseases. The presence of uncontrolled high blood pressure may produce aggressive bilateral retinal changes, thus hypertension must be under early and strict control in order to improve the visual outcomes. PMID:25120474

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.

[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)

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.

Outcomes of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration.

Science.gov (United States)

Hwang, John; Escariao, Paulo; Iranmanesh, Reza; Tosi, Gian Marco; Chang, Stanley

2007-01-01

To assess the outcome of macular hole surgery in patients treated intraoperatively for retinal breaks and/or lattice degeneration. Retrospective review of patients who underwent macular hole surgery from September 1998 to August 2005. Outcomes in eyes that received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration were compared to outcomes in a case-matched control group without retinal breaks or lattice degeneration. A total of 235 consecutive macular hole surgery cases were reviewed. Twenty-four eyes from 24 patients received intraoperative endolaser photocoagulation for retinal breaks and/or lattice degeneration. Macular hole closure occurred in all case and control eyes without any incidence of postoperative retinal detachment. Best-corrected visual acuity improvement of at least three Snellen lines occurred in 100% of case eyes and 92% of control eyes. Outcomes of macular hole surgery in patients with retinal breaks and/or lattice degeneration are similar to outcomes in the overall population when these conditions are treated with intraoperative endolaser photocoagulation. Postoperative retinal detachment does not appear to be correlated with treated retinal tears and greater attention should focus on detecting and managing intraoperative breaks. In our hands, routine use panoramic viewing has replaced indirect ophthalmoscopy, by saving time, and reducing the risk of contamination.

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

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

[Factors related to intraoperative retinal breaks in macular hole surgery].

Science.gov (United States)

Kumagai, K; Ogino, N; Demizu, S; Atsumi, K; Kurihara, H; Iwaki, M; Ishigooka, H; Tachi, N

2001-02-01

To evaluate the factors of intraoperative retinal breaks in macular hole surgery. This study included 558 eyes of 506 patients who underwent idiopathic macular hole surgery by one surgeon. Multiple regression was performed using the variables of gender, age, affected eye, lens status, stage, duration of symptoms, hole size, axial length, and lattice degeneration. The rate of retinal breaks was higher in stage 3 (16.0%) than in stage 4 (8.2%) (p = 0.014). In eyes with lattice degeneration intraoperative retinal breaks occurred in about 40% of the cases. Major factors were as follows: lattice degeneration (r = 0.24, p lattice degeneration, and gender (r = -0.18, p = 0.035) in eyes of stage 4 without lattice degeneration. The factors of intraoperative retinal breaks in macular hole surgery were lattice degeneration in all eyes and stage 3 in eyes without lattice degeneration. The high incidence of intraoperative retinal breaks in stage 3 was mainly due to the occurrence of posterior vitreous detachment. Male gender was a significant factor associated with intraoperative retinal breaks.

Retinal detachment repair

Science.gov (United States)

... medicines Problems breathing You may not recover full vision. ... detachments can be repaired. Failure to repair the retina always results in loss of vision to some degree. After surgery, the quality of ...

The Safety and Efficacy of Adjustable Postoperative Position after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

OpenAIRE

Lin, Zhong; Sun, Jin Tao; Wu, Rong Han; Moonasar, Nived; Zhou, Ye Hui

2017-01-01

Purpose. To report the safety and efficacy of adjustable postoperative position for rhegmatogenous retinal detachment (RRD). Methods. Retrospective review of 536 consecutive RRD eyes that underwent vitrectomy surgery for retina repair from year 2008 to 2014. The retinal breaks were divided into superior, lateral (nasal, temporal, and macular), and inferior locations, according to the clock of breaks. Patients with superior and lateral break location were allowed to have facedown position or l...

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

Science.gov (United States)

Cheema, Rizwan A; Al-Khars, Wajeeha; Al-Askar, 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.

[Internal limiting membrane peeling as prophylaxis of epimacular membrane formation in eyes undergoing vitrectomy for rhegmatogenous retinal detachement].

Science.gov (United States)

Hejsek, L; Dusová, J; Stepanov, A; Rozsíval, P

2014-06-01

Rhegmatogenous retinal detachment is a serious condition that can significantly impair visual function, even after a successful surgery. One of the complications that can significantly impair visual acuity in the postoperative period is a development of the epimacular membrane (ERM). The aim of this work is to monitor the effect of peeling of the internal limiting membrane (ILM) in the macula at the anatomical and functional results in the postoperative period, especially with regard to the development of ERM. Prospective study of 21 eyes, which underwent peeling of ILM during pars plana vitrectomy for rhegmatogenous retinal detachment (on detached macula). The ILM peeling was done without using decalin during this procedure. We tested best corrected visual acuity (BCVA) and followed fundus biomicroscopic findings. Proliferative vitreoretinopathy (PVR) was evaluated according to the recommendations of the Retina Society Terminology Committee. To exclude the development of ERM in the macula optical coherence tomography (OCT) was performed at the end of the 18-month follow-up period. In total, the results of 21 eyes of 21 patients who underwent PPV for rhegmatogenous retinal detachment were evaluated. In all of them was during PPV performed ILM peeling on detached macula, these are followed prospectively. ILM peeling without using decalin was sufficient in all eyes. All eyes with ILM peeling did not develop ERM at the end of the follow-up period. ILM peeling during PPV for rhegmatogenous retinal detachment reduces the risk of developing secondary ERM.

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

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.

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

Rhegmatogenous retinal detachments associated to Stickler syndrome in a tertiary eye care center in Saudi Arabia

Directory of Open Access Journals (Sweden)

Alshahrani ST

2015-12-01

Full Text Available Saeed T Alshahrani,1 Nicola G Ghazi,2 Saba Al-Rashaed2 1Ophthalmology Department, King Fahad Specialist Hospital, Dammam, 2Vitreoretinal Department, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia Purpose: To investigate the clinical findings and outcomes of rhegmatogenous retinal detachment (RRD in Stickler syndrome on affected and fellow eyes that underwent prophylactic retinopexy.Patients and methods: Chart review of 70 eyes (62 patients. Incidence of RRD, postoperative visual acuity, and risk factors were evaluated.Results: Twenty-two patients (35% had RRD in the fellow eye, 37% of the eyes had cataract, 93% had macular detachment, 50% had proliferative vitreoretinopathy, and 41% had posterior vitreous detachment. Success rates were: 60% of patients after scleral buckling; 57.1% after pars plana vitrectomy; and 75% after combined scleral buckling and pars plana vitrectomy. Sixty-one (93.8% of patients had successful surgery (including second surgery. Silicone oil tamponade was significantly associated with final anatomic outcome, with a protective odds ratio of 0.11 (P=0.027. Visual acuity improved in 54% of eyes and decreased in 5%. Statistically significant associations were present for eyes with final visual acuity ≥20/200, and total retinal detachment (P<0.001; preoperative cataract (P=0.023; and proliferative vitreoretinopathy (P<0.001. RRD developed in 16/44 eyes despite laser prophylaxis.Conclusion: Prophylactic retinopexy was not beneficial for Stickler syndrome patients. Success of primary surgery for RRD remains low. The primary surgery should be vitrectomy combined with scleral buckling and silicone oil tamponade. Keywords: Stickler syndrome, retinopexy, Gulf States, Saudi Arabia, ocular genetics, arthro-ophthalmopathy, collagen disorder

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 peeling group and was significantly higher 12 months postoperatively (P = 0.03). Internal limiting membrane peeling seems to prevent the occurrence of a postoperative ERM in patients with primary rhegmatogenous retinal detachment.

Effects of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment.

Science.gov (United States)

Blanco-Teijeiro, María José; Bande Rodriguez, Manuel; Mansilla Cuñarro, Raquel; Paniagua Fernández, Laura; Ruiz-Oliva Ruiz, Francisco; Piñeiro Ces, Antonio

2018-03-01

To determine the effectiveness of internal limiting membrane peeling during vitrectomy for macula-off primary rhegmatogenous retinal detachment in the prevention of postoperative epiretinal membrane formation and achievement of good visual outcomes and to identify preoperative and intraoperative risk factors for epiretinal membrane formation. We retrospectively analyzed data from 62 eyes of 62 consecutive patients with macula-off primary rhegmatogenous retinal detachment who underwent vitrectomy with (n = 30) or without (n = 32) internal limiting membrane peeling between January 2014 and March 2016 and were followed up for at least 12 months. The effects of internal limiting membrane peeling on visual outcomes and postoperative recovery of the macular structure were determined. We subsequently divided patients into an epiretinal membrane group and a non-epiretinal membrane group and assessed the effects of various preoperative and intraoperative factors on postoperative epiretinal membrane formation. Postoperative epiretinal membrane developed in 10 patients in the no internal limiting membrane peeling group and three patients in the internal limiting membrane peeling group. Postoperative visual acuity significantly improved in both groups. Epiretinal membrane formation was found to be correlated with a higher number of retinal breaks. Our results suggest that internal limiting membrane peeling during macula-off primary rhegmatogenous retinal detachment surgery can reduce the occurrence of postoperative epiretinal membrane, is safe, and results in favorable visual outcomes.

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.

[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.

Adenocarcinoma of the lung presenting as retinal detachment

Directory of Open Access Journals (Sweden)

Kaushik Saha

2014-01-01

Full Text Available Retinal detachment is a rare presentation of lung cancer. A young female presented with blurring of vision in her right eye for the last 10 days without any history of trauma. On indirect ophthalmoscopy, there was a presence of right sided retinal detachment which was treated with oral prednisolone (60 mg/day. After 1 month of continuous treatment, she came back with dry cough left sided chest pain and deterioration of her eye symptoms. Chest X-ray showed left lung mass. Computed tomography guided fine needle aspiration cytology and with immunohistochemistry confirmed adenocarcinoma of the lung. She was treated with 6 cycles of chemotherapy with paclitaxel and gemcitabine.

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.

Retrobulbar optic neuritis and rhegmatogenous retinal detachment in a fourteen-year-old girl with retinitis pigmentosa sine pigmento.

Science.gov (United States)

Hatta, M; Hayasaka, S; Kato, T; Kadoi, C

2000-01-01

A 14-year-old girl complained of a sudden decrease in right visual acuity. The patient had night blindness, a mottled retina but no pigments, extinguished scotopic electroretinographic response, central scotoma in the right eye and rhegmatogenous retinal detachment. She had initially received laser photocoagulation around the retinal tear and then corticosteroid therapy, cryoretinopexy and segmental buckling. Her right visual acuity increased to 1.0. The association of retinitis pigmentosa sine pigmento, retrobulbar optic neuritis and rhegmatogenous retinal detachment, as demonstrated in our patient, may be uncommon. Copyright 2000 S. Karger AG, Basel

Scleral Buckling Versus Primary Vitrectomy in the Management of Retinal Detachment Associated with Mild Vitreous Hemorrhage

Directory of Open Access Journals (Sweden)

Tansu Erakgün

2014-03-01

Full Text Available Objectives: The aim of this study was to compare the surgical impact of scleral buckling (SB and pars plana vitrectomy (PPV on the anatomic results and visual recovery in cases of rhegmatogenous retinal detachment with mild vitreous hemorrhage. Materials and Methods: In this study, we included 78 eyes of 78 phakic patients who underwent primary surgery for rhegmatogenous retinal detachment complicated by mild vitreous hemorrhage (38 eyes by SB,40 eyes by PPV;all patients had been followed for longer than 6 months after surgery. The surgical outcome and the rate of complications were retrospectively compared. Mann-Whitney U-test and chi-square test were used for the statistical analysis. Results: The reattachment rate after the first surgery was 78.9% (30/38 in the SB group and 95% (38/40 in the PPV group. The difference between the groups was statistically significant (p=0.035. Unseen retinal breaks in 4 eyes, malpositioned buckle in 2 eyes and insufficient closure of the break in 2 eyes of SB cases, as well as reopening of the original break in 2 eyes of PPV cases were the causes of failure. Visual improvement in the PPV group was significantly better than in the SB group in the third and sixth postoperative months (p<0.001 and p=0.026, respectively. Peroperative and postoperative complications were as follows: in the SB group-subretinal hemorrhage (5.2%, PVR of grade B or worse (10.5%, macular pucker (7.8%, and postoperative cataract (13%; in the PPV groupiatrogenic breaks (10%, lens damage (5%, PVR of grade B or worse (5%,macular pucker (5%, and postoperative cataract (35%. Conclusion: Even though the high incidence of peroperative complications such as iatrogenic breaks or postoperative complications such as cataract formation was the major drawback, the results indicate that PPV performed to alleviate peripheral vitreoretinal tractions and clear vitreous hemorrhage offers better anatomic and functional results than SB in the management of

Risk of serous retinal detachment in patients with end-stage renal disease on dialysis.

Directory of Open Access Journals (Sweden)

Yuh-Shin Chang

Full Text Available The aim of this retrospective, nationwide, matched cohort study was to investigate the association of serous retinal detachment with having end-stage renal disease (ESRD while on dialysis. The cohort study included 94,024 patients with ESRD on dialysis registered between January 2000 to December 2009 in the Taiwan National Health Insurance Research Database. An age- and sex-matched control group comprised 94,024 patients selected from the Taiwan Longitudinal Health Insurance Database 2000. Information for each patient was collected from the index date until December 2011. Twenty-seven ESRD patients and 11 controls developed serous retinal detachment (P < 0.001 during follow-up, demonstrating a significantly increased risk of serous retinal detachment in patients with ESRD on dialysis compared with controls (incidence rate ratio = 3.39, 95% confidence interval [CI] = 1.68-6.83. After adjustment for potential confounders, patients were 3.86 times more likely to develop serous retinal detachment than the full cohort (adjusted HR = 3.86, 95% CI = 1.15-12.96. In conclusion, patients with ESRD on dialysis demonstrate an increased risk of serous retinal detachment. Interdisciplinary collaboration between nephrologists and ophthalmologists is important to deal with serous retinal detachment in patients with ESRD on dialysis and prevent impairments of visual acuity.

Incidence rates of surgically treated rhegmatogenous retinal detachment among manual workers, non-manual workers and housewives in Tuscany, Italy

OpenAIRE

Curti, Stefania; Coggon, David; Baldasseroni, Alberto; Cooke, Robin M. T.; Fresina, Michela; Campos, Emilio C.; Semeraro, Francesco; Zanardi, Francesca; Farioli, Andrea; Violante, Francesco S.; Mattioli, Stefano

2013-01-01

Purpose Candidate risk factors for idiopathic rhegmatogenous retinal detachment (RRD) include heavy manual handling (requiring Valsalva’s maneuver). We assessed incidence rates of surgically treated idiopathic RRD among manual workers, non-manual workers and housewives resident in Tuscany, Italy. Methods We retrieved all hospital discharge records bearing a principal diagnosis corresponding to RRD coupled with retinal surgery for any resident of Tuscany during 1997–2009. After elimination of ...

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.

Time course of development of posterior vitreous detachments after phacoemulsification surgery.

Science.gov (United States)

Hikichi, Taiichi

2012-10-01

To determine when posterior vitreous detachments (PVDs) develop after phacoemulsification and aspiration combined with foldable intraocular lens implantation. Prospective, consecutive case series. A total of 575 eyes without a PVD preoperatively were studied prospectively and followed for 3 years after uneventful phacoemulsification surgery. All patients underwent a comprehensive ocular examination, including a dynamic vitreous examination using biomicroscopy with and without a preset lens and a preoperative retinal examination on the day of surgery; the day postoperatively; 1 week and 1, 3, 6, and 12 months postoperatively; and every 6 months for 3 years postoperatively. The patients were divided into groups and analyzed on the basis of age and refractive error or axial length. The cumulative incidence rates of eyes that developed PVD for 3 years postoperatively at each postoperative time point. The cumulative numbers and percentages of eyes that developed a PVD were 6 (1.0%), 18 (3.1%), 31 (5.4%), 45 (7.8%), 63 (11.0%), 88 (15.3%), 106 (18.4%), 133 (23.1%), and 172 (30.0%) within 1 week and 1, 3, 6, 12, 18, 24, 30, and 36 months, respectively. Eleven (6.4%) of the 172 eyes in which a PVD developed during the follow-up period had new retinal breaks with or without a retinal detachment. Eight (15.4%) of 52 eyes with lattice degeneration and 3 (2.5%) of 120 eyes without lattice degeneration had retinal breaks associated with a PVD; these percentages were significant (P = 0.003). Development of PVDs seems to accelerate after phacoemulsification and linearly accumulated for 3 years postoperatively. Approximately 6% of eyes with a PVD had retinal breaks and eyes with lattice degeneration had a 6.2-fold higher risk of developing retinal breaks associated with a PVD. Long-term follow-up is needed after phacoemulsification is performed. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Analysis of 23G and 25G+vitrectomy for retinal detachment

Directory of Open Access Journals (Sweden)

Ying-Li Lu

2016-06-01

Full Text Available AIM: To compare the clinical effect of 23G and 25G+ vitrectomy for retinal detachment. METHODS: Forty seven patients with retinal detachment were treated with 23G vitrectomy(27 eyes in 27 cases as group Aand 25G+ vitrectomy(20 eyes in 20 cases as group B. The operation time and the incidence of intraoperative complications were recorded. The occurrence of retinal reposition, visual acuity, intraocular pressure(IOPand complications were observed. Postoperative follow-up time of the two groups were 3d, 1wk, 3mo.The relevant records were statistically analyzed and compared. RESULTS: The operation time of 23G group and 25G+ group were 50.21+4.52min, 49.15+5.14min,respectively and there was no significant difference between the two groups(P>0.05. The main complications were retinal hemorrhage and iatrogenic retinal hole. There were 3 eyes with retinal hemorrhage, 2 eyes with iatrogenic retinal hole in 23G group, and 1 eye with retinal hemorrhage, 1 eye with iatrogenic retinal hole in the 25G+ group, and the difference was statistically significant(PP>0.05. The number of eyes with hypotonia in 23G and 25G+ group were 3 and 1 eyes respectively, the difference was statistically significant(PP>0.05. At the last follow-up, the results showed that 26 eyes(96%with retinal reposition in 23G group, 19 eyes(95%in 25G+ group, the difference was not statistically significant(P>0.05. CONCLUSION: The clinical effect of 23G and 25G+ vitrectomy for retinal detachment is similar, but 25G+ vitrectomy can reduce incidence of complications and early postoperative low IOP.

Dealings between Cataract and Retinal Reattachment Surgery in PVR

Directory of Open Access Journals (Sweden)

Svenja Deuchler

2016-01-01

Full Text Available Introduction. To evaluate the impact of the eye lens status and oil side effects on the outcome of vitreoretinal surgery in retinal detachment with proliferative vitreoretinopathy (PVR and a temporary silicone oil tamponade (SOT. Methods. 101 eyes were analyzed retrospectively and 103 eyes prospectively in regard to their retinal reattachment success rate and key factors for the outcome. Subgroup analysis of 27 eyes with Scheimpflug lens photography (SLP before and after retinal reattachment service with SOT was performed. For SLP (65% phakic eyes a Pentacam densitometry reference body with 3 mm diameter was chosen and 3 segments (anterior/mid/posterior were evaluated separately after a quality check. Results. The retinal reattachment rate was highest in the prospective pseudophakic group (p=0.039. Lens transparency loss occurred earlier in middle aged patients than in younger patients. Besides the nucleus, layers posterior and anterior to it showed specific transparency changes. The emulsification rate was higher when eyes had been operated on in the anterior chamber before retinal reattachment service. Conclusions. Retinal reattachment surgery seems to benefit from preoperative cataract removal. We found significant lens changes in the nucleus as well as in the layers anterior and posterior to it. This corresponds to the histology of the lens epithelium published before.

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.

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

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.

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

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...

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.

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...

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)

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

Directory of Open Access Journals (Sweden)

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.

Complex genetics of familial exudative vitreoretinopathy and related pediatric retinal detachments

Science.gov (United States)

Kondo, Hiroyuki

2015-01-01

Familial exudative vitreoretinopathy (FEVR) is a hereditary vitreoretinal disorder that can cause various types of retinal detachments. The abnormalities in eyes with FEVR are caused by poor vascularization in the peripheral retina. The genetics of FEVR is highly heterogeneous, and mutations in the genes for Wnt signaling and a transcription factor have been reported to be responsible for FEVR. These factors have been shown to be the regulators of the pathophysiological pathways of retinal vascular development. Studies conducted to identify the causative genes of FEVR have uncovered a diverse and complex relationship between FEVR and other diseases; for example, Norrie disease, a Mendelian-inherited disease; retinopathy of prematurity, a multifactorial genetic disease; and Coats disease, a nongenetic disease, associated with pediatric retinal detachments. PMID:29018668

Total retinal detachments due to retinoblastoma: Outcomes following intra-arterial chemotherapy/ophthalmic artery chemosurgery.

Directory of Open Access Journals (Sweden)

Megan A Rowlands

Full Text Available To report on the rate and timing of retinal reattachment and outcomes for retinoblastoma children who have total retinal detachments at presentation to our center and were treated with intra-arterial chemotherapy (ophthalmic artery chemosurgery, OAC.Single-center retrospective review of retinoblastoma patients who presented with total retinal detachments and were subsequently treated with OAC at MSKCC between May 2006 and July 2016. Endpoints were retinal detachment resolution, visual function, ERG amplitude, ocular survival, and patient survival from metastases.87 eyes of 84 retinoblastoma patients were included. Using a survival multistate model, by 36 months of follow-up, there was a 54% cumulative probability of complete retinal reattachment and a 76% probability of partial reattachment. 24% of eyes that completely reattached received only OAC without any prior or adjuvant treatments. Eyes that completely reattached were significantly more likely to have been diagnosed at a younger age (p<0.0001 and to have greater initial ERG values (p = 0.006. At final follow-up, 14% of eyes had gained at least 25 μV of ERG activity, and 8.0% had achieved hand motion vision or better, including one to 20/60. 13% of eyes were enucleated. No patient died from metastatic disease, and only one developed metastases.OAC can successfully treat previously considered "non-salvageable" retinoblastoma eyes with total retinal detachments, promote retinal reattachment in the majority of eyes, and preserve ocular and patient survival.

[Bilateral spontaneously reattached rhegmatogenous retinal detachment. Case report and differential diagnosis with pigmentary retinopathies].

Science.gov (United States)

García-Guzmán, Jorge Guillermo; Franco-Yáñez, Yasmín; Lima-Gómez, Virgilio

2014-01-01

A dark pigmentation of the ocular fundus presents in degenerative diseases such as retinitis pigmentosa; this disease must be distinguished from others whose evolution is not progressive, in order to estimate the functional prognosis of the patient. To analyze the features which distinguish spontaneously reattached retinal detachment from other causes of ocular fundus pigmentation, in order to be able to identify it even in bilateral cases. A case of a female with chronic visual loss is presented, who was referred for evaluation with the diagnosis of a pigmented retinopathy. Clinical exploration discarded causes as retinitis pigmentosa, retinal inflammatory diseases or trauma. Based on the clinical features, on the topography of pigmentation and in the information provided by electroretinography, a bilateral spontaneous reattachment of rhegmatogenous retinal detachment was diagnosed made. Clinical features of this entity are discussed, as well as the diagnostic approach to distinguish it from other pigment retinopathies. Clinical features of spontaneously reattached retinal detachment allow the explorer to distinguish it from other causes of bilateral pigmentation, despite presenting bilaterally. Since the prognosis of the attached retina is better than that of a degenerative disease, the correct diagnosis makes rehabilitation easier.

[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.

Occupational Lifting Tasks and Retinal Detachment in Non-Myopics and Myopics: Extended Analysis of a Case-control Study

OpenAIRE

Mattioli, Stefano; Curti, Stefania; De Fazio, Rocco; Cooke, Robin Mt; Zanardi, Francesca; Bonfiglioli, Roberta; Farioli, Andrea; Violante, Francesco S.

2012-01-01

Objectives: Lifting heavy weights involves the Valsalva manoeuvre, which leads to intraocular pressure spikes. We used data from a case-control study to further investigate the hypothesis that occupational lifting is a risk factor for retinal detachment. Methods: The study population included 48 cases (patients operated for retinal detachment) and 84 controls (outpatients attending an eye clinic). The odds ratios (OR) of idiopathic retinal detachment were estimated with a logistic regressi...

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.

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

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.

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.

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

Science.gov (United States)

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.

Final anatomic and visual outcomes appear independent of duration of silicone oil intraocular tamponade in complex retinal detachment surgery.

Science.gov (United States)

Rhatigan, Maedbh; McElnea, Elizabeth; Murtagh, Patrick; Stephenson, Kirk; Harris, Elaine; Connell, Paul; Keegan, David

2018-01-01

To report anatomic and visual outcomes following silicone oil removal in a cohort of patients with complex retinal detachment, to determine association between duration of tamponade and outcomes and to compare patients with oil removed and those with oil in situ in terms of demographic, surgical and visual factors. We reported a four years retrospective case series of 143 patients with complex retinal detachments who underwent intraocular silicone oil tamponade. Analysis between anatomic and visual outcomes, baseline demographics, duration of tamponade and number of surgical procedures were carried out using Fisher's exact test and unpaired two-tailed t -test. One hundred and six patients (76.2%) had undergone silicone oil removal at the time of review with 96 patients (90.6%) showing retinal reattachment following oil removal. Duration of tamponade was not associated with final reattachment rate or with a deterioration in best corrected visual acuity (BCVA). Patients with oil removed had a significantly better baseline and final BCVA compared to those under oil tamponade ( P =0.0001, <0.0001 respectively). Anatomic and visual outcomes in this cohort are in keeping with those reported in the literature. Favorable outcomes were seen with oil removal but duration of oil tamponade does not affect final attachment rate with modern surgical techniques and should be managed on a case by case basis.

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

Vitrectomy with internal limiting membrane peeling versus inverted internal limiting membrane flap technique for macular hole-induced retinal detachment: a systematic review of literature and meta-analysis.

Science.gov (United States)

Yuan, Jing; Zhang, Ling-Lin; Lu, Yu-Jie; Han, Meng-Yao; Yu, Ai-Hua; Cai, Xiao-Jun

2017-11-28

To evaluate the effects on vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with inverted internal limiting membrane flap technique for macular hole-induced retinal detachment (MHRD). Pubmed, Cochrane Library, and Embase were systematically searched for studies that compared ILM peeling with inverted ILM flap technique for macular hole-induced retinal detachment. The primary outcomes are the rate of retinal reattachment and the rate of macular hole closure 6 months later after initial surgery, the secondary outcome is the postoperative best-corrected visual acuity (BCVA) 6 months later after initial surgery. Four studies that included 98 eyes were selected. All the included studies were retrospective comparative studies. The preoperative best-corrected visual acuity was equal between ILM peeling and inverted ILM flap technique groups. It was indicated that the rate of retinal reattachment (odds ratio (OR) = 0.14, 95% confidence interval (CI):0.03 to 0.69; P = 0.02) and macular hole closure (OR = 0.06, 95% CI:0.02 to 0.19; P peeling. However, there was no statistically significant difference in postoperative best-corrected visual acuity (mean difference (MD) 0.18 logarithm of the minimum angle of resolution; 95% CI -0.06 to 0.43 ; P = 0.14) between the two surgery groups. Compared with ILM peeling, vitrectomy with inverted ILM flap technique resulted significantly higher of the rate of retinal reattachment and macular hole closure, but seemed does not improve postoperative best-corrected visual acuity.

Genetic risk of rhegmatogenous retinal detachment a familial aggregation study

NARCIS (Netherlands)

S.L. Go (Sioe Lie); C. Hoyng (Carel); C.C.W. Klaver (Caroline)

2005-01-01

textabstractObjective: To investigate the magnitude of the genetic risk of nonsyndromic rhegmatogenous retinal detachments (RRDs) in a familial aggregation study. Design: Two hundred three consecutive patients with RRD and 461 controls without RRD were ascertained at the Department of Ophthalmology

Genetic risk of rhegmatogenous retinal detachment: a familial aggregation study.

NARCIS (Netherlands)

Go, S.L.; Hoyng, C.B.; Klaver, C.C.W.

2005-01-01

OBJECTIVE: To investigate the magnitude of the genetic risk of nonsyndromic rhegmatogenous retinal detachments (RRDs) in a familial aggregation study. DESIGN: Two hundred three consecutive patients with RRD and 461 controls without RRD were ascertained at the Department of Ophthalmology of the

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...

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.

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

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

African Journals Online (AJOL)

retinal detachment symptoms, the predisposing/precipitating factors and the need ... Sebastian N. N. Nwosu, Guinness Eye Center, PMB 1534, Onitsha, Anambra ... the temporal retina and are all associated with total ... Table 2 shows the ocular risk factors. ..... Olurin O. Refractive errors in Nigerians: A hospital clinic study.

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.

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

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.

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.

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.

Macula-On Versus Macula-Off Pseudophakic Rhegmatogenous Retinal Detachment Following Primary 23-Gauge Vitrectomy Plus Endotamponade.

Science.gov (United States)

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.

WIDEFIELD SPECTRAL-DOMAIN OPTICAL COHERENCE TOMOGRAPHY IMAGING OF PERIPHERAL ROUND RETINAL HOLES WITH OR WITHOUT RETINAL DETACHMENT.

Science.gov (United States)

Casswell, Edward J; Abou Ltaif, Sleiman; Carr, Thomas; Keane, Pearse A; Charteris, David G; Wickham, Louisa

2018-03-02

To describe the widefield spectral-domain optical coherence tomography features of peripheral round retinal holes, with or without associated retinal detachment (RD). Retrospective, observational study of 28 eyes with peripheral round retinal holes, with and without RD. Patients underwent imaging with a widefield 50-degree spectral-domain optical coherence tomography (Heidelberg Engineering, Germany) and Optos ultra-widefield imaging systems (Optos, United Kingdom). Vitreous attachment at the site of the retinal hole was detected in 27/28 (96.4%) cases. Cases were split into three groups: RHs with RD (n = 12); RHs with subretinal fluid (n = 5), and flat RHs (n = 11), with minimal or no subretinal fluid. 91.6% retinal holes associated with subretinal fluid or RD had vitreous attachment at the site of the hole. Eighty percent had vitreous attachment at both edges of the retinal hole, in a U-shape configuration, which appeared to exert traction. By contrast, flat retinal holes had visible vitreous attachment only at one edge of the retinal hole in 45.4%. Vitreous attachment was commonly seen at the site of round retinal holes. Vitreous attachment at both edges of the retinal hole in a U-shape configuration was more commonly seen at holes associated with subretinal fluid or RD.

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.

Fundus autofluorescence findings in a mouse model of retinal detachment.

Science.gov (United States)

Secondi, Roberta; Kong, Jian; Blonska, Anna M; Staurenghi, Giovanni; Sparrow, Janet R

2012-08-07

Fundus autofluorescence (fundus AF) changes were monitored in a mouse model of retinal detachment (RD). RD was induced by transscleral injection of hyaluronic acid (Healon) or sterile balanced salt solution (BSS) into the subretinal space of 4-5-day-old albino Abca4 null mutant and Abca4 wild-type mice. Images acquired by confocal scanning laser ophthalmoscopy (Spectralis HRA) were correlated with spectral domain optical coherence tomography (SD-OCT), infrared reflectance (IR), fluorescence spectroscopy, and histologic analysis. Results. In the area of detached retina, multiple hyperreflective spots in IR images corresponded to punctate areas of intense autofluorescence visible in fundus AF mode. The puncta exhibited changes in fluorescence intensity with time. SD-OCT disclosed undulations of the neural retina and hyperreflectivity of the photoreceptor layer that likely corresponded to histologically visible photoreceptor cell rosettes. Fluorescence emission spectra generated using flat-mounted retina, and 488 and 561 nm excitation, were similar to that of RPE lipofuscin. With increased excitation wavelength, the emission maximum shifted towards longer wavelengths, a characteristic typical of fundus autofluorescence. In detached retinas, hyper-autofluorescent spots appeared to originate from photoreceptor outer segments that were arranged within retinal folds and rosettes. Consistent with this interpretation is the finding that the autofluorescence was spectroscopically similar to the bisretinoids that constitute RPE lipofuscin. Under the conditions of a RD, abnormal autofluorescence may arise from excessive production of bisretinoid by impaired photoreceptor cells.

Macular hole-associated retinal detachment in Best vitelliform dystrophy: Series of two cases and literature review

Science.gov (United States)

Tewari, Ruchir; Kumar, Vinod; Ravani, Raghav; Dubey, Devashish; Chandra, Parijat; Kumar, Atul

2018-01-01

Two eyes of 2 patients with macular hole-associated retinal detachment in clinically diagnosed vitelliruptive stage of Best vitelliform dystrophy were surgically managed by 25-gauge sutureless pars plana vitrectomy, internal limiting membrane (ILM) peeling with inverted ILM flap, and short-acting (SF6) gas tamponade. The patients were assessed with respect to best-corrected visual acuity, color fundus photographs, shortwave fundus autofluorescence, and swept source optical coherence tomography. Surgical intervention led to Type 1 closure of macular hole, resolution of retinal detachment, and improvement in vision in both patients. PMID:29676326

Macular hole-associated retinal detachment in Best vitelliform dystrophy: Series of two cases and literature review

Directory of Open Access Journals (Sweden)

Ruchir Tewari

2018-01-01

Full Text Available Two eyes of 2 patients with macular hole-associated retinal detachment in clinically diagnosed vitelliruptive stage of Best vitelliform dystrophy were surgically managed by 25-gauge sutureless pars plana vitrectomy, internal limiting membrane (ILM peeling with inverted ILM flap, and short-acting (SF6 gas tamponade. The patients were assessed with respect to best-corrected visual acuity, color fundus photographs, shortwave fundus autofluorescence, and swept source optical coherence tomography. Surgical intervention led to Type 1 closure of macular hole, resolution of retinal detachment, and improvement in vision in both patients.

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients

Directory of Open Access Journals (Sweden)

Katarzyna Nowomiejska

2017-01-01

Full Text Available Purpose. To evaluate functional and anatomical results of pars plana vitrectomy (PPV in the retinal detachment (RD followed by severe eye trauma. Methods. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB and proliferative vitreoretinopathy (PVR were included in the analysis. Results. Mean age of patients was 47 years; the majority of patients were men (88%. Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes. Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66% eyes had a functional success; 32 eyes (78% had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Conclusions. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

Same-Day Versus Next-Day Repair of Fovea-Threatening Primary Rhegmatogenous Retinal Detachments.

Science.gov (United States)

Gorovoy, Ian R; Porco, Travis C; Bhisitkul, Robert B; de Juan, Eugene; Schwartz, Daniel M; Stewart, Jay M

2016-01-01

To evaluate the outcomes of same-day versus next-day repair of fovea-threatening rhegmatogenous retinal detachments (FT RRD). Retrospective, multi-surgeon observational case series. Operative reports and medical records were reviewed to evaluate a number of visual and anatomic outcomes, including presenting features, intraoperative complications, and postoperative results in the repair of primary FT RRD undergoing same-day versus next-day repair with scleral buckling, pars plana vitrectomy, or both procedures. A total of 96 consecutive patients (43 same-day, 45 next-day, and eight two days later) were compared. There was no statistically significant difference in visual outcomes between same-day and next-day repair at postoperative months 3 and 6 and at last follow-up (month 3 mean BCVA 20/30 same day; 20/32 next day; p = 0.82). Preoperative vision was strongly correlated with postoperative acuity. Effect of differences in length or type of visual symptoms, location of RRD, gender, or lens status on postoperative month 3 best-corrected visual acuity (BCVA) was not statistically significant. Overall, 85% of patients had a BCVA of 20/40 or better at postoperative month 3. Reoperation rate and intraoperative complications were not statistically different between the two groups. Re-attachment was achieved in all but one patient in both groups. Time in the operating room was longer for same-day surgery (2.98 ± 0.46 hours) compared to next-day surgery (2.54 ± 0.38 hours) (p factoring in the type of surgery performed. However, one case did progress to a macula-off detachment in a superior RRD with breaks found in lattice degeneration. Next-day surgery provided equivalent visual outcomes. Emergent, same-day surgery has logistical and resource implications as it may be more expensive, may necessitate rescheduling of previously booked cases, and may limit preoperative examination by the surgeon and perioperative team.

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.

Retinal Endovascular Surgery with Tissue Plasminogen Activator Injection for Central Retinal Artery Occlusion

Directory of Open Access Journals (Sweden)

Yuta Takata

2018-06-01

Full Text Available Purpose: To report 2 cases of central retinal artery occlusion (CRAO who underwent retinal endovascular surgery with injection of tissue plasminogen activator (tPA into the retinal artery and showed a remarkable improvement in visual acuity and retinal circulation. Methods: Standard 25-G vitrectomy was performed under local anesthesia. Simultaneously, tPA (80,000 units/mL solution was injected into the retinal artery of the optic disc for 2–3 min using a microneedle. Changes in visual acuity, fundus photography, optical coherence tomography (OCT, fluorescein angiography, and laser speckle flowgraphy (LSFG results were examined. Results: Both cases could be treated within 12 h after the onset of CRAO. Case 1 was a 47-year-old woman. Her visual acuity improved from counting fingers before operation to 0.08 logMAR 1 month after the surgery. However, thinning of the retina at the macula was observed by OCT. Case 2 was a 70-year-old man. His visual acuity improved from counting fingers to 0.1 logMAR 2 months after the surgery. Both fluorescein angiography and LSFG showed improvement in retinal circulation after the surgery in case 2. Conclusions: Retinal endovascular surgery with injection of tPA into the retinal artery was feasible and may be a way to improve visual acuity and retinal circulation when performed in the acute phase of CRAO.

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

Serous Macular Detachments

Directory of Open Access Journals (Sweden)

Hakan Özdemir

2012-03-01

Full Text Available Serous macular detachment has only recently been recognized to occur in a significant number of eyes with macular pathology including diabetic retinopathy, retinal vein occlusion, Behçet disease, Irvine-Gass syndrome and pars planitis. These serous retinal detachments associated with retinal vascular leakage are not suspected clinically or angiographically but can be diagnosed with optical coherence tomography (OCT beneath the edematous neurosensory retina. The detection of shallow foveal detachment may be helpful in better understanding the pathogenesis of these disorders. In addition, the detection of serous macular detachment may also help to better guide and assess the results of therapy in the future. (Turk J Oph thal mol 2012; 42: 146-9

Krypton yellow laser for the treatment of macular hole in high myopia without retinal detachment.

Science.gov (United States)

Cai, Ji-Ping; Cheng, Jin-Wei; Ma, Xiao-Ye; Li, Yu-Zhen; Li, You; Wei, Rui-Li

2008-12-01

To evaluate the prophylactic effect of krypton yellow laser for the treatment of macular holes in high myopic eyes in order to reduce the risk of retinal detachment. Twenty-seven eyes of 27 patients with high myopia and macular holes were randomly assigned to two groups. Fifteen patients (group A, 15 eyes) were subject to laser photocoagulation around the hole margin along with an oral placebo (vitamin B1), while 12 patients (group B, 12 eyes) were only given the oral placebo (vitamin B1). The incident rate of retinal detachment due to macular hole and the mean best-corrected visual acuity of the two groups before and after treatment were measured. The data were statistically tested by X2 test and Student's t test. The incident rates of retina1 detachment in group A and group B were 20%(3/15) and 58.3%(7/12), respectively (X2=4.201, P0.05). The mean BCVA of group B on the initial examination was 24/200, while the mean BCVA at the final follow-up was 30/200 (P>0.05). No significant difference in initial visual acuity (P>0.05) or final visual acuity (P>0.05) was found between the two groups. Krypton yellow laser photocoagulation could reduce the incidence of retinal detachment due to a macular hole in high myopia with acceptable functional results in this study.

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.

Retinal pigment epithelial detachments and tears, and progressive retinal degeneration in light chain deposition disease.

Science.gov (United States)

Spielberg, Leigh H; Heckenlively, John R; Leys, Anita M

2013-05-01

Light-chain deposition disease (LCDD) is a rare condition characterised by deposition of monoclonal immunoglobulin light chains (LCs) in tissues, resulting in varying degrees of organ dysfunction. This study reports the characteristic clinical ocular findings seen in advanced LCDD upon development of ocular fundus changes. This is the first report to describe this entity in vivo in a series of patients. A case series of ocular fundus changes in three patients with kidney biopsy-proven LCDD. All patients underwent best corrected visual acuity (BCVA) exam, perimetry, colour fundus photography and fluorescein angiography; two patients underwent indocyanine green angiography, optical coherence tomography, ultrasound and electroretinography; and one patient underwent fundus autofluorescence. Three patients, 53-60 years old at initial presentation, were studied. All three presented with night blindness, poor dark adaptation, metamorphopsia and visual loss. Examination revealed serous and serohaemorrhagic detachments, multiple retinal pigment epithelial (RPE) tears, diffuse RPE degeneration and progressive fibrotic changes. Neither choroidal neovascularisation nor other vascular abnormalities were present. Final best corrected visual acuity (BCVA) ranged from 20/40 to 20/300. Progressive LC deposition in the fundus seems to damage RPE pump function with flow disturbance between choroid and retina. This pathogenesis can explain the evolution to RPE detachments and subsequent rips and progressive retinal malfunction.

[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.

Retinal oxygen saturation before and after glaucoma surgery.

Science.gov (United States)

Nitta, Eri; Hirooka, Kazuyuki; Shimazaki, Takeru; Sato, Shino; Ukegawa, Kaori; Nakano, Yuki; Tsujikawa, Akitaka

2017-08-01

This study compared retinal vessel oxygen saturation before and after glaucoma surgery. Retinal oxygen saturation in glaucoma patients was measured using a non-invasive spectrophotometric retinal oximeter. Adequate image quality was found in 49 of the 108 consecutive glaucoma patients recruited, with 30 undergoing trabeculectomy, 11 EX-PRESS and eight trabeculotomy. Retinal oxygen saturation measurements in the retinal arterioles and venules were performed at 1 day prior to and at approximately 10 days after surgery. Statistical analysis was performed using a Student's t-test. After glaucoma surgery, intraocular pressure (IOP) decreased from 19.8 ± 7.7 mmHg to 9.0 ± 5.7 mmHg (p glaucoma surgery had an effect on the retinal venous oxygen saturation. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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.

Value of internal limiting membrane peeling in surgery for idiopathic macular hole and the correlation between function and retinal morphology

DEFF Research Database (Denmark)

Christensen, Ulrik Correll

2009-01-01

conducted a randomized clinical trial including 78 pseudophakic patients with idiopathic macular hole stages 2 and 3. Patients were randomly assigned to macular hole surgery consisting of (i) vitrectomy alone without instrumental retinal surface contact (non-peeling), (ii) vitrectomy plus 0.05% isotonic ICG...... rate than surgery without ILM peeling (95% versus 45%). The overall functional results confirm that surgery for macular hole generally leads to favourable visual results, with two-thirds of eyes regaining reading vision (>or=20/40). Macular hole surgery can be considered a safe procedure with a low...... incidence of sight-threatening adverse events; the retinal detachment rate was 2.2%. Visual outcomes in eyes with primary hole closure were not significantly different between the intervention groups; however, for the stage 2 subgroup with primary macular hole closure, there was a trend towards a better...

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.

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.

Internal limiting membrane peeling in macula-off retinal detachment complicated by grade B proliferative vitreoretinopathy.

Science.gov (United States)

Foveau, Pauline; Leroy, Bertrand; Berrod, Jean-Paul; Conart, Jean-Baptiste

2018-04-02

To investigate the clinical benefit of internal limiting membrane (ILM) peeling as a surgical adjunct in the repair of primary retinal detachment (RD) complicated by grade B proliferative vitreoretinopathy (PVR). Retrospective, interventional, comparative case series. SETTING: Institutional. 75 consecutive patients who underwent vitrectomy for primary macula off RD complicated by grade B PVR. Patients were divided into an ILM peeling (group P) and a no ILM peeling (group NP). Anatomical success rate, best-corrected visual acuity, and spectral-domain optical coherence tomography (SD-OCT) characteristics were collected at 1 and 6 months. In all, 37 eyes with ILM peeling were included in group P and 38 eyes without ILM peeling were included in group NP. The anatomical success rate after single surgery was higher in group P (89%) than in group NP (66%, p=0.03). Mean final visual acuity was 0.41 ±0.40 logMAR in group P versus 0.43 ±0.22 logMAR in group NP (p=0.82). We found no epiretinal membrane (ERM) formation in group P, whereas five cases of ERM (20%) were detected in group NP (p=0.012). The two groups did not differ in terms of cystoid macular edema occurrence, macular thickness, or photoreceptor damage. ILM peeling during vitrectomy in macula off RD complicated by grade B PVR reduces the need for a second surgery for re-detachment or macular pucker. Copyright © 2018. Published by Elsevier Inc.

Outpatient- and inpatient-based buckling surgery: a comparative study

Directory of Open Access Journals (Sweden)

Lee JC

2014-04-01

Full Text Available Jin Cheol Lee,* Yu Cheol Kim*Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea *Both authors contributed equally to this workPurpose: To evaluate the clinical outcomes of ambulatory buckling surgery, comparing outpatient- with inpatient-based surgery.Methods: The authors performed a retrospective study of 80 consecutive cases of rhegmato genous retinal detachment from January 2009 to December 2011 treated by scleral buckling surgery. Two groups of patients were defined according to inpatient (group 1 or outpatient (group 2 surgery, and a comparison of several parameters between these two groups was performed.Results: Of the 80 subjects in this study, the average age of group 1 (50 patients was 49.7 years, and that of group 2 (30 patients was 47.5 years. There were no statistically significant differences in the average logarithm of the minimum angle of resolution-visual acuity, the condition of the lens, or the presence of retinal lattice degeneration prior to the surgery between the groups. There were no statistically significant differences in the patterns of tear or retinal detachment or in surgical procedure between the groups. Comparing the best-corrected visual acuity after 6 months with that prior to the surgery, the changes in group 1 and group 2 were 0.26 and 0.31, respectively. The functional success rates of group 1 and group 2 after 6 months were 90% and 93%, respectively, and the anatomical success rates of group 1 and group 2 after 6 months were 94% and 96%, respectively, but these were also statistically insignificant.Conclusion: Hospitalization is not essential for buckling surgery in uncomplicated rhegmatogenous retinal detachment surgery.Keywords: ambulatory, scleral buckling, rhegmatogenous retinal detachment

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

Vitrectomy with internal limiting membrane peeling vs no peeling for Macular Hole-induced Retinal Detachment (MHRD): a meta-analysis.

Science.gov (United States)

Su, Jing; Liu, Xinquan; Zheng, Lijun; Cui, Hongping

2015-06-20

we conducted our meta-analysis of published studies to assess existing evidence about the efficacy and safety of vitrectomy with ILM peeling vs. that of vitrectomy with no ILM peeling for Macular hole-induced retinal detachment. Databases, including Pubmed, Cochrane Library, Ovid, Web of Science, Wanfang and CNKI, were searched to identify studies comparing outcomes following vitrectomy with ILM peeling and that with no ILM peeling for macular hole-induced retinal detachment. The meta-analysis was performed by RevMan 5.1. Six comparative studies comprising 180 eyes were identified. It was indicated that the rate of retinal reattachment (Odds ratio (OR) = 3.03, 95 % Confidence interval (CI):1.35 to 6.78; P = 0.007) and macular hole closure (OR = 6.74, 95 % CI:3.26 to 13.93; P peeling than that in the group of vitrectomy with no ILM peeling. However, the improved BCVA (Weighted mean difference (WMD) = 0.14, 95 % CI: -0.20 to 0.47; P = 0.42) and the rate of postoperative complications were similar between the two groups. Vitrectomy with internal limiting membrane peeling is an efficient and safe procedure for macular hole-induced retinal detachment.

Serous Retinal Detachments Complicating Interferon-α and Ribavirin Treatment in Patients with Hepatitis C

Directory of Open Access Journals (Sweden)

Giulio Modorati

2011-03-01

Full Text Available Purpose: To report the cases of two patients with chronic hepatitis C infection showing serous retinal detachments similar to Vogt-Koyanagi-Harada (VKH disease. Methods: We reviewed the clinical records of two patients who were diagnosed with VKH-like disease during combined interferon-α (IFNα and ribavirin treatment. Results: Interruption of IFNα and ribavirin treatment in association with oral corticosteroids resulted in a favorable visual outcome in the case of diffuse retinal detachment (case 1. On the contrary, visual acuity did not improve when late cicatricial stage disease was already present (case 2. Conclusion: There is increasing evidence of a link between hepatitis C virus infection treated with pegylated IFNα-2b and the development of VKH-like disease. Knowing the potential side effects of IFNα and ribavirin administration is fundamentally important, as is the need to closely follow up those patients that need to undergo this treatment.

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.

Comparison of four surgical techniques for management of pseudophakic and aphakic retinal detachment: a multicenter clinical trial.

Science.gov (United States)

Moradian, Siamak; Ahmadieh, Hamid; Faghihi, Hooshang; Ramezani, Alireza; Entezari, Morteza; Banaee, Touka; Heidari, Ebadollah; Behboudi, Hassan; Yasseri, Mehdi

2016-09-01

To compare the visual and anatomical outcomes of four surgical techniques to manage pseudophakic and aphakic retinal detachment (PARD). In a multicenter randomized clinical trial, 211 eyes of 211 patients with PARD and proliferative vitreoretinopathy (PVR) grade B or less were randomly assigned to one of the four treatment groups: (1) scleral buckling (SB), 50 eyes, (2) vitrectomy without band, 51 eyes, (3) vitrectomy with encircling band (EB), 58 eyes, and (4) triamcinolone acetonide (TA) assisted vitrectomy, 52 eyes. Patients were followed for 12 months after the surgery. The best-corrected visual acuity (BCVA) and retinal reattachment rate at each follow-up time point were considered as the primary outcome measures. PVR, macular pucker, and cystoid macular edema were considered as the secondary outcomes. Visual improvement was achieved in all treatment groups relative to the baseline at all time points (all Ps  0.99). There were no statistically significant differences among the groups in terms of adverse events. SB, TA-assisted vitrectomy, and vitrectomy with and without buckle had comparable outcomes in the management of PARD.

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.

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.

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.

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.

Transscleral diode laser retinopexy in retinal reattachment surgery Retinopexia com laser de diodo transescleral na cirurgia de descolamento de retina

Directory of Open Access Journals (Sweden)

João Carlos de Miranda Gonçalves

2004-02-01

Full Text Available PURPOSE: Transscleral diode retinal photocoagulation (diopexy is becoming an accepted technique in the treatment of selected retinal diseases. The objective of this study is to evaluate diopexy technique in the production of adhesive chorioretinal lesions during the surgical treatment of the rhegmatogenous retinal detachment. METHODS: 25 patients with rhegmatogenous retinal detachment were enrolled in a prospective clinical-surgical study to evaluate the technique of transscleral diode laser photocoagulation to obtain adhesive chorioretinal lesions during retinal reattachment surgery. The surgery consisted of the placement of an exoplant silicon to produce a buckle effect combined with a drainage of subretinal fluid in most cases. RESULTS: By a mean follow-up of 10 months, 21 of 25 eyes had their retinas reattached after only one surgery with diopexy used in all cases. CONCLUSION: Transscleral diode laser photocoagulation was a technically easy, controlled, effective, reproducible and safe means of obtaining chorioretinal adhesion in retinal reattachment surgery.OBJETIVO: Fotocoagulação transescleral com laser de diodo (diopexia está se tornando técnica utilizada no tratamento de algumas doenças retinianas. O objetivo deste estudo é avaliar a técnica de diopexia na produção de lesões coriorretinianas aderentes durante o tratamento cirúrgico do descolamento de retina regmatogênico. MÉTODOS: Vinte e cinco pacientes com descolamento de retina regmatogênico participaram deste estudo clínico-cirúrgico prospectivo para avaliar a técnica de fotocoagulação com laser de diodo transescleral para obter lesões coriorretinianas aderentes durante a cirurgia de descolamento de retina. A cirurgia consistiu de colocação de explante de silicone para produzir efeito de introflexão escleral combinado com drenagem do líquido subretiniano na maioria dos casos. RESULTADOS: Após um período médio de seguimento de 10 meses, em 21 dos 25 olhos

The outcomes of pars plana vitrectomy without endotamponade for tractional retinal detachment secondary to proliferative diabetic retinopathy

Directory of Open Access Journals (Sweden)

Rao Muhammad Rashad Qamar

2013-10-01

Full Text Available AIM: To evaluate the outcomes of pars plana vitrectomy (PPV without the use of an ocular tamponade in patients having tractional retinal detachment (TRD secondary to proliferative diabetic retinopathy (PDR.METHODS: It was an interventional study conducted at the Department of Ophthalmology, B.V. Hospital, Bahawalpur, Pakistan, from July 2011 to July 2012. A total of 75 patients (84 eyes having TRD secondary to PDR were treated by PPV without using an ocular tamponade. All patients included in the study had a tractional retinal detachment secondary to proliferative diabetic retinopathy but didn’t have or develop retinal breaks before or during the study period. The surgical procedure included a PPV combined with the removal of the tractional retinal membranes and the application of endolaser photocoagulation to the retina. The mean follow-up period was 12 months.RESULTS:Successful retinal reattachement was observed in 78 of the operated eyes (92.8%. In these patients, the retina remained attached till the end of the one year follow-up period. Improvement in best corrected visual acuity (BCVA was seen in 63 eyes (75%. The visual acuity remained unchanged in 9 eyes (10.7%. Mean improvement in BCVA was 2.00+1.24 at baseline to 1.24+1.22 (PCONCLUSION: In the absence of the retinal breaks, a TRD secondary to PDR can be successfully treated by pars plana vitrectomy without the use of an ocular tamponade.

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.

A nationwide study on the incidence of rhegmatogenous retinal detachment in Denmark, with emphasis on the risk of the fellow eye

DEFF Research Database (Denmark)

Hajari, Javad N; Bjerrum, Søren S; Christensen, Ulrik

2014-01-01

PURPOSE: To estimate the risk of developing rhegmatogenous retinal detachment (RRD) in the fellow eye in patients with RRD in the first eye and to identify potential risk factors. METHODS: We used the Danish National Patient Registry to identify all surgeries performed for RRD in Denmark...... on the lens, and young age as significant risk factors (P risk of developing RRD on the second eye, and the risk increases with male gender and surgery on the lens but decreases with age....... in the period from January 2000 to July 2011. RESULTS: In 11,451 cases of RRD in the study period, 8,553 cases in 8,081 patients were identified as primary RRD with an annual incidence of 13.7 per 100,000 citizens. There was a significant increase in the number of cases with RRD during the study period...

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

Directory of Open Access Journals (Sweden)

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.

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.

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%.

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%.

Outcome of surgery in post-cytomegalovirus retinal detachment: Experience before and in the era of highly active anti-retroviral therapy in Indian eyes

Directory of Open Access Journals (Sweden)

Ramandeep Singh

2013-01-01

Full Text Available Purpose: To evaluate the outcome of surgery for cytomegalovirus associated retinal detachment (CMVRD in human immunodeficiency virus (HIV-infected patients in pre-highly active antiretroviral therapy (HAART and HAART era in Indian eyes. Materials and Methods: Retrospective, we reviewed medical records of all consecutive HIV patients, who underwent surgical repair for CMVRD from July 1998 to June 2011. We divided patients into two groups, i.e. group 1, pre HAART era and group 2, HAART era. We compared two groups for various parameters like visual outcome, surgical success, additional procedures, follow-up, etc., Results: Twenty-eight eyes of 26 patients were included; 12 eyes of the 11 patients in group 1 and 16 eyes of the 15 patients in group 2. Significant visual acuity improvement was seen in both groups. Complete anatomic success was seen in 11 eyes in group 1 and 15 eyes in group 2. One additional procedure in group 1 and 29 additional procedures were done in group 2. A mean follow-up was 16 months in group 1 and 41 months in group 2. Conclusion: There was no difference in outcome in pre-HAART and HAART group, except for longer follow-up and additional surgical procedures in HAART group.

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 bilateral giant retinal tears (GRTs) with better options of endotamponade. This is a case report of a 62-year-old man who presented with bilateral GRTs and associated retinal detachment. The tear in the right eye was supero-temporal and silicone oil was used as an endotamponade. The tear in the left eye was infero-temporal and perfluorocarbon liquid was used as an endotamponade. The outcome at 6 months after surgery was excellent with visual acuities of 6/6 in both eyes. Improved availability of endotamponade agents allows repair of bilateral GRTs to be done at the same time, with good surgical outcomes.

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)

Optical Coherence Tomography for Retinal Surgery: Perioperative Analysis to Real-Time Four-Dimensional Image-Guided Surgery.

Science.gov (United States)

Carrasco-Zevallos, Oscar M; Keller, Brenton; Viehland, Christian; Shen, Liangbo; Seider, Michael I; Izatt, Joseph A; Toth, Cynthia A

2016-07-01

Magnification of the surgical field using the operating microscope facilitated profound innovations in retinal surgery in the 1970s, such as pars plana vitrectomy. Although surgical instrumentation and illumination techniques are continually developing, the operating microscope for vitreoretinal procedures has remained essentially unchanged and currently limits the surgeon's depth perception and assessment of subtle microanatomy. Optical coherence tomography (OCT) has revolutionized clinical management of retinal pathology, and its introduction into the operating suite may have a similar impact on surgical visualization and treatment. In this article, we review the evolution of OCT for retinal surgery, from perioperative analysis to live volumetric (four-dimensional, 4D) image-guided surgery. We begin by briefly addressing the benefits and limitations of the operating microscope, the progression of OCT technology, and OCT applications in clinical/perioperative retinal imaging. Next, we review intraoperative OCT (iOCT) applications using handheld probes during surgical pauses, two-dimensional (2D) microscope-integrated OCT (MIOCT) of live surgery, and volumetric MIOCT of live surgery. The iOCT discussion focuses on technological advancements, applications during human retinal surgery, translational difficulties and limitations, and future directions.

Predictive factors for postoperative visual function of primary chronic rhegmatogenous retinal detachment after scleral buckling.

Science.gov (United States)

Fang, Wei; Li, Jiu-Ke; Jin, Xiao-Hong; Dai, Yuan-Min; Li, Yu-Min

2016-01-01

To evaluate predictive factors for postoperative visual function of primary chronic rhegmatgenous retinal detachment (RRD) after sclera buckling (SB). Totally 48 patients (51 eyes) with primary chronic RRD were included in this prospective interventional clinical cases study, which underwent SB alone from June 2008 to December 2014. Age, sex, symptoms duration, detached extension, retinal hole position, size, type, fovea on/off, proliferative vitreoretinopathy (PVR), posterior vitreous detachment (PVD), baseline best corrected visual acuity (BCVA), operative duration, follow up duration, final BCVA were measured. Pearson correlation analysis, Spearman correlation analysis and multivariate linear stepwise regression were used to confirm predictive factors for better final visual acuity. Student's t-test, Wilcoxon two-sample test, Chi-square test and logistic stepwise regression were used to confirm predictive factors for better vision improvement. Baseline BCVA was 0.8313±0.6911 logMAR and final BCVA was 0.4761±0.4956 logMAR. Primary surgical success rate was 92.16% (47/51). Correlation analyses revealed shorter symptoms duration (r=0.3850, P=0.0053), less detached area (r=0.5489, Ppredictive factors were better baseline BCVA [partial R-square (PR(2))=0.5316, Ppredictive factors for better vision improvement were better baseline vision [odds ratio (OR) =50.369, P=0.0041] and longer follow up duration (OR=1.144, P=0.0067). Independent predictive factors for better visual outcome of primary chronic RRD after SB are better baseline BCVA, shorter symptoms duration, shorter operative duration and longer follow up duration, while independent predictive factors for better vision improvement after operation are better baseline vision and longer follow up duration.

Retinal peripheral changes after laser in situ keratomileusis in patients with high myopia.

Science.gov (United States)

Suzuki, Cássia R; Farah, Michel E

2004-02-01

Retinal detachment has been reported after laser in situ keratomileusis (LASIK) in myopic eyes. This complication may be related to the risk from myopia before surgery or may be induced by LASIK surgery itself. We performed a study to evaluate retinal peripheral changes after LASIK in patients with high myopia and to correlate symptoms on presentation and vitreoretinal anatomic changes. The study was carried out at a university-affiliated hospital in São Paulo between November 1997 and February 1999. Patients scheduled to undergo LASIK were included if their spherical equivalent was greater than 6.00 dioptres. The exclusion criteria were previous retinal treatment and myopic macular degenerations. We performed binocular indirect ophthalmoscopy with scleral indentation and fundus biomicroscopy with Goldmann lens before LASIK and 1, 3 and 6 months after surgery. We examined 198 eyes preoperatively. Of the 198, 50 did not undergo LASIK surgery owing to refractive criteria, and 79 were lost to follow-up. We thus studied 69 eyes. The mean spherical equivalent preoperatively was -8.00 D (standard deviation 1.95 D). Twenty-four eyes had normal retinal periphery preoperatively; all 24 remained without alterations after LASIK. Forty-five eyes had peripheral alterations: 17 (24.6%) had cystic degeneration, 14 (20.3%) had lattice degeneration, 11 (15.9%) had white-without-pressure, 5 (7.2%) had cystic tufts, 3 (4.3%) had pavingstone degeneration, 2 (2.9%) had pigmentary alteration, 1 (1.4%) had holes with free operculum, and 1 (1.4%) had punctiform holes. The only alteration after surgery was almost punctiform holes around the previous cystic tuft 1 month after surgery in one patient. Retinal detachment did not develop in any of the eyes. In this group of patients it appears that LASIK did not lead to progressive peripheral retinal lesions in asymptomatic patients during the period studied.

Intravitreal low molecular weight heparin in PVR surgery.

Directory of Open Access Journals (Sweden)

Kumar Atul

2003-01-01

Full Text Available Purpose: To evaluate the efficacy of low molecular weight heparin (LMWH in prevention of postoperative fibrin formation following vitreoretinal surgery with proliferative vitreoretinopathy (PVR. Material and Methods: Thirty consecutive patients of retinal detachment with advanced PVR were enrolled in the study. They were randomised to study and control groups (n = 15 each. Study group patients received vitreoretinal surgery with 5 IU/cc of LMWH in vitrectomy infusion fluid. The control group patients received vitroretinal surgery without heparin in the infusion fluid. Patients were followed up at 1 week, 1 month and 3 months after surgery. Postoperative bleeding, media clarity, best-corrected visual acuity and success of the surgery at the end of 3 months were compared between the two groups. Results: At each follow-up visit, the study group showed a better media clarity, which was statistically significant ( P = 0.0042. The study group had a 50% better chance of retinal reattachment compared to the control group. Five patients had intraoperative bleeding in the study group (33% compared to 3 patients in the control group (20%. Conclusion: Use of intravitreal LMWH prevents postoperative fibrin formation and is beneficial in repair of retinal detachments with PVR.

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

[Gases in vitreoretinal surgery].

Science.gov (United States)

Janco, L; Vida, R; Bartos, M; Villémová, K; Izák, M

2012-02-01

To evaluate the importance and benefits of using gases in vitreoretinal surgery. The gases represent a wide group of substances used in eye surgery for more than 100 years. The role of intraocular gases in vitreoretinal surgery is irreplaceable. Their use is still considered to be the "gold standard". An important step in eye surgery was the introduction of expanding gases--sulfur hexafluoride and perfluorocarbons into routine clinical practice. The most common indications for the use of intraocular gases are: retinal detachment, idiopathic macular hole, complications of vitreoretinal surgery and others. The introduction of intraocular gases into routine clinical practice, along with other modern surgical techniques resulted in significant improvement of postoperative outcomes in a wide range of eye diseases. Understanding the principles of intraocular gases use brings the benefits to the patient and physician as well. Due to their physical and chemical properties they pose far the best and most appropriate variant of intraocular tamponade. Gases also bring some disadvantages, such as difficulties in detailed fundus examination, visual acuity testing, ultrasonographic examination, difficulties in application of intravitreal drugs or reduced possibility of retina laser treatment. The gases significantly change optical system properties of the eye. The use of gases in vitreoretinal surgery has significantly increased success rate of retinal detachment surgery, complicated posterior segment cases, trauma, surgery of the macula and other diseases.

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.

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

Science.gov (United States)

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.

Functional recovery following vitreoretinal surgery

NARCIS (Netherlands)

Scheerlinck, LME

2016-01-01

The general aim of this thesis was to evaluate functional outcome following vitreoretinal surgery for idiopathic epiretinal membranes (iERM) and rhegmatogenous retinal detachment (RRD). Idiopathic epiretinal membrane Pars plana vitrectomy with removal of the iERM is considered to be the standard

[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.

Vitreoretinal complications and vitreoretinal surgery in osteo-odonto-keratoprosthesis surgery.

Science.gov (United States)

Lim, Laurence S; Ang, Chong Lye; Wong, Edmund; Wong, Doric W K; Tan, Donald T H

2014-02-01

To describe the indications for and approaches to vitreoretinal surgery in patients with osteo-odonto-keratoprosthesis (OOKP). Retrospective case series. This was a retrospective review of all patients who had undergone OOKP surgery between 2003 and 2012 at our center. OOKP procedures were performed for severe ocular surface disease according to the indications and techniques described in the patient demographics of the Rome-Vienna Protocol. Indications for retinal surgery, surgical outcomes, and intraoperative and postoperative complications were documented. Operative techniques were reviewed from the surgical records, and any subsequent surgeries were also recorded. Thirty-six patients underwent OOKP, and retinal surgery was indicated in 13 (36%). The indications for and approaches to surgery were retinal detachment repair using an Eckardt temporary keratoprosthesis; assessment of retina and optic nerve health prior to OOKP surgery, using either a temporary keratoprosthesis or an endoscope; endoscopic cyclophotocoagulation for intractable glaucoma; endoscopic trimming of a retroprosthetic membrane; or vitrectomy for endophthalmitis with visualization through the OOKP optic using the binocular indirect viewing system. In all cases, retinal surgical aims were achieved with a single procedure. Postoperative vitreous hemorrhage occurred in 16 patients (44%), but all resolved spontaneously. OOKPs represent the last hope for restoration of vision in severe ocular surface disease, and the retinal surgeon is frequently called upon in the assessment and management of these patients. Temporary keratoprostheses and endoscopic vitrectomies are valuable surgical tools in these challenging cases, improving functional outcomes without compromising OOKP success. Copyright © 2014 Elsevier Inc. All rights reserved.

Retinal Detachment: Torn or Detached Retina Diagnosis

Science.gov (United States)

... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

Retinal Detachment: Torn or Detached Retina Treatment

Science.gov (United States)

... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

Retinal Detachment: Torn or Detached Retina Symptoms

Science.gov (United States)

... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

Descolamento de retina seroso em paraganglioma: relato de caso Serous retinal detachment in paraganglioma: case report

Directory of Open Access Journals (Sweden)

Oscar Villas Boas

2008-02-01

Full Text Available Os autores descrevem um caso de uma paciente gestante com hipertensão arterial resistente ao tratamento e descolamento seroso bilateral de retina. Confirmou-se, pelo exame anátomo-patológico, ser um paraganglioma.The authors describe a case of a pregnant patient with arterial hypertension that resists to the treatment and retinal bilateral serous detachment. It was confirmed to be a paraganglioma by anatomicopathological examination.

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.

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 

Bilateral orbital infarction and retinal detachment in a previously undiagnosed sickle cell hemoglobinopathy African child

Science.gov (United States)

Helen, Onakpoya Oluwatoyin; Ajite, K. O.; Oyelami, O. A.; Asaleye, C. M.; Adeoye, A. O.

2013-01-01

Bone infarction involving the orbit in sickle cell disease is not common. Bilateral orbital infarction in a previously undiagnosed sickle cell hemoglobinopathy has not been previously reported. 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 previous history of sickle cell hemoglobinopathy. PMID:23901183

iTRAQ Quantitative Proteomic Analysis of Vitreous from Patients with Retinal Detachment

Directory of Open Access Journals (Sweden)

Fátima Milhano Santos

2018-04-01

Full Text Available Rhegmatogenous retinal detachment (RRD is a potentially blinding condition characterized by a physical separation between neurosensory retina and retinal pigment epithelium. Quantitative proteomics can help to understand the changes that occur at the cellular level during RRD, providing additional information about the molecular mechanisms underlying its pathogenesis. In the present study, iTRAQ labeling was combined with two-dimensional LC-ESI-MS/MS to find expression changes in the proteome of vitreous from patients with RRD when compared to control samples. A total of 150 proteins were found differentially expressed in the vitreous of patients with RRD, including 96 overexpressed and 54 underexpressed. Several overexpressed proteins, several such as glycolytic enzymes (fructose-bisphosphate aldolase A, gamma-enolase, and phosphoglycerate kinase 1, glucose transporters (GLUT-1, growth factors (metalloproteinase inhibitor 1, and serine protease inhibitors (plasminogen activator inhibitor 1 are regulated by HIF-1, which suggests that HIF-1 signaling pathway can be triggered in response to RRD. Also, the accumulation of photoreceptor proteins, including phosducin, rhodopsin, and s-arrestin, and vimentin in vitreous may indicate that photoreceptor degeneration occurs in RRD. Also, the accumulation of photoreceptor proteins, including phosducin, rhodopsin, and s-arrestin, and vimentin in vitreous may indicate that photoreceptor degeneration occurs in RRD. Nevertheless, the differentially expressed proteins found in this study suggest that different mechanisms are activated after RRD to promote the survival of retinal cells through complex cellular responses.

Retinal Detachment Vision Simulator

Science.gov (United States)

... Feb 20, 2018 Gene Therapy May Be a Game-Changer for People With Inherited Retinal Disease Dec 19, 2017 ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

Screening retinal transplants with Fourier-domain OCT

Science.gov (United States)

Rao, Bin

2009-02-01

Transplant technologies have been studied for the recovery of vision loss from retinitis pigmentosa (RP) and age-related macular degeneration (AMD). In several rodent retinal degeneration models and in patients, retinal progenitor cells transplanted as layers to the subretinal space have been shown to restore or preserve vision. The methods for evaluation of transplants are expensive considering the large amount of animals. Alternatively, time-domain Stratus OCT was previously shown to be able to image the morphological structure of transplants to some extent, but could not clearly identify laminated transplants. The efficacy of screening retinal transplants with Fourier-domain OCT was studied on 37 S334ter line 3 rats with retinal degeneration 6-67 days after transplant surgery. The transplants were morphologically categorized as no transplant, detachment, rosettes, small laminated area and larger laminated area with both Fourier-domain OCT and histology. The efficacy of Fourier-domain OCT in screening retinal transplants was evaluated by comparing the categorization results with OCT and histology. Additionally, 4 rats were randomly selected for multiple OCT examinations (1, 5, 9, 14 and 21days post surgery) in order to determine the earliest image time of OCT examination since the transplanted tissue may need some time to show its tendency of growing. Finally, we demonstrated the efficacy of Fourier-domain OCT in screening retinal transplants in early stages and determined the earliest imaging time for OCT. Fourier-domain OCT makes itself valuable in saving resource spent on animals with unsuccessful transplants.

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

Science.gov (United States)

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.

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.

Vitreoretinal surgery in advanced coats disease.

Science.gov (United States)

Ozdamar, Yasemin; Berker, Nilufer; Batman, Cosar; Zilelioglu, Orhan

2009-01-01

To report the outcomes of vitreoretinal surgery for a patient with total retinal detachment and a subretinal nodule associated with Coats disease (CD). A 20-year-old woman stage 3B CD underwent vitreoretinal surgery with triamcinolone acetonide-assisted pars plana vitrectomy, limited retinotomy, removal of the subretinal nodule and membrane, endolaser photocoagulation, and silicone oil tamponade. The surgical outcomes were observed. Retinal attachment was achieved after vitreoretinal surgery, removal of the subretinal membrane, and endoresection of the subretinal fibrous nodule. No intraoperative or postoperative complications occurred due to the surgical technique. The retina remained attached during the postoperative follow-up period of 6 months. Vitreoretinal surgery is an effective surgical technique that provides successful reattachment of the retina and enables endoresection of the subretinal fibrous nodule in eyes with advanced CD. It also prevents the devastating intraocular complications leading to enucleation.

Translation of CRISPR Genome Surgery to the Bedside for Retinal Diseases

Directory of Open Access Journals (Sweden)

Christine L. Xu

2018-05-01

Full Text Available In recent years, there has been accelerated growth of clustered regularly interspaced short palindromic repeats (CRISPR genome surgery techniques. Genome surgery holds promise for diseases for which a cure currently does not exist. In the field of ophthalmology, CRISPR offers possibilities for treating inherited retinal dystrophies. The retina has little regenerative potential, which makes treatment particularly difficult. For such conditions, CRISPR genome surgery methods have shown great potential for therapeutic applications in animal models of retinal dystrophies. Much anticipation surrounds the potential for CRISPR as a therapeutic, as clinical trials of ophthalmic genome surgery are expected to begin as early as 2018. This mini-review summarizes preclinical CRISPR applications in the retina and current CRISPR clinical trials.

[Outcome of cataract surgery in patients with pigmentary retinal degeneration].

Science.gov (United States)

Grześk, Magdalena; Kałuzny, Józef; Malukiewicz-Wiśniewska, Grazyna

2007-01-01

To evaluate the results of cataract surgery in patients with RP because retinitis pigmentosa is one of the disease entities that belongs to tapeto-retinal degenerations. The occurrence of RP appearance is 1:4000 to 1:3000. Twenty patients with RP (7 women and 13 men, 33 eyes), who underwent cataract surgery were examined retrospectively. Average age in our group was 46.6 years. Visual acuity, intraocular pressure, slip lamp examination, fundus examination, cataract morphology, visual field were taken before surgery and on discharge, on the basis of medical documentation. Control examination was taken, on average, eighty one months after cataract surgery. Nine eyes were operated by phacoemulsification, 24 eyes by means of extracapsular cataract extraction. In the same way control group of 18 patients who underwent cataract surgery without RP (33 eyes) was examined. In RP group in 63.6% patients on discharge from the hospital and in 60.6% patients during the control examination, improvement of visual acuity was revealed. Deterioration was noted in 18.2% of patients on discharge from hospital and in 24.2% of patients during the control examination. In the control group improvement of visual acuity was revealed in 90.9% of patients on discharge and in 97% patients during the control examination, whereas deterioration of visual acuity occurred in 6.1% patients on discharge and in 3% patients during the check examination. In patients with retinitis pigmentosa cataract occurs earlier then in the control group. Cataract surgery for relatively minor opacities is beneficial in patients with RP, and causes improvement of visual acuity in most of eyes undergoing surgery.

Coats-like retinitis pigmentosa: Reports of three cases.

Science.gov (United States)

Kan, Emrah; Yilmaz, Turgut; Aydemir, Orhan; Güler, Mete; Kurt, Jülide

2007-06-01

Describing the ophthalmic findings of an exudative vasculopathy called as Coats-like retinitis pigmentosa on three patients. The etiology of the Coats-like retinitis pigmentosa is obscure. The principal theories have been discussed in this article. Three observational case series have been discussed. Complete ophthalmic examinations and color fundus photos, visual field, and fluorescein angiography have been performed. We have identified 3 patients who have some typical clinical features of Coats-like retinitis pigmentosa; peripheral serous retinal detachment, telangiectasia, prominent lipid deposition, pigmentary changes in peripheral retina, and loss of vision. None of the three patients had positive family history. All of the patients have had symptoms of nyctalopia, decreased central vision, and two of them have had constriction of visual field. All of the patients have had cataracts and two of them underwent cataract surgery. Fundus examination and fluorescein angiography of patients revealed typical retinitis pigmentosa with Coats-type changes in bilateral inferiotemporal quadrants. A better understanding of clinical features and genetic etiology of Coats-type retinitis pigmentosa will aid diagnosis and development of new therapies. If sufficient conditions arise, genetic factors that influence the expression of CRB1 mutations in Coats-like retinitis pigmentosa should be detected.

A qualitative study of regional anaesthesia for vitreo-retinal surgery.

Science.gov (United States)

McCloud, Christine; Harrington, Ann; King, Lindy

2014-05-01

The aim of this research was to collect experiential knowledge about regional ocular anaesthesia - an integral component of most vitreo-retinal surgery. Anaesthesia for vitreo-retinal surgery has predominantly used general anaesthesia, because of the length and complexity of the surgical procedure. However, recent advances in surgical instrumentation and techniques have reduced surgical times; this decision has led to the adoption of regional ocular anaesthesia for vitreo-retinal day surgery. Although regional ocular anaesthesia has been studied from several perspectives, knowledge about patients' experience of the procedure is limited. An interpretive qualitative research methodology underpinned by Gadamer's philosophical hermeneutics. Eighteen participants were interviewed in-depth between July 2006-December 2007 following regional ocular anaesthesia. Interview data were thematically analysed by coding and grouping concepts. Four themes were identified: 'not knowing': the time prior to the experience of a regional eye block; 'experiencing': the experience of regional ocular anaesthesia; 'enduring': the capacity participants displayed to endure regional ocular anaesthesia with the hope that their vision would be restored; and 'knowing': when further surgery was required and past experiences were recalled. The experience of regional ocular anaesthesia had the capacity to invoke anxiety in the participants in this study. Many found the experience overwhelming and painful. What became clear was the participant's capacity to stoically 'endure' regional ocular anaesthesia, indicating the value people placed on visual function. © 2013 John Wiley & Sons Ltd.

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

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.

Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy

DEFF Research Database (Denmark)

Ostri, Christoffer; Lux, Anja; Lund-Andersen, Henrik

2014-01-01

haemorrhage patients. For tractional retinal detachment patients, use of silicone oil was associated with low vision (visual acuity4 and p-values ≤ 0.03, logistic regression). Of the 134 patients who were phakic after surgery, 43% and 29% were phakic......-term predictor of low vision after surgery is use of silicone oil for endotamponade. About 2/3 of phakic patients will subsequently have cataract surgery the first 10 years after diabetic vitrectomy....

Four-port bimanual 23-gauge vitrectomy for diabetic tractional retinal detachment.

Science.gov (United States)

Wang, Zhao-Yang; Zhao, Ke-Ke; Li, Jia-Kai; Rossmiller, Brian; Zhao, Pei-Quan

2016-06-01

Four-port bimanual vitrectomy is a surgical technique that facilitates removal of epiretinal membranes in severe proliferative diabetic retinopathy (PDR). As the illumination is held by the assistant through the fourth scleral incision, fibrovascular membranes are removed by bimanual manipulation techniques. The objective of this study was to evaluate the safety and efficacy of four-port bimanual 23-gauge vitrectomy for patients with tractional retinal detachment (TRD) in severe PDR. Retrospective, comparative, consecutive, interventional case series. Sixty-six eyes of 58 consecutive patients who underwent primary vitrectomy for severe diabetic TRD. Thirty-six eyes of 31 cases that were treated with four-port 23-gauge vitrectomy were compared with 30 eyes of 27 cases that were treated with 23-gauge pars plana vitrectomy (PPV). Main outcome measures were best-corrected visual acuity (BCVA), retinal status, intraocular pressure, and incidence of intraoperative and postoperative complications with at least 6 months of follow-up. The primary and ultimate anatomic success rates (94.4% versus 93.3%, and 100% in both groups, respectively) and the mean BCVA changes did not differ significantly between groups. The whole surgical time and the membrane removal time were significantly (p four-port 23-gauge group than in the 23-gauge group. There was no difference in the incidence of intraoperative and postoperative complications in both groups. Four-port bimanual 23-gauge vitrectomy offers comparable anatomic success and shortens the surgical time compared with conventional 23-gauge PPV in patients with TRD resulting from severe PDR. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

COMPARATIVE ANALYSIS OF RETINAL REATTACHMENT SURGERY WITH OR WITHOUT INTERNAL LIMITING MEMBRANE PEELING TO PREVENT POSTOPERATIVE MACULAR PUCKER.

Science.gov (United States)

Forlini, Matteo; Date, Purva; Ferrari, Luisa Micelli; Lorusso, Massimo; Lecce, Gabriella; Verdina, Tommaso; Neri, Giovanni; Benatti, Caterina; Rossini, Paolo; Bratu, Adriana; DʼEliseo, Domenico; Ferrari, Tommaso Micelli; Cavallini, Gian Maria

2017-07-18

To determine whether internal limiting membrane (ILM) peeling during pars plana vitrectomy for rhegmatogenous retinal detachment reduces the incidence of epiretinal membrane (ERM) formation. In this retrospective study, preoperative, intraoperative, and postoperative data from all eyes undergoing pars plana vitrectomy for rhegmatogenous retinal detachment between January 2007 and December 2013 was analyzed. All cases with at least 1-year of follow-up were included. Data collection included vision, intraoperative complications, occurrence of ERM, and spectral domain optical coherence tomography characteristics. The OCTs were retrieved for all eyes and were graded by a single masked grader. Out of 159 eyes recruited, ILM peeling was done in 78 eyes (49%). Overall occurrence of ERM was 20%. Seven eyes (9%) in ILM peeling group and 25 eyes in the non-ILM peeling group (31%) showed ERM (P = 0.001). Postoperative vision was significantly better in eyes that had ILM peeling (0.48 ± 0.4 logarithm of the minimum angle of resolution [20/63] vs. 0.77 ± 0.6 logarithm of the minimum angle of resolution [20/125], P = 0.003). In multivariable models adjusting for type of tamponade, ILM peeling reduced the likelihood of ERM formation by 75% (P = 0.01). Internal limiting membrane peeling during pars plana vitrectomy for rhegmatogenous retinal detachment significantly reduces ERM formation in the postoperative period and is associated with better visual and anatomical outcomes.

Retinal findings in membranoproliferative glomerulonephritis

Directory of Open Access Journals (Sweden)

Ahmad M. Mansour

2017-09-01

Conclusions and importance: Drusen remain the ocular stigmata for MPGN occuring at an early age. The retinal disease is progressive with gradual thickening of Bruch's membrane and occurrence of retinal pigment epithelium detachment.

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.

Tomographic Structural Changes of Retinal Layers after Internal Limiting Membrane Peeling for Macular Hole Surgery.

Science.gov (United States)

Faria, Mun Yueh; Ferreira, Nuno P; Cristóvao, Diana M; Mano, Sofia; Sousa, David Cordeiro; Monteiro-Grillo, Manuel

2018-01-01

To highlight tomographic structural changes of retinal layers after internal limiting membrane (ILM) peeling in macular hole surgery. Nonrandomized prospective, interventional study in 38 eyes (34 patients) subjected to pars plana vitrectomy and ILM peeling for idiopathic macular hole. Retinal layers were assessed in nasal and temporal regions before and 6 months after surgery using spectral domain optical coherence tomography. Total retinal thickness increased in the nasal region and decreased in the temporal region. The retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and inner plexiform layer (IPL) showed thinning on both nasal and temporal sides of the fovea. The thickness of the outer plexiform layer (OPL) increased. The outer nuclear layer (ONL) and outer retinal layers (ORL) increased in thickness after surgery in both nasal and temporal regions. ILM peeling is associated with important alterations in the inner retinal layer architecture, with thinning of the RNFL-GCL-IPL complex and thickening of OPL, ONL, and ORL. These structural alterations can help explain functional outcome and could give indications regarding the extent of ILM peeling, even though peeling seems important for higher rate of hole closure. © 2017 S. Karger AG, Basel.

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

The application about krypton laser photocoagulation and intravitreal C3F8 in retinal detachment after vitrectomy%氪激光联合玻璃体腔C3F8填充在玻璃体切除术后视网膜脱离中的应用

Institute of Scientific and Technical Information of China (English)

李红; 蒋模; 蔡善君

2013-01-01

目的 探讨氪激光视网膜光凝联合玻璃体腔注气术在玻璃体切除、眼内气体填充术后发生视网膜脱离中的适应症及临床疗效.方法 对30例因视网膜脱离或玻璃体积血行玻璃体切割、眼内光凝、联合SF6或C3F8填充,术后发现局限性视网膜再脱离的患者采用双针法行玻璃体注气联合视网膜氪激光光凝筑堤的办法,以闭合裂孔,复位视网膜脱离.术中采取双针法交换玻璃体腔部分房水,术后俯卧位休息12～18 h后予全视网膜镜下寻找裂孔,并激光光凝裂孔周围视网膜,激光参数为:能量180～300 mw,曝光时间0.2 s,光斑直径200～300 μm.结果 30眼中,玻璃体腔注C3F8气体联合氪绿激光光凝术后25只眼视网膜脱离复位,随诊3～18月视网膜稳定；4只眼视网膜未能复位,再次行玻璃体腔灌注,视网膜激光光凝及硅油填充,随访6月视网膜脱离复位,术后1只眼未能随访.结论 对于玻璃体切割术后的发生视网膜脱离患者,行氪绿激光光凝联合玻璃体腔注长效气体术是一种操作简单、节省治疗时间和费用较为理想的治疗方法.%OBJECTIVE To investigate the effect about krypton laser photocoagulation with long-gas injection in eyes in the recurrent retinal detachment after vitrectomy and long-acting gas injection. METHODS For 30 cases with retinal detachment and vitreous hemorrhage, carried out vitrectomy surgery combined with SF6 or C3F8 filled, postoperatively found that limitations of retinal detachment in patients used double needle vitreous gas injection combined with retinal krypton laser photocoagulation embankment approach to close the hole and reattach retinal detachment. Took double needle to exchange aqueous Humour, postoperative prone position rest for 12 to 18 hours, then located holes and used laser photocoagulation around them, laser parameters; energy 180-300mw, exposure time 0.2S, spot diameter 200-300μ,m. RESULTS In 30 eyes

[Posterior vitrectomy with gas endotamponade and retinal laser therapy in treatment of patients with macular complications of the optic disc pit].

Science.gov (United States)

Cywiński, Adam; Kałużny, Jakub; Ferda, Daniela; Piwońska-Lobermajer, Anna

2015-01-01

Retrospective evaluation of functional and anatomical treatment outcomes in patients with macular cornplications of optic disc pit. 9 patients (eyes) underwent central posterior vitrectomy in conjunction with posterior vitreous detachment, retinal laser therapy to the optic disc pit area and endotamponade with expansile gas. It was followed by the patient's forced positioning (recommended for a few days especially at night), which ended the treatment protocol. Improved anatomical relationships, accompanied by functional improvement were achieved in each reported case. The resolution of macular lesions was slow, lasting even for several months. Too long delay in performing the surgery (over 5 months since the onset of visual impairment) was associated with the development of retinal complications, mainly macular hole formation, most likely caused by the long-term ischemia. The central posterior vitrectomy combined with posterior vitreous detachment, laser therapy, andd expansile gas tamponade offers good outcomes in patients with retinal complications of optic disc pit. Surgery performed shortly after the onset of visual dysfunction gives the best functional outcomes. Restoration of normal anatomical relationships is a long-term process. In some cases, though, these abnormalities may not resolve completely.

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

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

Vitrectomy with and without scleral buckling for retinal detachment Vitrectomia com e sem "scleral buckling" para descolamento da retina

Directory of Open Access Journals (Sweden)

Rubens Camargo Siqueira

2007-03-01

Full Text Available PURPOSE: To compare the surgical results of vitrectomy with and without scleral buckling for rhegmatogenous retinal detachment (RD. METHODS: Fifty-one patients with rhegmatogenous retinal detachment with proliferative vitreoretinopathy (PVR at different stages were submitted to pars plana vitrectomy as the primary surgery, 23 patients (45.09% with scleral buckle (group I and 28 (54.90% without scleral buckle (group II. Visual acuity, anterior segment complications, intraocular pressure, strabismus and retina reattachment rate were evaluated in both groups. RESULTS: The anatomical success and postoperative complications were similar in both groups. Retinal reattachment was achieved in 20 of 23 eyes (87% of group I and in 24 of 28 eyes (85.7% of group II after the initial surgery (p=1.000. Elevated intraocular pressure was noted in 2 eyes (8.7% of group I and 1 eye (3.6% of group II (p=0.583. Corneal abnormalities were seen in 3 eyes (13% of group I and 2 eyes (7.19% of the group II (p=0.647. Visual acuity improved from a preoperative median of 20/200 to a median of 20/100 in group 1 and from 20/400 to 20/100 in group 2; the difference between the two groups was statistically significant (pOBJETIVOS: Comparar os resultados cirúrgicos da vitrectomia com e sem "buckle" escleral para descolamento da retina regmatogênico (DR. MÉTODOS: Cinqüenta e um pacientes com descolamento da retina regmatogênico com proliferação vitreorretiniana (PVR em diferentes estádios foram submetidos a vitrectomia pars plana como cirurgia primária; 23 pacientes (45,09% com buckle escleral (grupo 1 e 28 pacientes (54,90% sem "buckle" escleral (grupo 2. Acuidade visual, complicações do segmento anterior, pressão intra-ocular, estrabismo e razão do redescolamento da retina foram avaliados em ambos os grupos. RESULTADOS: O sucesso anatômico e complicações pós-operatórias foram semelhantes em ambos os grupos. A reaplicação da retina foi obtida em 20 dos 23

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

间接镜氪激光光凝结合改进宽环扎治疗视网膜脱离%Krypton laser photocoagulation using indirect ophthalmoscopy combined with improved encircling scleral buckles in the treatment of retinal detachment

Institute of Scientific and Technical Information of China (English)

郑穗联; 陈如; 王若洁; 蔡剑秋; 施明光

2011-01-01

Objective To assess the clinical result of the krypton laser photocoagulation using indirect ophthalmoscopy combined with improved encircling scleral buckles.Methods Forty-one eyes of 41 patients were treated with encircling scleral buckles and drainage, some combined with intravitreal injection of gas or balanced salt solution (BSS).All of the retinal breaks were treated with krypton laser photocoagulation using indirect ophthalmoscopy after surgery.Results The visual acuity improved (P<0.05).The reattachment of the retina: 36 eyes were successfully repaired, 5 eyes became recurrent retinal detachment (the reattachment rate was 88.37%).Among the 5 cases, 4 patients were successfully treated with vitrectomy except one patient of traumatic retinal detachment was given up.Conclusions The treatment of retinal detachment should follow the principles of simple surgical methods and fewer complications.The krypton laser photocoagulation using indirect ophthalmoscopy combined with improved encircling scleral buckles in the treatment of retinal detachment in proper cases is a safe, simple and convenient, easy operated and effective method.%目的 讨论采用间接镜氪激光光凝结合改进宽环扎治疗视网膜脱离的临床疗效.方法 对41例41只眼PVRB级或以下的孔源性视网膜脱离病人行宽环扎、放液,部分病人联合玻璃体腔注气或平衡液,术后间接镜氪激光治疗视网膜裂孔.结果 视力提高:术后视力为3.87±0.74,术前视力为3.40±0.86,P<0.05.视网膜复位情况:41只眼中手术成功36只眼,5只眼复发性,成功率88.37%.5只眼复发性视网膜脱离,除1例外伤性视网膜脱离放弃手术外,其余患者均行玻璃体手术后复位.结论 对视网膜脱离术我们建议遵循手术方式简单、并发症少的原则.选择适当病例,间接镜氪激光光凝结合改进宽环扎治疗视网膜脱离是一种安全、简便、易操作、效果良好的方法.

Long-Term Outcomes of Total Exudative Retinal Detachments in Stage 3B Coats Disease.

Science.gov (United States)

Li, Albert S; Capone, Antonio; Trese, Michael T; Sears, Jonathan E; Kychenthal, Andres; De la Huerta, Irina; Ferrone, Philip J

2018-06-01

To evaluate the long-term outcomes of treatment of total exudative retinal detachments (ERDs) secondary to Coats disease (stage 3B) and the role of vitrectomy. Retrospective, observational case series. A total of 16 eyes in 16 patients undergoing treatment for total ERDs secondary to Coats disease with at least 5 years of follow-up. We reviewed the records of patients with stage 3B Coats disease. The interventions, including the timing of vitrectomy if used, and clinical course were recorded. The primary outcome measures were visual acuity at the most recent appointment, whether there was progression to neovascular glaucoma (NVG) or phthisis bulbi, and need for enucleation. All patients received ablative treatment (photocoagulation or cryotherapy), with 8 having scleral buckling (SB) and 6 having external drainage of subretinal fluid (XD). Of the 12 patients who had pars plana vitrectomy (PPV), 8 had early PPV (EV) in the first year after presenting, and 4 of 8 in the expectant management group had late PPV (late vitrectomy) at a mean of 4.3 years post-presentation for treatment of significant traction retinal detachment (TRD). The other 4 patients of 8 in the expectant management group did not require vitrectomy. Mean follow-up overall was 9 1/2 years. At the date of last follow-up, 50% had no light perception or light perception vision, which was consistent across the subgroups that underwent EV (4/8), late vitrectomy (2/4), or no PPV (2/4). A total of 4 of 16 patients had progression to NVG or phthisis, 1 of whom required enucleation. In this retrospective series of patients with Stage 3B Coats disease, ablative therapy with a combination of PPV, XD, or SB was effective in preventing progression to NVG or phthisis in the majority of patients, thus preserving the globe. Half of the patients (4/8) in this series who did not undergo PPV in the early vitrectomy group developed late-onset TRD, suggesting a possible role for early prophylactic vitrectomy with possible

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

Unusually delayed presentation of persistent Descemet’s membrane tear and detachment after cataract surgery

Directory of Open Access Journals (Sweden)

Morkin MI

2014-08-01

Full Text Available Melina I Morkin,1,2 Rehan M Hussain,2 Ryan C Young,2 Tracy Ravin,2 Sander R Dubovy,2 Eduardo C Alfonso2 1Department of Ophthalmology, Shiley Eye Center, University of California – San Diego, San Diego, CA, 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA Abstract: A 51-year-old male who had undergone phacoemulsification in his left eye 11 months prior presented with complaint of sudden onset of blurred vision in the same eye. Review of his clinical course, slit-lamp exam, pachymetry, and specular endothelial microscopy led to the diagnosis of acute hydrops caused by Descemet’s membrane dehiscence at the site of the incision. He was initially managed with medical treatment and observation. In the subsequent months of follow-up, the corneal edema and the patient’s visual acuity did not improve. Intracameral gas injection was performed 7 months after presentation, but because of persistent corneal edema and nonattached Descemet’s membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis. The patient has had a clear corneal graft since then. Although Descemet’s membrane detachment is a rather common complication after intraocular surgery, its unusually delayed presentation can also occur, and should not be confused with pseudophakic bullous keratopathy. Many mechanisms have been studied for the development of early tears and detachments after cataract surgery, but little is known about late presentations. The authors explore possible causes, and highlight the importance of instructing patients to avoid eye rubbing and any other type of trauma to the cornea after intraocular surgery. Keywords: Descemet’s membrane tear, detachment, cataract surgery, phacoemulsification

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.

Statin use and vitreoretinal surgery: Findings from a Finnish population-based cohort study.

Science.gov (United States)

Loukovaara, Sirpa; Sahanne, Sari; Takala, Annika; Haukka, Jari

2018-01-16

Vitreoretinal (VR) surgery is the third most common intraocular surgery after refractive and cataract surgery. The impact of statin therapy on VR surgery outcomes remains unclear, despite a potentially beneficial effect. We explored the association of preoperative statin therapy and the need for revitrectomy after primary vitrectomy. Our historical, population-based, register-based, VR surgery cohort consisted of 5709 patients operated in a tertiary, academic referral hospital in Finland, during 2008-2014, covering 6.5 years. Subgroup analysis was performed as follows: eyes operated due to (i) rhegmatogenous retinal detachment (RRD), (ii) VR interface diseases (macular pucker/hole), (iii) diabetic maculopathy or proliferative retinopathy, (iv) vitreous haemorrhage, (v) lens subluxation, (vi) vitreous opacities or (vii) other VR indication. The primary end-point event was revitrectomy during a postoperative follow-up period of 1 year due to retinal redetachment, vitreous rehaemorrhage, postoperative endophthalmitis, recurrent pucker or unclosed macular hole. Rhegmatogenous retinal detachment (RRD) was the second most frequent indication of VR surgery, including 1916 patients, with 305 re-operations with rate 0.20 (95% CI 0.18-0.23) per person-year. Statin treatment in time of operation was associated with lower risk of re-operation according to relative scale (incidence rate ratio 0.72, 95% CI 0.53-0.97), but not in absolute scale (incidence rate difference -0.58, 95% CI -4.30 to 3.15 for 100 person-years). No association with statin therapy and vitrectomy outcome was observed in the other VR subgroups. Use of statin treatment was associated with a 28% lower risk of revitrectomy in patients operated due to RRD. Further randomized clinical trials are highly warranted. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Establishing an experimental rat model of photodynamically-induced retinal vein occlusion using erythrosin B

Directory of Open Access Journals (Sweden)

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.

Update on wide- and ultra-widefield retinal imaging

Directory of Open Access Journals (Sweden)

Samir S Shoughy

2015-01-01

Full Text Available The peripheral retina is the site of pathology in many ocular diseases and ultra-widefield (UWF imaging is one of the new technologies available to ophthalmologists to manage some of these diseases. Currently, there are several imaging systems used in practice for the purpose of diagnostic, monitoring disease progression or response to therapy, and telemedicine. These include modalities for both adults and pediatric patients. The current systems are capable of producing wide- and UWF color fundus photographs, fluorescein and indocyanine green angiograms, and autofluorescence images. Using this technology, important clinical observations have been made in diseases such as diabetic retinopathy, uveitides, retinal vascular occlusions and tumors, intraocular tumors, retinopathy of prematurity, and age-related macular degeneration. Widefield imaging offers excellent postoperative documentation of retinal detachment surgery. New applications will soon be available to integrate this technology into large volume routine clinical practice.

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

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.

Cytomegalovirus retinitis and HIV: Case reviews from KwaZulu ...

African Journals Online (AJOL)

untreated, CMV retinitis can progress to retinal detachment with ... 1 Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris .... [18] Ocular TB .... patients for publication of these case reviews and accompanying images.

Efficacy of vitreoretinal surgery in the treatment of X-linked retinoschisis with serious complications

Directory of Open Access Journals (Sweden)

Chen Zhao

2013-10-01

Full Text Available AIM: To evaluate the efficacy of vitreoretinal surgery in the treatment of X-linked retinoschisis(XLRSand its complications. METHODS: A retrospective study was made on all the XLRS patients with severe complications after operation in this hospital. All the 25 patients(31 eyespresent with macular abnormalities with/without peripheral retina split bypreoperative OCT examination. Among the 31 eyes, there were 7 eyes with vitreous hemorrhage, 8 eyes with retinal detachment and vitreous hemorrhage, and 16 eyes with rhegmatogenous retinal detachment. All the 31 eyes were divided into 2 groups: group A included 15 eyes which underwent photocoagulation before the surgery, while the other 16 eyes in group B didn't perform photocoagulation before the surgery. All the patients underwent a pars plana vitrectomy without lensectomy associated with internal limiting membrane peeling. Photocoagulation was done to the retinal holes and degeneration areas in group A. Gas or silicone oil was filled in group B after retinal photocoagulation treatment. Three years later, analysis was made on the results of the visual acuity, postoperative anatomical and functional outcome in these 2 groups. Statistical analysis was made on the results of average visual acuity before and after operation by SPSS software method, the difference was statistically significant(PRESULTS: Postoperative anatomical and functional outcome were satisfied at the last visit. A total of 23 eyes'(74.2%visual acuity were improved with the mean visual acuity increasing from 0.13±0.08 to 0.24±0.16, the difference was statistically significant(t=-5.354,P=0.000. The average visual acuity in group A was improved from 0.11±0.08 to 0.22±0.15 after operation(t=-4.391, P=0.000. While the average visual acuity in group B increased from 0.14±0.08 to 0.26±0.15(t=-4.488, P=0.000. The visual changes in two groups were statistical significance. But when compared the average changes of visual acuity before

Long-term Evaluation of Laser Retinopexy in Retinal Breaks: A ...

African Journals Online (AJOL)

tulyasys

INTRODUCTION. Retinal detachment is a serious and sight-treating disease. ... a frequent, age-related problem in the ophthalmology clinic. ... recommended as an effective means of preventing. RD. .... of macular holes and retinal tears.

Risk factors for retinal breaks in patients with symptom of floaters.

Science.gov (United States)

Singalavanija, Apichart; Amornrattanapan, Chutiwan; Nitiruangjarus, Kanjanee; Tongsai, Sasima

2010-06-01

To identify the risk factors of retinal breaks in patients with the symptom of floaters, and to determine the association between those risk factors and retinal breaks. A retrospective analytic study of 184 patients (55 males and 129 females) that included 220 eyes was conducted. Patient information such as age, symptoms (multiple floaters, flashing), duration of symptom, refractive error, history of cataract surgery, family history of retinal detachment, and complete eye examination were recorded. The patients were divided into two groups, the first group (control group) had symptoms of floaters and no retinal breaks, the second group (retinal breaks group) had symptoms of floaters with retinal breaks. Chi-square test, and the multiple logistic regression were used for statistical analysis. Two hundred twenty eyes, 175 eyes of the control group and 45 eyes of the retinal breaks group were examined and included in this study. The multiple logistic regression analysis revealed that patients with multiple floaters, and floaters and flashing increased the risk of retinal breaks to 5.8 and 4.3 times, respectively, when compared to patients with single floater or floaters alone. Lattice degeneration increased the risk of retinal breaks to 5.9 times when compared to eyes that did not have lattice degeneration. Multiple floaters, flashing and lattice degeneration are risk factors of retinal breaks in patients with symptoms of floaters. Therefore, it is important for the ophthalmologists to be aware of these risk factors and the patients at risk should have follow-up examinations.

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

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.

COMPARISON OF 2D AND 3D VIDEO DISPLAYS FOR TEACHING VITREORETINAL SURGERY.

Science.gov (United States)

Chhaya, Nisarg; Helmy, Omar; Piri, Niloofar; Palacio, Agustina; Schaal, Shlomit

2017-07-11

To compare medical students' learning uptake and understanding of vitreoretinal surgeries by watching either 2D or 3D video recordings. Three vitreoretinal procedures (tractional retinal detachment, exposed scleral buckle removal, and four-point scleral fixation of an intraocular lens [TSS]) were recorded simultaneously with a conventional recorder for two-dimensional viewing and a VERION 3D HD system using Sony HVO-1000MD for three-dimensional viewing. Two videos of each surgery, one 2D and the other 3D, were edited to have the same content side by side. One hundred UMass medical students randomly assigned to a 2D group or 3D, then watched corresponding videos on a MacBook. All groups wore BiAL Red-blue 3D glasses and were appropriately randomized. Students filled out questionnaires about surgical steps or anatomical relationships of the pathologies or tissues, and their answers were compared. There was no significant difference in comprehension between the two groups for the extraocular scleral buckle procedure. However, for the intraocular TSS and tractional retinal detachment videos, the 3D group performed better than 2D (P < 0.05) on anatomy comprehension questions. Three-dimensional videos may have value in teaching intraocular ophthalmic surgeries. Surgical procedure steps and basic ocular anatomy may have to be reviewed to ensure maximal teaching efficacy.

KERATOPROSTESIS IN NIGERIAN EYES – 10 YEAR OUTCOME

African Journals Online (AJOL)

MRS ERAMEH

At 15 months post surgery, the patient had pars planitis that got us worried, and we suspected retinal detachment. An ultrasound scan suggested retinal detachment. The patient was referred to a vitreo-retinal centre that believed the retina was intact. The patient recovered after steroid medications and his vision was about.

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.

Comparisons of retinal nerve fiber layer thickness changes after macular hole surgery

Directory of Open Access Journals (Sweden)

Nelson Chamma Capelanes

Full Text Available ABSTRACT Purpose: To compare postoperative changes in retinal nerve fiber layer thickness in patients with macular holes treated with vitrectomy with Brilliant Blue-assisted internal limiting membrane peeling. Methods: Twenty-two eyes of 20 patients with macular holes were studied. Each eye was selected to undergo Brilliant Blue-assisted internal limiting membrane peeling. The circumferential retinal nerve fiber layer thickness was determined using spectral domain optical coherence tomography preoperatively and 2 months postoperatively. Mean overall and sectoral retinal nerve fiber layer thicknesses were obtained for each patient. Results: There was no statistically significant difference (p≥0.05 between the pre- and post-treatment measurements in relation to each CFN variable, i.e., on average, pre-treatment measures were the same as post-treatment measures. Furthermore, despite the differences between the pre- and post-treatment measures always being positive (pre-post >0, they are not statistically significant. Conclusions: This study showed no significant decrease in retinal nerve fiber layer thickness measurements after macular holes surgery, regardless of age or sex.

Barriers to Setting up a Vitreo‑retinal Unit of Ophthalmology in ...

African Journals Online (AJOL)

Vitreo‑retinal equipment is expensive and may be beyond the reach of a ... retinopathy, age‑related macular degeneration, retinal detachment ... requiring treatment. Earlier, we ... the Prevention of Blindness visited our institution and initiated ...

Surgical approach and optic coherence tomographic evaluation of optic disc anomaly in association with serous macular detachment.

Science.gov (United States)

Güven, Dilek; Balcıoğlu, Nihal; Türker, Cağrı; Baydar, Yasemin; Sendül, Yekta

2013-12-01

Serous macular detachment (SMD) may accompany optic disc pit (ODP) and cause visual loss if untreated. We want to present different therapeutic approaches and interesting optical coherence tomography (OCT) findings in three consecutive cases. In this case series, two patients with SMD and one patient with partial macular detachment and inferior retinal detachment accompanying ODP were evaluated before and after surgical intervention clinically and by spectral-domain OCT. The patients were 44 (case 1), 22 (case 2) and 24 (case 3) years old. Pars plana vitrectomy (PPV) + silicone oil + laser, PPV + sulfur hexafluoride gas (SF6) + laser and pneumatic retinopexy were applied, respectively. The patients were followed for 18, 15 and 14 months. Preoperative best-corrected visual acuities (BCVAs) were 5/100, 7/10 and counting fingers at 1 m. Vision improved in all cases with resolution of subretinal fluid. Final BCVAs were 3/10, 10/10 and 1/10, respectively. OCT images revealed optic disc anomaly details and changes after surgical intervention, photoreceptor outer segment alterations at the detached area and macular surface changes. Surgical intervention should be tailored individually in cases with SMD. OCT is efficient for in vivo evaluation of this pathological condition and anatomical outcomes of surgery.

Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study

Directory of Open Access Journals (Sweden)

Baran Gencer

2015-02-01

Full Text Available BACKGROUND AND OBJECTIVES: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. METHODS: This prospective study included 30 patients undergoing spinal surgery. Retinal nerve fiber layer thickness were measured one day before and after the surgery by using optical coherence tomography. Intraocular pressure was measured by tonopen six times at different position and time-duration: supine position (baseline; 10 min after intubation (Supine 1; 10 (Prone 1, 60 (Prone 2, 120 (Prone 3 min after prone position; and just after postoperative supine position (Supine 2. RESULTS: Our study involved 10 male and 20 female patients with the median age of 57 years. When postoperative retinal nerve fiber layer thickness measurements were compared with preoperative values, a statistically significant thinning was observed in inferior and nasal quadrants (p = 0.009 and p = 0.003, respectively. We observed a statistically significant intraocular pressure decrease in Supine 1 and an increase in both Prone 2 and Prone 3 when compared to the baseline. Mean arterial pressure and ocular perfusion pressure were found to be significantly lower in Prone 1, Prone 2 and Prone 3, when compared with the baseline. CONCLUSIONS: Our study has shown increase in intraocular pressure during spinal surgery in prone position. A statistically significant retinal nerve fiber layer thickness thinning was seen in inferior and nasal quadrants one day after the spinal surgery.

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

Results of laser treatment for sub-retinal neovascular membranes

African Journals Online (AJOL)

1990-09-01

Sep 1, 1990 ... haemonhagic detachment of the retinal pigment epithelium and sensory· retina produced by exudation from these new vessels.I-l This exudative and sometimes haemorrhagic process often leads to severe and permanent loss of central vision because of sub-retinal fibrovascular organisation.2 Progressive.

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.

Clinical Abservation of Krypton Laser Photocoagulation Preventing Retinal Detachment after LASIK on High Myopia%眼底激光预防中高度近视LASIK术后视网膜脱离的临床观察

Institute of Scientific and Technical Information of China (English)

周建平; 胡莉群; 胡长青

2014-01-01

目的观察LASIK术前对中高度近视患者行预防性眼底激光光凝的疗效。方法准备接受LASIK手术的中高度近视患者作详细眼底检查，直接眼底镜、间接眼底镜和三面镜检查明确有视网膜变性或(和)干性裂孔的患者共61例(112眼)行氪激光光凝治疗。结果61例(112眼)患者氪激光光凝术后变性区及裂孔封闭良好，未发生视网膜脱离。结论对明确有视网膜变性和裂孔的中高度近视患者LASIK术前行氪激光光凝是预防LASIK术后发生孔源性视网膜脱离的一种安全有效的方法。%Objective To observe the effect of krypton laser photocoagulation before LASIK on high myopia. Methods Full fundus examination on high myopic patients was performed with direct ophthalmoscopy, indirect ophthalmoscopy and three mirror contact lens. 112 eyes of 61 patients with peripheral retinal degeneration or retinal hole were treated by krypton laser photocoagulation before LASIK. Results 112 eyes of 61 patients with peripheral retinal degeneration or retinal hole were stable after krypton laser photocoagulation.No retinal detachment was occurred. Conclusion The krypton laser photocoagulation is a safe and ef ective method to preventing retinal detachment for the patients with peripheral retinal degeneration or retinal hole.

Thickening of inner retinal layers in the parafovea after bariatric surgery in patients with type 2 diabetes

DEFF Research Database (Denmark)

Brynskov, Troels; Laugesen, Caroline S; Floyd, Andrea K

2016-01-01

. METHODS: We examined 51 patients with T2D 2 weeks before and 1, 3, 6 and 12 months after bariatric surgery. Retinal thickness was measured with optical coherence tomography and automated segmentation in the fovea, parafovea and perifovea in each retinal layer. Retinal vessels were semiautomatically...... measured in a zone 0.5-1 disc diameters from the optic disc. RESULTS: The total macula thickened with a peak after 6 months in both univariate (2.7 ± 0.4 μm, p

Early Vitreous Surgery in the Treatment of Aggressive Posterior Retinopathy of Prematurity

Directory of Open Access Journals (Sweden)

A. V. Tereshhenko

2017-01-01

Full Text Available The goal is to identify objective indications for early primary vitreous surgery in infants with aggressive posterior ROP and to develop a methodology. Patients and methods. The study included 20 preterm infants (40 eyes with aggressive posterior ROP at the stage of formation exudative-tractional retinal detachment, which were divided into two groups. The main group consisted of 10 infants (20 eyes with severe manifestations of aggressive posterior ROP. The control group included 10 premature infants (20 eyes with aggressive posterior ROP, who underwent transpupillary laser coagulation of the retina (LC. In all cases (20 eyes 5-8 days after LC was recorded the progression of the disease. Based on data from a complex ophthalmic examination, given the progression of the disease after LC in the control group and baseline severe aggressive posterior ROP in the main group with the control with identical clinical picture, patients in both groups was made early vitreous surgery: in the main group — after ophthalmological examination and control after 8-16 days after LC. Results. In the main group after 6 months in 15 eyes (75% formed the correct vitreomacular interface, in 5 cases (25% were diagnosed with the smoothness of the foveolar pits by sealing the internal limiting membrane with no signs of retinal edema. In the control group after 6 months in 6 eyes (30% formed the right macular interface in 11 (55% — was defined by flatness or lack foveolar pit with no signs of retinal edema. On 3 eyes (15% in the 2nd zone remained a local retinal detachment. Conclusion. Primary vitrectomy performed according to the developed indications, allows to optimize the treatment of patients with aggressive posterior ROP in cases of inefficiency of the LC. It is an alternative and pathogenetically substantiated technology, which efficiency is not inferior to the traditional approach, including LС followed by vitreous surgery.

[Vitreoretinal outpatient surgery: clinical and financial considerations].

Science.gov (United States)

Creuzot-Garcher, C; Aubé, H; Candé, F; Dupont, G; Guillaubey, A; Malvitte, L; Arnavielle, S; Bron, A

2008-11-01

Vitreoretinal surgery has benefited from great advances opening the opportunity for outpatient management. We report on the 6-month experience of outpatient surgery for vitreoretinal diseases. From November 2007 to April 2008, 270 patients benefited from a vitreoretinal surgery, with 173 retinal detachments, 63 epiretinal membranes, and 34 other procedures. Only 8.5% (n=23) of the patients had to stay at the hospital one or two nights. The main reasons were the distance from the hospital and surgery on a single-eye patient. The questionnaire given after the surgery showed that almost all the patients were satisfied with the outpatient setting. In contrast, the financial results showed a loss of income of around 400,000 euros due to the low level of payment of outpatient surgery in France by the national health insurance system. Vitreoretinal surgery can be achieved in outpatient surgery with an improvement in the information given to the patients and the overall organization of the hospitalization. However, the current income provided with vitreoretinal outpatient surgery is highly disadvantageous in France, preventing this method from being generalized.

Cerebral migration of intraocular silicone oil: an MRI study

DEFF Research Database (Denmark)

Kiilgaard, Jens Folke; Milea, Dan; Løgager, Vibeke

2011-01-01

for retinal detachment. Methods: Nineteen patients included in this study were referred for silicone oil removal after uncomplicated retinal detachment surgery using internal silicone oil tamponade. Patients with a previous history of intraocular silicone oil, glaucoma or optic pit were excluded. After...

Keratopathy and pachymetric changes after photorefractive keratectomy and vitrectomy with silicone oil injection

DEFF Research Database (Denmark)

Buch, H; Vesti Nielsen, N

2000-01-01

We present a man who, after bilateral excimer laser photorefractive keratectomy (PRK) for high myopia in the right eye, had repeated retinal detachment surgery with lensectomy and injection of silicone oil. Visual acuity fluctuated in accordance with significant central corneal thickness diurnal...... variation. The case illustrates the possibility of PRK as a predisposing factor for keratopathy after retinal detachment surgery with silicone injection in an aphakic eye....

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.

Retinal tear presenting in a patient with ectrodactyly ectodermal dysplasia.

Science.gov (United States)

Grogg, Jane Ann; Port, Nicholas; Graham, Trevor

2014-04-01

This article aims to report a case of known ectrodactyly ectodermal dysplasia in a young male patient who subsequently was found to have a retinal tear and localized retinal detachment. This is a case report of a 22-year-old white male patient with a history of ectrodactyly ectodermal dysplasia. Our patient initially presented with an acute exacerbation of bilateral, red, irritated eyes. No recent changes in vision were reported. The patient's ocular surface disease was consistent with ectrodermal dysplasia syndrome. However, a dilated fundus examination revealed an asymptomatic retinal tear with a surrounding localized retinal detachment. In this case, the patient presented with longstanding ocular surface disease known to be associated with this patient's inherited ectoderm disorder. In addition, this patient revealed a retinal tear, raising the possibility that patients with inherited congenital ectodermal dysplasia could be at risk for damaged structures originating from the neural ectoderm. In this heterogeneous disease, we are contributing to the existing literature a case of ectodermal dysplasia syndrome with obvious ectodermal complications that also had retinal findings leading us to speculate question if neural ectoderm could also be involved in this inherited disease.

Transconjunctival drainage of serous and hemorrhagic choroidal detachment.

Science.gov (United States)

Rezende, Flávio A; Kickinger, Mônica C; Li, Gisèle; Prado, Renata F; Regis, Luiz Gustavo T

2012-02-01

To describe a novel surgical technique for drainage of bullous serous and hemorrhagic choroidal detachments. A prospective, consecutive case series of 6 eyes with serous and/or hemorrhagic choroidal detachments secondary to intraocular surgery was documented to evaluate the feasibility of using the 25-gauge and 20-gauge transconjunctival trocar/cannula systems to drain choroidal detachments. Two eyes had expulsive hemorrhagic choroidal detachments and 4 eyes had serous choroidal detachments after glaucoma surgeries. A 25-gauge infusion line was placed in the anterior chamber. A 20-gauge (in eyes with hemorrhagic choroidal detachments) or a 25-gauge (in eyes with serous detachments) trocar/cannula system was inserted into the suprachoroidal space 7.0 mm from limbus. After drainage, the cannulas were removed and no sutures were placed. Pars plana vitrectomy was performed only in eyes with concomitant pathology that demanded the additional procedure. The primary outcome measure was presence of choroidal detachment at 1 week, 2 weeks, and 1 month postoperatively. Secondary outcome measures were visual acuity at 6 months and intraocular pressure at 1 week and 1, 3, and 6 months postoperatively. Drainage of hemorrhagic choroidal detachments resulted in resolution of the detachments by 1 month postoperatively. In eyes with serous detachments, resolution was achieved by 1 week postdrainage. In both groups, intraocular pressure increased to at least 10 mmHg by postoperative Week 1. The visual acuity improved in all eyes. No complications related to the transconjunctival technique were noted. Transconjunctival drainage of serous and hemorrhagic choroidal detachments seems to be a feasible and simple surgical option with minimal scleral and conjunctival damage. Pars plana vitrectomy may not be necessary when draining choroidal detachments in this manner.

Ultra-wide field imaging system and traditional retinal examinations for screening fundus changes after cataract surgery.

Science.gov (United States)

Peng, Jie; Zhang, Qi; Jin, Hai-Ying; Lu, Wu-Yi; Zhao, Pei-Quan

2016-01-01

To compare the results of non-mydriatic ultra-wide field imaging system, mydriatic slit-lamp lens (Volk +90 D) and mydriatic Goldmann three-mirror contact lens examinations in screening fundus lesions among patients after cataract surgery. Non-mydriatic images were obtained with an Optomap panoramic 200Tx (Optomap 200Tx) 3d after surgery and graded by a blinded ophthalmologist. A mydriatic slit-lamp lens examination was performed by another blinded retinal specialist on the same day. A third blinded retinal specialist examined patients two weeks after surgery using a Goldmann three-mirror contact lens. In total, 160 patients (184 eyes) were examined, and 66, 69, and 75 cases of retinal lesion(s) were identified using the Optomap 200Tx, slit-lamp lens, and Goldmann three-mirror contact lens, respectively. In 13 cases, fundus changes were sight-threatening. The results obtained by Optomap 200Tx examination and by mydriatic slit-lamp lens examination have good consistency (P=0.375, Kappa=0.942). The mydriatic Goldmann three-mirror lens examination revealed more fundus lesions but are consistent with Optomap 200Tx (P=0.004, Kappa=0.897) and mydriatic slit-lamp lens examination (P=0.031, Kappa=0.932). Early post-operative fundus screening in cataract patients is extremely important and necessary to prevent further vision loss. Wide-field imaging is a feasible and convenient tool for fundus examination that can be used as a primary screening method among patients after cataract surgery.

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.

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...

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

Feasibility study on retinal vascular bypass surgery in isolated arterially perfused caprine eye model

Science.gov (United States)

Chen, Y; Wu, W; Zhang, X; Fan, W; Shen, L

2011-01-01

Purpose To investigate the feasibility of bypassing occluded segments of retinal venous main vessels in isolated, arterially perfused caprine eyes via the closed-sky vitrectomy approach using keratoprosthesis. Methods Isolated caprine eyes were used in this study. For each eye, the retinal vessel was perfused by Krebs solution via ophthalmic artery, and pars plana vitrectomy was performed using temporary keratoprosthesis. All retinal micro-vascular maneuvers were performed in a closed-sky eyeball. The main retinal vein was blocked by endodiathermy at the site of the vessel's first branching. Two openings, several millimeters apart, were created by vascular punctures in both the main vein and its branch vein wall straddling the induced occluded segment. Catheterization was achieved using a flexible polyimide tube, with each end inserted into the vessel wall opening. A sealed connection between the vessel and the tube was obtained by endodiathermy. Bypass of the occluded retinal vein segment was thus achieved, and the patency of this vascular bypass was confirmed by intravascular staining. Results Puncturing, catheterization, and endodiathermy were viable by closed-sky approach using keratoprosthesis. Bypassing of the occluded retinal main vein segment was accomplished with the combination of these maneuvers. Good results were obtained in 23 of 38 (60%) caprine eyes. Conclusions This study demonstrated that bypassing the occluded segment of retinal main vein can be successfully performed in a closed-sky eyeball model of isolated, arterially perfused caprine eye. This early work indicated that the more advanced retinal vascular bypass surgery in in vivo eye may be feasible in the future. PMID:21921946

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.

Internal Limiting Membrane Peeling to Prevent Post-vitrectomy Epiretinal Membrane Development in Retinal Detachment.

Science.gov (United States)

Akiyama, Kunihiko; Fujinami, Kaoru; Watanabe, Ken; Tsunoda, Kazushige; Noda, Toru

2016-11-01

To determine the efficacy of internal limiting membrane (ILM) peeling during vitrectomy for rhegmatogenous retinal detachment (RRD) regarding post-vitrectomy epiretinal membrane (ERM) development and visual outcomes. Retrospective, interventional, comparative case series. Setting: Institutional. One hundred and two consecutive eyes with RRD treated with vitrectomy and followed for at least 6 months. ILM was peeled without using dye such as indocyanine green (ICG). Observational Procedures: Patients were divided into 2 groups based on postoperative ERM development: Group 1, 81 eyes without ERM formation; Group 2, 21 eyes with ERM development. Patients also were divided into 2 subgroups: those with and without ILM peeling (58 and 44 eyes, respectively). Statistical analyses were performed between the 2 groups with/without ERM formation and between the 2 subgroups with/without ILM peeling for 5 preoperative factors including foveal involvement of the RRD, 4 intraoperative factors including ILM peeling, baseline best-corrected visual acuity (BCVA), and final BCVA. An association of ILM peeling with ERM prevention and the influence of ILM peeling on visual outcomes. ILM peeling was significantly (P peeling. ILM peeling without ICG staining during the initial vitrectomy for RRDs may prevent postoperative ERM formation with favorable visual outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

CASE REPORT OF SEVERE PROLIFERATIVE RETINOPATHY IN A PATIENT WITH CONGENITAL LIPODYSTROPHY.

Science.gov (United States)

Rosin, Boris; Jaouni, Tareq

2017-08-21

A case report of a patient with severe proliferative retinopathy due to congenital lipodystrophy. We reviewed the medical history, imaging, and surgical procedures of a 25-year-old woman with a history of congenital lipodystrophy, presenting with bilateral combined tractional and exudative retinal detachment, poorly controlled diabetes mellitus, and extreme dislipidemia. The patient underwent retinal detachment repair surgery both eyes. On the last follow-up, both retinae were flat, and visual acuity had improved in the right eye to J3 for near and finger counting 3 m for distance. Surgery combining pars plana vitrectomy and scleral bucking successfully flattened both retinae and significantly improved visual acuity in one eye in this case of bilateral retinal detachment with combined tractional and exudative components in a patient with congenital lipodystrophy. Surgical control of retinal complications is thus possible, provided there is adequate control of the underlying risk factors.

Optimizing the treatment of rhegmatogenous retinal detachment

DEFF Research Database (Denmark)

Hajari, Javad Nouri

2016-01-01

as an acute eye disease that needs immediate treatment. With the increasing number of cataract surgeries and an increased elderly population, the numbers of RRD occurrences are increasing. The aim of this thesis is to create knowledge on how treatment and care of RRD patients can be optimized. In the first...... within one year after initial surgery with pneumatic retinopexy, scleral buckling and VTX with gas, and one and a half years after surgery with VTX with oil. Also lack of oil removal within the first year is a failed operation. It is widely accepted that RRD is an acute disease but when should surgery...... to establish optimal conditions in the treatment of RRD....

Chorioretinal coloboma complications: retinal detachment and choroidal neovascular membrane

Directory of Open Access Journals (Sweden)

Rehan M Hussain

2017-01-01

Conclusion: RD and CNV were present in a high percentage of eyes with chorioretinal coloboma in these series. The frequent finding of retinal breaks outside the coloboma bed suggests that vitreoretinal interface abnormalities may play a role in development of RD in these eyes.

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.

Microscope-Integrated Intraoperative Ultrahigh-Speed Swept-Source Optical Coherence Tomography for Widefield Retinal and Anterior Segment Imaging.

Science.gov (United States)

Lu, Chen D; Waheed, Nadia K; Witkin, Andre; Baumal, Caroline R; Liu, Jonathan J; Potsaid, Benjamin; Joseph, Anthony; Jayaraman, Vijaysekhar; Cable, Alex; Chan, Kinpui; Duker, Jay S; Fujimoto, James G

2018-02-01

To demonstrate the feasibility of retinal and anterior segment intraoperative widefield imaging using an ultrahigh-speed, swept-source optical coherence tomography (SS-OCT) surgical microscope attachment. A prototype post-objective SS-OCT using a 1,050-nm wavelength, 400 kHz A-scan rate, vertical cavity surface-emitting laser (VCSEL) light source was integrated to a commercial ophthalmic surgical microscope after the objective. Each widefield OCT data set was acquired in 3 seconds (1,000 × 1,000 A-scans, 12 × 12 mm 2 for retina and 10 × 10 mm 2 for anterior segment). Intraoperative SS-OCT was performed in 20 eyes of 20 patients. In six of seven membrane peels and five of seven rhegmatogenous retinal detachment repair surgeries, widefield retinal imaging enabled evaluation pre- and postoperatively. In all seven cataract cases, anterior imaging evaluated the integrity of the posterior lens capsule. Ultrahigh-speed SS-OCT enables widefield intraoperative viewing in the posterior and anterior eye. Widefield imaging visualizes ocular structures and pathology without requiring OCT realignment. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:94-102.]. Copyright 2018, SLACK Incorporated.

Investigation of retinal damage during refractive eye surgery

Science.gov (United States)

Schumacher, S.; Sander, M.; Dopke, C.; Grone, A.; Ertmer, W.; Lubatschowski, H.

2005-04-01

Ultrashort laser pulses are increasingly used in refractive eye surgery to cut inside transparent corneal tissue. This is exploited by the fs-LASIK procedure which affords the opportunity to correct ametropia without any mechanical effects. The cutting process is caused by the optical breakdown occurring in the laser focus. During this process only a certain amount of the pulse energy is deposited into the tissue. The remaining pulse energy propagates further through the eye and interacts with the retina and the strong absorbing tissue layers behind. Therefore this investigation shall clarify if the intensity of the remaining laser pulse and the resulting temperature field can damage the retina and the surrounding tissue. Threshold values of the retinal tissue and theoretical calculations of the temperature field will be presented.

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.

Preserved scleral patch graft for unexpected extreme scleral thinning found at the scleral buckling procedure: A case report

Directory of Open Access Journals (Sweden)

Spela Stunf

2011-01-01

Full Text Available Pre-existing scleral pathology is an important risk factor for globe rupture during scleral buckling procedures. We report here, the surgical management of an unexpected scleral pathology found at the scleral buckling procedure in a retinal detachment patient. A 77-year-old white female with retinal detachment underwent a scleral buckling procedure. The surgery was converted into a scleral graft procedure, as extreme scleral thinning was found intraoperatively. An alcohol-preserved donor sclera graft was used. The second surgery for definitive retinal alignment was performed two weeks later. The presented case of an unexpected scleral pathology in a retinal detachment patient was managed with a combination of scleral grafting and pars plana vitrectomy, without any major complications. The anatomical outcome was excellent and the scleral rupture was prevented; the visual outcome was satisfactory. A conversion of the scleral buckling procedure into a scleral graft procedure has proved to be safe and effective for unexpected scleral pathology.

Efficacy of vitrectomy with triamcinolone assistance versus internal limiting membrane peeling for highly myopic macular hole retinal detachment.

Science.gov (United States)

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

2013-06-01

To compare the outcomes of pars plana vitrectomy (PPV) with or without the adjuvant surgical procedures: triamcinolone acetonide (TA) assistance and/or internal limiting membrane (ILM) peeling for the treatment of highly myopic macular hole retinal detachment (MHRD). Case-control study. Pars plana vitrectomy combined with 2 kinds of adjuvant surgical procedures were used on 96 highly myopic eyes with MHRD. These eyes were assigned to 4 groups randomly: Group 1, non-TA-assisted PPV and without ILM peeling; Group 2, non-TA-assisted PPV with ILM peeling; Group 3, TA-assisted PPV and without ILM peeling; Group 4, TA-assisted PPV with ILM peeling. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity were measured. The rates of both retinal reattachment and macular hole closure were higher in Group 2 (84.0 and 44.0%) and Group 3 (80.8 and 46.2%) than Group 1 (73.9 and 17.4%); however, there were no differences between Group 2 and Group 3 (P > 0.05). The rates of macular hole closure were extremely low in Group 1 and also in eyes with extreme long axial lengths (≥29.0 mm), "severe" chorioretinal atrophy, and posterior staphyloma. Pars plana vitrectomy with either TA assistance or ILM peeling was effective for the treatment of highly myopic MHRD. If you peel the ILM, adding TA does not affect closure rates; and if TA is used to visualize the vitreous, ILM peeling may not be necessary in MHRD. There was a lower anatomical success rate in MHRD with extreme long axial lengths, severe chorioretinal atrophy, and posterior staphyloma.

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

African Journals Online (AJOL)

Rabah M. Shawky

2013-12-05

Dec 5, 2013 ... low posterior hair line, partial left simian crease, and short fingers. MRI brain shows frontal ... 2. Case report. A 3.5 year old female child, fifth in order of birth of healthy ... centile), height is 89 cm (3rd percentile), and weight is 14.5 kg .... cephaly in 80%, hearing loss in 50%, iris or retinal coloboma in 60% ...

Influence of cataract surgery on optical coherence tomography and neurophysiology measurements in patients with retinitis pigmentosa.

Science.gov (United States)

Garcia-Martin, Elena; Rodriguez-Mena, Diego; Dolz, Isabel; Almarcegui, Carmen; Gil-Arribas, Laura; Bambo, Maria P; Larrosa, Jose M; Polo, Vicente; Pablo, Luis E

2013-08-01

To evaluate the effect of uncomplicated cataract phacoemulsification on the measurements of visual evoked potentials (VEP), pattern electroretinogram (PERG), and macular and retinal nerve fiber layer (RNFL) using 2 spectral-domain optical coherence tomography (OCT) instruments, the Cirrus OCT (Carl Zeiss Meditech) and Spectralis OCT (Heidelberg Engineering), in patients with retinitis pigmentosa (RP), and to assess the reliability of the OCT measurements before and after cataract surgery. Observational cross-sectional study. Thirty-five eyes of 35 patients with RP (20 men and 15 women, 45-66 years) who underwent cataract phacoemulsification were studied. At 1 month before and 1 month after surgery, visual acuity, VEP, PERG, and 3 repetitions of scans using the RNFL and macular analysis protocols of the Cirrus and Spectralis OCT instruments were performed. The differences in measurements between the 2 visits were analyzed. Repeatability of OCT measurements was evaluated by calculating the coefficients of variation. VEP amplitude, RNFL thicknesses provided by Cirrus and Spectralis, and macular measurements provided by Cirrus OCT differed between the 2 visits. VEP latency, PERG measurements, and macular thicknesses provided by the Spectralis OCT before surgery did not differ significantly from those after surgery. The OCT repeatability was better after surgery, with lower coefficients of variation for scans performed after surgical removal of the cataract. The nuclear, cortical, and posterior subcapsular types of cataracts did not show different repeatability. The presence of cataracts affects VEP amplitude, RNFL, and macular measurements performed with OCT in eyes with RP. Image repeatability significantly improves after cataract phacoemulsification. Copyright © 2013 Elsevier Inc. All rights reserved.

Small eyes big problems: is cataract surgery the best option for the nanophthalmic eyes

International Nuclear Information System (INIS)

Utman, S.A.K.

2013-01-01

Nanophthalmos refers to an eyeball of short axial length, usually less than 20 mm which leads to angle closure glaucoma due to relatively large lens. Intra-ocular lens extraction relieves the angle closure in nanophthalmos. Cataract surgery in a nanophthalmic eye is technically difficult with high risk of complications such as posterior capsular rupture, uveal effusion, choroidal haemorrhage, vitreous haemorrhage, malignant glaucoma, retinal detachment and aqueous misdirection. Various options are explained in the literature to perform cataract surgery in nanophthalmos, like extracapsular cataract extraction with or without sclerostomy; small-incision cataract extraction by phacoemulsification which not only helps maintain the anterior chamber during surgery but also reduces the incidence of complications due to less fluctuation of intraocular pressure (IOP) during the surgery. Cataract surgery deepens and widens the anterior chamber angle in nanophthalmic eyes and has beneficial effects on IOP in eyes with nanophthalmos but is associated with a high incidence of complications. (author)

Accuracy of deep learning, a machine-learning technology, using ultra-wide-field fundus ophthalmoscopy for detecting rhegmatogenous retinal detachment.

Science.gov (United States)

Ohsugi, Hideharu; Tabuchi, Hitoshi; Enno, Hiroki; Ishitobi, Naofumi

2017-08-25

Rhegmatogenous retinal detachment (RRD) is a serious condition that can lead to blindness; however, it is highly treatable with timely and appropriate treatment. Thus, early diagnosis and treatment of RRD is crucial. In this study, we applied deep learning, a machine-learning technology, to detect RRD using ultra-wide-field fundus images and investigated its performance. In total, 411 images (329 for training and 82 for grading) from 407 RRD patients and 420 images (336 for training and 84 for grading) from 238 non-RRD patients were used in this study. The deep learning model demonstrated a high sensitivity of 97.6% [95% confidence interval (CI), 94.2-100%] and a high specificity of 96.5% (95% CI, 90.2-100%), and the area under the curve was 0.988 (95% CI, 0.981-0.995). This model can improve medical care in remote areas where eye clinics are not available by using ultra-wide-field fundus ophthalmoscopy for the accurate diagnosis of RRD. Early diagnosis of RRD can prevent blindness.

Intravitreal gas injection without vitrectomy for macular detachment associated with an optic disk pit.

Science.gov (United States)

Akiyama, Hideo; Shimoda, Yukitoshi; Fukuchi, Mariko; Kashima, Tomoyuki; Mayuzumi, Hideyasu; Shinohara, Yoichiro; Kishi, Shoji

2014-02-01

To evaluate the clinical outcomes after gas tamponade without vitrectomy for retinal detachment associated with an optic disk pit using optical coherence tomography. Intravitreal gas injection was performed on 8 consecutive patients (mean age, 35.0 years; range, 15-74 years) with unilateral macular detachment associated with an optic disk pit. A 0.3-mL injection of 100% sulfur hexafluoride 6 gas was carried out without an anterior chamber tap. Patients treated with gas injection were instructed to remain facedown for 5 days. Complete retinal reattachment after only gas tamponade was achieved in four out of eight eyes. The mean number of gas injections was 1.8. The mean best-corrected visual acuity before and after the treatment with gas tamponade was approximately 30/100 and 20/20, respectively. The period required for reattachment after final gas treatment was 12 months. There were no incidences of recurrence after complete reattachment by gas tamponade in any of the cases during the 94-month average follow-up period (range, 64-132 months). Gas tamponade appears to be an effective alternative method for macular detachment associated with an optic disk pit, even though the mechanisms of optic disk pit maculopathy are still unknown.

MRI and intraocular tamponade media

Energy Technology Data Exchange (ETDEWEB)

Manfre, I. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Fabbri, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy)); Avitabile, T. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Biondi, P. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Reibaldi, A. (Inst. of Ophthalmology, Univ. of Catania (Italy)); Pero, G. (Dept. of Neuroradiology, Inst. of Neurosurgery, Univ. of Catania (Italy))

1993-05-01

Thirteen patients who underwent surgery for retinal detachment and injection of intraocular tamponade media (silicone oil, flurosilicone oil, or perfluoro-carbon liquid) underwent magnetic resonance imaging (MRI), using spin-echo T1- and T2-weighted images. The ophthalmic tamponade media showed different signal intensity, according to their chemical structure. Unlike ophthalmoscopy or ultrasonography, MRI showed no oil-related artefact, making possible recognition of recurrent retinal detachment. (orig.)

MRI and intraocular tamponade media

International Nuclear Information System (INIS)

Manfre, I.; Fabbri, G.; Avitabile, T.; Biondi, P.; Reibaldi, A.; Pero, G.

1993-01-01

Thirteen patients who underwent surgery for retinal detachment and injection of intraocular tamponade media (silicone oil, flurosilicone oil, or perfluoro-carbon liquid) underwent magnetic resonance imaging (MRI), using spin-echo T1- and T2-weighted images. The ophthalmic tamponade media showed different signal intensity, according to their chemical structure. Unlike ophthalmoscopy or ultrasonography, MRI showed no oil-related artefact, making possible recognition of recurrent retinal detachment. (orig.)

Ultra-Widefield Steering-Based Spectral-Domain Optical Coherence Tomography Imaging of the Retinal Periphery.

Science.gov (United States)

Choudhry, Netan; Golding, John; Manry, Matthew W; Rao, Rajesh C

2016-06-01

To describe the spectral-domain optical coherence tomography (SD OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Observational study. A total of 68 patients (68 eyes) with 19 peripheral retinal features. Spectral-domain OCT-based structural features. Nineteen peripheral retinal features, including vortex vein, congenital hypertrophy of the retinal pigment epithelium, pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment, typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen, were identified by peripheral clinical examination. Near-infrared scanning laser ophthalmoscopy images and SD OCT of these entities were registered to UWF color photographs. Spectral-domain OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, retinal pigment epithelium loss, or hypertrophy was seen in several entities, including congenital hypertrophy of the retinal pigment epithelium, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice, and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision

Complex descemet′s membrane tears and detachment during phacoemulsification

Directory of Open Access Journals (Sweden)

Faik Orucoglu

2015-01-01

Full Text Available Purpose: To report a case of complex Descemet′s membrane detachment (DMD and tears during phacoemulsification cataract surgery. Case Report: A 64-year-old woman underwent phacoemulsification surgery in her right eye and developed tears and partial loss of Descemet′s membrane (DM while the aspiration port was inserted through the main incision. Massive corneal edema obscured the view and the anterior chamber was barely visible the following day. Scheimpflug imaging was used to complement slit lamp examination in the postoperative period. Frequent topical corticosteroid drops were initiated. After 5 days of treatment, multiple tears and detachment of DM were visible and the anterior chamber was filled with air. After 5 weeks, the cornea regained much of its clarity despite large DM tears and focal loss of DM. Conclusion: Despite partial loss of DM, the corneal edema mostly disappeared after 5 weeks of air bubble injection. Scheimpflug imaging was beneficial in the diagnosis and monitoring of DM tears and detachments.

Hyperoxia-Induced Proliferative Retinopathy: Early Interruption of Retinal Vascular Development with Severe and Irreversible Neurovascular Disruption.

Directory of Open Access Journals (Sweden)

Michelle Lajko

Full Text Available Bronchopulmonary dysplasia (BPD is a major cause of neonatal morbidity in premature infants, occurring as a result of arrested lung development combined with multiple postnatal insults. Infants with BPD exposed to supplemental oxygen are at risk of retinopathy of prematurity as well. Thus, we studied the effects of hyperoxia on the retinal vasculature in a murine model of BPD. The retinal phenotype of this model, which we termed hyperoxia-induced proliferative retinopathy (HIPR, shows severe disruption of retinal vasculature and loss of vascular patterning, disorganized intra-retinal angiogenesis, inflammation and retinal detachment. Neonatal mice were subjected to 75% oxygen exposure from postnatal day (P0 to P14 to model BPD, then allowed to recover in room air for 1 (P15, 7 (P21, or 14 days (P28. We quantified retinal thickness, protein levels of HIF-1α, NOX2, and VEGF, and examined the cellular locations of these proteins by immunohistochemistry. We examined the retinal blood vessel integrity and inflammatory markers, including macrophages (F4/80 and lymphocytes (CD45R. Compared to controls, normal retinal vascular development was severely disrupted and replaced by a disorganized sheet of intra-retinal angiogenesis in the HIPR mice. At all time-points, HIPR showed persistent hyaloidal vasculature and a significantly thinner central retina compared to controls. HIF-1α protein levels were increased at P15, while VEGF levels continued to increase until P21. Intra-retinal fibrinogen was observed at P21 followed by sub-retinal deposition in at P28. Inflammatory lymphocytes and macrophages were observed at P21 and P28, respectively. This model presents a severe phenotype of disrupted retinal vascular development, intra-retinal angiogenesis inflammation and retinal detachment.

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

Influence of Cell Detachment on the Respiration Rate of Tumor and Endothelial Cells

Science.gov (United States)

Danhier, Pierre; Copetti, Tamara; De Preter, Géraldine; Leveque, Philippe; Feron, Olivier; Jordan, Bénédicte F.; Sonveaux, Pierre; Gallez, Bernard

2013-01-01

Cell detachment is a procedure routinely performed in cell culture and a necessary step in many biochemical assays including the determination of oxygen consumption rates (OCR) in vitro. In vivo, cell detachment has been shown to exert profound metabolic influences notably in cancer but also in other pathologies, such as retinal detachment for example. In the present study, we developed and validated a new technique combining electron paramagnetic resonance (EPR) oximetry and the use of cytodex 1 and collagen-coated cytodex 3 dextran microbeads, which allowed the unprecedented comparison of the OCR of adherent and detached cells with high sensitivity. Hence, we demonstrated that both B16F10 melanoma cells and human umbilical vein endothelial cells (HUVEC) experience strong OCR decrease upon trypsin or collagenase treatments. The reduction of cell oxygen consumption was more pronounced with a trypsin compared to a collagenase treatment. Cells remaining in suspension also encounter a marked intracellular ATP depletion and an increase in the lactate production/glucose uptake ratio. These findings highlight the important influence exerted by cell adhesion/detachment on cell respiration, which can be probed with the unprecedented experimental assay that was developed and validated in this study. PMID:23382841

Influence of cell detachment on the respiration rate of tumor and endothelial cells.

Science.gov (United States)

Danhier, Pierre; Copetti, Tamara; De Preter, Géraldine; Leveque, Philippe; Feron, Olivier; Jordan, Bénédicte F; Sonveaux, Pierre; Gallez, Bernard

2013-01-01

Cell detachment is a procedure routinely performed in cell culture and a necessary step in many biochemical assays including the determination of oxygen consumption rates (OCR) in vitro. In vivo, cell detachment has been shown to exert profound metabolic influences notably in cancer but also in other pathologies, such as retinal detachment for example. In the present study, we developed and validated a new technique combining electron paramagnetic resonance (EPR) oximetry and the use of cytodex 1 and collagen-coated cytodex 3 dextran microbeads, which allowed the unprecedented comparison of the OCR of adherent and detached cells with high sensitivity. Hence, we demonstrated that both B16F10 melanoma cells and human umbilical vein endothelial cells (HUVEC) experience strong OCR decrease upon trypsin or collagenase treatments. The reduction of cell oxygen consumption was more pronounced with a trypsin compared to a collagenase treatment. Cells remaining in suspension also encounter a marked intracellular ATP depletion and an increase in the lactate production/glucose uptake ratio. These findings highlight the important influence exerted by cell adhesion/detachment on cell respiration, which can be probed with the unprecedented experimental assay that was developed and validated in this study.

Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis.

Science.gov (United States)

Shahi, Sanjeet K

2017-05-01

Acute retinal necrosis (ARN), secondary to herpes simplex encephalitis, is a rare syndrome that can present in healthy individuals, as well as immuno-compromised patients. Most cases are caused by a secondary infection from the herpes virus family, with varicella zoster virus being the leading cause of this syndrome. Potential symptoms include blurry vision, floaters, ocular pain and photophobia. Ocular findings may consist of severe uveitis, retinal vasculitis, retinal necrosis, papillitis and retinal detachment. Clinical manifestations of this disease may include increased intraocular pressure, optic disc oedema, optic neuropathy and sheathed retinal arterioles. A complete work up is essential to rule out cytomegalovirus retinitis, herpes simplex encephalitis, herpes virus, syphilis, posterior uveitis and other conditions. Depending on the severity of the disease, the treatment options consist of anticoagulation therapy, cycloplegia, intravenous acyclovir, systemic steroids, prophylactic laser photocoagulation and pars plana vitrectomy with silicon oil for retinal detachment. An extensive history and clinical examination is crucial in making the correct diagnosis. Also, it is very important to be aware of low vision needs and refer the patients, if expressing any sort of functional issues with completing daily living skills, especially reading. In this article, we report one case of unilateral ARN 20 years after herpetic encephalitis. © 2016 Optometry Australia.

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

Treatment of Retinal Separation in HIV-infected Patients with Cytomegalovirus Retinitis

Directory of Open Access Journals (Sweden)

A. L. Onischenko

2017-01-01

Full Text Available HIV infection — is a socially significant problem for many countries, as the infected die in an average of 10-11 years due to the immunodeficiency virus. Up to 20% of patients with AIDS lose their sight because of cytomegalovirus retinitis (CMV retinitis, which occurs in 70% of HIV-infected people. In some patients with HIV infection blindness occurs because of acute retinal necrosis of CMV etiology. The algorithm of CMV retinitis treatment in HIV-infected patients is described in modern manuals (ganciclovir, valganciclovir, foscarnet and others on the background of antiretroviral therapy, but the tactics of treatment of retinal separation in these patients is not clearly defined. It may be “wait and see”, providing conservative treatment with antiviral drugs, and the active tactics — vitreoretinal surgery. In this article the authors present their personal clinical observations of three HIV-infected patients with CMV retinitis at the age of 8 to 36 years with a detailed analysis of the clinical data and the results of the laboratory tests. In particular, the authors give their own results of intravitreal introduction of ganciclovir in patients with CMV retinitis. Given the poor prognosis for the life of these patients, the authors put a deontological question of justification of active treatment of retinal separation in AIDS patients with CMV retinitis.

Changes in retinal nerve fiber layer thickness after spinal surgery in the prone position: a prospective study

OpenAIRE

Gencer, Baran; Cosar, Murat; Tufan, Hasan Ali; Kara, Selcuk; Arikan, Sedat; Akman, Tarik; Kiraz, Hasan Ali; Comez, Arzu Taskiran; Hanci, Volkan

2015-01-01

BACKGROUND AND OBJECTIVES: Changes in ocular perfusion play an important role in the pathogenesis of ischemic optic neuropathy. Ocular perfusion pressure is equal to mean arterial pressure minus intraocular pressure. The aim of this study was to evaluate the changes in the intraocular pressure and the retinal nerve fiber layer thickness in patients undergoing spinal surgery in the prone position. ...

Human cadaver retina model for retinal heating during corneal surgery with a femtosecond laser

Science.gov (United States)

Sun, Hui; Fan, Zhongwei; Yun, Jin; Zhao, Tianzhuo; Yan, Ying; Kurtz, Ron M.; Juhasz, Tibor

2014-02-01

Femtosecond lasers are widely used in everyday clinical procedures to perform minimally invasive corneal refractive surgery. The intralase femtosecond laser (AMO Corp. Santa Ana, CA) is a common example of such a laser. In the present study a numerical simulation was developed to quantify the temperature rise in the retina during femtosecond intracorneal surgery. Also, ex-vivo retinal heating due to laser irradiation was measured with an infrared thermal camera (Fluke Corp. Everett, WA) as a validation of the simulation. A computer simulation was developed using Comsol Multiphysics to calculate the temperature rise in the cadaver retina during femtosecond laser corneal surgery. The simulation showed a temperature rise of less than 0.3 degrees for realistic pulse energies for the various repetition rates. Human cadaver retinas were irradiated with a 150 kHz Intralase femtosecond laser and the temperature rise was measured withan infrared thermal camera. Thermal camera measurements are in agreement with the simulation. During routine femtosecond laser corneal surgery with normal clinical parameters, the temperature rise is well beneath the threshold for retina damage. The simulation predictions are in agreement with thermal measurements providing a level of experimental validation.

Relationship of retinal morphology and retinal sensitivity in the treatment of neovascular age-related macular degeneration using aflibercept.

Science.gov (United States)

Sulzbacher, Florian; Roberts, Philipp; Munk, Marion R; Kaider, Alexandra; Kroh, Maria Elisabeth; Sacu, Stefan; Schmidt-Erfurth, Ursula

2014-12-11

To relate the functional response to distinct morphological features of the retina during aflibercept treatment for neovascular AMD (nAMD). A total of 726 retinal locations in 22 consecutive eyes presenting with treatment-naive nAMD underwent a standardized examination with spectral-domain optical coherence tomography (SD-OCT) and topographic microperimetry (MP) at baseline, after 3 and 12 months of continuous intravitreal aflibercept therapy. The retinal sensitivity at each stimulus location was registered to the corresponding location on SD-OCT morphology. Subsequently, the microperimetric responses were evaluated with respect to the following underlying SD-OCT features: neovascular complex (NVC), subretinal fluid (SRF), intraretinal fluid (IRF), intraretinal cystoid space (IRC), serous pigment epithelium detachment (sPED), and fibrovascular pigment epithelium detachment (fPED). Baseline sensitivity was reduced to mean values of 1.8 dB in NVC, 2.2 dB in IRC, 2.8 dB in IRF, 2.6 dB in sPED, 3.6 dB in SRF, and 4.6 dB in fPED. Improvements in retinal sensitivity were most pronounced during the initial 3-month interval, when significant recovery was documented for SRF and sPED with +4.0/5.5 dB (P 0.05 for each category). Significant functional benefits following intravitreal aflibercept treatment could be detected over all defined morphological pathologies. The level of improvement varied dependent on the associated feature with the best prognosis for visual improvement in SRF and sPED and least with intraretinal fluid and particularly intraretinal cysts. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

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

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...

Clinical observation for the treatment on retinal hole%氪激光治疗视网膜裂孔预防视网膜脱离的临床观察

Institute of Scientific and Technical Information of China (English)

孟薇; 贾红艳; 孙競

2012-01-01

目的 分析氪激光治疗视网膜裂孔预防视网膜脱离的效果.方法 将75例(78只眼)视网膜裂孔患者分成两组,一组用氪多波长激光治疗47例(49只眼);一组随访观察28例(29只眼).结果 视网膜裂孔和视网膜周边变性单纯用氪多波长激光治疗49只眼,成功100%;随访组28例(29只眼),22只眼裂孔无变化.有8只眼于24个月内出现局限性视网膜脱离,两组比较P＜0.01.对失败病例立即行激光治疗,8只眼全部视网膜复位、裂孔封闭.结论 使用激光治疗视网膜裂孔和变性可以预防视网膜脱离的发生;单纯视网膜裂孔玻璃体条件好时可以随访观察,但应缩短随访时间,长时间密切观察;对视网膜裂孔伴有局限性视网膜脱离,可以试用激光治疗.%Objective To evaluate the method to treat retinal holes and analyze the effect of treating and preventing retinal detachment using krypton laser. Methods Patients with retinal holes were divided into two groups ,47 patients (49eyes)were treated with krypton laser and another 28 patients(29eyes) were followed up. Results No patients(49eyes) treated with krypton laser occurred retinal detachment , which the achievement ratio was 100%. 8 eyes in follow-up group occurred local retinal detachment and other 22 eyes had no change. The difference between two groups were statistically sig - nificant. Conclusion Treating retinal holes and retinal degeneration by laser can prevent retinal detachment . Patients with simple retinal hole who had a good vitreous body can be followed up for a long time . Laser therapy can be used to treat patients with local retinal detachment.

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.

Retinal complications after aqueous shunt surgical procedures for glaucoma.

Science.gov (United States)

Law, S K; Kalenak, J W; Connor, T B; Pulido, J S; Han, D P; Mieler, W F

1996-12-01

To assess retinal complications and to identify risk factors for retinal complications following aqueous shunt procedures. Records of 38 consecutive aqueous shunt procedures that were performed on 36 patients at the Eye Institute of the Medical College of Wisconsin, Milwaukee, from June 1993 to March 1995 (minimum follow-up, 6 months) were reviewed. The mean +/- SD follow-up was 11.4 +/- 5.2 months (median, 10.5 months). Twelve patients (32%) had the following retinal complications: 4 serous choroidal effusions (10%) that required drainage, 3 suprachoroidal hemorrhages (8%), 2 vitreous hemorrhages (5%), 1 rhegmatogenous retinal detachment (3%), 1 endophthalmitis (3%), and 1 scleral buckling extrusion (3%). Surgical procedures for retinal complications were required in 8 (67%) of these 12 patients. Visual acuity decreased 2 lines or more in 9 (75%) of these 12 patients. The median onset of a postoperative retinal complication was 12.5 days, with 10 patients (83%) experiencing complications within 35 days. Serous choroidal effusions developed in 10 other patients (26%), and these effusions resolved spontaneously. Visual acuity decreased 2 lines or more in 2 (20%) of these additional 10 patients. Patients who experienced serious retinal complications were significantly older, had a higher rate of hypertension, and postoperative ocular hypotony. Serious retinal complications were distributed evenly among patients with Krupin valves with discs and Molteno and Baerveldt devices. Experience with the Ahmed glaucoma valve implant was limited. Aqueous shunt procedures may be associated with significant retinal complications and subsequent visual loss.

Type 3 Neovascularization Associated with Retinitis Pigmentosa.

Science.gov (United States)

Sayadi, Jihene; Miere, Alexandra; Souied, Eric H; Cohen, Salomon Y

2017-01-01

To report a case of type 3 neovascular lesion in a patient with retinitis pigmentosa (RP) complicated by macular edema. A 78-year-old man with a long follow-up for RP was referred for painless visual acuity decrease in the right eye. Best-corrected visual acuity was 20/125 in the right eye and 20/40 in the left. Fundus examination showed typical RP and macular edema in both eyes. In the right eye, spectral domain optical coherence tomography revealed a marked cystic macular edema associated with disruption of the Bruch membrane/retinal pigment epithelium complex overlying a pigmentary epithelium detachment, with a vascular structure which appeared to originate from the deep capillary plexus and to be connected with the subretinal pigment epithelium space. Optical coherence tomography angiography showed a high-flow vessel infiltrating the outer retinal layers in the deep capillary plexus segmentation, and a tuft-shaped, bright, high-flow network that seemed to be connected with the subretinal pigment epithelium space in the outer retinal layer segmentation. This presentation was consistent with an early type 3 neovascular lesion in the right eye. Type 3 neovascularization may be considered a possible complication of RP.

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.

Determination of retinal surface area.

Science.gov (United States)

Nagra, Manbir; Gilmartin, Bernard; Thai, Ngoc Jade; Logan, Nicola S

2017-09-01

Previous attempts at determining retinal surface area and surface area of the whole eye have been based upon mathematical calculations derived from retinal photographs, schematic eyes and retinal biopsies of donor eyes. 3-dimensional (3-D) ocular magnetic resonance imaging (MRI) allows a more direct measurement, it can be used to image the eye in vivo, and there is no risk of tissue shrinkage. The primary purpose of this study is to compare, using T2-weighted 3D MRI, retinal surface areas for superior-temporal (ST), inferior-temporal (IT), superior-nasal (SN) and inferior-nasal (IN) retinal quadrants. An ancillary aim is to examine whether inter-quadrant variations in area are concordant with reported inter-quadrant patterns of susceptibility to retinal breaks associated with posterior vitreous detachment (PVD). Seventy-three adult participants presenting without retinal pathology (mean age 26.25 ± 6.06 years) were scanned using a Siemens 3-Tesla MRI scanner to provide T2-weighted MR images that demarcate fluid-filled internal structures for the whole eye and provide high-contrast delineation of the vitreous-retina interface. Integrated MRI software generated total internal ocular surface area (TSA). The second nodal point was used to demarcate the origin of the peripheral retina in order to calculate total retinal surface area (RSA) and quadrant retinal surface areas (QRSA) for ST, IT, SN, and IN quadrants. Mean spherical error (MSE) was -2.50 ± 4.03D and mean axial length (AL) 24.51 ± 1.57 mm. Mean TSA and RSA for the RE were 2058 ± 189 and 1363 ± 160 mm 2 , respectively. Repeated measures anova for QRSA data indicated a significant difference within-quadrants (P area/mm increase in AL. Although the differences between QRSAs are relatively small, there was evidence of concordance with reported inter-quadrant patterns of susceptibility to retinal breaks associated with PVD. The data allow AL to be converted to QRSAs, which will assist further

MANAGEMENT or cATARAcr sURGERY IN A

African Journals Online (AJOL)

female trader with previously undiagnosed high myopia. ... the surgeon with the information he needs on the risks ... macular degeneration and retinal detachment." High ... PC IOL. Error AC IOLError. 3,5 - () 54 (),5 - ()44. 30) - () ()4 () () -- () ()6.

Retinal diseases in a reference center from a Western Amazon capital city.

Science.gov (United States)

Malerbi, Fernando Korn; Matsudo, Nilson Hideo; Carneiro, Adriano Biondi Monteiro; Lottenberg, Claudio Luiz

2015-01-01

To describe retinal diseases found in patients who were waiting for treatment at a tertiary care hospital in Rio Branco, Acre, Brazil. Patients underwent slit lamp biomicroscopy, dilated fundus exam and ocular ultrasound. Patients were classified according to phakic status and retinal disease of the most severely affected eye. A total of 138 patients were examined. The mean age was 51.3 years. Diabetes was present in 35.3% and hypertension in 45.4% of these patients. Cataract was found in 23.2% of patients, in at least one eye. Retinal examination was possible in 129 patients. The main retinal diseases identified were rhegmatogenous retinal detachment (n=23; 17.8%) and diabetic retinopathy (n=32; 24.8%). Out of 40 patients evaluated due to diabetes, 13 (32.5%) had absent or mild forms of diabetic retinopathy and did not need further treatment, only observation. Diabetic retinopathy was the main retinal disease in this population. It is an avoidable cause of blindness and can be remotely evaluated, in its initial stages, by telemedicine strategies. In remote Brazilian areas, telemedicine may be an important tool for retinal diseases diagnosis and follow-up.

Roturas retinianas em retinocoroidite por toxoplasmose: série de casos Retinal tears in toxoplasmic retinochoroiditis: case series

Directory of Open Access Journals (Sweden)

Daniel da Rocha Lucena

2009-12-01

Full Text Available Trata-se de série retrospectiva de 10 pacientes com rotura retiniana e retinocoroidite por toxoplasmose atendidos no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, de janeiro de 2007 a abril de 2008, com objetivo de avaliar a relação entre lesões de retinocoroidite e a ocorrência de rotura retiniana. Foram utilizados teste de Fisher e qui-quadrado com nível de significância pThis study is a retrospective case series aiming to evaluate the relation between toxoplasmic retinochoroiditis scars and the occurrence of retinal tears. Ten patients with retinal tear and toxoplasmic retinochoroiditis examined at the School of Medicine of Ribeirão Preto Clinics Hospital, between January 2007 and April 2008, were included. Fisher test and qui-square test with significance level of p<0.05 were used. Eight cases (80% had retinal detachment. Twelve tears were found and localized mostly in the temporal superior periphery (6 cases, 50%. No statistically significant association between retinal tear and chorioretinal scar localization was observed considering five retinal quadrants (p=0.0828 or three zones (p=0.2507. The occurrence of retinal tears in patients with uveitis may be related to early posterior vitreous detachment caused by the intraocular inflammatory process. No correlation was observed between the localization of retinal tears and chorioretinal scars in this study, which suggests a causative factor not directly related to the presence of a scar.

Incidence and causes of iatrogenic retinal breaks in idiopathic macular hole and epiretinal membrane.

Science.gov (United States)

Yagi, Fumihiko; Takagi, Seiji; Tomita, Goji

2014-03-01

To evaluate the incidence and cause of iatrogenic retinal breaks (RBs) and postoperative retinal detachment (RD) in cases of idiopathic macular hole (MH) and epiretinal membrane (ERM). We analyzed 79 eyes with MH and 41 eyes with ERM, the relationship between the incidence of RBs and RD, and the frequency of posterior vitreous detachment (PVD) and lattice degeneration (LD). The incidence of RBs related to the operation was significantly higher in eyes with MH. The frequency of PVD was significantly higher in eyes with ERM. The frequency of LD did not differ between groups. In the MH group, the incidence of RBs related to the operation was high in eyes without PVD, but with LD. We observed four cases of RD in the MH group. The MH group had higher incidence of RBs related to the operation, especially in eyes without PVD or with LD.

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.

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

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.

Radiologic Findings in Hydrated Hydrogel Buckles

International Nuclear Information System (INIS)

Lee, Sung Bok; Lee, Nam Ho; Jo, Young Joon; Kim, Jung Yeul; Lee, Yeon Hee; Kim, Song Soo

2008-01-01

Hydrogel buckles, which are used in scleral buckling surgery for retinal detachment, have been associated with late complications after successful retinal reattachment surgery, including strabismus, extraocular motility restriction, extrusion through the eyelid or conjunctiva, intraocular erosion, and scleral erosion. Hydrogel buckles sometimes appear as well-marginated, circumferential, lobulating, contoured cystic masses mimicking orbital cysts on orbital CT or MRI. We report the radiologic findings in 5 patients whose hydrogel buckles needed to be differentiated from orbital cysts

Radiologic Findings in Hydrated Hydrogel Buckles

Energy Technology Data Exchange (ETDEWEB)

Lee, Sung Bok; Lee, Nam Ho; Jo, Young Joon; Kim, Jung Yeul; Lee, Yeon Hee; Kim, Song Soo [Chungnam National University, Daejeon (Korea, Republic of)

2008-11-15

Hydrogel buckles, which are used in scleral buckling surgery for retinal detachment, have been associated with late complications after successful retinal reattachment surgery, including strabismus, extraocular motility restriction, extrusion through the eyelid or conjunctiva, intraocular erosion, and scleral erosion. Hydrogel buckles sometimes appear as well-marginated, circumferential, lobulating, contoured cystic masses mimicking orbital cysts on orbital CT or MRI. We report the radiologic findings in 5 patients whose hydrogel buckles needed to be differentiated from orbital cysts.

In vivo sectional imaging of the retinal periphery using conventional optical coherence tomography systems

Directory of Open Access Journals (Sweden)

Abhishek Kothari

2012-01-01

Full Text Available Optical coherence tomography (OCT has transformed macular disease practices. This report describes the use of conventional OCT systems for peripheral retinal imaging. Thirty-six eyes with peripheral retinal pathology underwent imaging with conventional OCT systems. In vivo sectional imaging of lattice degeneration, snail-track degeneration, and paving-stone degeneration was performed. Differences were noted between phenotypes of lattice degeneration. Several findings previously unreported in histopathology studies were encountered. Certain anatomic features were seen that could conceivably explain clinical and intraoperative behavior of peripheral lesions. Peripheral OCT imaging helped elucidate clinically ambiguous situations such as retinal breaks, subclinical retinal detachment, retinoschisis, choroidal nevus, and metastasis. Limitations of such scanning included end-gaze nystagmus and far peripheral lesions. This first of its kind study demonstrates the feasibility of peripheral retinal OCT imaging and expands the spectrum of indications for which OCT scanning may be clinically useful.

In vivo sectional imaging of the retinal periphery using conventional optical coherence tomography systems.

Science.gov (United States)

Kothari, Abhishek; Narendran, V; Saravanan, V R

2012-01-01

Optical coherence tomography (OCT) has transformed macular disease practices. This report describes the use of conventional OCT systems for peripheral retinal imaging. Thirty-six eyes with peripheral retinal pathology underwent imaging with conventional OCT systems. In vivo sectional imaging of lattice degeneration, snail-track degeneration, and paving-stone degeneration was performed. Differences were noted between phenotypes of lattice degeneration. Several findings previously unreported in histopathology studies were encountered. Certain anatomic features were seen that could conceivably explain clinical and intraoperative behavior of peripheral lesions. Peripheral OCT imaging helped elucidate clinically ambiguous situations such as retinal breaks, subclinical retinal detachment, retinoschisis, choroidal nevus, and metastasis. Limitations of such scanning included end-gaze nystagmus and far peripheral lesions. This first of its kind study demonstrates the feasibility of peripheral retinal OCT imaging and expands the spectrum of indications for which OCT scanning may be clinically useful.

Clinical features and prognosis of eyeball rupture: eye injury vitrectomy study.

Science.gov (United States)

Feng, Kang; Wang, Chang-guan; Hu, Yun-tao; Yao, Yi; Jiang, Yan-rong; Shen, Li-jun; Pang, Xiu-qin; Nie, Hong-ping; Ma, Zhi-zhong

2015-01-01

The objective of the study was to delineate clinical characteristics, surgical interventions, anatomic and visual outcomes of ruptured eye balls after trauma, and establish the prognostic indicators, which can assist clinicians in making correct surgical decisions during globe exploration for ruptured eyes. The study design used was a multicentre prospective cohort study, including six university-affiliated tertiary hospitals. We selected 242 cases of ruptured globe from the Eye Injury Vitrectomy Study database, until 31 December 2012. All selected cases underwent vitreoretinal surgery, enucleation or evisceration, and were followed up for at least 6 months. Age, visual acuity (VA) after injury, ocular trauma zone, time to surgery, corneal laceration, scleral wound, extrusion of iris or lens, ciliary body damage, intraocular haemorrhage, retinal detachment or defect, proliferative vitreoretinopathy (PVR) and choroidal damage were the predisposing factors evaluated by logistic regression models. We compared the pre-surgical indicators between cases of anatomically restored eyes with VA of 4/200 or better, or eyes with initial no light perception restored light perception or better, and cases of VA worse than 4/200, silicone oil-sustained eyes, phthisis or enucleation. Nearly 40% of cases with ruptured globe were anatomically restored through vitreoretinal surgery. The closed-funnel retinal detachment or extensive retinal loss (odds ratio [OR] = 3.38, P = 0.026), PVR-C (OR = 3.45, P = 0.008), and choroidal damage (OR = 4.20, P = 0.004) were correlated with poor outcomes. The closed-funnel retinal detachment or extensive retinal loss, PVR-C, and choroidal damage are the risk factors for unfavourable outcomes in globe ruptures. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

Retinal changes in pregnancy-induced hypertension

Directory of Open Access Journals (Sweden)

Akash Pankaj Shah

2015-01-01

Full Text Available Aims: The aim was to determine the prevalence of retinal changes in pregnancy-induced hypertension (PIH and any association between the retinal changes and age, parity, blood pressure, proteinuria, and severity of the disease. Settings and Design: Hospital-based cross-sectional study. Materials and Methods: All the patients admitted with a diagnosis of PIH were included in this study. Age, gravida, gestation period, blood pressure, and proteinuria were noted from the case records. Fundus examination was done with a direct ophthalmoscope. The findings were noted and were analyzed using SPSS program. Results: A total of 150 patients of PIH were examined. The mean age of patients was 25.1 years. The gestation period ranged from 27 weeks to 42 weeks; 76 (50.67% were the primi gravida. 92 (61.33% patients had gestational hypertension, 49 (32.67% patients had preeclampsia, and 9 (6% had eclampsia. Retinal changes (hypertensive retinopathy were noted in 18 (12% patients - Grade 1 in 12 (8% and Grade 2 in 6 (4%. Hemorrhages or exudates or retinal detachment were not seen in any patient. There was statistically significant positive association of retinal changes and blood pressure (P = 0.037, proteinuria (P = 0.0005, and severity of the PIH (P = 0.004. Conclusions: Retinal changes were seen in 12% of patients with PIH. Occurrence of hypertensive retinopathy in PIH cases has been decreased due to better antenatal care and early detection and treatment of PIH cases. There is a greater chance of developing retinopathy with increase in blood pressure, severity of PIH, and proteinuria in cases of PIH.

Vitreolensectomy in Marfan's syndrome.

Science.gov (United States)

Hubbard, A D; Charteris, D G; Cooling, R J

1998-01-01

To evaluate the effectiveness of pars plana vitreolensectomy in the management of subluxed lenses associated with Marfan's syndrome and to assess the need for intraoperative retinal photocoagulation to prevent post-operative retinal detachment. A retrospective review was carried out of 40 eyes of patients with Marfan's syndrome who underwent pars plana vitreolensectomy for subluxed lenses. All patients demonstrated stable or improved visual acuity following surgery with a low incidence of complications. Pars plana vitreolensectomy is a safe and effective treatment for subluxed lenses in patients with Marfan's syndrome. It appears that intraoperative prophylactic laser treatment need only be applied to areas of lattice degeneration to limit the incidence of post-operative retinal detachment.

Mechanisms of Retinal Damage from Chronic Laser Radiation.

Science.gov (United States)

1981-07-01

and the other by 15 a slower, partly reversible rod cell degeneration It appears that a normal light cycle protects the rat eye somewhat from the...lium, disturbing the metabolic support of the receptors. Gross separation as in retinal detachment is known to cause degeneration of receptors and...border by scatter and reflection. A particular kind of specialization in the retina is represented by the fovea and macula . In the center of the macula

Type 3 Neovascularization Associated with Retinitis Pigmentosa

Directory of Open Access Journals (Sweden)

Jihene Sayadi

2017-04-01

Full Text Available Purpose: To report a case of type 3 neovascular lesion in a patient with retinitis pigmentosa (RP complicated by macular edema. Case Report: A 78-year-old man with a long follow-up for RP was referred for painless visual acuity decrease in the right eye. Best-corrected visual acuity was 20/125 in the right eye and 20/40 in the left. Fundus examination showed typical RP and macular edema in both eyes. In the right eye, spectral domain optical coherence tomography revealed a marked cystic macular edema associated with disruption of the Bruch membrane/retinal pigment epithelium complex overlying a pigmentary epithelium detachment, with a vascular structure which appeared to originate from the deep capillary plexus and to be connected with the subretinal pigment epithelium space. Optical coherence tomography angiography showed a high-flow vessel infiltrating the outer retinal layers in the deep capillary plexus segmentation, and a tuft-shaped, bright, high-flow network that seemed to be connected with the subretinal pigment epithelium space in the outer retinal layer segmentation. This presentation was consistent with an early type 3 neovascular lesion in the right eye. Conclusion: Type 3 neovascularization may be considered a possible complication of RP.

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...

Bilateral nanophthalmos and pigmentary retinal dystrophy--an unusual syndrome.

Science.gov (United States)

Proença, Helena; Castanheira-Dinis, A; Monteiro-Grillo, M

2006-09-01

To report the clinical picture of the rare association of nanophthalmos and pigmentary retinal dystrophy and its cataract surgery outcome. We report a case of a 60-year-old female who presented with bilateral slowly progressive visual loss. The patient presented with bilateral light perception visual acuity, exotropia, brunescent cataract hindering fundus examination and hypodontia. Ultrasonography revealed bilateral nanophthalmos. A visual-evoked potential was also performed preoperatively. Cataract surgery with +40D IOL implantation was uneventful. Postoperative fundus examination revealed pigmentary retinal dystrophy, confirmed by electrophysiologic tests. Glycosaminoglycan urinary excretion was normal. Congenital bilateral nanophthalmos may rarely be associated with pigmentary retinal dystrophy. We suggest thorough preoperative evaluation in nanophthalmic eyes for the exclusion of significant features concerning visual prognosis.

Pulmonary oedema in a patient undergoing vitreo-retinal surgery under peribulbar block

Directory of Open Access Journals (Sweden)

Anjolie Chhabra

2012-01-01

Full Text Available A 42 - year-old diabetic and hypertensive male with good effort tolerance was administered peribulbar block for vitreo-retinal surgery. Ten millilitres of an equal mixture of 2% lignocaine and 0.5% bupivacaine was administered for the block after ascertaining negative aspiration for blood. Inadequate akinesia of the eye necessitated further supplementation with 4 mL of local anaesthetic (LA mixture. Thirty minutes later, the patient complained of uneasiness, respiratory distress and desaturated despite oxygen supplementation. He was found to be in pulmonary oedema. He subsequently developed a weak thready pulse, became unresponsive, apnoeic and had generalized tonic clonic convulsions. Immediately, atropine 0.6 mg, followed by midazolam, intubation, mechanical ventilation, morphine and furosemide, were administered intravenously. Spontaneous respiration returned in 20 minutes and he started responding to verbal commands 90 minutes later. He was weaned off the ventilator the next morning. There was no evidence of an ischemic myocardial event and non-contrast computerized tomography scan of the head was normal. The reversible cardiorespiratory arrest, associated convulsions and loss of consciousness were suggestive of LA toxicity. Pulmonary oedema manifesting as respiratory distress and desaturation can be the initial manifestation of LA toxicity in patients with pre-existing cardiovascular disease undergoing eye surgery under peribulbar block.

The effect on outcome of peribulbar anaesthesia in conjunction with general anesthesia for vitreoretinal surgery.

Science.gov (United States)

Ghali, A M; El Btarny, A M

2010-03-01

The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5-7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml(-1)) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling.

Cataract surgery in Knobloch syndrome: a case report

Directory of Open Access Journals (Sweden)

Bongiovanni CS

2011-06-01

Full Text Available Carmen Sílvia Bongiovanni1, Carla Cristina Serra Ferreira1, Ana Paula Silvério Rodrigues1, João Borges Fortes Filho2, Márcia Beatriz Tartarella11Department of Ophthalmology, Congenital Cataract Section, Medical School, Federal University of São Paulo, São Paulo; 2Department of Ophthalmology, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, BrazilAbstract: Knobloch syndrome is an autosomal recessive disorder associated with early-onset ocular abnormalities and central nervous system malformations. Ocular abnormalities are usually severe, and include high myopia, vitreoretinal degeneration, retinal detachment, macular abnormalities, and cataract. The most frequent systemic changes are midline malformations of the brain, ventricular dilation, and occipital encephalocele. Cognitive delay may occur. We report a case of cataract in a child with Knobloch syndrome. Cataract surgery and follow-up are described.Keywords: Knobloch syndrome, cataract, phacoemulsification, vitreous, right eye, left eye, genetic

Willingness to pay for health care services in common cold, retinal detachment, and myocardiac infarction: an internet survey in Japan.

Science.gov (United States)

Yasunaga, Hideo; Ide, Hiroo; Imamura, Tomoaki; Ohe, Kazuhiko

2006-02-20

The application of Willingness To Pay (WTP) measurement with Contingent Valuation Method (CVM) to medical services is gradually increasing. Knowing what influences WTP is an important matter because validity of CVM in medical services remains controversial. The objective of this survey is to measure WTP for the treatment of typical acute illnesses and to analyze the factors affecting WTP. A questionnaire survey was conducted over the Internet, in which 795 men and women between 40 and 59 years old responded to questions about WTP for medical expenses in three hypothetical scenarios: common cold (CC), retinal detachment (RD) and myocardiac infarction (MI). Mean WTP was $29.9 for CC, $2,233 for RD, and $8,976 for MI. WTP for RD and MI was lower in the low-income group. While WTP for CC did not vary with income, WTP was higher in groups whose current subjective fitness levels were low. Although WTP measurements are criticized frequently for their validity and reliability, they are still useful for determining the economic value of medical services. Based on the results of this study, it is deemed necessary to enhance safety nets for low-income earners in regards to serious illnesses that incur high medical expenses. Further, it is recommended that the rate of co-payments be set relatively high with respect to mild illnesses for which alternative services are available.

A retrospective study on the incidence of post-cataract surgery Descemet's membrane detachment and outcome of air descemetopexy.

Science.gov (United States)

Odayappan, Annamalai; Shivananda, Narayana; Ramakrishnan, Seema; Krishnan, Tiruvengada; Nachiappan, Sivagami; Krishnamurthy, Smitha

2018-02-01

To study the anatomic and functional outcome of air descemetopexy in postcataract surgery Descemet's membrane detachment (DMD). Retrospective study. Setting: Institutional. Records of 112 patients who underwent air descemetopexy for postcataract surgery sight-threatening DMD at Aravind Eye Hospital, Pondicherry, between January 2013 and December 2015 were studied. Anatomical outcome refers to reattachment of the Descemet's membrane (DM). Functional outcome was given by the best-corrected visual acuity. The mean age was 66.47±8.46 (SD) years, the male to female ratio was 45:67. The incidence of DMD was more in extracapsular cataract extraction (0.26%) and manual small incision cataract surgery (0.11%) than phacoemulsification (0.04%) (p=0.005 and pair descemetopexy, 78 (71%) out of the 110 patients had DM reattachment. The complications noted after descemetopexy include persistent DMD (21.8%), corneal decompensation (7.3%), appositional angle closure (18%), pupillary block with air (2.7%) and uveitis (2.7%). Age, sex and timing of intervention did not influence the reattachment rate. Fifteen patients underwent repeat air descemetopexy for persistent DMD among whom nine (60%) had successful reattachment. Almost 75% of patients had vision better than 6/18 1 month after anatomically successful descemetopexy. Air descemetopexy is a safe and efficient modality of treatment of DMD and should be tried even in patients with severe DMD before planning a major surgery like endothelial keratoplasty. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

SD OCT Features of Macula and Silicon Oil–Retinal Interface in Eyes Status Post Vitrectomy for RRD

Directory of Open Access Journals (Sweden)

Manish Nagpal

2015-03-01

Full Text Available Aim: To objectively document findings at the Silicon oil-Retinal interface, macular status and tamponade effect in Silicon Oil (SO filled eyes using SD OCT. Methods: 104 eyes of 104 patients underwent SD OCT examination, horizontal and vertical macular scans, in silicone oil filled eyes which underwent silicone oil injection post vitrectomy for rhegmatogenous retinal detachment. Findings were divided into 3 Groups; Group A: Findings at silicon oil retinal interface, Group B: Macular pathology and Group C: Tamponade effect. Group C was further divided into two groups; Group 1: Complete tamponade and Group 2: Incomplete tamponade. Results: Group A: subsilicon epiretinal membranes N = 17 (16.3%, emulsified silicon oil N = 16 (15.4% Group B: foveal thickening N = 22 (21.2%, foveal thinning N = 6 (5.7%, subfoveal fluid N = 8 (7.6%, macular hole N = 2 (1.9%; Group C: Incomplete tamponade was noted in N = 12 (11.5%, complete tamponade N = 92 (88.5%.10 out of 104 eyes (9.6% had recurrent retinal detachment post silicon oil removal. 8 of these eyes had complete tamponade and 2 had incomplete tamponade. Conclusion: SD OCT is a useful tool to assess the SO–Retina interface, tamponade effect and macular pathology in SO filled eyes. There is lesser incidence of redetachment with incomplete tamponade in OCT.

Five-year outcomes of pars plana vitrectomy for macular edema associated with branch retinal vein occlusion

Directory of Open Access Journals (Sweden)

Nishida A

2017-02-01

Full Text Available Akihiro Nishida,1,2 Hiroshi Kojima,1,2 Takanori Kameda,1,2 Michiko Mandai,1,3 Yasuo Kurimoto1,2 1Department of Ophthalmology, Kobe City Medical Center General Hospital, 2Department of Ophthalmology, Institute of Biomedical Research and Innovation, 3Laboratory for Retinal Regeneration, RIKEN Center for Developmental Biology, Chuo-ku, Kobe, Hyogo, Japan Purpose: Long-term outcomes of pars plana vitrectomy (PPV for macular edema (ME associated with branch retinal vein occlusion (BRVO have been previously reported, but the studies did not report the number of additional treatments after surgery. During 5 years of follow-up, we therefore investigated the efficacy and safety of PPV for BRVO and evaluated the incidence of additional treatments. Methods: We retrospectively reviewed the medical records of 25 eyes of 24 patients who underwent PPV for ME associated with BRVO and were followed up for at least 5 years. Best-corrected visual acuity was measured, and foveal thickness was assessed by optical coherence tomography. Additional treatments were also investigated. Results: The logarithm of the minimal angle of resolution (logMAR improved from 0.53±0.23 at baseline to 0.16±0.25 at 5 years (P<0.0001. The foveal thickness decreased from 535±222 µm at baseline to 205±143 µm at 5 years (P<0.0001. For the eyes with residual ME, the following additional treatments were performed within 5 years of follow-up: sub-Tenon injection of triamcinolone acetonide in two eyes, intravitreal injection of bevacizumab in three eyes, grid laser photocoagulation in one eye, and direct photocoagulation of macroaneurysm in one eye. Additional surgeries were performed in two eyes: for one eye, phacoemulsification extraction of the ocular lens and intraocular lens implantation were performed because of cataract progression, and for the other eye, additional PPV was done for postoperative retinal detachment. Conclusion: PPV was effective for resolution of ME

Optical coherence tomography findings and retinal changes after vitrectomy for optic disc pit maculopathy

Directory of Open Access Journals (Sweden)

Gaurav Sanghi

2014-01-01

Full Text Available Purpose : To study the optical coherence tomography (OCT patterns in optic disc pit maculopathy and retinal changes after vitreous surgery. Materials and Methods : Retrospective review of consecutive cases with optic disc pit maculopathy seen at two tertiary eye institutes from January 2005 to June 2009. Results : Twenty-four eyes of 23 patients are included. The presenting visual acuity ranged from 20/400 to 20/20 (median:20/80. The median age at presentation was 24 years (range, 6-57 years. Optical coherence tomography demonstrated a combination of retinoschisis and outer layer detachment (OLD in 19 (79.17% eyes, OLD only in 3 (12.5% eyes and retinoschisis only in 2 (8.33% eyes. An obvious communication (outer layer hole between the schisis and OLD was seen in 14 (73.68% of the 19 eyes with both features. Of the 21 eyes with retinoschisis, schisis was present in multiple layers in 15 (71.43% and single layer in 6 (28.57% eyes. Eleven eyes underwent pars plana vitrectomy including creation of posterior vitreous detachment (PVD, fluid-air exchange, low intensity laser photocoagulation at the temporal edge of the optic disc pit and non-expansile perfluoropropane gas (14% injection. Five (45.45% of 11 eyes undergoing vitrectomy had complete resolution and 4 (36.36% eyes had partial resolution of maculopathy. Visual acuity improved in 8 (72.72% of 11 eyes. Conclusion : Optical coherence tomography demonstrates multiple layer schisis and outer layer detachment as main features of optic disc pit maculopathy. Vitrectomy with PVD induction, laser photocoagulation and gas tamponade results in anatomical and visual improvement in most cases with optic disc pit maculopathy.

Eye Emergencies

Science.gov (United States)

... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

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,

A novel platform for minimally invasive delivery of cellular therapy as a thin layer across the subretina for treatment of retinal degeneration

Science.gov (United States)

Rotenstreich, Ygal; Tzameret, Adi; Kalish, Sapir E.; Belkin, Michael; Meir, Amilia; Treves, Avraham J.; Nagler, Arnon; Sher, Ifat

2015-03-01

Incurable retinal degenerations affect millions worldwide. Stem cell transplantation rescued visual functions in animal models of retinal degeneration. In those studies cells were transplanted in subretinal "blebs", limited number of cells could be injected and photoreceptor rescue was restricted to areas in proximity to the injection sites. We developed a minimally-invasive surgical platform for drug and cell delivery in a thin layer across the subretina and extravascular spaces of the choroid. The novel system is comprised of a syringe with a blunt-tipped needle and an adjustable separator. Human bone marrow mesenchymal stem cells (hBM-MSCs) were transplanted in eyes of RCS rats and NZW rabbits through a longitudinal triangular scleral incision. No immunosuppressants were used. Retinal function was determined by electroretinogram analysis and retinal structure was determined by histological analysis and OCT. Transplanted cells were identified as a thin layer across the subretina and extravascular spaces of the choroid. In RCS rats, cell transplantation delayed photoreceptor degeneration across the entire retina and significantly enhanced retinal functions. No retinal detachment or choroidal hemorrhages were observed in rabbits following transplantation. This novel platform opens a new avenue for drug and cell delivery, placing the transplanted cells in close proximity to the damaged RPE and retina as a thin layer, across the subretina and thereby slowing down cell death and photoreceptor degeneration, without retinal detachment or choroidal hemorrhage. This new transplantation system may increase the therapeutic effect of other cell-based therapies and therapeutic agents. This study is expected to directly lead to phase I/II clinical trials for autologous hBM-MSCs transplantation in retinal degeneration patients.

Classification of posterior vitreous detachment

Science.gov (United States)

Kakehashi, Akihiro; Takezawa, Mikiko; Akiba, Jun

2014-01-01

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 (OCT). By biomicroscopy, the vitreous condition is determined based on the presence or absence of a PVD. The PVD then is classified as either a complete posterior vitreous detachment (C-PVD) or a partial posterior vitreous detachment (P-PVD). A C-PVD is further divided into a C-PVD with collapse and a C-PVD without collapse, while a P-PVD is divided into a P-PVD with shrinkage of the posterior hyaloid membrane (P-PVD with shrinkage) and a P-PVD without shrinkage of the posterior hyaloid membrane (P-PVD without shrinkage). A P-PVD without shrinkage has a subtype characterized by vitreous gel attachment through the premacular hole in a posterior hyaloid membrane to the macula (P-PVD without shrinkage [M]). By OCT, a shallow PVD is classified as the absence of a shallow PVD or as a shallow PVD. A shallow PVD is then subclassified as a shallow PVD without shrinkage of the posterior vitreous cortex, a shallow PVD with shrinkage of the posterior vitreous cortex, and a peripheral shallow PVD. A shallow PVD without shrinkage of the posterior vitreous cortex has two subtypes: an age-related shallow PVD and a perifoveal PVD associated with a macular hole. PMID:24376338

Unusual Surprises in Glaucoma Filtering Surgeries: Lessons Learned and Review of Literature.

Science.gov (United States)

Rao, Aparna; Padhy, Debananda; Roy, Avik Kumar; Senthil, Sirisha

2018-01-01

To describe an unusual series of complications after glaucoma filtering surgeries with their clinical findings and outcome after tailored non-conventional modes of therapy. Eighteen patients who underwent re-interventions (medical or surgical) after glaucoma filtering surgeries during the period at two tertiary centers, excluding those that required conventional modes of treatment (medical control or re-trabeculectomy, simple wound closure for traumatic wound dehiscence, bleb revision or needling, laser iridotomy), were included. Relevant clinical details with intraoperative videos, intraoperative or postoperative problems, and images with course after re-intervention were retrieved from the hospital database. Clinical details which helped in clinching diagnosis and cause for problems and course after intervention with final vision and intraocular pressure were evaluated. Six of 18 eyes required surgical management for an unusual course of events after an uneventful filtering surgery. Bleb morphology and close follow-up of the conjunctiva, in addition to intraocular pressure (IOP) and anterior chamber (AC) configuration, helped diagnose possible aetiology and appropriate tailored management. All patients had good IOP and visual outcome in all except one with macular scar status after retinal detachment surgery. Assessment of the bleb morphology in the postoperative course coupled with monitoring of the conjunctival wound are essential to conventional monitoring of IOP and anterior chamber configuration to arrive at appropriate management for rare unusual events after glaucoma surgery.

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

OpenAIRE

Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

2013-01-01

In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

Progressive atrophy of retinal pigment epithelium after trypan-blue-assisted ILM peeling for macular hole surgery

Directory of Open Access Journals (Sweden)

Sachin Jain

2013-01-01

Full Text Available We report a case of progressive atrophy of the retinal pigment epithelium (RPE after trypan-blue-assisted peeling of internal limiting membrane (ILM for macular hole surgery. A 68-year-old Caucasian female underwent a 20-g pars plana vitrectomy for a chronic stage-3 macular hole. The ILM was stained with 0.06% trypan blue (VisionBlue™, DORC Netherlands for 2 min after fluid air exchange. Dye was reapplied for another 2 min due to poor staining. The ILM was completely removed around the macular hole with forceps. RPE atrophy was noticed at the edge of the hole 1 month after surgery. It progressively increased in intensity and enlarged over 2 years. Her final visual acuity was counting fingers, significantly worse compared to her presenting visual acuity of 20/200. Progressive atrophy of RPE in our patient was most likely due to the toxicity of trypan blue. Reapplication of the dye may increase the likelihood of toxicity.

Effect of cataract surgery on retinal nerve fiber layer thickness parameters using scanning laser polarimetry (GDxVCC).

Science.gov (United States)

Dada, Tanuj; Behera, Geeta; Agarwal, Anand; Kumar, Sanjeev; Sihota, Ramanjit; Panda, Anita

2010-01-01

To study the effect of cataract extraction on the retinal nerve fiber layer (RNFL) thickness, and assessment by scanning laser polarimetry (SLP), with variable corneal compensation (GDx VCC), at the glaucoma service of a tertiary care center in North India. Thirty-two eyes of 32 subjects were enrolled in the study. The subjects underwent RNFL analysis by SLP (GDx VCC) before undergoing phacoemulsification cataract extraction with intraocular lens (IOL) implantation (Acrysof SA 60 AT) four weeks following cataract surgery. The RNFL thickness parameters evaluated both before and after surgery included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average, inferior average, and nerve fiber index (NFI). The mean age of subjects was 57.6 +/- 11.7 years (18 males, 14 females). Mean TSNIT average thickness (microm) pre- and post-cataract surgery was 49.2 +/- 14.1 and 56.5 +/- 7.6 ( P = 0.001). There was a statistically significant increase in RNFL thickness parameters (TSNIT average, superior average, and inferior average) and decrease in NFI post-cataract surgery as compared to the baseline values. Mean NFI pre- and post-cataract surgery was 41.3 +/- 15.3 and 21.6 +/- 11.8 ( P = 0.001). Measurement of RNFL thickness parameters by scanning laser polarimetry is significantly altered following cataract surgery. Post the cataract surgery, a new baseline needs to be established for assessing the longitudinal follow-up of a glaucoma patient. The presence of cataract may lead to an underestimation of the RNFL thickness, and this should be taken into account when analyzing progression in a glaucoma patient.

Evaluation of the macula prior to cataract surgery.

Science.gov (United States)

McKeague, Marta; Sharma, Priya; Ho, Allen C

2018-01-01

To describe recent evidence regarding methods of evaluation of retinal structure and function prior to cataract surgery. Studies in patients with cataract but no clinically detectable retinal disease have shown that routine use of optical coherence tomography (OCT) prior to cataract surgery can detect subtle macular disease, which may alter the course of treatment or lead to modification of consent. The routine use of OCT has been especially useful in patients being considered for advanced-technology intraocular lenses (IOLs) as subtle macular disease can be a contraindication to the use of these lenses. The cost-effectiveness of routine use of OCT prior to cataract surgery has not been studied. Other technologies that assess retinal function rather than structure, such as microperimetry and electroretinogram (ERG) need further study to determine whether they can predict retinal potential in cataract patients. There is growing evidence for the importance of more detailed retinal evaluation of cataract patients even with clinically normal exam. OCT has been the most established and studied method for retinal evaluation in cataract patients, but other technologies such as microperimetry and ERG are beginning to be studied.

Ultra-Widefield Steering-Based SD-OCT Imaging of the Retinal Periphery

Science.gov (United States)

Choudhry, Netan; Golding, John; Manry, Matthew W.; Rao, Rajesh C.

2016-01-01

Objective To describe the spectral-domain optical coherence tomography (SD-OCT) features of peripheral retinal findings using an ultra-widefield (UWF) steering technique to image the retinal periphery. Design Observational study. Participants 68 patients (68 eyes) with 19 peripheral retinal features. Main Outcome Measures SD-OCT-based structural features. Methods Nineteen peripheral retinal features including: vortex vein, congenital hypertrophy of the retinal pigment epithelium (CHRPE), pars plana, ora serrata pearl, typical cystoid degeneration (TCD), cystic retinal tuft, meridional fold, lattice and cobblestone degeneration, retinal hole, retinal tear, rhegmatogenous retinal detachment (RRD), typical degenerative senile retinoschisis, peripheral laser coagulation scars, ora tooth, cryopexy scars (retinal tear and treated retinoblastoma scar), bone spicules, white without pressure, and peripheral drusen were identified by peripheral clinical examination. Near infrared (NIR) scanning laser ophthalmoscopy (SLO) images and SD-OCT of these entities were registered to UWF color photographs. Results SD-OCT resolved structural features of all peripheral findings. Dilated hyporeflective tubular structures within the choroid were observed in the vortex vein. Loss of retinal lamination, neural retinal attenuation, RPE loss or hypertrophy were seen in several entities including CHRPE, ora serrata pearl, TCD, cystic retinal tuft, meridional fold, lattice and cobblestone degenerations. Hyporeflective intraretinal spaces, indicating cystoid or schitic fluid, were seen in ora serrata pearl, ora tooth, TCD, cystic retinal tuft, meridional fold, retinal hole, and typical degenerative senile retinoschisis. The vitreoretinal interface, which often consisted of lamellae-like structures of the condensed cortical vitreous near or adherent to the neural retina, appeared clearly in most peripheral findings, confirming its association with many low-risk and vision-threatening pathologies

Willingness to pay for health care services in common cold, retinal detachment, and myocardiac infarction: an internet survey in Japan

Directory of Open Access Journals (Sweden)

Imamura Tomoaki

2006-02-01

Full Text Available Abstract Background The application of Willingness To Pay (WTP measurement with Contingent Valuation Method (CVM to medical services is gradually increasing. Knowing what influences WTP is an important matter because validity of CVM in medical services remains controversial. The objective of this survey is to measure WTP for the treatment of typical acute illnesses and to analyze the factors affecting WTP. Methods A questionnaire survey was conducted over the Internet, in which 795 men and women between 40 and 59 years old responded to questions about WTP for medical expenses in three hypothetical scenarios: common cold (CC, retinal detachment (RD and myocardiac infarction (MI. Results Mean WTP was $29.9 for CC, $2,233 for RD, and $8,976 for MI. WTP for RD and MI was lower in the low-income group. While WTP for CC did not vary with income, WTP was higher in groups whose current subjective fitness levels were low. Conclusion Although WTP measurements are criticized frequently for their validity and reliability, they are still useful for determining the economic value of medical services. Based on the results of this study, it is deemed necessary to enhance safety nets for low-income earners in regards to serious illnesses that incur high medical expenses. Further, it is recommended that the rate of co-payments be set relatively high with respect to mild illnesses for which alternative services are available.

Role of macrophage migration inhibitory factor (MIF) in the effects of oxidative stress on human retinal pigment epithelial cells.

Science.gov (United States)

Ko, Ji-Ae; Sotani, Yasuyuki; Ibrahim, Diah Gemala; Kiuchi, Yoshiaki

2017-10-01

Proliferative vitreoretinopathy (PVR) is the major cause of treatment failure in individuals who undergo surgery for retinal detachment. The epithelial-mesenchymal transition (EMT) in retinal pigment epithelium (RPE) cells contributes to the pathogenesis of PVR. Oxidative stress is thought to play a role in the progression of retinal diseases including PVR. We have now examined the effects of oxidative stress on the EMT and related processes in the human RPE cell line. We found that H 2 O 2 induced the contraction of RPE cells in a three-dimensional collagen gel. Analysis of a cytokine array revealed that H 2 O 2 specifically increased the release of macrophage migration inhibitory factor (MIF) from RPE cells. Reverse transcription-polymerase chain reaction and immunoblot analyses showed that H 2 O 2 increased the expression of MIF in RPE cells. Immunoblot and immunofluorescence analyses revealed that H 2 O 2 upregulated the expression of α-SMA and vimentin and downregulated that of ZO-1 and N-cadherin. Consistent with these observations, the transepithelial electrical resistance of cell was reduced by exposure to H 2 O 2 . The effects of oxidative stress on EMT-related and junctional protein expression as well as on transepithelial electrical resistance were inhibited by antibodies to MIF, but they were not mimicked by treatment with recombinant MIF. Finally, analysis with a profiling array for mitogen-activated protein kinase signalling revealed that H 2 O 2 specifically induced the phosphorylation of p38 mitogen-activated protein kinase. Our results thus suggest that MIF may play a role in induction of the EMT and related processes by oxidative stress in RPE cells and that it might thereby contribute to the pathogenesis of PVR. Proliferative vitreoretinopathy is a major complication of rhegmatogenous retinal detachment, and both oxidative stress and induction of the EMT in RPE cells are thought to contribute to the pathogenesis of this condition. We have now

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

Science.gov (United States)

Shinohara, Elio Hitoshi; Kaba, Shajadi Carlos Pardo; Ruiz, Marcelo Martinson; Horikawa, Fernando Kendi

2013-01-01

In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy. PMID:23853472

Inicial nasal mucosa detachment using piezoelectric device in the Le Fort I osteotomy: A technical note

Directory of Open Access Journals (Sweden)

Elio Hitoshi Shinohara

2013-01-01

Full Text Available In maxillary Le Fort I type osteotomy the detachment of the nasal mucosa should be done carefully. Piezoelectric surgery contributed much to increase the safety of osteotomies, despite the initial advantage of minimizing the risk of injury in nervous tissue, mainly in bilateral sagittal split osteotomy; we use the piezoelectric device for the initial detachment of the nasal mucosa in the maxillary osteotomy.

Bilateral acute retinal necrosis associated with bilateral uveal effusion in an immunocompetent patient: A challenging association

Directory of Open Access Journals (Sweden)

S Bala Murugan

2018-01-01

Full Text Available Bilateral uveal effusion syndrome associated with bilateral acute retinal necrosis is a diagnostic and therapeutic challenge. A 52 year old man presented with bilateral angle closure with choroidal detachment. With restricted fundus view, parenteral steroid was started. During close follow up bilateral discrete areas of peripheral retinitis were noted. Parenteral steroids were promptly stopped and parenteral antivirals with oral steroids were continued. It showed healing response with nil recurrences till last follow up. Aggressive treatment of bilateral uveal effusion with parenteral steroids can cause progression of bilateral acute retinal necrosis leading to phthisis bulbi. However early diagnosis, prompt intervention and close follow up are the key elements to therapeutic success even during diagnostic surprises and avoid costly mistakes.

Serious adverse events and visual outcomes of rescue therapy using adjunct bevacizumab to laser and surgery for retinopathy of prematurity. The Indian Twin Cities Retinopathy of Prematurity Screening database Report number 5.

Science.gov (United States)

Jalali, Subhadra; Balakrishnan, Divya; Zeynalova, Zarifa; Padhi, Tapas Ranjan; Rani, Padmaja Kumari

2013-07-01

To report serious adverse events and long-term outcomes of initial experience with intraocular bevacizumab in retinopathy of prematurity (ROP). Consecutive vascularly active ROP cases treated with bevacizumab, in addition to laser and surgery, were analysed retrospectively from a prospective computerised ROP database. Primary efficacy outcome was regression of new vessels. Secondary outcomes included the anatomic and visual status. Serious systemic and ocular adverse events were documented. 24 ROP eyes in 13 babies, received single intraocular bevacizumab for severe stage 3 plus after failed laser (seven eyes), stage 4A plus (eight eyes), and stage 4B/5 plus (nine eyes). Drug was injected intravitreally in 23 eyes and intracamerally in one eye. New vessels regressed in all eyes. Vision salvage in 14 of 24 eyes and no serious neurodevelopmental abnormalities were noted up to 60 months (mean 30.7 months) follow-up. Complications included macular hole and retinal breaks causing rhegmatogenous retinal detachment (one eye); bilateral, progressive vascular attenuation, perivascular exudation and optic atrophy in one baby, and progression of detachment bilaterally to stage 5 in one baby with missed follow-up. One baby who received intracameral injection developed hepatic dysfunction. One eye of this baby also showed a large choroidal rupture. Though intraocular bevacizumab, along with laser and surgery salvaged vision in many otherwise progressive cases of ROP, vigilance and reporting of serious adverse events is essential for future rationalised use of the drug. We report one systemic and four ocular adverse events that require consideration in future use of the drug.